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It's a long and bumpy ride. I finally worked up the energy to post some of this.
Big Girl Job
Almost 4 years after graduating, I finally have my big girl job! As of last Sunday, I am officially part-time at <big hospital>. Some days I wonder what I was thinking.
Just Making Sure
I did get annoyed with my boss on this one. Some of you may remember me mentioning that one of our full-time techs retired in January. We (rightly) figured they weren't going to replace her and would rely more on the PRNs to pick up the slack. And then things got busy. Slammed to the wall, run down to the cafeteria and eat your lunch on the way back upstairs, you're lucky if you get to pee kind of days. And miracle of miracles a position was posted! For part-time, not full-time, but hey, baby steps.
I still wasn't convinced. I didn't bother applying because I didn't think they were actually going to hire anyone for it. Trust me, it wouldn't be the first time. After a few weeks, the boss pops in for rounds and asks me if I'm planning on applying for it because they're starting interviews. Well, sure, now that I have faith you're actually going to fill the position. I applied that night. It was still a few more weeks before I got an interview (keep in mind, I'm an internal candidate who's already worked there for over a year) and a few more after that before I was officially hired.
The other reason I didn't apply initially is because there are some changes in the works that I do not like. At all. As a PRN, I had much more control over how much crap I was willing to put up with. As part-time, not so much. It's also quite a pay cut for me. To the tune of almost $4/hr less. But I discussed it with Mr Jedi and we decided me going to part-time was the right move.
So imagine my surprise when I met with both my bosses and they threw this gem at me:
"We just want to make sure you're serious about wanting this position because we had to come to you for you to apply for it and you've been asking to go home early some days."
Ok, let's address each of those in turn (for the record, none of this was said out loud--I'm not an idiot).
As for approaching me to apply for the position, see above. Once I knew they were serious about hiring for it, I was serious about applying for and wanting it. People who know me well know I'm not going to make such a drastic change in my life if I wasn't serious about wanting it. Generally speaking, I don't do things I don't want to do.
Secondly, with as anal as you guys are being about hours, you're concerned about the one that costs you more per hour being mindful of that fact and trying to keep the budget in line? Didn't you just ream us out for being over on hours again? As the PRN, I was the first to get budgeted out. You can't have it both ways, cupcake. And from now on, I'm leaving when I'm done, screw the budget. But I smiled and said yes I was serious about the job, I want it, I know what I'm signing on for.
Changes
Awhile back there was an incident (these incidents always seem to involve the same coworker, too) where a doc wanted a stress test late on Saturday afternoon. Up until then, the weekend call was set up like so: A cardio tech to come in on Saturday like a normal work day and work till they were done, or be on call until noon. There was a second tech on call for general studies. Sunday was a call day for cardio until noon and then the general tech was on all day and night for general studies.
Now, depending on when the page in question actually came through, she may have had a legit point. Anywho, she got paged--ostensibly outside the time frame--couldn't do the exam right away, but came back and did it later. Which of course pissed off the doc that she didn't drop everything she was doing and come in to do his test.
Apparently the second shift EKG techs don't know how to run a treadmill for a stress test. The brilliant decision reached by management is to train the imaging techs to do it "in an emergency." This was met with much resistance because it's only a matter of time before "in an emergency" becomes a routine thing. Which I'll get to momentarily. The other change that came out of this was that any order that comes through, we have to do. Even stupid stuff we don't normally do on the weekends. Even scans that on their own don't earn enough hours in their little algorithm to pay a tech to do it on a regular day. Call is time and a half.
Oh, and we're opening availability on Saturdays for cardio until 4p. If the cardio tech finishes before then and goes home (or there aren't any cardios to do), the general person is supposed to pick up the cardio side as well.
You can imagine how well that went over.
Now, as far as hooking up patients goes, I'm lucky(?) enough to already know how to do it because I've done it at other facilities. The other two girls (who are the main two who work in cardio) have not, so for all intents and purposes, they've never been trained how to do it. Really truly, it's not difficult to get a patient wired up and it's not hard to run the treadmill. What is difficult is doing all that plus having to take blood pressures and inject the isotope at the right time. It's a lot to juggle even with just one patient. Now imagine having 4 to do on a weekend all alone.
What makes me feel really uncomfortable is the fact I don't read EKGs very well. I know mostly what the little squiggles correspond to and I know what asystole and V-tach look like (flatline and wild and crazy respectively). That's about it. When it comes to subtle changes like ST changes that might be Really Bad Things, I'm not trained to recognize them. "But," says the boss, "the physician or NP should be watching that!" Uh huh. Yeah, they should. I know a fair number who don't. A few aren't even in the room. And that makes me nervous. So I asked about EKG training. Apparently a 2-hour course is sufficient.
Called it
So, that hooking up our own patients "in an emergency"? Insufficient staff doesn't count as an "emergency." The managers in their infinite wisdom () have cut us to one EKG tech instead of two. So for any more than 2 or 3 patients, they're forcing us to start hooking people up ourselves to attempt to keep the flow going. Which of course takes someone away from imaging duties in order to run stresses. The other day we had 11 and by 10a had only managed to get one person on the treadmill. Needless to say, we had a waiting room full of (rightfully) pissed off patients. And then one of our treadmills (and our one EKG tech) got shanghaied to do a stress echo. Now, why is it ok for our patients to wait hours for their stress tests, but the (non-STAT outpatient) stress echo has to be done OMFGRIGHTFREAKINGNAO! When this question was asked of the boss, she just rolled her eyes and walked off.
I do have some tales from my week working outpatient, but as this has already gone on long enough, I'll post those another day.
