Mandatory CME

[sas5814]

This has been stuck in my craw for months and it pops into my head from time to time so I want to run up the flag pole. Its a bit long.

Last year our ortho department had a few people show up who had splints applied in the ER who had sores under the splints because they weren't constructed or applied properly. this led to a conversation between the chief of ortho and the vice pres of clinical services also a physician. They decided some training on splints would be a good thing for all the PAs and NPs and not any of the physicians. Then it went from the folks in the ER to us in the UC (totally unrelated and unconnected department) because "they apply splints too." I pushed back because they expected us to capture this "opportunity" on our days off making no allowance for the fact we are 50% staffed and working mandatory OT for almost a year now. It died out for a while and then the great high mucky muck told my medical director "there will never be a good time. Get it done." Now it is a mandatory 3 hours of training on 3 different days totaling 9 hours. I pushed again. We are hourly employees. Mandatory training on our days off without pay? Nuh-uh. So they figured out a way to make it CME. Nope...no pay no work. It got pretty tense and I thought I was going to get fired but finally they agreed to pay us for the time and it is mandatory and we have a choice of days to pick, on our non-work days, to go. All this painted with the "it will make you better providers" brush.

Here are man some disorganized thoughts:

What could have been a good opportunity turned into an unpleasant obligation as soon as it became mandatory.

It is pure hubris for the admin/physicians to cook this up and then be stunned when everyone didn't see what a great thing they were doing for us.

Why exclude the physicians if it will make us all better providers? Can't they be improved too? I have worked first in the military and then for 17 years in medically under-served areas. I have done primary casting and splinting by the barrel full. I would bet I have rolled more plaster than any physician in the ER or UC . Do they get a pass because they have more semesters of biochem that I do?

The entire concept stinks of "they are all the same with the same knowledge,skills, and education. So they all need the training." It is insulting on it's face because it presumes we are all the same and need the physicians to decide what training we  all need regardless of our experience level.

"It will make you a better provider" is a bit of philosophical sophistry that can be used to justify almost anything.

Pushing back makes you "not a team player" meaning you just have to eat whatever shit sandwich they hand you with a smile on you face.

"Just get it done" is the laziest kind of sad excuse for leadership. No consideration for our work schedules, time off, whether or not it was good for the mission of the department etc.

 

That is it. My rant of the day. Now off to start my 12. I hope there is a physician somewhere I can call when something hard comes in.

[CAdamsPAC]

2 hours ago, sas5814 said:

This has been stuck in my craw for months and it pops into my head from time to time so I want to run up the flag pole. Its a bit long.

Last year our ortho department had a few people show up who had splints applied in the ER who had sores under the splints because they weren't constructed or applied properly. this led to a conversation between the chief of ortho and the vice pres of clinical services also a physician. They decided some training on splints would be a good thing for all the PAs and NPs and not any of the physicians. Then it went from the folks in the ER to us in the UC (totally unrelated and unconnected department) because "they apply splints too." I pushed back because they expected us to capture this "opportunity" on our days off making no allowance for the fact we are 50% staffed and working mandatory OT for almost a year now. It died out for a while and then the great high mucky muck told my medical director "there will never be a good time. Get it done." Now it is a mandatory 3 hours of training on 3 different days totaling 9 hours. I pushed again. We are hourly employees. Mandatory training on our days off without pay? Nuh-uh. So they figured out a way to make it CME. Nope...no pay no work. It got pretty tense and I thought I was going to get fired but finally they agreed to pay us for the time and it is mandatory and we have a choice of days to pick, on our non-work days, to go. All this painted with the "it will make you better providers" brush.

Here are man some disorganized thoughts:

What could have been a good opportunity turned into an unpleasant obligation as soon as it became mandatory.

It is pure hubris for the admin/physicians to cook this up and then be stunned when everyone didn't see what a great thing they were doing for us.

