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Hold out or resign?

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Just a little background about my experience. I have been working in the ED for about 2 years now. My first year and a half was mostly low acuity/rapid care experience. I then decided to try out working at an ED that has their PA’s work up higher acuity medical patients. They hire PA’s with little experience and train them between 3-6 months. I was told I would get 2 mo of training but just before I started, they said they needed someone full time and gave me only 8 shifts of training, then I started full time.

I’ve now completed 6 mo here and I feel I have been progressing well but my boss gave me a poor review, stating that my medical knowledge is lacking. He gave me an example, where a 4-yr old presented with calf pain, normal vital signs, no activity/injury causing the pain and no other symptoms. The exam was normal except for tenderness to the calves. I was stumped so I went to my SP and he looked at the patient, ordered tests and diagnosed the child with viral myositis. My boss said I should have known what it was without my SP’s help. My boss basically said I have 2 more months to impress them or I’m out. I admit, I have a lot more to learn but this has really been a confidence breaker. My boss’s advice was to read more journals. I want to try to improve to their expectations but I just get the impression that I’m going to be let go.

Ironically, my ED director from my last job sent me an email asking if I would like to return, as there is an opening. My last job had its problems, like I’m sure most jobs do, but what would be the wisest move? Should I stick with the current job while applying to other places, hoping something else comes through soon or return to the old job? Also, my current contract requires I pay back 2 mo of salary if I quit before the 1-yr mark.

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Have a sit down heart to heart with your current ED director. Tell him of your decision to leave, and that the primary reason is THEIR failure to perform on the hiring premise that they would TEACH you.

Some folks have a knack for ED some don't. You may in fact develope the knack after several more years in fast track... Arguably, recognizing what " doesn't fit" and what "doesn't feel right" is the first step in being a good ED PA. the fact that you stopped to ask about the leg pain kid shows good thinking... Lots of PAs would have sent him out the door with a diagnosis of contusion. (btw, you might ask the director to explain to you how a viral myositis with localized tenderness differs from a contusion... Both can have elevated CKs... I'd be interested in his answer...)

Before the heart to heart, accept the return to the old ED offer.

After the heart to heart, I doubt they will enforce the payback clause. If they try, negotiate it as you leaving based on their failure to perform...

And simply don't pay it.

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