So I've been a nurse for 33 years.
The last 11 as a nurse practitioner,
I've worked in a male dominant medical practice for eight years.
The reason that I picked nursing was because I have empathy
and I am great at people pleasing.
This, I believe, is how I reacted to being raised by a narcissistic father
and a mother who was an enabler.
This is Donna.
Donna worked as a registered nurse and later as a nurse practitioner.
She says she's a people pleaser, never one to rock the boat,
which she attributes to her upbringing in a family with a highly controlling father.
I was not home for dinner and my spouse had to take that over
and he was not happy with that because we had three hungry teenage boys at the end of the day.
And this was one of my tasks as a mother, cook dinner or a crackpot, things like that.
So this was not in his realm to do, you know, so this frustrated him.
Working 60-hour work weeks as a wife and mother of three teenage boys
would be overbearing for anyone in that situation.
But Donna kept pushing through, not realizing the work situation she was committed to
was not only toxic for her marriage, but also for her personal well-being.
My name's Carly and this is Toxic Workplace,
a podcast that gives a platform for people to share their stories of working in a destructive environment.
I spent the first seven years of my career within a toxic workplace
and let me tell you, it kills your spirit.
This podcast is here to expose what goes wrong in these companies
and hopefully it'll spark a change to make it right.
In this episode, we hear from Donna, who worked for a medical group of 12 doctors
who manipulated their staff to be overworked, underpaid and underappreciated.
Donna explains how the narcissistic characteristics of these doctors
isolated her from her coworkers and kept her tied to the practice for eight years.
So it's really a crazy story.
I worked at this big hospital and it's grown.
I've been there for over 30 years.
I'm not there with them anymore.
I would work usually night shift.
This way the boys were home.
I already had dinner. The house was organized.
I'd go to work, come home, hopefully be home before they went to school.
And then they did all their activities.
So I had everything under control.
One of the nurses that I worked with in the unit was going to NP school.
So she said, come take this class.
And we didn't have at that time any big universities in town.
This is a small town.
So we would travel three hours, she and I, and it just kept growing.
And I was in no rush to get anything.
I was just looking for, I guess, a hobby.
I knew the boys were going to grow.
I knew they were looking at colleges.
I knew they were not going to be around.
So I knew I had to find maybe a new purpose.
It was a two year program.
I went part time. I completed in three years.
And then the hospital had a neurology group.
They didn't own the neurology group, but they wanted to own the neurology group
because the hospital at this point was trying to buy up groups.
So they said to the neurology group, hey, we will hire three nurse practitioners
and you can have them and you can rent a nurse.
So when I went into the interview, they're sitting behind the tables
and I walk in and there's a chair in front of them.
Like I had done something bad or I was presenting something, you know.
And I'm like, what?
This is not an interview.
What I didn't realize then is that the hospital and this neurology group
and administration, they were having their own power struggle.
Donna earned her nurse practitioner license and was eager to move up
in the medical profession with new credentials.
When the hospital that she already worked in had an opportunity
with a neurology group, she jumped at the chance.
She said the interview process felt cold, intimidating and impersonable,
but they liked her and they extended her the offer.
At first, the doctors were very welcoming and complimentary,
which she refers to as love bombing.
But the honeymoon phase eventually faded and the doctors had her working
long past her scheduled shift.
The hours were extremely long.
If I tried to leave there at a decent time so I could get dinner and,
you know, I had a family to take care of and they would guilt me into staying longer.
And I thought that the job would be eight hours a day.
I thought, you know, hey, if I'm there at seven, I'd be home by three, four.
I'd be there for my family, which it turned out I was not.
I was there at seven in the morning.
I had to get up very early.
And then by three o'clock, I was like, oh, my God, I get to leave.
And then I would be stuck there till seven, eight, nine o'clock at night, five days a week.
Because you work in a hospital and the hospital has patients coming in 24-7.
So we have patient lists and everything is computerized now.
I would be typing, trying to finish up my last patient.
And then on the computer screen, the doctor would assign who would see what patient.
So it would have my initials.
So as three o'clock approaching, I'm like, oh, my God, I'm going to get out of here.
And then I see my initials on three, four other patients.
I'm like, what?
And they're like, yeah, well, they need to be seen.
