nixietink Posted February 12, 2017 Share Posted February 12, 2017 Hi all! I'm a new grad - been working about 4 months in ortho. I have recently been asked to help at a different practice while they get up to full staffing. The days I assist in their clinic I am being asked to also round and discharge on patients prior to clinic. Their practice is much more high volume and performs more surgeries requiring an inpatient stay. On clinic days I am often discharging between 6 and 9 patients prior to clinic that starts at 9:00 am. Being expected to discharge this many patients prior to a 9 am clinic makes me extremely uncomfortable, as I am often rushing through rounding/discharging - fearing I am missing something important. I was wondering what the norm is for PAs who work in a surgical specialty? How much time are you given to round/discharge and typically how many patients? Link to comment Share on other sites More sharing options...
Arthropathy Posted February 12, 2017 Share Posted February 12, 2017 That is quite a task before clinic. Are these patient known to you before hand? If I am anticipating a DC I will do all the paperwork the day before and just check in in the morning and put the DC order in. But even then I can handle about 3 or 4 and still get to clinic on time. If I was expecting to round/DC 9 patients daily I would ask to shave and hour or two off clinic time. Link to comment Share on other sites More sharing options...
nixietink Posted February 13, 2017 Author Share Posted February 13, 2017 That is quite a task before clinic. Are these patient known to you before hand? If I am anticipating a DC I will do all the paperwork the day before and just check in in the morning and put the DC order in. But even then I can handle about 3 or 4 and still get to clinic on time. If I was expecting to round/DC 9 patients daily I would ask to shave and hour or two off clinic time. These patients are totally foreign to me since I'm only at their office once per week and in their OR a few days prior. Thank you for your insight - I wasn't sure if I was just sounding whiney or if my concerns were as legitimate as they felt. Link to comment Share on other sites More sharing options...
KMD16 Posted February 13, 2017 Share Posted February 13, 2017 Someone not doing there job and wants the PA to clean up the mess. This is far too many patients to discharge. How often do you do this per week? If it's once per week maybe it's doable but then it's scary if you don't know this patients. The decision to recharge this patients should be the surgeon not you unless you have all the surgeon's discharge perimeter hands down. Just my 2c Link to comment Share on other sites More sharing options...
KMD16 Posted February 13, 2017 Share Posted February 13, 2017 Hi all! I'm a new grad - been working about 4 months in ortho. I have recently been asked to help at a different practice while they get up to full staffing. The days I assist in their clinic I am being asked to also round and discharge on patients prior to clinic. Their practice is much more high volume and performs more surgeries requiring an inpatient stay. On clinic days I am often discharging between 6 and 9 patients prior to clinic that starts at 9:00 am. Being expected to discharge this many patients prior to a 9 am clinic makes me extremely uncomfortable, as I am often rushing through rounding/discharging - fearing I am missing something important. I was wondering what the norm is for PAs who work in a surgical specialty? How much time are you given to round/discharge and typically how many patients? Any idea how long you're expected to help out? I'm sure you did not sign up for this. It wasn't in your contract. Do not work for free. How many days in a week are you required to assist at these clinic? And, does your contract states clinic time start at 9am? Again, don't work for free. More high volume practice. A lot of money my friend. The more they operate the more revenue they generate. Of course, they don't want to round rather they wants to operate more. Don't work for free! Demand to be compensated for coming early. You've got to bring up your concern. If you're uncomfortable, don't do it and let it be known. Yes. It's a lot of patients to discharge even if you come in at 4am. Would say the average discharge per day if you're working for 1 surgeon is about 2-4. For spine cases, 2 (rarely 3) per day if all goes well ( no post op complications etc). Link to comment Share on other sites More sharing options...
SedRate Posted February 13, 2017 Share Posted February 13, 2017 Agree with the above posters. Discharging 3-4 is doable before clinic but 6-9 is double the work and tedious. Take off an hour or two of clinic and/or ask for extra pay. They will eventually hire someone to do this; right now you're doing it for free AND continuing to do your job. Negotiate compensation for these extra hours and duties. Not only because you should be compensated but to save yourself the headache in the event you get stuck doing it for 6 months while they finally hire and get someone credentialed. Or worse, if they never end up hiring someone and stiff you. Always protect yourself. Link to comment Share on other sites More sharing options...
