Changing to new hospital

[KansasPharmGirl]

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I have been working in a critical access hospital for the past 4 years. It’s 2 hours from the metro area I’m from. I’m the only pharmacist, so I’m the PIC. I’m comfortable here, I built the pharmacy side of our new EHR, set up new Pyxis. I live extremely close. I’ve been looking for a job in a better area for awhile- also because I have felt like I’m not really growing here anymore. A lot of the time, we have low patient census so it can get a little boring (not currently). Also I work Mon-Thu plus on call the rest of the time. I’m the go-to person for the Pharmacy. I accepted an offer at a brand new hospital in the area I’m from (and family all there). It’s part of a well-known hospital. It hasn’t opened yet but is starting as 40 bed and will expand to 80. The place has good benefits. The hours are four 10 hour days, no call. It rotates equally between 7am-5pm and 10am-8pm. Now I’m getting sad about leaving and terrified I’ll regret it. Has anyone been in a similar situation?

 

[TheBlaah]

I used to work at a critical access hospital for a year so I may be able to relate to your situation.

While I do miss the complete autonomy I had, I DO NOT miss being on call 24/7. It's nice being able to go places without anything hanging over your head. This also means you're not necessarily responsible for everything in the hospital, which is nice.

While it does mean my new job is more "focused", my duties aren't as varied as it used to be, but you get used to it. At the same time though, you'll probably get to see stuff your critical access hospital maybe didn't have the facilities for (different surgeries and ICU's, ect).

As for your situation, it seems like a no-brainer to take the new job. Your family's there, and it's in a nicer area with actual amenities. I remember having to drive an hour to actual do anything fun; which also meant a possible hour long drive back if I get called back to the hospital.

 

[Reirrac]

I left my previous job after 3 years for a federal position close to family and relatives. I was also sad to leave after building up an efficient work pattern and goodwill from the team and management. But the chance to live near family with a job I could work comfortably until retirement was the opportunity I did not want to miss. Some regrets here and there but in the end I did what I felt was best for everyone involved.

The same would apply to you; do what is best for you.

 

[lord999]

Separation anxiety from a good job (though you do believe the job is too placid for your tastes) is honestly a good problem to have. You will jump into an unknown environment where there are both the highs and lows of startup culture. Its a hard thing to consider, but the fear of the unknown is a usually a good sign that your current job is not bad.

However, you're not looking for a good job, you have one. You want a better job, which is why you were looking. You're not going to know ahead of time, but there is the potential. For good pharmacists (though less so in this era), the harder decisions are not from a bad to a good job, but a good job to a potentially better one or potentially a worse one but still good. But, since you find yourself at a local trough, is that what you are willing to accept? Your seeking is your subconscious desire for better is my read on you. Do your due diligence but something about "nothing ever happens here" is a place that you want to go from even though it is comfortable enough.

One other matter, if you are used to doing things yourself and now have to work with a team, that will not be comfortable to adapt to. But there is only so much you can do on your own. You will also have to adapt to the idea that a non-CAH has to be procedurally more formal in practice and the policies are less flexible than a CAH. You cannot bring much of that CAH culture into a more normal hospital or else you will paint a target on your back for being too expedient.

 

[KansasPharmGirl]

Separation anxiety from a good job (though you do believe the job is too placid for your tastes) is honestly a good problem to have. You will jump into an unknown environment where there are both the highs and lows of startup culture. Its a hard thing to consider, but the fear of the unknown is a usually a good sign that your current job is not bad.

However, you're not looking for a good job, you have one. You want a better job, which is why you were looking. You're not going to know ahead of time, but there is the potential. For good pharmacists (though less so in this era), the harder decisions are not from a bad to a good job, but a good job to a potentially better one or potentially a worse one but still good. But, since you find yourself at a local trough, is that what you are willing to accept? Your seeking is your subconscious desire for better is my read on you. Do your due diligence but something about "nothing ever happens here" is a place that you want to go from even though it is comfortable enough.

One other matter, if you are used to doing things yourself and now have to work with a team, that will not be comfortable to adapt to. But there is only so much you can do on your own. You will also have to adapt to the idea that a non-CAH has to be procedurally more formal in practice and the policies are less flexible than a CAH. You cannot bring much of that CAH culture into a more normal hospital or else you will paint a target on your back for being too expedient.

