Leaving an already understaffed hospital

[heyjack70]

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Has anyone left an inpatient job at a facility that is already understaffed, barely getting by with locums, knowing it will leave the facility even worse off? Locums in our area are not very quick to be found, takes several months (a state without much psychiatry presence, so usually locums have to apply for license which delays things). How do you handle the guilt of leaving colleagues behind knowing they'll potentially be getting screwed with extra work and longer days, as you go onto bigger and better things?

 

[lanzhou_lamian]

There's nothing to feel guilty about. Keeping the hospital staffed is not your job. Give adequate notice so that you can leave gracefully without burning bridges and move on to your next chapter.

 

[michaelrack]

they will probably bring in an NP to replace you

 

[TexasPhysician]

1. No such thing as an over-staffed psych hospital, so leaving will always result in temporary extra work for others.

2. Smart colleagues will have clauses in their contracts to be compensated well for extra work.

3. If the job was that great, they wouldn’t have difficulty filling.

 

[robellis]

Has anyone left an inpatient job at a facility that is already understaffed, barely getting by with locums, knowing it will leave the facility even worse off? Locums in our area are not very quick to be found, takes several months (a state without much psychiatry presence, so usually locums have to apply for license which delays things). How do you handle the guilt of leaving colleagues behind knowing they'll potentially be getting screwed with extra work and longer days, as you go onto bigger and better things?

The guilt? Lol you must be new..there’s no guilt this is a business, cold hearted business. They will replace you asap if they could find someone cheaper and they would sleep like a baby..no guilt at all get that notion out of your head, you’re providing a service for money, nothing more and nothing less. Do what’s best for you and don’t give it a seconds thought.

 

[Candidate2017]

Lol! I imagine the admin are cackling and clinking their champagne glasses to celebrate that things are going as planned: They've gotten rid of a psychiatrist, and will attempt to foist extra work on the remaining doctors, make things as miserable as possible to eventually drive them out, and then replace them with NPs under the guise that the facility is underserved, locums is too expensive and doctors are greedy.

 

[hamstergang]

Has anyone left an inpatient job at a facility that is already understaffed, barely getting by with locums, knowing it will leave the facility even worse off? Locums in our area are not very quick to be found, takes several months (a state without much psychiatry presence, so usually locums have to apply for license which delays things). How do you handle the guilt of leaving colleagues behind knowing they'll potentially be getting screwed with extra work and longer days, as you go onto bigger and better things?

I think the guilt makes sense, and I'd feel it too. You want things to work out at the hospital, if nothing else than for the patients' sake. And you should develop some relationship with your colleagues, so of course you'd feel bad if their work gets harder. You can have emotions in business and still do ok.

What I would focus on is that wherever you're heading needs you too (whether another hospital, a population of patients where your private practice will be, or your family/your own enjoyment if you're cutting down on work). The loss at A is offset by the gain at B. At least you did them some good for some time at your current site.

 

[Bartelby]

"The graveyards are full of indispensable men."

I agree with hamsetergang that guilt, on the one hand, makes sense. In every job I have worked I genuinely connected with my coworkers. They helped me out, and I helped them out. I think it is natural to feel like you are letting them down when you leave. I also care about the care my patients receive, and have a hard time thinking their care might suffer.

On the other hand, these systems are not our responsibility. Especially when they have been designed in dysfunctional ways, it typically becomes a "take it or leave it" situation. We don't have any duty to stay on when things get bad, and I don't think anyone faults us for taking the opportunities that are best for our own lives and families. I have watched people more important than me to my organization come and go, and I have grown experienced enough to realize that things somehow continue on without them in ways I would not have imagined beforehand.

 

[thepoopologist]

You're not responsible for the staffing because you are the staff...and you're leaving. Anyways, the guilt dissipates quickly.

 

[Zyprexa100]

Your job is to take care of patients and yourself. The admins should care about staffing.

 

[Sushirolls]

And this is another definition, among many, defining a Big Box Shop.

Could always stay, open your own independent practice if able, get the others to jump ship if possible and be a medical group separate from hospital that strives to control more of the day to day admin? Maybe logistically impossible but a good way to channel guilt if you are strongly attached to the area and people.

 

[Psych19]

I'm at a hospital with a pretty limited number of psychiatrists. One of my colleagues has signaled he plans to leave next summer. Not sure if they want to convince him to stay or would be successful in trying. Not sure if they'll be able to replace him by then. It may or may not increase my workload.

I harbor zero resentment. He should make a decision in his own best interest. An optimistic me thinks his departure might signal to admin they need to create more favorable conditions to keep psychiatrists--I realize this may be foolish thinking.

Fortunately my contract is up this coming summer as well and I think it puts me in a pretty strong renegotiating position.

Bottom line, I wouldn't worry too much about it. Best thing you can do is just give as much advance notice as possible to admin and your colleagues.

 

[fluorescent colors]

I don't think there is anything to worry about. They will probably hire one or 2 NPs or a PA-C that has done a residency in psychiatry.

 

[Sikrouf]

I ve done it a year ago
Last time ive checked they were still doing fine without me
People will manage one way or another

 

[FlowRate]

They could always reduce admissions while down an attending. It is not your fault that they likely won't.

 

[MedMan80]

Worst thing that can really happen is an inpatient unit needing to shut down (Can't really run it without an MD in many states), save that NP can always pick up some of the outpatient load and other patients will get referred elsewhere.

 

[michaelrack]

Worst thing that can really happen is an inpatient unit needing to shut down (Can't really run it without an MD in many states)

Administration can always find a telepsych doctor to supervise the np

 

[MedMan80]

Administration can always find a telepsych doctor to supervise the np

That might be true, just saying what actually almost happened to our rural hosp a few years ago (pre-pandemic) when docs left