SoundofMusic 10,532 Views
Joined Apr 7, '07.
Posts: 1,017 (55% Liked)
Thank you -- that's incredibly nice of you to say. I really am grateful for the non-condemning attitudes here -- I wasn't sure what would happen if I shared what I could, but it's been so painful I just can't stand the thought of anyone else going through it.
We do have incredible responsibility as nurses, and even more as NP's. And it's just so easy to miscommunicate with patients. I'd just say -- always make sure you and they are on the same sheet of music -- fully explain, fully educate, and document that you did. Same goes for insurance charges also .... because they will come back more than anything if they're upset about a charge.
Wanted to post this, as a way to share my story, and help another practitioner avoid what I've gone through over the past few months. Many of you out there are probably too smart to land where I did, but then again, many out there who are new or who are cruising along just not thinking about it may benefit from my advice.
Earlier this year I was involved in a patient dispute, was terminated from my position, and the company reported me to the Board of Nursing.
There was no harm done to the patient -- more of a charting/billing issue in which I made an incredibly dumb mistake while working in a very pressured position in a retail setting and had zero administrative support to fall back on.
Anyway, a few lessons here I'd like to share:
1. FIRST AND FOREMOST -- get a malpractice policy and keep it current at all times, every minute while you are working. The malpractice policy will come in handy when you have to hire a lawyer to represent you in any dealings with the BON, even if you are innocent. Remember, ANYONE can report you to the BON -- a co-worker, a patient, a "friend," a doctor ....anyone.
2. Don't panic, and get a lawyer. There are lawyers out there who do this for a living and will counsel and advise you on how to present yourself in the best light to the investigators and/or board. Be prepared to fork out at least $2500 to start to retain them. It will go up from there if there are additional needs.
3. If you're in a bad job where you are not supported, or perhaps not really getting along with people you work with, or are unsure of their support, LEAVE as soon as possible and find a better job. Even if you are being paid well with outstanding benefits, etc. There is sometimes so much risk in what we do -- and patients are unpredictable and have the entitlement mentality going in many cases. Don't do patients any favors ...follow the policies of your employer at all times. Do not stay in a job where you feel you are being asked to do more than you can handle -- eventually something can and will happen. Call for help when you need it.
4. If you make an error, do NOT expect the company to come to your aid. They will throw you "under the bus" so to speak very quickly. And rightly so -- they have a company to uphold, and you are just not the priority to them. Thus, the malpractice policy, again -- very important.
5. Take care of yourself -- get counseling, get therapy -- whatever it takes. It's an intensely rough situation to go through -- you may be dealing with the loss of your income, the loss of your colleague support, the loss of your identity -- extremely rough thing. Was for me -- it just about killed me, literally. Luckily I had a wonderful medical provider (an NP who is fantastic) who recommended various steps for me to talk to get my equilibrium back, both mentally and professionally. Luckily I also have a wonderful spouse, family and friends who were there to support me. Luckily, my husband provides an income that we can get by on without my income. If this is not the case for you, you REALLY need to hear this.
6. Be truthful, and tell the story. Tell every detail, and don't try to cover up anything that you did. Yes, it will difficult and mortifying at times to admit what you did ...but this is what I did -- and in the end, the new doctor I will be working with knows the entire details of my story, and has been completely understanding. I had to go on many many interviews after being fired, however, and some of them were not pretty because I was just not ready to present myself properly. I also had to explain to the malpractice company what had happened to be cleared by them. I may receive a "reprimand" to my license soon, and it will follow me forever, unless I get it expunged from my record.
7. Know that you are in an extremely demanding profession and that you are held to an a very high standard -- higher than an RN. Go on the BON site and do a little CME for yourself -- look at the discipline process - look at the various types of discipline that can result from your errors. (for example, Getting a DUI is an instant LOSS of your license, etc.) Know that once you receive a public discipline, it will not only be reported to the state you worked in, but any other state in which you have a license. It will be public, and it will also be sent to a national data bank where anyone will be able to see it as long as you have it. It may make getting certain jobs very difficult.