And I'm like, oh, OK.
And each patient takes a good, you know, a hospitalized patient.
By the time you interview them, assess them, you know, order stuff and, you know,
sign off to your physician, it's an easy hour, 45 minutes to an hour.
So you're giving me four patients at three o'clock.
I'm not getting out of there.
I would be told, well, we have to work until we see all these people.
But it's 24-7.
They have primary seeing them.
It's not necessary for us to see them.
But the doctors were making money.
The more patients you see when you're in independent practice, the more money you get.
So if, let's say, I just made 20 bucks an hour and there's four more patients to see
and he makes maybe just say $100 out of each patient and he only has to pay me $20,
I was salaried.
So once eight hours was up, it was free slave labor.
OK, to clarify, Donna was technically employed by the hospital.
And then the hospital subbed her out to this neurology group.
The neurology group was paid out based on the number of patients they saw in the hospital.
So they would try and cram as many patients per day in order to maximize their profits.
The doctors of this neurology group definitely took advantage of Donna's work arrangement.
Donna's point about primary being available was that it wasn't as though if Donna didn't
see these patients, the patients would be left unattended to because a primary nurse
that worked for the hospital would have attended to the patient.
But if that was the case, then the neurology group couldn't bill for the patient.
Donna says that not only were the doctors assigning her to patients long after her shift
was supposed to end, but they would also say things that would make her feel guilty about
leaving before her assigned patients were cared for.
It was like 8 o'clock at night and he said, yeah, well, I have all these patients to see
and I'll just go see these patients.
And even though my daughter is at such and such place having a miscarriage, I'll just
stay here and finish these patients.
Choosing to stay at work while your daughter is going through something traumatizing?
The message the doctor is sending is clear.
It doesn't matter what's going on in your life.
Even if it's a family emergency, you need to stay at work until you've seen all your
patients.
It should go unspoken, but I'll say it anyway, work should never take precedence over a family
urgency.
Working around the clock put a serious strain on Donna's marriage to the point she and
her husband had to separate, which affected her teenage sons.
There was one evening where Donna had to leave early and the doctor she was working with
literally said she could not leave.
My husband and I did have a period where we did separate.
We lived apart and the youngest son could not thrive at that time.
And it was, I guess, my day to pick the son up.
And I couldn't because I couldn't get out of work until I finally said to the one particular,
well, I have to leave.
It was very early, five o'clock, which was early to leave, even though we started at
seven a.m.
You know, and the shift was only eight hours.
And I said, well, I have to go.
It's my night to pick up my son.
And the doctor, he was like arguing with me like, no, you need to stay.
We need to finish his arms.
I said, I finally said, this is my son and I'm the only one tonight to pick up.
And this one son had a little difficulty with his father leaving the house.
You know, so I knew I had to be there for my son.
And I knew his practice after school practice was over and I needed to be there.
You know, and he's like, no, you know, I need you.
And I'm like, no, my son needs me.
And then I walked away.
They were big bullies.
What were they going to do?
Who was even the boss of me?
Was it one of the twelve?
Was it the hospital who had a gazillion administrative people?
No.
The work culture within this neurology group had some deeper layers.
Donna's childhood experience gave her insight here because it runs parallel to how her father
treated her and her sisters.
Her father was a narcissist and in typical narcissistic fashion, he would triangulate
her and her sisters as a way to control them.
Donna realized the doctors were doing the same exact thing to her and the other NPs.
The doctors wanted to divide and conquer.
This fueled unhealthy competition.
Donna says she wasn't able to form true bonds with her peers.
And even if she wanted to, it didn't matter.
They never stayed long.
There would be two or three nurse practitioners, one or two, usually one doctor in the hospital
that we were at.
We had so many patients.
We never really had like a close bond to the nurse practitioners and it was because one
of us that day, that week, that flavor of the week, we didn't, I didn't really use it
at that time, but it would trigger us to be the chosen one competing for like your father's
favor.
Another nurse practitioner had left.
They don't, they didn't stay very long, maybe a year's the most because they can't take
it.
We would never really talk among each other because we were always pitted against each
other.
If this one didn't get it this day, then that one would get it.
So we never were able to form a friendship, a bond.
