Am I a Sucker or What?
November 12, 2017 7:28 PM   Subscribe

How can I make this job in healthcare more tolerable?

I work in the outpatient rehab field. I'm a registered nurse with a bachelor's degree. I've been at my current position for 10 years. I've been a nurse for nineteen years, with a one and four-year gap where I didn't work when my kids were born/little.

In the world of nursing my job would be considered cake. My manager tells me this is the job that nurses are pining for and "you have to read the obituaries to get this job."

I do agree that this job is mostly easy compared to other nursing jobs. Gone are the stressful days of working 12-hour shifts on the floor. I'm 45 and would not return to 12-hour shifts unless I had to.

I currently work 7am-3pm, three days a week, and get full-time benefits (which frankly suck). I don't work holidays or weekends. My manager is flexible and I can take time off whenever I need to. Although I don't request much time off because I only work three days a week. I generally take a week off in Spring and a week off in Summer, and a 2-3 other random days.

As I've grown older I'm starting to get antsy, burnt out, and wondering if I'm being taken advantage of.

When I first started this outpatient rehab job I was still working as a floor nurse in an acute care setting and took a $4 per hour pay cut. My manager told me that she couldn't pay me what I was making (even though I worked for the same hospital). I agreed to the pay cut because I wanted an easier schedule. I had little kids and didn't want to work long days. For six months I worked both jobs in the same hospital. One day a week in the acute care setting and two days a week in the outpatient setting. After six months I quit the acute care job and remained in the outpatient setting part-time.

Ten years later and I'm still in the outpatient setting and considered full-time. Here are my concerns:

1. It has taken me ten years to reach the rate of pay I was making ten years ago and I'm still underpaid as far as nurses go. I've had meager raises and "market adjustments". I've rationalized accepting lower pay because I generally just take blood pressures and help people get on exercise machines. (I also watch telemetry monitors, send progress notes to doctors, call doctors, schedule appointments, do new patient evaluations, speak to any given number of people walking in to inquire about our program, check charges, address patient concerns, make smalltalk with patients, deal and chitchat with family members, wheel patients to the ER if they are having unresolved chest pain or new rhythm change, answer phones, yada, yada, yada.

My manager is not a micro-manager. She's friendly and easy-going. She does receive bonuses for making productivity so she is frugal and reluctant in ordering supplies or hiring enough staff. Since working in this department there have only been two people, per day, on staff. We have a total of four employees to cover five days and that includes my manager. We have patients transferring to our facility from different parts of the country(I live in FL and there are many people who spend half the year here) and they state their rehabs up north had five or more employees.

On each day there are two people working. One is "at the desk" and one is "on the floor". We have a big facility (think of a large open gym). I am usually the floor person. This means when patients come in (we can take eight patients per hour) I hook them up to a telemetry pack, take their blood pressure and pulse oximetry and record, and then get them on their first exercise machine. Patients usually do three different machines and the floor person assists them with each machine and takes two additional blood pressures before the patient leaves. We see about 25-30 patients per day and have a one-hour lunch break. I am growing resentful of being the floor person. I am on my feet all day and do not sit. I stand at a laptop and walk patients around all day. This has been okay for the most part. I like walking around and being active, but as I grow older I am starting to get tired.

In January we hired a new person. My boss had me train her and my boss suggested that I train her to be on the floor first. I didn't do this. I trained her on how to be at the desk. How to chart and record EKG strips and everything about our setting except how to work the machines -- she has since learned the machines. It's not rocket science. She is fifteen years my senior and when she first started I was thinking, "I can't make her the floor person, it's chaotic and a lot of walking." I regret this.

