Becoming an NP after discipline

SkyIsTheLimit86, BSN · Apr 4

Shisa2222 said:

Is it going to be hard to find preceptors if you had prior disciplinary action on your RN license?

Even if I get into a FNP program, get my RN monitoring action cleared, will it be easy for me to find jobs as FNP?

I graduate next month with my PMHNP. It wasn't hard for me to find preceptors, but it can be for some. My history of being disciplined wasn't an issue personally. I still have to face licensing so I think that might be a bit complicated.

NurseJackie69 · Apr 5

SkyIsTheLimit86 said:

I graduate next month with my PMHNP. It wasn't hard for me to find preceptors, but it can be for some. My history of being disciplined wasn't an issue personally. I still have to face licensing so I think that might be a bit complicated.

Licensing with the state board will be zero issue ASSUMING.....keyword......ASSUMING the BON knows about your past and you are currently under consent order. What will or what could be an issue for SOME, not all...but SOME? Your national certifying body such as the ANCC or AANPCB as sometimes, these organizations will Still certify you, but put your certification on a "Conditional Certification," which lasts until your consent order is done and your monitoring is over. It's not a big deal. The 2nd potential issue comes with again, SOME, not all, but SOME credentialing facilities getting you credentialed because they know there can POSSIBLY, not always, but POSSIBLY be issues with Insurance Reinbursement. If....If....this is a problem, it would more than likely be a problem at a Smaller Private Facility and LESS likely of a problem at a larger Inpatient facility which has a massive provider/insurance reimbursement pool.

As for getting your state BON APRN/NP license, that should be no issue. As for getting a job and getting a job means....the facility and your peers and the Docs are happy to have you and want to hire you and this will be no major problem 8 out 10 times. But, IF there are problems, they will rest in getting credentialed at the facility and getting past human resources/risk management department who in some cases would argue that you are not worth the hassle of fighting insurance companies for reimbursement, and again, a possible CONDITIONAL national certification instead of FULL certification which comes from your national certifying body, but this is not a huge deal either way in MOST cases.

Lastly, if you land a job at a place that doesn't pay for your malpractice (which means you pay for your own) expect to pay a lot more while you are still under consent order/monitoring. In my opinion, for NPS, your best bet is starting with a large hospital system which usually pays your malpractice and reimbursement for insurance is not as big of a problem in this setting compared to a small outpatient office. This is absolutely not to say that NPS can't land jobs at outpatient clinics when starting or returning yo practice while in monitoring/recovery/consent order. I'm just saying there is often less hassle with larger hospitals compared to smaller outpatient clinics.

For CRNAs, it's the opposite. They often return to practice is smaller GI clinics or eye clinics where they can be watched and usually in a medical supervision type of model where the majority of the reimbursement comes from the Anesthesiologist so the insurance thing isn't as big of a deal and the in-hospital setting is often unwilling to accept the risk of a CRNA first returning to practice as these places are bigger and the CRNA can't be watched as closely. Additionally, CRNAs do nerve blocks and epidural at many hospitals and they can bill/get reimbursement for this and the hospital knows that reimbursement is an issue.

Shisa2222 · Apr 9

Even if I get into a FNP program, get my RN monitoring action cleared, will it be easy for me to find jobs as FNP?

NurseJackie69 · Apr 9

Shisa2222 said:

Even if I get into a FNP program, get my RN monitoring action cleared, will it be easy for me to find jobs as FNP?

"Find Job" is your question. "Find Job" means many things. It means..

1. The Physicians and NP's at the facility are OK with hiring you and giving you a chance with your background history. For NP's, roughly half will say yes and half will say no, so if it's 50%, I still consider that pretty dang easy. It's a bit more work and you might get a bit more "No's" compared to someone who doesn't have a past, but 50% is pretty good in my opinion. Compare that to an RN who is returning to practice and trying to land that first job and it's closer to 90% that will say, "No."

2. "Find Job" doesn't just mean the above paragraph. It also means.....after step 1 above is accomplished, Will the Human Resources/Risk Management Division at that hospital ALLOW the request of the Physicians/NP's above to HIRE you. These people have power and your biggest obstacle is this step, NOT step one. Most RN's, not NP's, but most RN's who are returning to practice don't know this and they think, "the Chief Nurse at xyz wouldn't hire me," when in fact, most of the resistance likely didn't come from the nursing part at all, but it came from human resources/risk management, but the nurse ASSumes it's the "nursing department" that didn't hire her, when in most reality, the nursing part Chief and Unit Manager were probably beating down the door or going to bat for the nurse against the human resources/risk management department. As an NP, you will still be able to accomplish this hurdle and it's Not easy. This lowers the former 50% above in paragraph one down to about a total of 25%. 25% still ain't bad. That means plenty of jobs, just more work. Remember this, after you get your first job as an NP, after one year of work and your monitoring contract is fully over and license restored, the 25% number quoted above down skyrockets to about 75%. Are these numbers exact? Of course not. I'm just giving you a point of reference or general idea.