They were your coworkers, but it was such a competitive culture.
We could not do that.
There was a very high turnover rate.
We were always angry with each other.
I was angry.
I'm like, Hey, Roseanne, I mean, that was my patient.
I was assigned that patient.
Why did you go see that patient?
Oh, I was done early.
So I just went to see that patient.
You know, meanwhile, I've already done the work.
I was a people pleaser.
I would do whatever that person, if the NP wanted to take that patient away with me,
I'm like, Oh yeah, gee, oh yeah, that's fine.
You know, if the doctor wanted to criticize, no, that's not the right diagnosis is blah,
blah, blah, blah, blah.
I'm like, Oh yeah, sure.
Right.
Great Lord.
You know, I did not cause conflict at work.
The other form of narcissistic abuse Donna realized was happening now in hindsight was
gaslighting.
And if you've ever been gaslit by someone, you know, it's a total mind fudge.
Gaslighting is a manipulation tactic used to make someone question themselves, whether
it be their knowledge on something, their capabilities, or even a simple action they
did earlier in the day.
For our interview, Donna explained to me that she did a lot of life self reflecting and
research about narcissistic abuse due to her childhood circumstances and quickly realized
that the doctors also partook in gaslighting.
She says she questioned her capabilities and knowledge as a nurse practitioner, and she
questioned whether she was good enough for the doctor's standards.
The doctors would quickly shoot down her diagnoses on patients on a regular basis or Donna would
do something for a patient exactly how the doctors wanted it.
But then when being reviewed, they would tell her they wanted things done a different way.
Nurse practitioners have been around since like the 1960s, I believe.
This is a small little town.
This is a older doctor town at that time in 2010.
And nurse practitioners were new.
The hospital had not used them.
The doctors had not used them.
We were told, you know, hey, you were not educated like us.
You didn't spend four years in medical school.
We don't even know why you guys were created.
I was gaslighted, I'm sure, many, many times.
I thought, oh my God, what did I get myself into?
I'm out of my league.
Maybe I can't get this right.
Maybe I should just go back to the bedside, bedside nursing.
God, it was much easier.
And my salary from night shift was the same, exact same as working for the, as a nurse
practitioner.
I really wanted the experience.
I did say something to Human Resources and they said, that's the way it is.
We don't have the power to change it.
It was the gaslighting that eventually helped Donna realize she needed to get out of the
situation.
She tells me the end started to unravel one day when she made detailed notes on a patient
and used the same note template the group had been using for the eight years she'd
been employed.
The template was basically a fill in the blank questionnaire that was created by one of the
doctors in the group.
But one of the other doctors decided to single her out that day.
He turned to her and said that her notes were not up to par.
She knew this wasn't the case.
She knew she took meticulous notes and followed the protocol and expectations of the practice.
Donna was infuriated.
She gave pushback and disagreed and the doctor didn't like it at all.
I just went off.
I don't even remember what I said, but I just went off and he got up because he was just
so taken back.
That's when I knew I had to leave.
He would avoid me.
He wouldn't talk to me.
He wouldn't give me patience.
It was just like, I had nothing to do that day.
It was the craziest thing.
And then I went and I printed out all my notes because in the computer system, you know,
the nurse practitioner sees the patient first, she puts her note in and then the doctor goes
in, he clicks on the note, he makes an addendum and he'll change anything.
So I went back, I printed up my note before he touched it and then the note after that
he touched it, I highlighted the difference and then I brought it to whoever was my boss
at that time in administration who didn't really care because, you know, she had a million
other things going on.
That was my aha moment.
When I'm looking at my note and then his note that he addendum and I thought, no, this is
not right.
I did try to bring him up.
I did try to have like a discussion with the administration and I thought I was going into
a meeting with him and administration and they told me once I got into the meeting,
the other nurse practitioners were there as well and I thought it was like a coming to
meeting or let's get to work meeting or, you know, this is what's going on.
But it was all to put the nurse practitioners, especially me, in our place.
The doctor did not speak.
He just had his arms folded sitting there next to administration and when I tried to
bring up the topic, I was told this is not what this meeting is for.
After that meeting, I knew I knew I had to leave.
The gaslighting had finally caught up to the doctor and Donna was finally getting hip to
it.
