NewFNP's CEO signed her final loan repayment form yesterday. Her last full-time day is one week from today.
Saturday, August 23, 2008
There is not one part of newFNP that is sad to be leaving full time practice at her clinic. And that makes her very fucking sad.
Provider burnout is not new. Articles have been written, schools talk about it, practitioners live it. And for what? There is a lot of talk about a broken health care system in every media outlet to which one chooses to listen. But it's not just the Medicare reimbursement or the HMOs and PPOs that are broken.
It's organizations like newFNP's clinic - where the average shelf-life of a provider is less than three years; where there is not one hour - hell, there's not one minute - of administrative time scheduled for providers; where there is no one to follow up on referrals to specialists; where there is not one registered nurse, not one LVN, not one CNA; where providers work through lunch every day; where lab results, correct phone numbers and vital signs aren't in charts; and where patients are double and triple booked.
NewFNP is partially to blame for her own burnout. But, you know what, her clinic is responsible as well. It doesn't seem too far fetched to make efforts to take care of one's employees. NewFNP's senior management believes that providers are just there to see patients, and as many as possible each and every day, all the while fixing the errors of other staff members, filling out endless forms and attempting to care for the physical and, often times, emotional well-being of the patients.
It's too much. NewFNP isn't sure if it's her - if her lack of personal fortitude is the problem, or if it's the dysfunctional environment in which she works. She thinks that, given her degrees from top schools, it's the latter, but it's not in newFNP's nature to let herself off the hook that easily. Perhaps it just means that she needs to choose her next practice site more wisely, if she ever goes back to full time practice. Perhaps she needs to impact health outcomes from a more hands off venue.
NewFNP thought that she would be working with the urban poor forever. She sought out a free health clinic in the frigging ghetto. And now she wants to get the hell away from it. That is sad.
One thing newFNP can say is that she learned a lot these past three years. And she continues to learn every day. And that is a really lovely thing about nursing and medicine. But when it's time to go, it's time to go.
And it's time.