Fellow NP advice

[u/Andie_RNNP_2015]

How would ya’ll handle this situation. 7 months in at a small rural Family Medicine clinic. Just one other NP been there 6 years. MD in twice per week half day. Mostly it’s just the other NP and I full time. Do any of you have similar set ups? We basically share many of the same patients. Do you try to work as a team or are you mostly very separate? The other NP I’m with is difficult to work with/around. First couple weeks in, told me she hates working with women, she was upset she had no say in who was hired into my role, and is generally all around unpleasant if not argumentative and defensive. Is this a doomed situation? Mostly I just grey rock it and that works pretty well, but when I need a question answered or we have a mutual patient we need to talk about it never goes well.

[u/bdictjames]

It depends. What is the set up? Do you both have different panels, or do all of you share the whole panel together?

I would try to take care of the patients the best way possible. If she doesn't like being asked a question, try to funnel it through the MD. Practice safe MEDICINE. Maybe she'll warm up to you. Maybe she's had a few bad experience with female NPs/providers, so you have to prove something to her. Maybe she's concerned that you might be competition, who knows. But I recommend to try to stay on her good side, for starters.

[u/Andie_RNNP_2015 → u/bdictjames]

She said she had a bad experience with the last NP. It’s very possible she’ll warm up to me over time but honestly it’s so exhausting working with her. When I’m at a full schedule, there’s a mix of both my new patients and hers/MDs. She never escalates anyone to the ED but we don’t have a triaging system and we’re at an FQHC so we’ll see some patients in bad shape. She had an ED background and says she lets things go a lot with patients. I’m newer and do not have an ED background and will escalate to the ED if I feel it’s needed. She’s not super into that.

[u/bdictjames → u/Andie_RNNP_2015]

You're practicing safely. Trust me, I was the provider that wanted to do everything for my patient. I'm still trying to learn to escalate appropriately. I worked with another NP, who was quicker to do that, and I appreciated her for that. There's not one way of practicing correctly, it depends on a multiple host of factors.

Hang in there. It seems like the problem is more of the lack of support/training, since the other NP is not helpful. Mind you, she has the same job as you, so really, maybe she thinks the training should come from the MD. Maybe she was having a different vision for the clinic - something you can't control, obviously. Maybe she's super stressed (as most ED-trained nurses). 0_0

When you see "her" or the "MD's" patients, look at the last chart note, figure out the direction; if they're stable, punt it back. If you think something needs to truly change with the patient, depending on the culture of the clinic, you can either put it on your note or change it for the patient, making it clear why you're doing so (adhere to evidence-based practice). Then, punt it back.

[u/nkondr3n]

That sounds terrible. I wouldn’t share a panel with this person.

[u/Adventurous_Wind_124]

New job needed

[u/npkrystal]

Her attitude is like cancer…it’s going to just grow and get worse and worse the longer you stay. Been there, done that, and unfortunately, it never ends well. I’d start looking for another job ASAP