3. "Find Job" also means accomplishing step 1 and steps 2 above AND....malpractice insurance. Yes, you will find it. If you work at a hospital, you will be covered under their plan, but this is where the risk management/human resources/bean counter people come in. Still, if you accomplish steps 1 and 2 above, this step can still be done. If you are working in an outpatient setting that doesn't pay for their providers malpractice insurance (there are many of them, roughly half of them pay and half make the providers pay for it themselves) then you WILL get insured, but expect to pay double what you would or even 2.5 times that amount for the first 3 or 4 years. Understand that if you work at an outpatient place that doesn't pay for the NP's malpractice insurance, you generally are paid at a higher salary or hourly rate and if you work at a place that pays your malpractice, you generally (not always, but generally) are paid at a slightly lower hourly or salary rate.

4. Final Step. Your National Certification for your NP. Advanced Practice Nurses have National Credentialing Organizations. These are the organizations that Certify you. If you are still under a board consent order/in monitoring when you take your national exam to become an NP, your National Certification will say something to the effect of Being Certified, but "Conditional Certification" instead of "Full Certification." The very day you are done with monitoring and no longer under consent order from the BON, you immediately will be "Fully Certified." This matters slightly regarding your malpractice insurance. Malpractice Carriers (assuming you pay your own) will charge more. So for example, if an an average NP pays 2,500 per year for Malpractice, with your background and being only "Conditionally Certified" you might end up paying 7500 for the first year of work, and when you get Fully Certified, that will drop to about 5000. Again, are these numbers exact? Of course not. I'm just giving you a frame of reference. After you have worked 3 years and are long out of monitoring and all is well and life is back to normal for 3 years and you have worked as an NP for 3 years without problems, your malpractice drops to about 3500. You are generally ALWAYS going to pay more for the rest of your practice life because of your background, but NOT much more after your consent order is done, you are Fully Certified, and you have worked about 3 years. Is the increase in malpractice for you a big deal? I don't think it is considering you are about to add thousands to your annual pay the day you get a job as an NP.

Hope this helps. Go for NP. You WILL get a job and the entire process is nowhere near as hard compared to getting that First Job back in nursing as an RN after getting in trouble. Are there some hurdles? Sure, but they are easily overcome and there are hundreds of RN's who are/were in monitoring and completed their NP's and they have a past, but they are working, found jobs, and are doing well.

Shisa2222 · Apr 9

What if the disciplinary action on RN license occurred due to some dismissal from university due to misunderstanding with prior preceptor who reported the student who was innocent.

NurseJackie69 · Apr 10

Shisa2222 said:

What if the disciplinary action on RN license occurred due to some dismissal from university due to misunderstanding with prior preceptor who reported the student who was innocent.

The future job (the human resources officer) at the place you are applying for and the malpractice insurance company that sets in New York or Chicago isn't interested on whether you are "guilty or innocent" or your story. They are interested in one thing......is their any disciplinary infractions on your license related somehow or someway to drugs, alcohol, or mental health. If the answer is yes, then they perceive you as a risk. Does this way of thinking and perception make it morally right or OK? It sure does NOT, but that's simply the way it is

GlassHouse · Apr 10

NurseJackie69 said:

The future job (the human resources officer) at the place you are applying for and the malpractice insurance company that sets in New York or Chicago isn't interested on whether you are "guilty or innocent" or your story. They are interested in one thing......is their any disciplinary infractions on your license related somehow or someway to drugs, alcohol, or mental health. If the answer is yes, then they perceive you as a risk. Does this way of thinking and perception make it morally right or OK? It sure does NOT, but that's simply the way it is

I would agree with this except change it to, "they are interested in if your current license is active without restrictions"

past discipline is not as concerning

they care about the current

btw I got my NP and have been working for 3 years no issues. Past discipline (probation) on RN license for dui /risk of further drug and alcohol abuse

please keep in mind it's all a case by case basis on if the licensing board will grant NP based on RN history

but once you are clear and get that NP license, there should be zero issues going forward

Shisa2222 · Apr 10

So if the dismissal from university that happened due to honor code violation at clinical (non criminal :not involving drugs/alcohol/or mental health), does it still needs to get reported to BON?

GlassHouse · Apr 10

Shisa2222 said:

So if the dismissal from university that happened due to honor code violation at clinical (non criminal :not involving drugs/alcohol/or mental health), does it still needs to get reported to BON?

If you're asking if you have to report a dismissal from a university on your BON application (RN or NP) - that's totally determined by individual state boards of nursing. They might ask it on your app they might not I don't know.

you could lie. You could not. It's your call.

NurseJackie69 · Apr 10

Shisa2222 said:

So if the dismissal from university that happened due to honor code violation at clinical (non criminal :not involving drugs/alcohol/or mental health), does it still needs to get reported to BON?

No. Most applications do not ask this and they do not have any way of knowing. This dismissal could still be chalked up to academics and that is easy to defend because you were a student in a student role. You weren't convicted of a crime and the BON has no chance of finding out and if they did, you can defend that easily because you were dismissed for something related to academics. Me personally, I wouldn't bring it up to the BON.