6 Ways to Avoid Accepting a Bad Healthcare Job

By Angela Rose On Dec 5, 2018 for HEALTHeCareers.com

What makes any particular job a ‘bad’ one? Maybe the pay is too low. Perhaps the hours don’t work with your other commitments. It could be the commute is too long, or the opportunity for advancement is too little. A job might be bad because it has a poor culture, a work environment or mission that doesn’t mesh with your values. Whatever the reason, moving on could be your quickest route to happiness, especially if you’re an in-demand physician, physician assistant or nurse practitioner. But how do you make sure the next healthcare job you choose is better than the last?

1. Ask about the previous job holder.

“I always tell nurse practitioners to ask why the practice is hiring,” says Renee Dahring, MSN, CNP and founder of NP Career Coach. “In other words, why did the person who held the job previously leave? You may find out it’s a new position. In that case, do you want to be in a newly created NP job? The employer may have misconceptions about what an NP can or cannot do.”

David Wolfe, founder and CEO of NP Now, an NP and PA recruiting firm, agrees. “It’s important for NPs and PAs to ask why the last employee left,” he says. “Why is the group losing people? Sometimes groups overutilize NPs, requiring them to see lots of patients and work overtime without pay. Ask candid questions so that you can identify any red flags.”

2. Request clear expectations.

“You have to be assertive when asking about role specifics,” says Susan Odegaard Turner, founder and CEO of consulting firm Turner Healthcare Associates, Inc. “Ask for a job description and talk about the tasks you’ll be expected to do. Understanding those specifics will drive a lot of your success after you are hired.”

Wolfe agrees that job seekers should make sure they have clear expectations of the position. “Asking questions like ‘What are the productivity benchmarks I need to hit in order to be successful?’ can help,” he says. “That way, you’ll know what the hiring manager expects and whether you can really provide it. If they won’t give you a straight answer about their expectations, that can be a red flag.”

Dahring also encourages healthcare professionals to ask about the specific characteristics needed to be successful within the organization. “That will help you get at the culture,” she explains. “Oftentimes a bad job isn’t due to an issue with clinical skills but with fitting in with the culture of the organization.”

3. Shadow a current provider.

For the clearest picture of an organization’s day-to-day work environment, spend some time shadowing another NP, PA or physician employee.

“An employer can hide dysfunction during an interview or while walking you through the clinic,” notes Dahring. “If you’re feeling at all uncomfortable about the opportunity, ask for a shadow day with a current clinician. Nobody can hide dysfunction for half a day.”

Wolfe agrees. “A good employer will let you interview and shadow the NPs and physicians who work for them,” he says. “If they won’t, it’s usually a bad sign.”

4. Understand how you’ll be compensated.

While you don’t need to bring compensation up in your initial interview, you’ll definitely want detailed information on how you’ll be paid before you accept an employment agreement.

“Are you going to be paid hourly or salary?” asks Wolfe. “How many hours are the current providers actually working? A lot of groups will say they’re offering a 40-hour position on salary but actually expect you to stay until 7 pm every day to do charting. That’s why it’s important to ask the hiring manager and NPs when they actually come in and leave every day.”

5. Research the organization’s history and reputation.

Odegaard Turner suggests an Internet search to find out if the organization was recently sold or downsized as well as to look for any news pertaining to its relationship with unions. “Is it a positive or negative relationship?” she asks. “Kaiser Permanente, for example, has a very positive relationship with the labor unions they deal with. They’re going to provide a different environment than an organization that is fighting for or against unionization.”

“You should also look at Glassdoor and other employee review websites to see what other providers are saying about the company online,” adds Wolfe.

Dahring suggests considering patient reviews as well. “If patients aren’t happy, that could indicate a problem,” she says.

And while you’re at it, Odegaard Turner advises personally evaluating the customer service side of the organization. “You can do that as easily as standing in the emergency room lobby on a Friday night or calling the front desk to see how you’re treated,” she explains. “You can learn a lot about a facility by the way they treat their customers.”

