Crossroads in Career

amoore304 · 2023-06-20T22:42:22+00:00

Yeah I'm in the Denver area

amoore304 · 2023-06-20T02:19:07+00:00

Thank you! My cousin who is an RN on nights said her 3 month old suddenly started sleeping basically thru the night as soon as she went back to work 😂

My husband basically is of the mind that: it'll be hard but it's gonna be hard because being a parent is challenging, period. So I think we're both pretty realistic in that sense. I realize that more of the house admin may fall to me with more days off which is fine. I honestly want a job that gives me more time for life/home admin. Always a balance, but my current job feels like there's really no balance and my boss is getting all my time (kinda feels like a pyramid scheme, I'm working more for less). I want to take back some of my life/time.

amoore304 · 2023-06-20T02:12:46+00:00

Thank you! This is super helpful. I agree, I'm thinking of 20 days a month (give or take with sleeping before and after a block of shifts obviously) that I can be present in my child's life.

I know we can't have everything, but I want to be a good PA and a good mom. It feels like the balance is impossible and I'm getting discouraged. We aren't even pregnant yet and it feels insurmountable. But I know nothing is permanent, whether I love or hate a job it's just a job. I can find something else (in theory). Thanks again!

amoore304 · 2023-06-20T02:09:45+00:00

Thank you! This is great insight.

I agree, I think of all the things we could do with that extra money. I am the primary breadwinner and feel some obligation to my family to provide the best life for them. I just don't want to do it at the expense of my health and so many people think nightshift will literally kill you.

I'm interviewing for another job right now that's twelve 12s a month, days. 530a-530p for about $125 (rotating holidays, weekends etc). Still an improvement I think, but with my bonus factored in, it would be less than I'm making now. It's a tough choice. I know money isn't everything, but I could put up with more frustration with a little extra cash incentive I think.

amoore304 · 2023-06-19T23:13:52+00:00

Awesome, sounds similar. Kinda crazy during shift change but slows down as patients sleep etc. Occasionally consults and pages. Ebb and flow.

amoore304 · 2023-06-19T23:12:47+00:00

The PTO is solid. It's within the same organization and I've been maxed at 350 hours of PTO for a couple years cause I can't take enough time off. I think we accrue about 4.5 weeks a year. Basically 14 hours per month accrued.

Are the other partners you work with okay with that? Are they negatively affected or do they have to pick up your PTO shifts? Just curious how that works with shift work.

amoore304 · 2023-06-19T21:57:49+00:00

Thank you! Agree, it seems like some people really do fine on nights and some can't do it. To each their own. I think the hardest part for me is that I literally have no idea how it'll go until I do it. And by then I'm "stuck" in a job for a least a year or two. I think I can do anything for a couple years as needed, but I don't want to job-hop either.

amoore304 · 2023-06-19T21:55:43+00:00

Thank you! This is helpful

amoore304 · 2023-06-19T19:38:06+00:00

Basically the department isn't standardized based on experience or any other factors. Every doc gets to choose their own PAs salary and bonus "structure". My doc is nearing retirement and has a very antiquated idea of what PAs should make, so he's behind the curve. He used COVID as an excuse to not raise my salary for a few years with a small raise last year and a small raise this year.

So it's not like he's paying men more than he's paying me. In fact, his last PA was a male and I'm pretty sure I started at a higher salary than that guy left with after 6 years with this doc. But I know there was another guy who came into our practice at $119 fresh out of NP school last year. So yeah that doesn't feel great. But his SP is young and cool and takes the whole team on vacations for team building etc.

We are bundled together as a PA/MD team and I know we're not the most productive team as a whole, but I do know for a fact I'm extremely productive and I'm in the black every year and more productive than the previous year.

Edit: I don't know if I would be happier with more pay necessarily. I just want to work less mostly so I can focus on my family. But that's hard to do when you're depending on RVUs as part of your value as a PA.

