Working in Massachusetts

Working in MA has had its ups and downs. I am working at a hospital owned internal medicine practice. The first week was orientation which was good because I wasn’t thrown into seeing patients. I learned the EHR and shadowed. I found out that week that I would be working between two clinics which I wasn’t aware of before starting. I am mostly covering vacations in one clinic and then the other clinic has two physicians on FMLA that I am covering.

Apparently the two physicians have been in and out of work over the last year, so patients are frustrated that they haven’t been able to get in to be seen. Most of them haven’t had any labs done in the last 12 months, nor are aware of test results they completed over the last 6 months. I work 3-4 days at this clinic which can be exhausting, since the patients often come with a list of 12 problems they need addressed since they haven’t been seen in a year. 

At the other clinic, I mostly see acute visits and hospital follow ups. The patients are friendly at both clinics and are quite diverse – a mixture of Irish, Russian, Puerto Rican, Italian, and Polish patients. I do miss seeing children because pediatric patients are usually more straightforward and have less problems than adults. They make it a nice balance between seeing complex adult patients.

I like that I have admin time, 30 minutes before lunch and 1 hour before the end of the day. It definitely helps me stay on schedule and to finish my workflow. Most of the time I am able to finish early, which is always a plus. During the interview, the site made it seem like I would be seeing 20-22 patients per day. However, they allow 40 minutes for ER/hospital follow ups and for patients that are 80 and older. So, it is unlikely I will ever see that many patients per day. I think the most patients I have seen per day is 15.

There are many other NPs and PA’s that work at the clinics that are very friendly. They warned me about some of the physicians in the practice, that they can be petty and have you send THEIR patient refills if you saw their patient last for even an acute unrelated visit. This happened to me when I saw a patient for ER discharge for headache. The following week I was on vacation, and when I returned, there was a message in my inbox about the patient requesting a different medication for their headache. Their PCP told the patient I was on vacation and they would have to wait until I return (even though they are the PCP), which I found ridiculous.

About 6 weeks into the assignment, I was asked to extend. I told them I would let them know when it’s closer to the end. If I did extend, it would only be for a few weeks, not months. My main incentive is that I would be able to experience my favorite season here, which is Fall!

One thought on “Working in Massachusetts

  1. I so enjoy your updates!

    I am currently doing a 1-month gig in Utqiagvik, AK!! My hospital provided apartment is a huge 1 bedroom, right across from the Arctic Ocean.

    Almost everyone up here is a traveler of some kind – from nurses to the guys in the stockroom, to administrators.

    The PNP I’m covering for is ‘on-slope’ for 2 months, then goes ‘off-slope’ for 1 mo. I want to do the one-month x4 that he is off-slope!

    They pay so much stupid money up here, I couldn’t afford to NOT take this job! Would be more than I make in a year as a lower 48 PNP.

    Brand new hospital, pt’s, when they show up, are usually pretty nice. But don’t keep them waiting. They are Native Alaskans and fall under IHS. If you keep them waiting, they have no problem going up to Admin, next thing u know, you are gone.

    I agreed to a family with 7 kids to do their WCC’s – they give me an hour for each WCC -as u know, completely unheard of. I reviewed all charts, AK Vak-Trak, pended all vaccines – guess who did not show up?!! My RN (no MA’s all RN’s) has been calling mom all a.m. – no answer.

    Oh well.

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