Why exclude the physicians if it will make us all better providers? Can't they be improved too? I have worked first in the military and then for 17 years in medically under-served areas. I have done primary casting and splinting by the barrel full. I would bet I have rolled more plaster than any physician in the ER or UC . Do they get a pass because they have more semesters of biochem that I do?

The entire concept stinks of "they are all the same with the same knowledge,skills, and education. So they all need the training." It is insulting on it's face because it presumes we are all the same and need the physicians to decide what training we  all need regardless of our experience level.

"It will make you a better provider" is a bit of philosophical sophistry that can be used to justify almost anything.

Pushing back makes you "not a team player" meaning you just have to eat whatever shit sandwich they hand you with a smile on you face.

"Just get it done" is the laziest kind of sad excuse for leadership. No consideration for our work schedules, time off, whether or not it was good for the mission of the department etc.

 

That is it. My rant of the day. Now off to start my 12. I hope there is a physician somewhere I can call when something hard comes in.

You are preaching to the choir "My PA Brother". Typical gutless "Suit" behavior, don't find and deal with the offender, treat everyone as the problem(except physicians because they are all-knowing and infallible). Of course, you mere peons should roll over and play dead when they trod upon your time off without compensation!!

[GetMeOuttaThisMess]

This has been stuck in my craw for months and it pops into my head from time to time so I want to run up the flag pole. Its a bit long.
Last year our ortho department had a few people show up who had splints applied in the ER who had sores under the splints because they weren't constructed or applied properly. this led to a conversation between the chief of ortho and the vice pres of clinical services also a physician. They decided some training on splints would be a good thing for all the PAs and NPs and not any of the physicians. Then it went from the folks in the ER to us in the UC (totally unrelated and unconnected department) because "they apply splints too." I pushed back because they expected us to capture this "opportunity" on our days off making no allowance for the fact we are 50% staffed and working mandatory OT for almost a year now. It died out for a while and then the great high mucky muck told my medical director "there will never be a good time. Get it done." Now it is a mandatory 3 hours of training on 3 different days totaling 9 hours. I pushed again. We are hourly employees. Mandatory training on our days off without pay? Nuh-uh. So they figured out a way to make it CME. Nope...no pay no work. It got pretty tense and I thought I was going to get fired but finally they agreed to pay us for the time and it is mandatory and we have a choice of days to pick, on our non-work days, to go. All this painted with the "it will make you better providers" brush.
Here are man some disorganized thoughts:
What could have been a good opportunity turned into an unpleasant obligation as soon as it became mandatory.
It is pure hubris for the admin/physicians to cook this up and then be stunned when everyone didn't see what a great thing they were doing for us.
Why exclude the physicians if it will make us all better providers? Can't they be improved too? I have worked first in the military and then for 17 years in medically under-served areas. I have done primary casting and splinting by the barrel full. I would bet I have rolled more plaster than any physician in the ER or UC . Do they get a pass because they have more semesters of biochem that I do?
The entire concept stinks of "they are all the same with the same knowledge,skills, and education. So they all need the training." It is insulting on it's face because it presumes we are all the same and need the physicians to decide what training we  all need regardless of our experience level.
"It will make you a better provider" is a bit of philosophical sophistry that can be used to justify almost anything.
Pushing back makes you "not a team player" meaning you just have to eat whatever shit sandwich they hand you with a smile on you face.
"Just get it done" is the laziest kind of sad excuse for leadership. No consideration for our work schedules, time off, whether or not it was good for the mission of the department etc.
 
That is it. My rant of the day. Now off to start my 12. I hope there is a physician somewhere I can call when something hard comes in.

I know that this wouldn’t have been directed toward me in past ED years because we were too lazy. “Uh, ER tech? Can you go sugar tong 11C? Thanks.”

[KMD16]

Very sad. Not surprised. We’re all MLP( mid level provider); a connotation that I can’t stand.

Classic politics in medicine on display. One ‘s years in the field doesn’t matter as long as you’ve the PA credential behind your name.

We’re never credited for our work. You will never get the praises for your skills or hard work. They gets the praises and glory.