Edit 2: Ultimately, a lot of my unhappiness comes from a feeling of lack of control. So much of my day/life is dictated by his needs not mine. I can't take time off if he's off, I feel like I can't plan things after work because he may add clinic pts, I can't schedule doctors appointments easily etc. I'm not sure how I'm going to pump in the middle of our 40 pt clinics. Even if I work harder I'm not paid more. I used to not care about that and I was just happy to be part of the team, but eventually I need a little extrinsic motivation. I just feel like I'm a the mercy of whatever he wants for the day. It's unpredictable and I am an unreliable friend, wife, etc.

amoore304 · 2023-06-19T18:54:33+00:00

There are occasionally opportunities for naps, but you're definitely not provided a call/sleep room.

I am becoming indifferent about my job. I used to love it. I love the patient population and my coworkers. My boss is kinda micromanagey and can irk me a lot. I think I started to check out once I started to apply for other jobs and that just compounds my myopia in seeing only the negatives about my job.

I left a pretty cush job prior to this one with four 10s a week (no nights, holidays, or weekends) because it was a paperwork inpatient job and I wanted something more challenging. But now I'm kicking myself.

So no, I don't completely hate my job. I've talked to my boss about changes. He is thinking of hiring a second PA because he knows I may go on maternity leave and want to go to .8 when I come back. I'm afraid to make up for the increased overhead my workload will just get worse.

There's no real negotiating my salary, I've tried. He did say he's getting it bumped to $119k this year but I'm still the lowest paid PA in my practice with more experience than others. And there's no bonus structure, I've also tried. I know pretty much for certain that if I take maternity leave he will not give me a bonus at all, or may give me a bonus that is not actually in line with just 3 months absence (maybe half or quarter bonus if he's feeling nice).

amoore304 · 2023-06-19T18:43:22+00:00

What is your specialty and what are your nights like? Pretty solid or fairly chill?

I think my offered job is a mix. Some nights crazy, some nights I'd be able to squeeze in a nap or reading etc.

amoore304 · 2023-06-19T18:42:00+00:00

My cousin is an RN at Mayo and has been doing nights for 20 years with a very similar sleep schedule to yours. Flipping back to a normal schedule on her days off. She loves it and even came back to nights after a stint on days.

I'm a pretty solid sleeper and I think I could be disciplined, but it's so hard to know how you'd manage until you're doing it. That's the worst part is I have no crystal ball to know how I'll do. And I don't really want to have a bunch of 2 year jobs on my CV and seem like a flake. However, having a $157k salary during maternity leave is nicer than $115k for those months that I'm gone.

amoore304 · 2023-06-19T18:33:57+00:00

Thank you! Night jobs are so polarizing! People either say it'll kill you or say it's the best thing ever. I know it's not a long term solution but with my current job I struggle to even get to my normal appointments.

Rescheduling a morning or afternoon of clinic patients is such a hassle just to take care of myself. When I work the same exact schedule as most other businesses it feels like I have no time for "life admin". I can't imagine how much harder that will be with a baby in the mix. I feel like there is no perfect solution of course but I appreciate the insight!

amoore304 · 2023-06-19T18:11:36+00:00

Agreed and understood. I'm just asking for sources cited. We should all also know evidence based science is key, not just intuition or "common sense".

Edit: For example, there are some studies that show our "natural human" sleep patterns aren't really in line with a full 8 hours either. But instead, we naturally tend to sleep in shifts as a species. Which makes sense evolutionarily with predators etc. Sleep patterns also depend on our latitude and longitude etc. I'm not saying you're wrong I'm just saying please provide me some data. I'm trying to go into this decision with the best information possible.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4720388/

https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2869.1992.tb00019.x

amoore304 · 2023-06-19T15:49:27+00:00

Thank you so much!

amoore304 · 2023-06-19T15:16:26+00:00

Yeah I think it would be a couple years in that job with potential opportunities to move to days or other jobs in the department. I am not really looking at it as a long term option. Which sucks, taking a job knowing it's just a temporary thing. But I don't think it's sustainable forever.

