Was I duped into this job??

[kat82]

---

Members don't see this ad.

I started my first job out of residency a month ago and so far I like it for the most part. Before I took the job I did my research and spoke to plenty of attendings who for the most part liked it. Now that I've been working for a month people are letting their guards down and I don't like the comments I've been hearing. Certain residents and PA's are commenting about how the attendings here are miserable. One even said "I hope you only have a 1 year contract here" It seems like the leadership has changed over the past year to take on a much more "business" model of doing things (ie, much more focus on efficiency and the bottom line- money) whereas things used to be much more laid back. It seems like thats the main issue. I do know a couple of attendings quit b/c of this. But overall the attendings seem ok and most of them have been there for years and don't seem to be going anywhere. I don't feel buddy buddy enough with them to just ask them up front how they really feel. The perspective I'm getting is from the PAs and residents, like I said.

It doesnt really bother me at this point- the ED is really well run and efficient. I like the other attendings, residents, PAs, and the ancillary care is great (nursing/techs). Its a good patient population. I have some good academic opportunities available to me as well. Compared to where I did residency, I like it way better. I find most of my shifts to run pretty smoothly and I'm generally happy with my work situation. Is there something even better out there? I dont know b/c I have nothing to compare it to. What I don't like is the paper charts, and the fact that the volume can be incredibly high sometimes, overwhelming the staff (where is it NOT like this?). I haven't had much contact with the administration because I'm so new, so I haven't had to meet with anyone or get reviews yet. Maybe when I do, it will affect how I feel about this place.

Overall I am happy but feeling discouraged at the negative comments made by other people. It makes me second guess if I shouldve taken this job and if I'm going to actually hate this place in 6 months or a years time

Is this common? I feel like people complain about their jobs no matter where they are and I'm wondering if people have similar experiences at their sites.

 

[Apollyon]

So you are happy so far, but other people are bitching? You haven't been screwed (yet) in any way?

You don't know how unhappy some people are; no matter what, some people always, always will complain or be a Debbie Downer.

It's a little early, I believe, to be looking at pulling on the rip cord. That could change acutely from a single, intense event that changes everything, or could be a gradual feeling.

However, for now, keep your own counsel. The very reasons that others state an unhappiness could be the same that make you happy to be there.

 

[deleted6669]

many folks see paper charts and/or dictation as a positive, not a negative. everywhere that I have worked that instituted an emr had to double staff to see the same number of patients and it never got better, even 10 yrs out....

 

[EM_Rebuilder]

Be happy if your happy and dont let others who might be unhappy for whatever reason bring you down....

We are professionals, we can decide if the job is good or not after working there a while without the influence of nurses, residents, etc etc...

Some people are unhappy because of location, resitance of spouse to move, family ties, etc etc... and some people just cannot be made happy.

Also, you've only been there a month, and your post essentially says 'I am happy but worried about what others are saying'... Until you get any of that pressure from the outside (admin, etc) that is unwarrented, then I would not worry too much about it..

Good Luck...

 

[8654Marine]

Keep your own counsel, doc.

You are at a different level than the residents and mid-levels. They have their own environment and agenda.

You work in an academic setting. I work in a community. There is gonna be belt-tightening all around.

I heard a hospital is asking for providers to volunteer for pay cuts.

Turnover isn't necessarily a bad thing. Sometimes, the stagnant can hang on like barnacles.

What's important is how your feel at the beginning and end of a shift.

Constantly re-assess.

 

[Arcan57]

If the culture changed then there are going to be people that were invested in the old culture and pissed about the new way of doing things. If you were used to 1.4 pph and taking a 30 minute lunch break while your shop had 5 hr wait times and horrific length of stay issues, then you're going to be pissed when the leadership that was allowing that gets sacked and replaced with people who got the job specifically to improve the metrics.

If you're ok with how the volume feels and aren't having to cut corners on patient care, then you're probably in an good place right now. If your shifts feel like a constant string of near-misses mixed with actual disasters and you're having unscheduled meetings with the ED director to discuss your performance than I'd be very concerned.