Somehow the new person thinks that she is at the desk all the time and doesn't have to work the floor, ever. I open our facility every day at 7am (we see maintenance patients as well and a lot of them come in early) and when she comes in at 8am I get up from the desk and work the floor. I never told her we are going to take turns or I need her to work the floor. Since I've worked in this department for ten years, I know every facet of the job. My manager tells me "you could run this place, you could be me." Since this new employee has been here it has been uncomfortable. She expects to work the desk and I have enabled this and haven't spoken up. I have led her to believe that this is all that she will be doing and I have been killing myself on the floor. I am not an especially assertive person and instead seethe with resentment when I am bending over taking blood pressures and adjusting exercise equipment all day. She also had instituted some new duties we never used to do before she got there (because we don't have time) but now do them because she wants to and that falls to the floor person. Sometimes I feel like I'm answering to her, when I've been in this job for ten years and know all the ins and outs and still have to guide her in certain things. She is competent and quick and very organized.

I don't know whether to talk to my boss, my coworker, both, or resign, ask for a raise (we get zero or 1% yearly pay raises). My main concern is that I don't want to work the floor so much. We are so busy and I feel burnt out and taken advantage of. I don't make enough money to deal with 40 plus maintenance and monitored patients a day essentially on my own. I feel like I've been unfairly compensated and have mostly ignored it rationalizing that money isn't everything and lifestyle is more important.

Thank you for reading and if there is any advice on how to handle my situation in the most professional way, I would appreciate any guidance. I think I'm afraid to leave because I'll regret it.
posted by loveandhappiness to Work & Money (13 answers total) 1 user marked this as a favorite
I have used the word boss and manager interchangeably.
posted by loveandhappiness at 7:30 PM on November 12, 2017

You can learn to communicate better with your manager and your coworker. Learn some assertive communication and practice it. That will help this work environment.
As for pay, nurses don’t typically get raises beyond 1 to 2 per cent, and that is not decided by your individual manager by by the organization. If you need more money you need to look for a new job. At that point you can get a big jump in salary.
posted by SyraCarol at 7:42 PM on November 12, 2017

I know you have said you are not assertive, and maybe this isn't feasible, but why not bring up with her the possibility of switching desk and floor nurses at a set rotation. Perhaps it might work switching at lunch/halfway through the shift? Unless that would be a huge handoff.

You could couch it in "I like what you have done with the new responsibilities, they really help with patient care in areas XYZ, and I would like to get competent at doing them" as a way to soften the blow and make her more receptive.

Regardless of the timeframe in which you can envision changing desk and floor nurses, you need to speak up about it. Discuss with her that you would like to switch desk and floor shifts at whatever rotation (half shifts, full shifts, weekly, whatever), and then discuss it with your manager, no matter whether the conversation with your coworker goes well or goes poorly, just so there's a step where responsibilities get clarified.

As someone who has also dealt with the healthcare raise structure, I agree with SyraCarol that you are unlikely to get a big jump in compensation unless you change jobs. However, you can definitely improve your workload here through communication. Your manager seems to know you are an asset. Believe it yourself, then use that confidence to practice advocating for your own needs as fiercely as you would for your patients.
posted by skyl1n3 at 7:51 PM on November 12, 2017 [3 favorites]

Hmm.. I'm a nurse. I think it may be time to move on. Every nursing job will eventually burn you out and there are other nursing positions that are low stress and also would provide a change of atmosphere. I'm also in my forties and I know having to learn a new job will be stressful but ultimately could be an improvement with possibly more pay.

I'd look at clinic jobs, inpatient case manager jobs, outpatient psych, or telephonic advice.
posted by latkes at 8:30 PM on November 12, 2017 [2 favorites]

Tell your boss that you need coworker to start working the floor and that you want to do shifts at the desk. Couch it as coworker needs the experience. I can't see a reason to argue against this request.
posted by vivzan at 10:08 PM on November 12, 2017 [6 favorites]

I apologize if I missed this in your post, but does your boss even know how you feel about floor work? It sounds like when the new employee came your boss tried to even things out by telling you to train them for floor work. Might the fact that you trained them for desk work in spite of that advice have given your boss the impression that you want floor work to be your domain?
posted by trig at 12:11 AM on November 13, 2017 [15 favorites]