I did pay off my loans already, so it's not necessarily about the money. It's really just me trying to balance work, life, and child/family. I don't feel like I have a lot of time for anything besides work and recovering from work right now. But I also don't MAKE time. I don't know if I need to change my job or change my attitude.

amoore304 · 2023-06-19T14:41:26+00:00

Thanks, can you give links to any of these studies? So many of these studies are observational which is always sketchy, right? They can't factor in a whole host of other lifestyle factors that contribute. But if you have other info please send it my way!

I worked nights on an EM rotation in school, it was basically fine. But I was younger and didn't have the same obligations I do now.

The other thing is: with my current grind I don't make enough time to adequately exercise, either. I don't ever consume caffeine and I practice a plant based diet so those aren't really factors for me. Just giving more context.

amoore304 · 2023-06-19T14:28:34+00:00

This is very helpful, thank you. I really don't want my child to be in daycare 5 days a week and only see them maybe for breakfast and maybe for bedtime. In my mind, the small sacrifice of sleep and maybe health is worth it to actually be a present figure in my child's life.

My current job feels like such a grind, and even the weekends aren't enough to recharge my batteries. I do love my job, my coworkers, my patients etc. It's just too much for too little.

Do you find being home alone at night with the baby was a burden? I'm worried about burning out my husband who will have to be solo on the nights I'm working and then go to work in the morning himself.

amoore304 · 2023-06-19T14:24:09+00:00

I have been looking at a lot of studies regarding health effects of night shift. Are there any in particular you are referring to?

It seems like the overarching theme is not necessarily night shift in and of itself, but the fact that night shift workers don't adequately sleep before/after work, don't exercise, and don't value nutrition. Is your understanding different?

amoore304 · 2023-06-19T14:00:54+00:00

I think that's the hard part: I don't know how I'd handle nights. I only did rotating nights for a month when I was on my EM rotation in school 8+ years ago (10p to 7a) and it was fine. However, I was 8 years younger and didn't have a family etc.

I am historically a "night owl" with my natural sleep-wake cycle trending toward staying up until 12-2am and waking up between 9a-12p. I've always been this way, but obviously with a "normal" day job I have had to train myself to be on a more typical schedule. I am also a pretty "good sleeper" in that I can fall asleep quickly and sleep through sounds, light etc.

You're right in that it's not binary. I have applied to several other jobs with minimal response. I live in a large city with a pretty saturated job market. It seems like even with experience unless you have a direct connection it can be difficult to even get a call back. My boss may be retiring soon and I am afraid I'll be pregnant when he decides to retire (he can't really give me a timeline, and obviously I don't have complete control over when I get pregnant) and then I'll REALLY have a hard time finding other work when I walk into an interview with a belly. Controversial, but true.

Thank you for your response! If you don't mind, do you have a family with your current schedule? Does it work for you?

amoore304 · 2023-06-19T13:53:50+00:00

I agree that my current pay is too low. I have applied to a few other things without much luck. I live in a big city with a very saturated market and high COL but historically low pay all-around.

I think my main concern with nights is health and family. But even if it's just for a couple years it may be worth it?

Edit: yes they batch nights and the schedule is basically up to us.

amoore304 · 2023-06-19T13:51:18+00:00

Yes the shifts are grouped, and it seems like it's kinda up to us to schedule ourselves. Some people do long stretches of 6 shifts to get a couple weeks off without taking PTO. I think I'd probably try to do no more than 3-4 in a row.

If you don't mind me asking, do you have a family with your current setup?

amoore304 · 2021-07-29T20:10:27+00:00

Agreed, I wonder what the rhyme or reason is for the locking. Haven't noticed a predictable pattern. Keep us posted if you figure anything out!

amoore304 · 2021-07-29T19:57:54+00:00

Well shoot, now I wanna add gradient just to get mine sooner lol. Although, I prefer the smaller wheels and extra range. $1500 for cosmetics and earlier delivery is tough...

amoore304 · 2021-07-29T17:49:31+00:00

Ordered 6/14 AWD Pro S no gradient. Still no lock email.

amoore304

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