To quickly recap, Donna entered her patient notes in a system and then printed them out
because she had an inkling that this doctor was possibly a shyster.
After the doctor entered his notes in the system, which was within the same note screen,
she printed and compared the two.
The doctor had gone into her notes and changed things.
This time she had the printed proof, but apparently that wasn't enough for the hospital administration
to hear her out.
My guess is that Donna's issue wasn't a priority or maybe the doctors were untouchable
and it wasn't worth the administration's time, which is speculation, but it's a convoluted
message they're giving by not taking her complaint seriously.
They did, however, drop everything for the doctor and call a mandatory meeting.
I can just see the doctor sitting there with the administration, arms crossed, not speaking
and acting like a big baby.
He was caught doing something he shouldn't have and in order to divert the attention
of the administration and everybody else, he called a random meeting about something
completely unrelated and then shut Donna's voice down.
When that Sunday night comes and you have to go, oh my God, I gotta go to work, you
know, when you're nauseous and I'm moaning to my husband and I'm upset and I haven't
done what I wanted to do, I don't feel rested.
So that Sunday my husband said, write the letter, go ahead.
So I did.
I wrote the letter.
I was at my boss's office at seven o'clock.
I waited for her secretary to come and I knew I had to get to rounding on patients.
And so I handed the secretary the letter and then I went to work and then the big boss
called me, one of the big bosses, you know, she said to me something very simple and then
she said, well, we'll speak soon and hung up.
I never spoke to her.
I never saw her.
Her assistant called me and said, oh, you can't do two weeks, you have to do four weeks,
you're an NP.
I said, fine, whatever.
You know, I was going to argue with people and that was it.
From a business perspective, why wouldn't the administration want to talk to Donna and
get an idea of what happened?
Why did this employee quit after eight years with this neurology group?
Speculating again, but if someone quits and nobody asks questions, then they don't care.
Are they not willing to fix the issue?
Do they not have the ability to fix the issue?
With such high turnover in this group, I would think someone is asking questions or trying
to make life easier for these NPs.
But Donna says that wasn't the case.
They simply didn't care to change and they would keep bringing in new NPs through their
revolving door.
I think the doctor's profits were being taken by administration, you know, because this
particular hospital, many others are trying to buy up all these practices.
And this is what this is one way to get that group to come on board.
You know, hey, we'll give you a rent a nurse and you know, we'll pay for them and all this
other stuff.
And finally, there was a big divorce and this group left the hospital because the hospital
wanted to buy them and they didn't want it.
The hospital formed their own neurology group and they're having difficulty keeping the
doctors, the new neurologist doctors.
So it sounds like both ends were corrupted.
The hospital is focused on enticing the doctor group to join the hospital and favoring them
as a means to get them on board.
Meanwhile, the doctors aren't interested and are overworking the hospital staff in order
to make money over and above the cut the hospital's taking at the end of the day.
There's no doubt life working for this group was miserable.
It put a huge strain on Donna's marriage, which by the way, she's happily married to
her husband now after 31 years.
But working under such a high stress environment took a toll not only on her marriage and her
son's lives, but also on her mental health and wellbeing.
In order to deal with the stress, she started to see a psychiatrist who prescribed medications
to help get her through the hectic days.
I was popping Xanax during the day, three to four times a day, nevermind the antidepressants
too.
As a regular RN, I was fine.
Life was good.
The bedside was much easier than being a nurse practitioner.
No, this was towards the end.
I was going to therapy, therapy at seven or eight o'clock at freaking night because I
couldn't get there during the day.
And of course, they're not open on the weekend.
Psychiatrist said, I can peel you off the ceiling.
Moving my marriage, that's a life stressor there.
We have a middle son.
He was, you know, the middle child, a little difficult at times.
So we had that to deal with.
I had school calling me in the middle of the day and I felt so bad.
I'm like, I can't get my child.
I can't go to him and be with him and say, hey, what's going on, dude?
You know, I couldn't do that.
As a mother, there's nothing harder than watching your child struggle and feel like
you can't be there for them.
As a determined woman with a career, there is a real drive that pushes you to prove yourself,
to prove your capabilities and your knowledge.
As a career mom myself, I completely understand the struggle Donna went through.