The finances scream out more to me in your post than the office issue. You need better benefits and you feel underpaid. You're in your 40s and deserve (yes, deserve) compensation for your experience and education as an RN. You know where else you can make a great salary with good benefits? Home health. Admins, medication management, oversee the other nurses and therapists, have weekends/holidays off, work when you want within reason. I believe it is time for a setting change. Start looking!
posted by missh at 2:19 AM on November 13, 2017 [2 favorites]

Get a new job. You seem bored to tears, and it seems to be making you sad and frustrated and every aspect of your job irritating.
posted by Diablevert at 3:49 AM on November 13, 2017 [1 favorite]

I can’t speak to whether you should switch jobs. But if you want your co-worker to start doing floor work, I’d handle it by (1) cutting loose from blaming them for the current situatio n. How it happened makes perfect sense, but it does sound like you set it up that way rather than being maneuvered into it by the new nurse. If you’re not blaming her, I think the change will be easier to manage. (B) Work out what you think as an appropriate way to split desk and floor duties, and announce it to her as the new norm ‘now that she’s fully trained on the desk duties.’ If you get pushback, I’d go to your manager then, but I think the framing that the new nurse only got to be on the desk full time because she was being trained might make changing it pretty smooth.
posted by LizardBreath at 6:32 AM on November 13, 2017 [5 favorites]

For some people at some times an easy-peasy job fits right in with their life goals and needs. Sounds like this one was perfect--when you needed a simple job with a short & flexible schedule. But it sounds like that has run its course. I recommend you start looking for a new job, particularly one that pays better.

In the meantime, work it out with your boss and coworker so that you split the floor shits. Morning on the floor, afternoon on the desk, perhaps? I agree that you can make this about the new coworker learning the proper duties. Talk to you boss and see if the schedule change can come from her.
posted by carrioncomfort at 7:13 AM on November 13, 2017

This sounds like a really tough situation, but it also sounds like she thinks that's her job because it's the job you trained her to do. It was even suggested to you to train her on floor work first, and you didn't do that. I don't see anything in your post that indicates that she's advocated for not working on the floor. I don't think there's anything wrong with what you did or how you feel now, but it's not like she's an entitled person who's refusing to do the tasks she's supposed to - unless there's something like that you didn't mention. I understand it's awkward to resolve this now, but I don't see any indication that there's a reason not to just talk to her. "When you first started, I thought it would be easier for you to do desk work, and you've been great at that, but now we need to work out a schedule so that we're both doing floor and desk work." People who are just starting a job often begin with the easier tasks.

It does sound like burnout is the bigger problem though, and other people have given you great advice on that. Good luck.
posted by FencingGal at 7:40 AM on November 13, 2017 [4 favorites]

FencingGal put my thoughts into words for me. It's quite possible that the new nurse thinks that you enjoy being on the floor. If you're always doing it, maybe she thinks that you want the exercise and movement - there are many people who wouldn't want to be 'stuck behind a desk all day.'

I think the key is to institute split shifts - each person works half the day on the floor and half the day at the desk. And/or find out what each person prefers. If you work with someone who prefers the floor, maybe you work desk all day when you work with that person. Get your manager on board - it sounds like they value your opinion, and will work with you.

Also - you don't have to be eternally grateful for this job just because other people see it as the dream job. Yes, it may be a great job, but that doesn't mean that it's great for you. You don't have to stay in a job until you die just because other people would flip for this job. It was right for you at a time in your life, but that may not be the case now. Are you tired of working the floor all the time, or are you just done with this job in general? If you have trouble standing up for yourself, that won't magically change with a new job. You may find yourself being walked over in a new job too.
posted by hydra77 at 12:33 PM on November 13, 2017

Thank you all for answers and suggestions. I️ appreciate it. Yesterday I brought it up to my coworker and she said she would absolutely trade off desk and floor duties. She said it was no problem at all. I expressed that I was getting a bit burnt out working on the floor all of the time and she said she believed I preferred the floor. She said it would be good for her to work for on the floor.

I was catastophrizing and it didn’t need to be so hard. Thank you again.
posted by loveandhappiness at 5:46 AM on November 14, 2017 [5 favorites]

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