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SoundofMusic 11,910 Views

Joined Apr 7, '07. Posts: 1,029 (55% Liked) Likes: 2,199

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  • Jul 29

    Quote from SoundofMusic
    even the PA's I work with were far better prepared. Now that I'm here, I wish I'd gone to PA school. A nurse turned PA is a nice combo -- you've got the nursing background, but get the medical training to prepare you more thoroughly.
    Definitely agree! I feel like the only advantage to being an NP over PA is the potential for independent practice, which the vast majority of NP's don't utilize anyway. PA's can switch specialties so much easier without additional schooling. And admission criteria is stricter. However I think both are/will be subjected to over-saturation soon. Most PA's I've worked with just seem more sound/confident in their clinical judgement; although, there are some outstanding NP's out there too.

  • Jul 29

    In an exam room with a patient and his overbearing wife. She demands that he needs antibiotics and I tell her. "it ain't happening!"

    I get a rush every time....

  • Jul 18

    I am not a prude either. I also hate corporate anything that includes scripting.

    That said, it would grate on my nerves. Loud people already grate on me even out in a social setting. Yet I still like a good atmosphere and laughs when appropriate, just not like what your saying.

  • Jul 17

    Speaking as someone who does medical malpractice claims for a living, I endorse these comments. I would also point out that the malpractice insurer, your employer, or the state medical or nursing associations may offer what we call 'second victim' support activities, ranging from speaking with a therapist or peer, to group support meetings. I have run many of these activities, and they can be very helpful.

  • Jul 17

    Over on the NP forum, we’ve been discussing lawsuits - this is something very real and worrisome for providers. While nurses can get sued; most often they are dragged into a suit along with others; while APRNs by virtue of being providers can “stand alone” and take the brunt of the lawsuit themselves.

    Unfortunately I can speak to this firsthand. I’ve been an APRN for over ten years now and I still shudder when I remember the incident that completely changed my practice. For privacy sake, I will keep it general. I made a prescribing error.

    So...began the odyssey of lawyer visits, depositions, court appearances, meetings with my boss, with the practice president, and many many years of endless waiting wondering: would I have a job, would I have a license, would my house be taken, my wages from whatever job I could ever get be garnished, would I have to declare bankruptcy and on and on my imagination wandered?

    It was very stressful on me, my family, my co-workers. And oh yeah...did I say you can’t talk about it to anyone??? Me...who talks all day long! To worry in silence for many years was another stressor.

    In the end...an out of court settlement was reached for what I considered to be a lot of money but for what the attorneys patted themselves on the back for negotiating. I came out with my job intact.

    On the day I signed the settlement, I received the final blow - oh yeah didn’t we tell you that this has to be reported to the board of nursing and the National Practitioners Data Bank? Uh...what???

    More worries, more time...in the end after I hired an administrative law attorney to appear with me for the BON hearing, my license was cleared. My name does appear in the NPDB and will always show a payout for a malpractice suit. However, it is possible to get a job with this and it is possible to get credentialed with this on your record.

    Some things I’ve learned along this bumpy road:


    1. Always be scrupulously honest with everything. If you are in the NPDB - everyone will find out anyway.
    2. Keep your own malpractice insurance. Although your practice will cover your lawsuit expenses, it will usually not cover your licensure protection and you will need that if you are found at fault.
    3. If you find yourself being sued, realize this is a long haul adventure. Get yourself some support which can be difficult as you will be told “don’t talk to anyone.” You can talk to clergy, or a counselor or your spouse with the expectation of privacy as long as you don’t discuss the case itself but rather your feelings and emotions.
    4. Be kind to yourself - this is stressful. It can happen to anyone at anytime. It does NOT mean you are a bad person, a bad provider or that you made a poor career choice.
    5. We always want to do the best for our patients but we are human - we do make mistakes - sometimes our mistakes don’t cause harm, but unfortunately sometimes they do.


    And to those of you reading this saying, “that would never happen to me, I’m too cautious, I’m too smart, I would never harm a patient,” until ten year ago I was thinking the same thing….

