You Can't Silence Us

I now work for a free standing Emergency Room. The regional manager had mentioned during my interview that they were opening a new location this summer, and asked if I would consider taking over as the manager, or was I wedded to just being PRN. I told her that would depend on the terms of the offer. I’m guessing the current managers consider me to be a threat, at least judging by what has happened since.

I had worked a total of 7 days at my new job since completing onboarding: one or two days per week, not counting the three weeks of the Europe trip. I got called into the office by the site manager. On her computer screen, the ED manager from the other site where I did my onboarding was there via TEAMS. The manager looks at me and says “How do you think you are doing?”

I said, “Well, I would have said fine, but since we are having this meeting, I’m guessing that’s not right.”

Both laugh. Then the manager continues, telling me that she has had “people” come to her and tell her that I am taking too long to triage my patients. I tell her that this is concerning to me, and I am more than willing to increase my speed, if they can tell me where I am lagging. No one wants to be “that guy” who no one wants to work with.

They tell me they have no idea. The manager attending by TEAMS says, if only there was some way we could get data from EPIC (our medical charting software) we would be able to tell you. I wish EPIC had a report for that.

“It does- there are reports for everything a nurse does- triage time, treatment efficiency, average time to complete medication orders, all of it. Let me show you how,” I offered.

The manager replied: “Well, we aren’t sure that those reports are accurate. There are ways to game that data.”

So then I asked them where I am slow, and what I can do to show improvement. They tell me that they don’t know. Then they instruct me to go see nurses Amy and John, who are working with me that day. They can watch me work and tell me. They tell me that the standard is for the patient to wait 2 minutes or less in the waiting room, and 10 minutes or less for triage. The expectation is that I comply with those numbers. Then they thanked me for not being difficult and accepting the counseling like a professional.

So I took their advice and went to see Amy and John. That’s helpful, because Amy has worked with me for 4 of the 7 shifts I’ve had so far. They were both surprised, and told me I wasn’t slow, and couldn’t see anything I was doing wrong.

So I turned to EPIC- you know, the ones the manager at first said didn’t exist, and then told me weren’t accurate. According to EPIC, there are 18 nurses in my department. I ran a nurse efficiency report. The report showed the nurses have average triage times ranging from 2 minutes to 9 minutes, with an average of all of them being 4 minutes and 32 seconds. My average time? 4 minutes and 3 seconds. Not one of my patients has been longer than 8 minutes. In addition, I see more patients than my coworkers on the days that I am working, which indicates that I am faster than they are. Not more than any one of my coworkers- more than they are combined. On the days I work, I see 55% of all patients who walk through the door. The other two nurses on shift with me see the remaining 45% combined. I’m fast enough that coworkers tell me to sit down and let them catch a couple of patients.

So I sent an email to the manager informing her that Amy and John had no suggestions, and EPIC showed my average times to be far below the required ten minutes. I then asked if they could be more specific, because I cannot correct a deficient behavior if my leadership can’t even tell me what behavior it is that I need to correct. I attached a copy of the report.

This is some piss-poor management. They complain that my work isn’t sufficient. They can’t tell me what exactly I’m doing that is deficient, nor can they tell me how to correct that deficiency. Instead they send me to talk to a pair of coworkers for advice, who also can’t see where I am doing anything wrong.

What management school is that?

In this case, the email I sent was for documentation purposes. I only work there one or two days a week. They had talked to me about joining the management team, but I don’t want to go full time again, no matter what the pay. I’m going to keep my head down and do three to five more years working part time, then collect social security. I am no longer fighting the workplace wars that are so stressful and aren’t that important.

It’s been over a month since all of that took place. No one has said a word, and I received no answer to my email. I suspect that my MBA, the fact that I am more certified than my managers, I am more knowledgeable on the EPIC software as evidenced by her not even knowing how to run the nurse efficiency report, and let’s face it, because I am a man, all make me a target.

I’ve been watching my coworkers. One of the ones who has a 2 minute triage average? Yeah, when a patient walks in, he moves them in the computer from lobby to a room, then charts his entire assessment and triage. All without getting up from his desk. Then he goes to the lobby to actually put the patient in a room, enters vital signs, and collects any needed labs. In other words, he isn’t fast, he is lying. He isn’t doing his job, he is just reporting that he is doing his job. That is something I refuse to do. This is what happens when management cares more about metrics than outcomes. Too many administrators are like that, but I just won’t do it. Reports are supposed to reflect reality, but too many nurses bend reality to fit what the reports show.

So my plan here is now: No write-ups, no escalations, no drama, not being the fastest, best, or most efficient nurse. Keep my head down, collect my $50 an hour, and go home at the end of the day. If someone says something to correct or counsel me, the answer will be “Got it—I’ll keep that in mind. Thank you for your input.”

Things are winding down as I glide into retirement. In January, I sold the rental properties and paid off my house. I need to earn enough this year to cover my capital gains from that on next year’s taxes. Next year, I pay off my Jeep Gladiator. Then I keep putting money away to fund my future travels. I don’t need to be right, or be the best, I just need to be paid. Keep my eye on the prize. Let them all keep fighting over who is the best and playing office political games. I’m not playing those any longer.

I only have three years before I can retire. After that, I only work until I get tired of the bullshit.