I have thought of all of this, a LOT. I do have a tech, so I’m not completely alone. I understand it will be different though working with a small team. And yes it will be more structured, which I think may be good, because there isn’t much consistency at my current hospital… One other concern is the financial situation at my hospital. We had a financial auditor (not sure exact title) say we wouldn’t stay open much longer. It IS doing better at the moment, as we are busier from Covid, however I think it will slow back down. Most of the time, we have 5 patients or less. Right now that isn’t the case, of course.

“Do your due diligence but something about "nothing ever happens here" is a place that you want to go from even though it is comfortable enough.”

^Do you mean that is something to walk away from?

 

[lord999]

I have thought of all of this, a LOT. I do have a tech, so I’m not completely alone. I understand it will be different though working with a small team. And yes it will be more structured, which I think may be good, because there isn’t much consistency at my current hospital… One other concern is the financial situation at my hospital. We had a financial auditor (not sure exact title) say we wouldn’t stay open much longer. It IS doing better at the moment, as we are busier from Covid, however I think it will slow back down. Most of the time, we have 5 patients or less. Right now that isn’t the case, of course.

“Do your due diligence but something about "nothing ever happens here" is a place that you want to go from even though it is comfortable enough.”

^Do you mean that is something to walk away from?

I don't know you, but the fact you're looking makes me think that you are looking for a new and harder challenge and not in the resume interview talk BS way.

Staying comfortable in an easy job is harder than it looks, particularly when you are under challenged. But you also worry about the opposite and the likelihood that this will be a good job but not as good as the one you have right now. That's the part that I would have anxiety with myself, That will be good to leave but the new job will not be as good as the old one but still fine.

 

[KansasPharmGirl]

Thank you all. My hospital offered me a big counter offer, which makes it even harder to leave. But I think I’m going to move forward to the new hospital. I’m 29 years old and in a town of 3,500, and 2 hours away from my family... I could get stuck here if I don’t take this opportunity.

 

[lord999]

Thank you all. My hospital offered me a big counter offer, which makes it even harder to leave. But I think I’m going to move forward to the new hospital. I’m 29 years old and in a town of 3,500, and 2 hours away from my family... I could get stuck here if I don’t take this opportunity.

No, a good pharmacist creates their opportunities, you will get more if you are reasonably good at the personality management as well as the job. However, if you get a great deal where you can reunite with your family, location is generally much more difficult and is worth taking a hit on other considerations for.

 

[Sparda29]

I once made the mistake of leaving a good job (3 minute drive from my house), good pay, part of a good health system, union position, small department with pharmacists who report to the director instead of reporting to lead pharmacists/operations managers, working with a cool Rph and tech on the evening shift in relaxed culture.

I thought I was making a good decision by accepting an offer to transfer to the flagship pediatric hospital of the health system but I HATED all the bureaucracy that came with moving into a big hospital where they have like 40 staff Rphs, every satellite with their own lead pharmacist, 3 different operations managers, 2 assistant directors, 10 clinical pharmacists, and a director who you never see, and all these damn managers/lead RPhs have their own personalities, and an extremely uptight culture, and non-union position.

The pediatric job was more mentally stimulating and it felt like I was doing something that makes a real difference, versus at the small hospital where it just felt repetitive by verifying orthopedic surgery order sets and dealing with common geriatric ailments. Despite all that, I could not stand the nitpicking. criticism, and uptight culture that came with working at the big pediatric hospital and I ultimately ended up leaving it to go to independent pharmacy and it took 5 years to get back into a full-time hospital job after that.

 

[KansasPharmGirl]

I once made the mistake of leaving a good job (3 minute drive from my house), good pay, part of a good health system, union position, small department with pharmacists who report to the director instead of reporting to lead pharmacists/operations managers, working with a cool Rph and tech on the evening shift in relaxed culture.

I thought I was making a good decision by accepting an offer to transfer to the flagship pediatric hospital of the health system but I HATED all the bureaucracy that came with moving into a big hospital where they have like 40 staff Rphs, every satellite with their own lead pharmacist, 3 different operations managers, 2 assistant directors, 10 clinical pharmacists, and a director who you never see, and all these damn managers/lead RPhs have their own personalities, and an extremely uptight culture, and non-union position.