6. Read the fine print.

If you’re eager to get back to work, it can be tempting take the first position you’re offered. However, experts urge a careful review of the contract first.

“Don’t accept a job if they won’t give you an offer in writing or a formal contract,” says Dahring. “That can be a warning sign that things aren’t managed well. Lots of promises may be made, but verbal promises are as good as the paper they are written on.”

If you don’t want to impact your future prospects should the position not work out for you, “look out for a non-compete clause in the employee agreement,” Wolfe adds. “Non-compete clauses aren’t that common, but they’ve been in about a third of the NP employment agreements I’ve seen.”

He says you should also make sure bonuses are mapped out in the contract. “How are the RVU [relative value unit] bonuses calculated?” he asks. “It’s important to understand how many patients you need to see in order to get productivity bonuses, and you should have that outlined in the employment agreement.”

 

Posted by Susan Odegaard Turner – MentorRN

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Trusting Your Team

I recently had a chance to take a river cruise on the Rhine in Europe. Although low water levels impacted the tour as planned, the teamwork that was demonstrated is some of the best I have ever seen. There were multiple types of staff on the cruise, and the service was impeccable.

By far, the most impressive teamwork I saw was that of the crew who sail and pilot the river boat. This boat is 600 feet long and houses 120 passengers plus 50 crewmembers. To sail from Amsterdam to Basel, Switzerland, the boat needed to pass through numerous river locks. Locks allow a boat to go upriver, as water comes into the lock to raise the boat to a higher water level.

Traversing locks is a specialized, dangerous and difficult process. It takes all sailing crew on deck and available to assist. The captain of the boat relies on his crew members’ feedback to adjust the position of the ship. There is only 5-6 inches of wiggle room on the side of the boat entering the lock, so it is a very precise procedure.

As the captain stands next to the steering mechanism for the ship, there are crew members present in the front and rear of the ship. The person in the front tells the captain which way to turn the shift and how to utilize the thrusters that move the boat forward to enter the lock. The captain gets constant feedback by radio from the crew in the back and front of the ship, and adjusts the dials, joy sticks and dynamics accordingly, but he cannot see the ship move, except from his place in the middle of the boat.

The captain must trust his guides to tell him the changes to the ship course and direction. He doesn’t question or argue about their directions. He acts on them and make the requested adjustments. They see where the ship is going from the front and rear, but he cannot.

This process is the ultimate test of trust. This crew did this procedure 15-20 times during this 7 day cruise. It was an incredibly well coordinated ballet of behaviors by several crew members at the same time. No one argued, questioned or did their own thing. When was the last time you and your team worked like this crew?

Posted by Susan Odegaard Turner – MentorRN

Leadership and the Human Condition

There are numerous definitions for the “human condition”, both religious, philosophical and otherwise. It is people being who they are, with all their lumps, bumps and ugly stuff. One of the biggest challenges of leadership in any setting is accepting people as they are; exactly as they are, in their present human condition, no matter how snarky and frustrating.

As leaders, most of us strive to provide direction, meaning and hope to those we oversee. Helping people improve means taking where they are in their human condition. This is not always easy to accept or identify. Some folks are grateful, seek out input and accept mentoring and coaching gracefully and graciously. Many others are difficult, defensive, angry and resistant. You cannot lead someone that you do not understand or accept.

Consider your role as supervisor, manager, director, or C suite person. Do you accept folks the way they currently are; especially if they are difficult? Or, instead, do you lead who you want them to be? That never works. I have struggled in my leadership role to deal with folks that are difficult people. That means I have not accepted them in their current human condition. How are you doing with acceptance?

Posted by Susan Odegaard Turner – MentorRN

Chaos and your True North

There is a photo on Facebook today in my feed that shows a sunflower growing through a tiny crack between bricks. There is absolutely nothing, except pulling it out or spraying weed killer that will stop that flower from flourishing in that unlikely space. Are you like that flower or do you feel like your direction is wavering with all the chaos we are experiencing in our lives and country?