Also, it's probably good to get your start in a place that's busy, uses your full skill set, and has at least some pressure on metrics. It's easier to adapt to rigorous working conditions and then relax then vice-versa. This will help you maintain career flexibility later.

 

[ccfccp]

Agree with above. Only you can gather the data and make a decision from there.

Also, as someone doing administration work, the focus on metrics is only going to get work in the next several years. It's not something that's only happening at your shop; it's everywhere.

 

[RustedFox]

There's an article in ACEP news last month (or maybe June, but pretty sure it was July) that shows that adding an MD/DO shift does nothing to decrease length of stay.

Makes perfect sense. People who need to get worked up... are gonna take time to get worked up. Making us "hustle" any faster isn't going to change the speed of labs, radiology, consultants, etc.

 

[AmoryBlaine]

I have definitely noticed that some attendings and residents are just never happy.

Over time I just paid less and less attention to them.

Downstaffed? "How do they expect me to do this work?"
Upstaffed? "How do they expect me to keep my numbers up?"
Labs taking too long? "How am I supposed to dispo people?"
Lab process improves? "Now it's like they want me to make a decision right away!"

Minor changes in shift structures got interpreted as massive, pan-institutional conspiracies.

I look to the people I want to emulate and listen to them. If the hard working, positive, good people are upset than the shop is in trouble.

Haters gonna hate.

 

[dotcb]

Don't worry about how others feel. Check your own pulse on how you feel - which sounds like you're happy.

It is the nature of residents to complain - it's in the job description for indentured servants.
PA's - The midlevels I work with grumble if they're asked to see more than 1 patient/hr.
Attendings grumble about residents, having to see patients independently, shift buy-down, salary, etc.
At the end of the day, it's how you feel that matters, not the noise.

 

[Old_Mil]

It doesnt really bother me at this point- the ED is really well run and efficient. I like the other attendings, residents, PAs, and the ancillary care is great (nursing/techs). Its a good patient population. I have some good academic opportunities available to me as well. Compared to where I did residency, I like it way better. I find most of my shifts to run pretty smoothly and I'm generally happy with my work situation.

If this is how you feel about your job, then does it matter if there are others there who feel differently? There is always something better. There is also always something worse.

As far as the paper charts, paper charts in an emergency department are a patient safety issue that your administration needs to address and eliminate. You cannot effectively address emergencies if you're juggling a ream of paper to see a dozen patients.

 

[docB]

It doesnt really bother me at this point- the ED is really well run and efficient. I like the other attendings, residents, PAs, and the ancillary care is great (nursing/techs).

These are by far the most important things to consider. What other people say should be considered but given much less weight.

There is gonna be belt-tightening all around.

I can't agree with this enough. People who quit because they don't want to toe the line with all the bad things that are coming can run but it will catch up with them sooner rather than later. No one is immune to the changes that are in the wind.

IAlso, it's probably good to get your start in a place that's busy, uses your full skill set, and has at least some pressure on metrics. It's easier to adapt to rigorous working conditions and then relax then vice-versa. This will help you maintain career flexibility later.

👍

 

[kat82]

Thanks everyone, you've made me feel much better. I've been thinking about it a lot. I think the people who are grumbling are the ones who have been there forever, because there is a new huge push on metrics, and these are attendings/PAs who are used to a more laid back approach. I personally dont mind it if the department is trying to revamp things to make things more efficient. I think its because I'm new to this and I wasn't around for the good ol' days

 

[Apollyon]

Thanks everyone, you've made me feel much better. I've been thinking about it a lot. I think the people who are grumbling are the ones who have been there forever, because there is a new huge push on metrics, and these are attendings/PAs who are used to a more laid back approach. I personally dont mind it if the department is trying to revamp things to make things more efficient. I think its because I'm new to this and I wasn't around for the good ol' days

"The good ol' days weren't always good/And tomorrow ain't as bad as it seems"

[YOUTUBE]ph7oZnBH05s[/YOUTUBE]

 

[kat82]

Hahah! Love that. Agree with you. I'm going to hang in there! Working today and I'm not dreading it so I guess thats a good sign