8. While you may love and admire your colleagues, they are not your friends. They are sort of like that company you work for ....they'll help you to a degree, but when push comes to shove, everyone will have their own best interests in mind. You WILL stand alone to defend yourself. Be good, be friendly, but always keep that professional boundary with them.
9. Do the best job you can and do try to make a few contacts at your job who you may need to use later as references. I am thankful that I had a very good relationship with some of my colleagues and that they were absolutely there to support me through this ordeal. But that's because I always helped them when I could, and I tried to be a decent person at work.
Now that I have somewhat survived this ordeal and looking back, I'm not sure I'd change a thing -- I learned so much -- learned about the reality of the profession, learned about myself and who I am. Got knocked down from my very high horse (and I was on a high one -- I was a top clinician and producer for my organization and thought I could do no wrong). Learned how to handle a tough situation, learned the law, and learned that there are better jobs out there. Most of all, I learned that TRUTH is key ....be truthful in everything you do, even if it means letting a patient yell or get a little mad. Your license and your livelihood is at risk -- and really nothing is worth that, ever.
And lastly, do not affix your identity to this job. For me, I had to re-learn that my worth as a person is not defined by what I do, or how much money I make, etc. This is probably one of the hardest things I had to re-learn and face. Love your job, but love your God, your spouse, your family, your life that make life worth living ... these are the things that will ultimately sustain you in the end.
Thanks so much- it got me out of a bad job, that is for sure. I did get hired by a new employer and am doing fine!
I am about seven months off orientation now, and it seems I'm still making mistakes, even worse ones. Every day I walk in, there seems to be something that just gets thrown at me and there just aren't the friendly preceptors around now -- just the nasty old seasoned nurses who aren't too nice about my mistakes. I get tired of it, but try to go on and chalk it up to learning and "doing the time." Even though the experiences are trying, I'm learning from them and hope to fall back on it at some point.
I was horrible in a code situation last night, and I just feel like the biggest dope this a.m. I was surrounded by all the experienced hot shots who basically reduced me to an errand girl in a code for MY patient -- ****** me off. They just all seem to come in and take over and it can make you feel like THEY dont' trust YOU to know what you're doing. The problem is -- that vibe actually reduces my confidence and I start screwing up -- I hate it when that happens.
I just wish over and over the "seasoned" nurses would cut new nurses some fricking SLACK. How can we automatically perform brilliantly in every situation when we haven't even lived through them yet? There is often "teaching" on skills in theory, but no real life experience taught until you're knee deep in crap --
I dont' know the answer -- it's just incredibly painful to be climbing up that learning curve!
Very kind of you to say! I would never make the same mistake again, that I can tell you!
Very rough, isn't it? I can't even explain it .... it's just a total threat and assault on your personal self image, your professional and personal identity ..... a threat to your overall livelihood. If you have actually harmed a patient intentionally that's one thing, but unintentional errors due to poor judgement which result in no harm .... I really do feel the punishment is a bit extreme in the sense that it is public and stays in data banks, etc.
And as far as I know -- record of these errors stay with us forever, unless we pay more fines to have them expunged. In my opinion, this should change if a nurse or provider can prove they've taken steps to remediate and/or have passed a certain period of time without any similar violation ..... but it sticks with you.
Well, without sharing any personal details, I was notified of the report a full two months after the incident. This was shocking to me as Inthought perhaps they had just tossed it, but the wheels of the boards turn slowly. Once you are contacted by the board they give you a couple of weeks to respond. Hopefully at this point you have a lawyer giving you guidance and sending the documents and communicating to the board for you. The board investigator then takes a look at the response and determines if a violation occurred. In my state, I would have to sign something that basically says I will accept the board's discipline whatever that may be. I personally am hoping for a lesser outcome such as a counseling letter. Every state may be somewhat different. It's my understanding that once I sign the consent order, it could take months to hear from the board as to their final decision. It's truly a nerve wracking process, but in my case, I did find another job with an employer who heard my story and hired me anyway. I'm very grateful for that, but it was pretty mortifying to have to explain myself.
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