Good job for sticking to your gun!

[SERENITY NOW]

Are the PAs the ones putting on splints at your place?  IMO, that is below our pay grade and not an efficient use of provider time.  Should be techs or nurses to do it... make them go through the training.  Sure, reductions that need to be immobilized perfectly should be splinted by us, but for everything else its not necessary as long as you properly train the techs/nurses.  

[Joelseff]

Typical Admin BS.

 

Sigh... I'm RTW on Monday after a 5 week disability for an injury and will admit, though I miss my pts and colleagues, not really ecstatic to return to the place. New admin installed 2 yrs ago with a whole bunch of pie in the sky ideas for US to do! [emoji35][emoji2959] Like we don't have enough crap in our plates...

 

What the hell happened? 20 yrs ago, I used to love Medicine... Hell 10 yrs ago... Now I'm hoping to win the 1.6BB mega millions so I won't ever have to work anymore! [emoji1696][emoji1696][emoji1696][emoji2957]

 

Sent from my SAMSUNG-SM-G891A using Tapatalk

 

 

 

 

[Arthropathy]

I wouldn't go.

Do you think you will get fired if you don't go? I would think not, they are just power playing you. At the end if the day attendance at a splint lecture would not be grounds for firing. And if it was, I wouldn't want to work there anyway.

 

We had a new emr and I was required to go to training on an off day, which is all fine with me until they said  we weren't getting paid. Nope, and I let them know. "Well you won't be able to use the new emr without being signed off". I guess I won't be using the new EMR then.

Granted this was my per diem job and I was able to walk away, which is why I had the power to say no in the first place. Yes, I got paid for the training.

[ventana]

The really sad thing.  

 

They lumped everyone together when it likely was a few isolated providers.  

The (ortho) should have been forced to figure out who treated the patient and that provider (re)trained.   

 

WTH. 9 hours of splinting?  Better be teaching closed reductions and film reading and a bunch of other stuff.  Extremity splinting should take a 30 min lecture and 2 hrs max hands on. Done.  Period.  

 

 

 

The whole mandatory unpaid training.  Good for you for standing up.  

[sas5814]

On 10/20/2018 at 10:47 PM, SERENITY NOW said:

Are the PAs the ones putting on splints at your place?  IMO, that is below our pay grade and not an efficient use of provider time.  Should be techs or nurses to do it... make them go through the training.  Sure, reductions that need to be immobilized perfectly should be splinted by us, but for everything else its not necessary as long as you properly train the techs/nurses.  

No we don't apply splints. The nurses and MAs do. Are they going to the training? Nope. Why are we? "It will make you better providers."

[sas5814]

"Do you think you will get fired if you don't go? I would think not, they are just power playing you. At the end if the day attendance at a splint lecture would not be grounds for firing. And if it was, I wouldn't want to work there anyway."

 

I am already a marked man. They have been known to get rid of people for "not being a team player" or "just not a good fit for the organization." This isn't unique to this place either.

[GetMeOuttaThisMess]

Do they ask you to go and inspect the splint following application?  We were asked to years ago but that later faded into the sunset.

[sas5814]

No not usually unless they have some concern. That was one of the reasons for making us go.

[rev ronin]

The pay for the training is a big deal.  I am hourly; I will not work salaried for a corporation or government entity. Anything I do is chargeable time.  Staff meeting, mandatory training, charting, patients... it's all straight time, or time-and-a-half if over 40 per week.  I hear other PAs say they can't have their contracts structured that way.  I have no idea why I have so much relative freedom six years in when others don't.

Insults and stupidity are tolerable, as long as they're paying you.  Nine hours pay for stupidly redundant CME? Waste of time and money, but yeah, I'll take the bigger check.

Remember that if you're hourly, then state wage and hour laws should govern what you can or cannot be forced to do on your own time.  Can't make a McDonald's cashier show up for unpaid training? Then you can't make a PA show up for unpaid training.