    It happens….be prepared…

    And...if it happens to a colleague...please be very supportive. Realize they can’t discuss the details but let them know you care, invite them for lunch, remind them of all the positives they bring to their job. And...remember to keep supporting them thru the long haul - realize when they are gone for a court date, deposition, meeting and touch base with them and let them know you care.

    This is a caring profession but sometimes we are least kind to each other...

  • Jul 10

    Thank you again for enlightening many of us on this subject. Ironically as a new grad RN I did purchase my own 1 year insurance policy on the advice of my critical care professor, because he scared the dickens out of us with stories, yet as an APRN we walk into job interviews assuming that the malpractice insurance they are offering as part of their "stellar competitive package" will always be there to provide relief if ever found in this situation. It is definitely disheartening to learn that the health care entity can decide you practiced out of scope or didn't follow guidelines and choose not to cover you with your work malpractice. Because of your post I have started researching malpractice insurance for myself on the side, because as you demonstrated this can happen to anyone and the companies are out for themselves. I do have a friend working as an APRN for a county health dept that had this exact thing occur and she is leaving because they didnt back her even though she did nothing wrong and it was a potential hazardous SE from the procedure.
    I appreciate that we all come together and share honest stories form practice with one another on here. Its hard to connect with colleagues in the workplace and often times NP and PA's dont want to openly discuss these things. This was very sobering and I thank you for sharing your experience. Good luck with your new job and remember that this was just a bump in the road and it does NOT define you as an NP.

  • Jul 9

    Thanks for this post. I work in retail and your post is a sobering reminder that these companies certainly don't care about their staff to any degree. I've noticed recently that the chart audit team has become much more active and is sending nastygrams about the most minute things. I practice with my patients' best interests in mind but perhaps I should scale back to protect myself. It's unfortunate is has to be that way, to only practice 'inside the cookie cutter' or be at risk.

  • Jul 8

    Thanks for a very sobering post. The fallout from being reported to the BON and/or terminated has huge repercussions. For me, as it seems for you, the emotional toll it takes on a practitioner is unbelievable. Providers who make mistakes are often the second victim. And for those of you who still sit on your high horse (as I once did), it CAN HAPPEN TO YOU! No one is bulletproof.

    I've been sued and a claim was paid out on my behalf because of an error I made.

    I wish the students and new APNs could understand that though we are paid well, have great benefits and respect, that when push comes to shove, you WILL stand alone.

  • Jun 13

    OP: Thanks for sharing. Very humble and helpful of you. I am sorry you have to endure this ordeal, and I am proud of the person you are for wanting to share it in hopes of helping others.

  • Jun 13

    OP: Powerful post. But everything you said pertains to every level of nursing, not just advanced practitioners. Getting fired was the most emotionally devastating thing that ever happened to me- and I learned so much from it. It made me a better nurse.

    Thank you for sharing this.

  • May 23

    As a new NP this is such an eye opener to me and I thank you for this post. I never thought about needing my own malpractice insurance as my company provided a policy. I will now be looking into my own policy. I thank you again.

  • May 22

    Thank you for sharing your experience. I often think about what incredible responsibility is on my shoulders in my work position. It does not take much at all to make an error, especially with an electronic record where clicking one wrong button can mean something very different gets ordered. I am sorry for your struggle and I hope you are on the upswing now.

  • May 22

    Quote from SoundofMusic
    Oh gosh ... a travel nurse ought to have a triple policy.... so much risk, especially also not knowing your staff all that well. I have to wonder about the lawyers, too. Mine never asked if I had insurance -- but I wish I had.
    The facility will throw the travel nurse under the bus any chance they get!

  • May 22

    While I'm not an APN, this really validates my feelings about holding malpractice insurance. I've spoken to a few nurses out there and I keep hearing, "It increases your likelihood of being sued because the lawyers find out who is insured. " Thus, pulling a Jerry McGuire and "show me the money." I feel it's better to be safer than sorry and I'm a travel nurse so I'm put in very unfamiliar situations all the time. Sorry for the struggle but I appreciate your thoughts.

  • May 22

    @SOM - yes, any discipline stays on our state's BON site FOREVER and it flashes a bright RED like some sort of beacon when you do licensure lookup.


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