Jump to content

Turmoil over wanting to step down from leadership role...advice?


Guest ERCat

Recommended Posts

I've been the lead PA for my ER for six years now. Every six months or so the feeling of wanting to drop the position comes over me but I always chicken out and tell myself to stick it out and hope it'll get better. It hasn't though. From the beginning...I've hated it.

I have hated being essentially a middle man, having ZERO control over decisions and just having to relay the news to the PAs, and bear the brunt of their complaints. They know that I have little power and thus it makes my role very confusing...and lacking any sort of credibility. Anytime a PA asks something I have to ask the ER director if it's OK. What is the point of me being a middle man?

I also feel like I SUCK at the role. The previous lead PA did regular meetings. I tried doing that, and setting up lectures, and it was like pulling teeth to get people to attend. I felt like I was nagging and it was a lot of work so I just stopped. Now we all just communicate through a group text. I feel like I am taking the lead from my group and avoiding in person meetings because everyone seems that they would rather do anything else with their time, but again, this makes me feel like less of a lead PA.

I hate never being able to be off of work as I always have the threat of a midnight phone call of "I can't come in" tomorrow and having to deal with it. I don't have the flexibility to be the one to just jump in and help cover a shift at the drop of a hat now (I have a new baby) so there is that guilt there. When no one can cover, I feel like it would inevitably fall on me.

I don't agree with decisions of the hire ups. I feel like no one cares about patient care and it's all about metrics. I have to be the monkey supporting all of that and it doesn't feel authentic to me.

All for a measly 1000 dollars a month.

The pros of keeping this role - 1) I have a lot more job security and with furloughs of some of our PAs last year, I need all the security I can get; 2) it looks good to have this on a resume and I might be disappointed in myself for demoting myself / moving down in life, and 3) the thing I care about most is I CAN DO THE SCHEDULE. I can give myself somewhat of a regular schedule which is helpful as I have a new baby and I don't know if the future scheduler would keep that regularity. 4) This is really only maybe 10-15 hours of a commitment per month. I can do it all from home. Why am I complaining so much?

Any insight would be appreciated.

Link to comment
Share on other sites

  • Moderator

That’s a tough one. You derive a lot of personal satisfaction from your job and that makes it harder to “be in charge” when you’re not in charge at all. 
 

if it were me, I would let someone else have the headache. It’s not worth the moral injury IMO. In your shoes, the way you explain it, I may stay.

You’ve had it on your resume long enough that it’s rock solid and easy to explain why you stepped down. Also, doesn’t sound like you’re being any less of a leader. You don’t have power, they know you don’t have power, so how are you or anyone else expected to get anything done?

But there is a lot to be said about making your own schedule and feeling your job is secure. With a new baby, that is huge weight off. Maybe talk it over with your wife? I think that would help. Aren’t the furloughs over though? I feel like the volume is up everywhere and jobs are picking up. 
 

this is a really personal decision. Do you prioritize your mental health so you can be a great dad and not have this weighing on your mind, or do you risk less time with them and job security just for a little stress relief. What new stressors are going to come up if you step down and will those be less than the stressors you have now?

 

good luck buddy. I’m hoping to create a chief APP position at my hospital and I’m worried this is how it’s going to turn out.

Link to comment
Share on other sites

  • Moderator

I did a lead PA position for two years and hated every minute of it. Writing the schedule meant I got the worst schedule after everyone else got time off for cme, vacation, etc. I worked ridiculous hrs and got 10% over base pay. I got called every day to cover shifts. Every single day, even when I said "don't call me for this shift as I am not available".  I had to attend lots of 7 am meeting at which nothing was ever decided and my input was not valued, all after getting off work at 0100. There are places that empower their lead PAs. I was not at one of them. 

Link to comment
Share on other sites

PAs have a horrible time getting a seat at the big table. 

Somehow nurses keep getting admin positions but they are no more and likely less qualified.

This is my quandary and why I am starting the DMSc degree next year.

If I get the training for leadership and admin - do I have right initials behind my name to get a seat at the table and get supervisory status - something to work with?

It remains to be seen but more PAs need to be in these positions. 

For your position - I have been there - literally - in the ER when my kids were little. I see your pros and cons list - same that mine was. 

Maybe let someone else do it and re-eval in 9-12 months. BUT, mentor the new person and try to keep the scheduling job for months to "teach" the newbie. 

