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SoundofMusic 10,244 Views

Joined Apr 7, '07. Posts: 1,013 (55% Liked) Likes: 2,160

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  • 1
    traumaRUs likes this.

    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.

  • 0

    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.

  • 1
    meanmaryjean likes this.

    Oh yes, it absolutely makes you better, and stronger .... But you're gonna go through some extraordinary pain to get there.

  • 0

    Sorry whatever you went through, Trauma -- I know it had to be hard. Agree about the emotional toll -- I think I will just be forever changed by it, down to the deepest parts of my psyche. It was a struggle to also not want to quit being an NP, to quit being a nurse. At times I do feel we are held to an impossible standard .... we just are expected not to make mistakes .....ever.

    What I never realized is the permanent nature of your discipline. If it's a public reprimand, it stays public in our state for three months, and then remains in the system available to anyone in healthcare organizations who have a need to know forever. You can hire a lawyer again to get it expunged, and there does yet another few hundred dollars.

    If you LOSE a license, forget it. It stays on the roles for 50 years and can effect your ability to obtain any other type of job which requires any sort of license.

  • 25
    adreamdeferred, KCMnurse, Stepney, and 22 others like this.

    Hello:

    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.

  • 0

    Well, I am going through something similar now. Don't have the reprimand yet, but the attorney I hired said it's a 50/50 chance. My error was alleged to be falsifying information. And I did falsify something, although at the time it did not seem like a huge matter to me, and I was trying to satisfy the demands of a patient at the time. I made a stupid mistake. I meant no harm, but it was definitely stupid and careless of me. So, in all of this, I have done two things:

    1. I have taken full responsibility for my action, have taken CME's and done everything possible to fully understand the why's and how's of my violation.
    2. I have admitted it to the board, and to the the new employer I have recently been hired by.

    In doing all of this, as unbelievably hard and mortifying as it was, I learned fully from the error, and I operated out of full disclosure and honesty going forward. Believe me, THIS is the best policy for all involved. Once I explained what happened at an interview, the doctor basically understood and felt I would do better working for him, as his office would provide better admin support. From there on, the problem has just gotten smaller and smaller.

    Yes, it may be on my license for anyone to view, but I will be glad to tell my story in the future.

    Everyone, and I mean EVERYONE makes mistakes. I had no ill intent when I made my error, but I had to understand that what I did WAS wrong and unacceptable to practice. Sometimes you just have to learn the hard way. If, however, you are the type of person who did or does have an extremely ill intent when making an error, perhaps you don't need to be in practice ....I mean, we do have an ethical standard to follow and you have to want the best for your patients and for your employer.

    So, you learn, you move on, you don't let it entirely define you, and you get whatever job you can. then you work hard in that job and recover your practice as much as possible.

    But honestly is the best policy -- full disclose everything to everyone who has the right to know (not to anyone else, however -- it's your business only), and go from there.

    I feel after my experience that folks are far more forgiving than you'd expect, especially if you are honest with them. While I'm still going through everything now, I feel I will likely be a stronger provider in the long run.

    Oh, and don't set foot in any practice without your own personal malpractice policy. Remember, it also pays your legal fees if you happen to be reported for something, and/or have a claim against you. Hiring any lawyer to start runs at least $2500 and up.

  • 4

    Well, I graduated at 50 from NP school. I've been doing it for about 3-4 years now and I will say -- it's demanding. But you aren't lifting 700 pound people anymore, pushing or pulling, so it's physically easier. That said, you must know that you will still work very hard as an NP -- just in a different way.

    Overall I'm glad I did it, with mixed feelings. I miss the camaraderie of nursing, but I enjoy the intellectual stimulation, working with great doctors, and the respect and extra pay it brings. Working with and diagnosing patients is hard, though -- it takes studying and reading that NEVER ends ...ever, because it's always all changing every five minutes. It takes skill to deal with patients, their personalities, their complaints, their badgering. You really need to have a backbone at times. And you have to be entirely ethical and take great care with documentation.

    If you can do all that at an older age, then go for it. It's not really an age thing -- it's a skill thing. Some people can manage all that, have tons of energy, skill and brainpower, no matter what their age. If you were 35 and had all the energy, yet didn't have the brains or interpersonal skill, or discipline to learn and continuously study to be an NP, then you would not be an NP. What I'm saying, is age just isn't everything .... If you have what it takes to be an NP, then you have what it takes, no matter what your age. Hope that makes sense.

  • 1
    em3120 likes this.

    I'd say that once you get out there, anxiety can be tough, but what you truly experience more often is just stress -- for a million reasons -- mostly just as you race against the clock trying to get so many tasks done. So, you spend a lot of time working on time management skills -- and it's just something you have to practice -- I always had to tell
    myself -- just keep putting one foot in front of the other. If I had a bad day, I'd just learn from
    it and go back the next day ..... and always try to have a plan .... for the day. If you have a plan, you just work towards trying to stick to it .... anxiety just comes and goes -- and eventually you'll learn who you can work with and before you know it, you'll be having a blast ..... no worries -- you will likely be a great nurse, because you're cautious and you get that it's not a joke -- it's real -- and you'll be super careful and conscientious ... all the hallmarks of a great nurse.