I have a friend who is a religious leader in the Catholic Church. As a non-Catholic, I rely on him to help me understand the chaos around the latest accusations and revelations of clergy abuse. I mentioned how hard it must be to keep your perspective during all this craziness. His response was something I will always envy and respect. I’m paraphrasing, but the gist was that “no one could cause him doubts or consternation with his faith and spiritual practice because he was steadfast in his beliefs.” In spite of all the allegations, poor choices, lack of transparency and cover-ups, his direction and “true north” remained the same.

I’m not sure many of us can say the same. Some of us don’t have a true north. We don’t really know or recognize what we believe in; no matter what. My true north has changed as I have aged. Relationships have ended and new ones begun because of my true north values. Do you know what you believe during chaos? Do you have a true north to look to for reassurance and direction?

 

Posted by Susan Odegaard Turner – MentorRN

Changing Patterns

I’ve been thinking a lot about personal boundaries and making life changes. I have recently decided to make some different personal choices related to healthy living. It means stopping old behaviors and trying out new ones. I have done many things the same way for a very long time, so it feels very odd to do things another way. It is hard to do anything differently in middle-age, even when it is good for you. Not all the new choices fit well. It is difficult to change habits, but also invigorating to try something new. I have given myself permission to keep what works and throw out the rest. Fortunately, most of the new stuff is worth keeping.

I have also decided to readjust personal boundaries in my relationships with others. This is also part of healthy living but harder to do. I am pushing back on folks that demean or ridicule, and eliminating relationships that are toxic to me. These changes are also difficult, but are critical to taking care of my emotional self and soul space. Sometimes I feel like going back to old behaviors, but the risk is too great. What are you willing to make changes for?

 

Posted by Susan Odegaard Turner – MentorRN

What is Your Limit?

I recently returned from two weeks in Israel and Jordan with a tour group. It was my first time being on an organized traveling tour. I am not good at being herded. However, I met amazing people and did enjoy the trip. It became clear on the second day that I would have to work hard to physically keep up. Part of that is being overweight. But, I also don’t routinely push myself while working out at the gym, which I do regularly. It was also hot and humid in the Middle East so I was challenged!

I struggled to keep up and took a fall that set me back a day. However, I persevered and did not give up! What I learned is that people are very kind. Folks helped me climb up and down stairs, and over rough ground. It killed me to need help, but now I am better at asking for it. Independent middle aged women struggle to ask for help, and I am the worst! What I also my limit is far greater than I thought. I could do more if I try. I can walk farther, move more, and do more sets at the gym. What can you push your limit on?!

 

Posted by Susan Odegaard Turner – MentorRN

Trash in My Own Yard

I have recently witnessed a few serious events of friends that make me want to go into other peoples’ lives (yards) and help them clean up their trash. I assume they can’t see it, won’t do it correctly or would do all things differently if they were able. I am such a great codependent, I want to jump in and fix it all, as if I know what they need.

A couple of them are in denial about what they are dealing with. Another is totally clueless. No matter what, it is not my business. I have to firmly RESIST the impulse to get in there and tell them what they are doing wrong. I have tried to rationalize that I am teaching. As an RN, this is a common theme. I call it support, education, helping, or being there. I actually think I know better than they do about their life. It also makes me feel needed and useful.

I figure I have learned to manage some life challenges, so they should do that too. I have also learned that it is not my job to facilitate someone else’s ah-ha’s. “It’s not my journey.” is my new mantra for living. I am not good at moving in and out of the piles, so I am mostly sitting outside the yard. I can support at a distance, instead of sitting with them in their piles of trash. I can provide health information, emotional support and back away. What I need to do is look in my own backyard instead of worrying about everyone else’s. Whose yard are you sitting in?!

 

Posted by Susan Odegaard Turner – MentorRN