Hope it works out for you! Be strong!

  • Like 1
Link to comment
Share on other sites

  • Moderator

First congrats on parenthood!!  It is the hardest job you will ever have!!

 

1) 6 years of doing it and new kid.  No worries about dropping it

2)do not be the one to pick up extra shifts.  Kids are only little once 

3) $1000/month for 10-15 hrs/m is 66-100/hr pay.  About what salary is 

4) covid has sucked the life out of most jobs in medicine.  And increased stress and burn out.   In the last 2 months about 4% of the US workforce has quit job per month.  That means almost one in ten people have quit their jobs in past two months!   Society is burned out!!!  Medicine jobs seem to be lagging a bit but they are opening up 

5)you have the worst job. Period.  Their is no joy in what you describe.  You are basically paid 1000/m to do schedule and protect the ER director from the PA complaints 

 

so with a new kid and 6 yrs of doing it.  And post covid.  Time for some change.  Yup it might blow up and you get laid off so think before you leap     Write pros and cons list. Talk to Sig Other. Maybe talk to boss (but they will screw you if you give them the chance).  Most of all figure out what you want.  

Link to comment
Share on other sites

My thoughts:

  • Keep the position so that you are in control of the schedule.  
  • Make it clear to everyone: the PA's and NP's as well as the medical director that you're not the person who can be called at the last minute to fill all schedule holes or last minute outages.  Let a shift go unfilled to make the point.
  • Be honest with yourself and your peers about how little control you have.  Realistically, few if any lead PA's have much if any control over any ED policies.
  • Upvote 1
Link to comment
Share on other sites

Thank you all so much for your responses and giving me some things to think about.

I was thinking the other thing that makes me hate this position so much that I didn’t even mention is the fact that it makes me feel bad and incompetent. I don’t enjoy doing things I am not “good” at. And this job, I don’t feel like I am good at because I have no real authority. I also don’t enjoy it, so I don’t go out of my way to do things like… meetings! Team pow wow get togethers outside of work! Christmas gifts for “everyone on my team!” Am I supposed to be doing this  crap? Because I have no motivation to do and never did. It’s also not really within the culture of our group. At the same time, I’m just adding fuel to the “I suck at this” fire. Self fulfilling prophecy.

The schedule is everything. The schedule makes a hell of a lot of difference. Sure, sometimes I have to work a ton in a row when people are on vacation to make the puzzle pieces of scheduling fit and I will never allow myself to be the one who gets thanksgiving, Christmas Eve and Christmas off (every year it is someone and I am too ashamed to let myself have my turn). But overall I have the schedule I need that actually keeps us from having to hire any sort of childcare! That’s huge.

in addition to scheduling I interview new people and now have the authority to hire without the doc’s input. I do the schedule. But that’s the extent of my power. Everything else is just puppeting what I am told and dealing with complaints about bad admin decisions. 
 

What the heck is a lead PA… am I really in a “leadership” or “management role”? at this point it might be helpful for me to think that I am NOT. Just do what is required of me and nothing more? I don’t know.

 

Link to comment
Share on other sites

  • 2 weeks later...

As a fellow lead PA I can tell you, I am glad I just gave my resignation from the position. I feel your angst.

I don't need to tell you its thankless, and I only work for a small group where PAs make up 50% of the hospital medical staff.  I've had some say in things over the years and we pull a lot of weight, but dealing with everyone's complaining about the schedule (even though I have never turned down a request - ever) isn't worth it.  The only saving grace has been being able to control the schedule, but even that comes with major caveats.  

Its a leadership position but not a management position in my mind... unless you are sitting in E-suite meetings or something akin to that, you are the go-between.  

That said, you've been at it for 6 years.  Someone thinks you do it well.  

Its good that you can hire without input - you can build the team you want.  This is important for long-term cohesiveness for any organization.  But, that only works if you feel like you belong... so the question is - do you?  If so, then you have your fiefdom and what you do matters.  if not, I'd think you have you're answer...

Although pastures tend to not really be greener elsewhere, you have to be content with what you do.  Your kids are only young once.  Even when they are young, that doesn't sink in until years later.  If the schedule control allows you to do what you want, and you can shape your milieu, give it some real consideration before you give it up. 

Just my 0.02,

G

 

  • Like 1
  • Upvote 1
Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More