registered nurse

licensed practical nurse

patient care technician

medical assistant

physician assistant

Rochester Regional Health

Mid level management and supervisors that directly oversee the "boots on the ground" employees / therapists have increasingly become less supportive of overall employee health and morale in favor of securing their bottom line. At the beginning of the COVID-19 pandemic, my supervisors were supportive and communicative and generally felt "there" for me. However in the last 8 months, there has been a slow decline of this and increasing staff turnover and low employee morale among my coworkers. Especially regarding fiscal and budgetary concerns--these should not be the burden of the lowest level employee. Management needs to be equipping us with the tools to meet productivity standards instead of just telling us to do more and schedule more clients to meet targets. Additionally, supervisors are in constant meetings and are out of touch with the needs of their employees. They are constantly changing clinic and workflow standards and seem to be implementing and "rolling out" new workflows and job demands every week. The lowest level employees and therapists are the last to know of these new changes and are expected to change their workflow as soon as the PowerPoint presentation is over.  Supervisors also tend to be out of touch with the concerns and grievances of their employees as most do not keep to the set OASAS supervision guidelines as they constantly have to hop from meeting to meeting. Supervision then tends to focus solely on case management / productivity concerns and is over in 15mins. I can't speak to how out of touch mid level management seems to be with the actual needs of their employees. Contrary to other agencies and practices with substance use and mental health, supervisors do not even keep their own small caseloads, so they don't even grasp the reality of what they are asking their staff to do. Some of these practices and behaviors were present prior to the pandemic, but due to increased community demand for services and added stress of the pandemic, the issues with these managerial behaviors have only been exacerbated. I also have yet to see any employee satisfaction survey offered to me, but that could greatly help in feeling like my complaints would actually be heard.


A typical day begins early with am rounds. Ensuring staffing is efficient, customer service and schedules are going well and the OR's are supported adequately. If I am needed I scrub in or pitch in. If not, I head to the office. Typically I begin by returning phone calls, emails and reviewing cost of cases from previous day. I check on the weeks schedule and check on any needed items/supplies or pre-cost issues. I then move on to my work. I am currently merging two centers into one for a total of 12 OR capacity. This also includes "build on" plans for the Center I currently occupy. I also focus on physician and case recruitment needs to target volumes budgeted for that month. I oversee quality, infection control and education as well all clinica operations. This requires creativity and energy in order to constantly drive positivity and customer service as well as high quality efficiency. I use a shared governance model in order to achieve these goals. I also empower staff to "speak up" as I am available often to hear their ideas/concerns.  My open door times are open for staff to come in and discuss any issue they like. I also hold frequent meeting with clinical leadership to assist with needs. I perform quality covert rounds frequently and encourage other staff to do as well. Currently projects I am working on : case picking efficiency, volume growth, staffing analysis and a new staffing plan/system operations in order to liason two surgical centers into one philosophy. Survey readiness is also taking much of my time lately as we are due for survey in February and end of year must also be completed. Multiple meetings are taking place both internally and externally surrounding operations and the future of the Center as a whole. Two large systems have merged each with a center operating separately. Currently, this is taking up most of my time. I perform rounds atleast 3 times a day when I am not working in the OR's.  My day ends with creating a list or plan for the next day. Since all clinical operations are my responsibility; this is a brief view of a "more normal" day.

Incivility and discrimination by RN manager toward APP providers persistent with established norms of hostility that was normalized. Frequent sabotage of workflow by manager to undermine and humiliate APP in clinic.  Manager constantly underlining comments to make team member as target for bullying in the office and intimidate to silence. Practice manager was very poor leader who are coached to see her skills in title and was rewarded for reinforcement of incivility.  She excluded me as medical provider from the team and put me to work in one room while I was  not trained and coached in practice while making undermining comments to everybody all day, "she is lazy," "she thinks she knows what she is doing, I know it, I am her manager." However, while everybody was telling me what to do as provider and bullied that I was rude when I asked questions seeking clarification, manager went to upper management saying I was rude disrespectful to her staff and nurses with confrontation refusing to see patients. Manager often exhibited verbal and physical aggression. Director took her side. I had to ask where the restroom and breakroom was there because it was not told. I knew nothing about anything going on in clinic while everybody did and were manipulative bullying me and complaining about me. It got to the point when I had to leave because it would not be worth it. Too toxic environment. My only mistake was I did not research about that manager ahead of time prior applying for the job and ruined my career. I would have known her and that she was fired before for same behavior at Unity ED and alterations of patients' chart records. It is sad that in 21st century, it does exist. It was reported to HR and upper management, absolutely nothing was done but director retaliated me instead with disciplinary action for going to HR.

Worked there for years before having to relocate out of state. Starting amount out of high school at the time was great, and with shift differential and yearly raises it wasn't too bad. Though there were times when we would find out new hires were making nearly as much as us seasoned aides were. Coworkers and managers differ depending on what unit and shift you're on, but on my floor everyone was always nice and helpful. I miss a lot of my residents and coworkers. 

There were some frustrating things over the years with higher management like the DON and facility administrators changing over a lot and only caring about budgets and not the patients or staff. I went through about 3 or 4 different unit managers before we got a fantastic one. Not to mention there will also always be residents you don't get along with, but you'll find that everywhere. You have your chill days an you'll have days where you want to quit on the spot, but it was good steady work helping others.

Lack of staff on other units means they would pull from my unit to staff others and leave us short which was frustrating, but if you had good fellow aides and nurses you could survive the shift.