  • 2
    MommaFNP2012 and JeanettePNP like this.

    I just graduated last year at that magic age of 49 1/2. By the time I got hired I was one month away from being 50. They just didn't seem to care. It was all about my experience as a nurse. I think companies now like to hire a more diverse group of people. I try to look good for my age ... not totally skinny, but I keep my hair up, dress youthful, etc.

    And now my "maturity" helps me, just like it did when I was a nurse. (I didn't get my BSN until I was 44).

    I do get tired, even as an NP. NP work can also be stressful, but in a different, less physical way. I still just work a less than 40 hour per week work week.

    I'm glad I did it. I feel I get a tad more respect as an NP, vs. a nurse. Sad, but true. I like the brainwork and working with docs, other colleagues, etc. It feels like a more grown up type of job!

    Good luck. You'll still be in your 50's, even if you don't go back to school ...so might as well go back to school!

    I feel it has energized me and given me purpose, and that I'm doing a lot of good in the world. My kids are also grown ...at least 2 of them are. Still have a 12 year old at home, so I'll never have an empty nest and I'll probably also never retire!

    Good luck -- go for it - let's show them that women over 50 are worth hiring!!!!

  • 0

    Hello -- I'm a FNP, with about one year experience working at a Target Clinic. Looking to move down to Raleigh within the next year or two. Can anyone speak to the employment landscape for FNP's in the Raleigh area?

    Any info on directions to go would be appreciated. I'd love to continue to work for Target part time or as a float, (or not) and perhaps also branch out into another area of practice. Any info would be appreciated.

  • 1
    MC1906 likes this.

    I think I took it before the change, but I doubt it matters. Another thing that really helps is doing ALL the free practice questions on the ancc web site. They are there -- just look for them -- do them ALL, the ones before and after the test changes.

    Try not to be nervous, really. It's hard, but if you prepare, you will do fine.

    What helped me was buying the yellow ancc book, reading as much as possible, doing their practice questions and the free ones. A colleague of mine and I also bought a package of free practices questions from ancc and split the cost.

    Know a little about Hippa, medicare/Medicaid, theories ...honestly, the yellow ancc book helped me the most, and it's a great resource to keep afterwards in practice.

    Good luck ...

  • 0

    I guess I waited about two months or so to take the ANCC. I started studying about 2 weeks after graduation, and I felt I pretty much took the max amount of time to study based on reports from my peers. That said, I have children and a busy home life, so I had to squeeze in study time whenever I could, and I just don't have hours and hours to devote to it ...so that probably dragged it out for me.

    I am not aware of the option to pay extra to expedite the process. I think that stinks that they try to extort even more money out of anyone ...they ARE extremely slow in their process ...but to ask for more to speed it up? That just annoys me, lol.

    I know employers want you to "speed up," but you get this from everyone. I started a job recently, and started earlier than I was really ready for ...as a result, I am SO tired and just struggling to catch up on sleep and just general relaxation time, of which I have had NONE since I graduated.

    If you can, ask them to be patient ...do it at the pace that is right for you. You can't start a job burnt out ..that is what I've done and I'm regretting it. After your boards, take a week off if you can ... you will need it. It was a very draining and emotional experience for me and I just wish I'd told the world to WAIT a bit before I started working again. I guess i'm thankful to have work, but I'm TIRED!

    Good luck and enjoy your little one most of all!

  • 1
    MC1906 likes this.

    Hey there -- was trying to get back to this post to let cougdog know I passed the ANCC! Even got a new job, too! lol.

    ALL your suggestions were fantastic ..I ended up buying the ancc yellow book, and so glad I did ...what a great resource!

    The family NP prep was also fantastic ...if only for the way it simulates the online test taking experience.

    I knew a lot of the questions right off the bat ...and of course, some of them seemed like they came from outer space and I had no idea how to answer ...but something in me just knew how to reason through it, because I just did so many darn practice questions!

    Anyway, thanks again for taking the time to post and help out your fellow NP's around the country!

  • 0

    Just received an offer from a GI practice, and I am a new grad, which is nice, as the market is so tight. Wished I could find a strict family practice type position, but there just don't seem to be any openings that don't ask for 1-2 years of experience.

    Doc is great, practice is really close to my house, and the hours are great. Job seems easy ...mainly doing H&P's, and seeing pts at the hospital after their surgeries, etc.

    Pay is on the low side, but hubby makes a decent salary, so I'm not clamoring for a huge salary to start ...

    My question is, can I at least eventually move into more family practice type roles as time goes on? Or will I get pidgeon holed? Don't really want to do GI for the rest of my life, but I don't mind starting out and learning ... part of me always did want to do a speciality, for the narrower focus and perhaps a bit less stress ...I don't know what to think.

    Wish our market wasn't so tight ...it's just saturated where I live.

  • 0

    Had it filled out ..sent it in WITH my paperwork myself, but they said that was fine also ...they have my stuff and have sent me an email that it is under review ...it's just baloney. I went to Marymount Univ which is right near Bethesda where they are ... if they can't figure out which courses we took, then there is something wrong ...


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