KMD16 Posted February 16, 2017 Share Posted February 16, 2017 OP Any update? Link to comment Share on other sites More sharing options...
nixietink Posted March 5, 2017 Author Share Posted March 5, 2017 OP Any update? I did find out that clinic time is supposed to start at 10 am. So, I've been getting an extra hour to round - which helps. But I've been finding that I am rounding on upwards of 12 patients some days, and still arriving an hour late to clinic. Agree with the above posters. Discharging 3-4 is doable before clinic but 6-9 is double the work and tedious. Take off an hour or two of clinic and/or ask for extra pay. They will eventually hire someone to do this; right now you're doing it for free AND continuing to do your job. Negotiate compensation for these extra hours and duties. Not only because you should be compensated but to save yourself the headache in the event you get stuck doing it for 6 months while they finally hire and get someone credentialed. Or worse, if they never end up hiring someone and stiff you. Always protect yourself. I looked into this. So my contract states the office I work at but slyly throws in that I may be needed at other clinics within the organization. As a salaried employee, they will not budge on this. Link to comment Share on other sites More sharing options...
south Posted March 5, 2017 Share Posted March 5, 2017 I've heard this a lot in surgical specialties, including where I worked before. Hired for OR first assist and some rounding at one site, suddenly becomes rounding and wound care clinic at the other facility before even going to the main site for the workday. Obviously only getting what you have said here, but doesn't seem like much of a team concept or any concern for the sudden doubling of your workload/hours... Link to comment Share on other sites More sharing options...
SedRate Posted March 5, 2017 Share Posted March 5, 2017 I did find out that clinic time is supposed to start at 10 am. So, I've been getting an extra hour to round - which helps. But I've been finding that I am rounding on upwards of 12 patients some days, and still arriving an hour late to clinic. I looked into this. So my contract states the office I work at but slyly throws in that I may be needed at other clinics within the organization. As a salaried employee, they will not budge on this. Try to sit down with them and have a frank discussion. Request a timeframe for when this extra work is expected to cease. Not only for your own peace of mind but to plant a seed in their mind that you're not planning on continuing do this. You're not a resident. What they're expecting of you is a lot for a new grad... Do they have experience hiring/keeping new grads? See if they can provide any additional resources or support staff to help offset these extra duties. Make sure you don't come across as not wanting to be a team player... But there's only so much you should be able and willing to do as a new grad. Link to comment Share on other sites More sharing options...
SedRate Posted March 5, 2017 Share Posted March 5, 2017 Is there a way you can do half of your rounds in the AM and the other half after clinic? Link to comment Share on other sites More sharing options...
nixietink Posted March 5, 2017 Author Share Posted March 5, 2017 Try to sit down with them and have a frank discussion. Request a timeframe for when this extra work is expected to cease. Not only for your own peace of mind but to plant a seed in their mind that you're not planning on continuing do this. You're not a resident. What they're expecting of you is a lot for a new grad... Do they have experience hiring/keeping new grads? See if they can provide any additional resources or support staff to help offset these extra duties. Make sure you don't come across as not wanting to be a team player... But there's only so much you should be able and willing to do as a new grad. They have a huge problem retaining PAs, and tend to really only hire new grads. For some reason, no other PA has brought this up as an issue!! I have tried to discuss the issue with no avail - always brushed off. Supposedly this will be over next month. Wanted to make sure I gave everyone an update. Is there a way you can do half of your rounds in the AM and the other half after clinic? They have to discharge them out of the unit in the AM, so they have rooms available for the patients having surgery that day - plus I'm in their clinic all afternoon with my last patient at 4:40. Link to comment Share on other sites More sharing options...
Moderator ventana Posted March 5, 2017 Moderator Share Posted March 5, 2017 Just slow down Get behind Do a good job with each patient Let the chips fall. Link to comment Share on other sites More sharing options...
SHU-CH Posted March 5, 2017 Share Posted March 5, 2017 Just slow down Get behind Do a good job with each patient Let the chips fall. This is good advice. Patients come first. Work at the speed you need to work at to ensure patients get the best care you can give them. Link to comment Share on other sites More sharing options...
south Posted March 6, 2017 Share Posted March 6, 2017 I agree with this. Tell them you have made some harmless mistakes that have really bothered you from working too fast and feel you are being pushed to work faster than any new graduate should be asked to, patients first as mentioned. Clinic can be covered by anyone and you get there when you have done a good job at the job they dumped on you. Link to comment Share on other sites More sharing options...
ajnelson Posted March 6, 2017 Share Posted March 6, 2017 They have a huge problem retaining PAs, and tend to really only hire new grads. For some reason, no other PA has brought this up as an issue!! I have tried to discuss the issue with no avail - always brushed off. Supposedly this will be over next month. Wanted to make sure I gave everyone an update. If they have a problem retaining PAs and only hire new grads... this is a red flag for me... Link to comment Share on other sites More sharing options...
Arthropathy Posted March 6, 2017 Share Posted March 6, 2017 ^Agreed. While ultimately not fair to the patients in the waiting room, the practice is putting unrealistic demands on you. And you should not be breaking your back to meet them. Let them know it is impossible to meet the primary requirements of your job with these extra tasks, and they can either make an adjustment or run your clinic an hour late. Meanwhile brush up your CV. Link to comment Share on other sites More sharing options...
cbrsmurf Posted March 6, 2017 Share Posted March 6, 2017 20-25 min to discharge a typical patient (surgeries you see a lot of) AND are familiar to you is a good pace (for me, in ENT) in my opinion. I don't know what other people's experiences are. Link to comment Share on other sites More sharing options...
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