Room to grow with nursing programs if you wanted to advance, and being part of a larger hospital system meant you could transfer around. I learned a lot over the years, rehab, LTC, respiratory, wound care, etc. You see a lot just from helping out nurses and observing what they're doing.

According to coworkers, a lot of things went downhill around the time I left, so I'm not sure how things are now though.

The grass isn't always greener and I'm sad I had to leave.

Moved to NY from NC. When I received my job offer at Unity and was in negotiations, they switched HR reps on me and the person that followed up with me knew nothing regarding my questions or my ask. Salary offer was below my previous pay, so I asked them to match. They couldn't. To go from hourly where we got paid overtime and shift differential to basic salary, the pay cut was drastic. The benefits did not meet the par of my previous job in terms of PTO, 401k match, maternity/paternity leave, sick days, bonuses. The only pro was the pension, but you would only get if you worked at least either 4 or 5 years. There are no guaranteed annual raises.

Their Epic EMR system was bare-bones and they weren't going to spend money on an IT support team. All the money funneled to the main hospital for development. The other facilities were left trying to cut all costs. Workload was more than it should have been due to system inefficiencies, high turnover, and cost cutting. There were always drug shortages here, not always due to national shortage, but cost cutting. They were compounding many commercially available items to cut costs. 

There was no life/work balance because the schedule was all over the place. There were several times where I had to work until 11:30p and come in at 07:30am the next day. They'll cut your days off short more often than not, for example, you'll get off late Friday night and have to come in early Monday.

The majority of the staff were unhappy. There was high turnover with the technicians especially, so there was constantly new people that didn't know many things. These new people would end up training even newer people.

I hated what my job had become at this place so I quit and moved after I got my old job back.

Working at Rochester Regional Health provided valuable experience in Epic build, optimization, and cross-department collaboration. The projects are meaningful and directly impact patient care, which makes the work rewarding. However, advancement opportunities can be limited, and recognition for high performers doesn’t always align with effort or results. Management is approachable but often constrained by process and workload. It’s an excellent environment to build technical and clinical documentation expertise, though growth may require moving into a different system or consulting space.

My position with Rochester Regional Health was personally rewarding and positive on many levels. I interacted with employees with a variety of skills and expertise. Duties and responsibilities were
made clear, with a focus on team work and collaboration. 
A typical day at work would involve interviewing, triaging, and providing nursing care to adults with behavioral health issues such as mental health, substance abuse, or general social-emotional problems that influenced independent functioning within the community. 
After triaging a patient, if medical information gathered indicated a need for a higher level of care, the nurse communicated closely with the medical and/or psychiatric provider to arrange a transfer to an acute hospital setting for more intense medical monitoring and care.
The discharge disposition of most patients was either admit to acute inpatient unit on-site, or discharge with follow-up outpatient or inpatient services within 72 hours.

Day shift ran from 6am-2pm.  Upon arriving to work I would get my care cart ready with toiletries for the patients.  I was assigned to a group that I would have every shift and would assist each one of my patients in their morning cares.  They would then eat breakfast either by themselves or with assistance.  After breakfast some residents would go to activities or lay back down until lunch time.  During that time residents that were able to would work on ambulating or have other cares done such as nail care or some of the women would have hair appointments.  Residents would then have assistance getting ready for lunch and assisted in eating.  After lunch they were assisted either to activities or to their room to lay down.  At that time I would document their daily tasks and report anything that was not the normal for the resident.  The hardest part of the job was having patients pass away.  Even though when hired they say not to get attached it is very hard because for some of them you are their family.  The most enjoyable part of the job was getting to know each of them and things from early to mid 1900's.  It was neat learning about their lives.

I loved my job, my co-workers were the best and I made my job worthwhile. The management will lie to your face, and cross you every chance you get. Some admin staff care about their patients, and they aren't afraid to call out lazy/incompetent staff regardless of role or status. Unfortunately, a lot of admin that aren't current or former nurses, care more about the dollar amount and their bonuses. They also will sabatoge your efforts to advance or move to another career. One of my co-workers attempted to switch to a clinical role from our department, only to have our director spread rumors and wreck his chances. Our director also refuses to hire old employees, regardless of their record. We had a guy try to come back with a spotless record and was making improvements within the department and the hospital leave for a better job, and when things didn't work out and he tried to come back, our director kept contacting him informing him that he would be starting soon, only to hire another candidate, with no track record and we now have to train this guy. Great place to work, horrible leadership to work with.

There was not a typical day at the emergency department at Rochester Regional Health. Each day that I walked into work, there was a level of uncertainty. Was the department busy or was it easy-going and empty. I always would log into a computer to check to see how many patients were in my assigned pod. Then, I would decide how the rest of my shift would go. 

I learned a lot about myself and my position while working at Rochester Regional Health. I learned to be more confident in my work which ultimately made working more enjoyable. I also learned more about being a patient care tech from splinting patients to doing CPR. 

Management always wanted to make sure that their employees knew that they were valued by sending an email or making up meals and bringing it in. It made for a more positive atmosphere and made employees feel wanted. 

The hardest part about working in the emergency department is that you will never know what each shift will look like and the amount of stress you will be put under. However, I think that is my favorite part about working in emergency services. 

The most enjoyable part about work is the patient interaction and genuinely being able to help a patient who is really sick.

Top Job Titles	Average Salary
Registered nurse 13 salaries reported	$43.52 per hour
Licensed practical nurse 19 salaries reported	$26.84 per hour
Patient care technician 16 salaries reported	$18.17 per hour
Medical assistant 27 salaries reported	$19.07 per hour
Physician assistant 8 salaries reported	$126,164 per year

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