Someone remind me why I went into medicine again?
Big Girl Job
Almost 4 years after graduating, I finally have my big girl job! As of last Sunday, I am officially part-time at <big hospital>. Some days I wonder what I was thinking.
Just Making Sure
I did get annoyed with my boss on this one. Some of you may remember me mentioning that one of our full-time techs retired in January. We (rightly) figured they weren't going to replace her and would rely more on the PRNs to pick up the slack. And then things got busy. Slammed to the wall, run down to the cafeteria and eat your lunch on the way back upstairs, you're lucky if you get to pee kind of days. And miracle of miracles a position was posted! For part-time, not full-time, but hey, baby steps.
I still wasn't convinced. I didn't bother applying because I didn't think they were actually going to hire anyone for it. Trust me, it wouldn't be the first time. After a few weeks, the boss pops in for rounds and asks me if I'm planning on applying for it because they're starting interviews. Well, sure, now that I have faith you're actually going to fill the position. I applied that night. It was still a few more weeks before I got an interview (keep in mind, I'm an internal candidate who's already worked there for over a year) and a few more after that before I was officially hired.
The other reason I didn't apply initially is because there are some changes in the works that I do not like. At all. As a PRN, I had much more control over how much crap I was willing to put up with. As part-time, not so much. It's also quite a pay cut for me. To the tune of almost $4/hr less. But I discussed it with Mr Jedi and we decided me going to part-time was the right move.
So imagine my surprise when I met with both my bosses and they threw this gem at me:
"We just want to make sure you're serious about wanting this position because we had to come to you for you to apply for it and you've been asking to go home early some days."
Ok, let's address each of those in turn (for the record, none of this was said out loud--I'm not an idiot).
As for approaching me to apply for the position, see above. Once I knew they were serious about hiring for it, I was serious about applying for and wanting it. People who know me well know I'm not going to make such a drastic change in my life if I wasn't serious about wanting it. Generally speaking, I don't do things I don't want to do.
Secondly, with as anal as you guys are being about hours, you're concerned about the one that costs you more per hour being mindful of that fact and trying to keep the budget in line? Didn't you just ream us out for being over on hours again? As the PRN, I was the first to get budgeted out. You can't have it both ways, cupcake. And from now on, I'm leaving when I'm done, screw the budget. But I smiled and said yes I was serious about the job, I want it, I know what I'm signing on for.
Changes
Awhile back there was an incident (these incidents always seem to involve the same coworker, too) where a doc wanted a stress test late on Saturday afternoon. Up until then, the weekend call was set up like so: A cardio tech to come in on Saturday like a normal work day and work till they were done, or be on call until noon. There was a second tech on call for general studies. Sunday was a call day for cardio until noon and then the general tech was on all day and night for general studies.
Now, depending on when the page in question actually came through, she may have had a legit point. Anywho, she got paged--ostensibly outside the time frame--couldn't do the exam right away, but came back and did it later. Which of course pissed off the doc that she didn't drop everything she was doing and come in to do his test.
Apparently the second shift EKG techs don't know how to run a treadmill for a stress test. The brilliant decision reached by management is to train the imaging techs to do it "in an emergency." This was met with much resistance because it's only a matter of time before "in an emergency" becomes a routine thing. Which I'll get to momentarily. The other change that came out of this was that any order that comes through, we have to do. Even stupid stuff we don't normally do on the weekends. Even scans that on their own don't earn enough hours in their little algorithm to pay a tech to do it on a regular day. Call is time and a half.
Oh, and we're opening availability on Saturdays for cardio until 4p. If the cardio tech finishes before then and goes home (or there aren't any cardios to do), the general person is supposed to pick up the cardio side as well.
You can imagine how well that went over.
Now, as far as hooking up patients goes, I'm lucky(?) enough to already know how to do it because I've done it at other facilities. The other two girls (who are the main two who work in cardio) have not, so for all intents and purposes, they've never been trained how to do it. Really truly, it's not difficult to get a patient wired up and it's not hard to run the treadmill. What is difficult is doing all that plus having to take blood pressures and inject the isotope at the right time. It's a lot to juggle even with just one patient. Now imagine having 4 to do on a weekend all alone.
What makes me feel really uncomfortable is the fact I don't read EKGs very well. I know mostly what the little squiggles correspond to and I know what asystole and V-tach look like (flatline and wild and crazy respectively). That's about it. When it comes to subtle changes like ST changes that might be Really Bad Things, I'm not trained to recognize them. "But," says the boss, "the physician or NP should be watching that!" Uh huh. Yeah, they should. I know a fair number who don't. A few aren't even in the room. And that makes me nervous. So I asked about EKG training. Apparently a 2-hour course is sufficient.
Called it
So, that hooking up our own patients "in an emergency"? Insufficient staff doesn't count as an "emergency." The managers in their infinite wisdom (
) have cut us to one EKG tech instead of two. So for any more than 2 or 3 patients, they're forcing us to start hooking people up ourselves to attempt to keep the flow going. Which of course takes someone away from imaging duties in order to run stresses. The other day we had 11 and by 10a had only managed to get one person on the treadmill. Needless to say, we had a waiting room full of (rightfully) pissed off patients. And then one of our treadmills (and our one EKG tech) got shanghaied to do a stress echo. Now, why is it ok for our patients to wait hours for their stress tests, but the (non-STAT outpatient) stress echo has to be done OMFGRIGHTFREAKINGNAO! When this question was asked of the boss, she just rolled her eyes and walked off.I do have some tales from my week working outpatient, but as this has already gone on long enough, I'll post those another day.
Someone remind me why I went into medicine again?
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