Monday, March 03, 2008


NewFNP has recently begun to wonder more and more -- is she part of the solution or part of the problem?

NewFNP is type A to the nth degree, she is a stubborn Capricorn and she is addicted to having things done correctly, generally on the first try.  She is unfailingly punctual.  She expects that the people with whom she works will get their jobs done correctly so that her job is easier.   

Perhaps these personality traits are more suited to, oh let's say, dictator than to that of an FNP in a community health clinic.  While newFNP knows that her expectations oftentimes exceed the ability of her support staff and sometimes of other clinical staff, during a busy clinical day in which newFNP is correcting the mistakes or oversights or laziness of others, she cannot help but to grow frustrated.

NewFNP is so used to having things screwed up that she perpetually dreads and anticipates the mistake du jour.  

For instance, last Friday, three providers were scheduled, two were working and zero patients were cancelled until newFNP had a fit of apoplecty in front of the clinic manager and scheduler.* Today, one of newFNP's clinical colleagues left early and newFNP was overly sensitive to ensuring that the front desk staff was aware of her departure and would allow for a reduction in patients as a result of having one less provider.  NewFNP is so sensitive to foolishly booked schedules that she was unable to see her way through the management of two physicals scheduled at the same time - mom and baby - who arrived an hour late and wanted to be seen together.  Though not an unreasonable request, it seems more unreasonable when A) the one month old boy's father was present and B) the pair were an hour late.

NewFNP is confused.  She has autonomy in her practice, the physicians do not see her as incompetent or "less than" because she chose to be a nurse rather than a doctor, she has decent benefits and a reasonable salary, although that last point is negotiable.  

But is newFNP doing any good when she feels like she is walking into the DMZ as she crosses her clinic's threshold?  Do other providers have to remind themselves to smile?  Is her frustration causing her circulating cortisol level to rise to the point where newFNP will be rendered infertile and laden with belly fat?  Will she need therapy, IVF and relacore?

Is it worth it?  Is this just what it is, what it always will be?

In writing this, newFNP thinks back to this morning when she arrived at her desk to find a sweet coffee cup, wrapped in paper towel - a gift from a patient.  So lovely and sweet.  Is newFNP an asshole for thinking of leaving these sweet patients, frustrating though they and the practice may be?  

NewFNP is holding out for the four-day workweek.  Rumors have been circulating that the clinics may open for extended hours.  Three days off each week might be the ticket.  Hiking, movies, yoga, hair-dos, shopping, cooking.  That may just turn over a new, happy leaf in newFNP. 

* Alas, not the first time.


BostonFNP said...

It isn't just you. The people that we are supposed to be helping can be frustrating. The people who are supposed to be helping us help our patients are frustrating. The "system" is endlessly frustrating. The fact that Lindsey Lohan does nothing all day but drive an expensive car and pretend to be someone else for a couple of hours while I'm on my 12th hour of work today and her net worth is about a zillion times what mine is is frustrating. Do you think that she would be willing to trade? Even for a week? I'm pretty sure she couldn't hack it... that's not such a frustrating thought!

Serena said...

I'm right there with you. I've just hit the 3-year mark at my community health center and feel like I'm about to rip my hair out. The patients are very dependent, and expect so much. My friend did derm with her FNP, and it's beginning to sound wonderful (except then I suppose I'd have to deal with Lindsey Lohan types).

Anonymous said...

Thank you, my friend, collegue. It's very validating to know I'm not the only one pulling out my hair. I'm telling you, by 330p on Friday I'm having psychotic fantasies about that last patient who walked in with FBS of HHH and BP of 220/110! Oh, and you forgot to take meds this morning and have no idea why you are here today...why the frick did they come??!!