We want it all, the motherhood and the career, but it comes at a price.
Finding balance and tending to your own needs is key when you've got so much on your plate.
Luckily, she found refuge from the storm in a yoga practice and meditation.
I left in 2018.
In 2017, there was a yoga studio that opened up across the street from the hospital.
It was good to do the exercise, but it was the meditation.
I don't know if you've experienced yoga with the chakras and all this other stuff.
Oh my God, we had to spilling out of emotions, not just me, but everybody there.
We'd sit in this big circle and we would meditate and they would bring up whatever subject.
It was just we'd be crying.
It was just, you know, it was my ah moment.
It was like you had a group of girls there and everybody had their own little issues.
I brought this issue up.
They really listened and they really said, yeah, something needs to change.
That's when I knew and I had confirmation that it wasn't just me.
It was very validating to be with these yogis, to do the meditation, to move my body.
My body was so stressed out.
And when I get stressed out, I have low back pain.
My shoulders get crunched up.
So I would go there and you know, you're moving your body this way and that way.
And God, my body just needed it.
Just, you know, the tension.
Finding her balance and inner calm was the light Donna needed to find in order to open
her eyes to the situation.
After only a year of regularly attending this yoga studio, she was able to see the toxicity
within her workplace for what it was.
And she found the courage to stick up for herself and take a stand.
This courage would grow.
And after she left the neurology group, she would be inspired to start a practice of her
own.
The practice where the culture fostered empowerment and flexibility, which allowed Donna and her
associates to truly have a work-life balance.
I got busy starting my own medical practice.
And during my day at the hospital, you get to know certain people.
So in the state that I live in, we need a collaborator, a doctor to be the collaborator.
So I found a young female doctor to be my collaborator.
I hired her.
I have her and another nurse practitioner and office staff.
And we have an outpatient clinic.
I run things a little different at the clinic.
I try to make the work exciting and make it their own.
What was important is that the tasks that they did, the tasks being seeing the patients,
I wanted them to get the reward for seeing those patients.
So what we do is we have a percentage or maybe a sliding scale pay so that if they get a
percentage of what they make and their percentage is higher than what I would get from their
work.
So if they see a patient and the patient, let's just say for, I use a hundred dollars
because it's a round number.
So they would get 70% of that fee and I would get 30%.
And the 30% is not my profit.
It is to keep basically the lights on at the end of the day.
It is to basically pay for liability insurance.
It's to pay for electronic charting, credentialing, things like that.
So that's what their 30% is.
So let's say you want to work every day this week except Wednesday because you have something
going on.
Well, you can do that.
If you want to start your day at nine and end by three, well, you can do that.
If it's your birthday, you want to go to the spa all day with your girlfriend, well, you
can do that.
So you make your schedule the way you would like.
And if you want to work hard, if you want to buy a pretty dress for a ball, just to
say, you could put in a couple of extra patients per day or whatever and then you can make
extra money.
So it's what you need.
There's a reward.
This has been together since 2018 and no, there's no turnover.
I think I had a scribe left to go to occupational therapy school.
And that was because it was out of time, out of area.
And she was willing to come back during vacation times.
But I just could, you know, I have to be careful.
When you run a business, it's, yeah, what I'm trying to do is first to give them autonomy,
you know, to let them run with their ideas.
We have to do marketing for my business.
So it's, you know, what kind of clients do you want?
Where do you, where do you want to get these clients from?
So it's a lot of autonomy.
Yeah, it can be challenging and, you know, they can be creative.
It's interactive, engaging.
It's a connection with your effort and your reward.
You know, I made great efforts at the hospital, but the reward was not there.
I loved Donna's story because it has such a Hollywood-worthy ending.
She endured a hardship, took everything she learned and her negative experience and used
it to create something amazing.
She created a workplace that is the complete opposite of the one that beat her down.
She overcame an overbearing obstacle and used it as her silver lining.
She's happy, thriving and enjoying life.
Donna's story is a testament that toxic workplaces can be the best tool to help you transcend
and rise above some of life's hardest hurdles.
So the next time you're banging your head against your desk or about to blow up because
your boss is a complete jerk, just remember this is all leading you to something greater
than you realize.
I hope you enjoyed the podcast.
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