The pediatric job was more mentally stimulating and it felt like I was doing something that makes a real difference, versus at the small hospital where it just felt repetitive by verifying orthopedic surgery order sets and dealing with common geriatric ailments. Despite all that, I could not stand the nitpicking. criticism, and uptight culture that came with working at the big pediatric hospital and I ultimately ended up leaving it to go to independent pharmacy and it took 5 years to get back into a full-time hospital job after that.

Now I’m questioning my decision even more! The hospital I’m going to is brand new but it’s only 40 bed with 2 full time pharmacists, 1 part time, plus eventually a pharmacy manager (and night shift pharmacists). It’s eventually going to expand to 85 bed. So it won’t be a huge place. They have a main hospital like 25 mins away which is a lot bigger but I won’t be working at that one. I am very worried about what the culture will be like, because my current place is very relaxed.

 

[Rockinacoustic]

Now I’m questioning my decision even more! The hospital I’m going to is brand new but it’s only 40 bed with 2 full time pharmacists, 1 part time, plus eventually a pharmacy manager (and night shift pharmacists). It’s eventually going to expand to 85 bed. So it won’t be a huge place. They have a main hospital like 25 mins away which is a lot bigger but I won’t be working at that one. I am very worried about what the culture will be like, because my current place is very relaxed.

Unless you plan to work at a critical access place and be "The Pharmacist" for the rest of your life, you're going to have to learn to deal with people and workplace culture eventually.

 

[Sparda29]

Unless you plan to work at a critical access place and be "The Pharmacist" for the rest of your life, you're going to have to learn to deal with people and workplace culture eventually.

There workplace politics everywhere but some of these big hospitals are ridiculous and definitely not good fits for people with relaxed attitudes.

I know one of the major hospitals in the Bronx has this problem at the flagship hospital. I've heard horror stories about how they look down on grandfathered-in RPhs who were working there before residency became a thing, now only hire residency trained PGY1s to work as staff RPhs on day shift (they'll hire non-residency trained people but only for evenings and overnights), they have video cameras in the pharmacy department recording the staff and will use them to enforce **** like dress code, and to see if you're on your cell phone or are wearing earbuds. You have to be nuts to work there.

I'm thankful that I don't have to deal with this **** on the overnight shift, but I do have some overlap with the day shift, which ends up being the worst part of the shift.

 

[mustang sally]

Just personally, I think it’s normal to be a little bit sad when one door closes, whether it’s a move, job change, relationship change, whatever. The hospital you were at was a big part of your life for several years after all. It doesn’t mean that you aren’t making a good decision for yourself and it sounds like you will do awesome at the new job!

 

[grizzlesgrizzlies]

I know one of the major hospitals in the Bronx has this problem at the flagship hospital. I've heard horror stories about how they look down on grandfathered-in RPhs who were working there before residency became a thing, now only hire residency trained PGY1s to work as staff RPhs on day shift (they'll hire non-residency trained people but only for evenings and overnights)

We all know the hospital setting tends to be pretentious about who they hire due to supply and demand, but that takes the cake.

 

[Rockinacoustic]

We all know the hospital setting tends to be pretentious about who they hire due to supply and demand, but that takes the cake.

Why? I'd preferentially hire residency trained people for all shifts.

 

[grizzlesgrizzlies]

Why? I'd preferentially hire residency trained people for all shifts.

It's one thing to ONLY hire residency trained RPhs across the board, I would totally understand. It's another thing for them to hire non-residency trained RPhs (regardless of years of inpatient experience) for the evening/overnight/PRN pool. They're basically getting second class treatment at that point. I mean, are PGY1s really in the position to pick and choose what shifts they want to work?

 

[Sparda29]

Why? I'd preferentially hire residency trained people for all shifts.

To be a staff RPh? Nah, you don't need residency training to be a staff RPh.

A residency should get you a job as a clinical manager.

 

[Sparda29]

It's one thing to ONLY hire residency trained RPhs across the board, I would totally understand. It's another thing for them to hire non-residency trained RPhs (regardless of years of inpatient experience) for the evening/overnight/PRN pool. They're basically getting second class treatment at that point. I mean, are PGY1s really in the position to pick and choose what shifts they want to work?

Their justification for it is that the day shift has rotating roles. One week they might be in central fill, then IV room, then rounding, satellites.

We all learned how to round.