Disciplinary Action?

Nurses Professionalism

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I'll try to explain this as best I can. I am a new nurse. I've been a working RN since February at a rehab facility. Technically, that was not my fist job. Right out of nursing school, I was hired by a major hospital in Ohio. I went through orientation, drug testing, physicals without any trouble. Next was the PBDS assessment. Performance based development system - where we were asked to provide a medical diagnosis to a set of conditions: video scenarios with some backing vitals, conditions, etc. I was to understand that the test was to tailor my training. When I did not pass it, I was terminated and was told to go out, get some experience and re-apply. Behind the scenes, the hospital in question reported us (all that did not pass the PBDS) to the board of nursing, saying that we did not practice in a safe manner and are subject to disciplinary action. Seriously? So I was offered a shot at doing some extra study in the manner of CEU's to improve my ability. My ability to practice outside my scope (in my viewpoint - we do not do medical diagnoses). As part of this offer, my license would not be view-able online as active for one year. All because I was hired by this particular hospital. I want to know what "possible disciplinary action" constitutes - I cannot get anyone to tell me what that is. I did not harm anyone, I did not steal medications, I did not commit any torts, negligent actions, or have any dependency issues. I go to work every day and help people recover. And I am good at it. My residents love me and what I do for them. I was an engineer for 20 years before deciding to make the career change and it's working. Things would be great if I had not applied at that particular hospital. Do I submit to the performance improvement program or should I let the board decide my fate without knowing the potential outcome? I just want it all to go away but that does not seem to be a possibility.

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Specializes in Nursing Professional Development.

Who "offered you a shot at some extra study" ? Was that the State Board of Nursing? Has the State Board already ruled on your case? I don't understand exactly where you are in the process.

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You've just found yourself in the middle of a minefield. There's a discussion of PBDS here:

https://allnurses.com/nursing-educators-faculty/performance-based-development-393490.html

That begins with this:

Few subjects have stirred up as much controversy within the nursing community as the performance based development system (pbds) nursing "competency" assessment. What exactly is this test and why is it so controversial?

Performance-based development system (pbds) is the creation of dorothy del bueno, the founder of performance management services. Pbds is a commercial competency exam that can be individually tailored to evaluate hospital personnel. In practice, it is almost exclusively used to test the competency of nurses. At least 500 hospitals nationwide currently use the pbds system.

You might also want to read this travel nurse website:

The Performance Based Development System assessment tool affects travel nurses | Healthcare Traveler

Google will show quite a few more links.

The next might be relevant to your situation. Note the "most new graduates." That paper is from the creator of the test.

Aggregate results for competency assessment of new registered nurses using the Performance Based Development System indicate that most new graduates do not meet expectations for entry-level clinical judgment ability. This article discusses implications for nursing education and offers recommendations for developing clinical judgment in nursing students.

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Del Bueno seems to be someone with a mission, one that could prove quite lucrative for her. That can be dangerous.

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My next remark is a touchy one. Can you document this remark: "[COLOR=#000000]Behind the scenes, the hospital in question reported us (all that did not pass the PBDS) to the board of nursing, saying that we did not practice in a safe manner and are subject to disciplinary action."[/COLOR]

[COLOR=#000000]If so, you might want to consult a lawyer, since that certainly seems to constitute a serious case of libel. Failing a test isn't a failure to "practice in a safe manner" nor does it seem you were "subject to disciplinary action" for anything you did. Go to court, and they'd have to deliver those documents.[/COLOR]

[COLOR=#000000]For a parallel, imagine that you're home one evening and drinking a bit too much. There's a knock at the door and a state trooper proceeds to come in and administer the standard sobriety tests for drivers. Failing that test, he then writes you out a ticket as if you'd been driving. What you've described is a bit like that. No wrong deeds, just a failed test in a situation devoid of any harm done.[/COLOR]

[COLOR=#000000]Just keep in mind that, as a nurse, suing a hospital might not be a good career move, so don't let a lawyer push you into it. It'd might be best done under the cover of a class action lawsuit that attempts to sign up all those who've been so treated this way back as far as the statue of limitations allows.

Indeed, I did graduate work in medical ethics at the University of Washington medical school, and I'm left wondering why the hospital's lawyer would let the hospital put itself at risk by taking such measures. Not hiring/firing based on a failed test is the hospital's prerogative. Trying to wreck your nursing career is another matter. And any hospital that wants to make passing that test a requirement can administer the test. There's no need use the state board of nursing and deceptive accusations of "disciplinary action" as an end around that.

[/COLOR]

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[COLOR=#000000]One addition remark. Almost all tests can be gamed, including this one. A quick look suggests there are online resources to do that for this one. That'd probably be the least controversy-prone way to get past the hurdle. Learn the game, play the game, and laugh at it afterward.

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--Michael W. Perry

This is worth reading too, including the comments:

In Our Own Words: The PBDS Test for Nurse Travelers

The ones who really should be getting ticked off at the PBDS are nursing schools. They've just said someone is qualified to be a nurse and weeks later, a PBDS says that person isn't.

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Specializes in Oncology; medical specialty website.

This sounds absolutely crazy!

If you are dealing with the BON, get a lawyer, preferably one who is experienced in dealing with the BON.

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Specializes in Med/Surg, Ortho, ASC.

Do you know for a fact that the BON is involved? Or has the hospital simply told you that it is?

This sounds insane. But the PP poster is correct - if the BON is already involved, you will definitely need an attorney familiar with nursing boards.

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The offer for performance improvement (by the nursing board) would prevent public disciplinary action. If it's not too late for that. I just cant believe that I need a lawyer for a training exercise that involved zero patients. It's crazy. I was hoping to find out what could possibly happen if I leave it to the board to decide without any intervention. I feel like I've been stepped on by an 800 lb gorilla. In my eyes, of course, I feel like I've done nothing wrong.

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Get a lawyer. If you were truly reported to the BON for failure to properly make MEDICAL diagnoses, I'd be tempted to sue the hospital. And I am usually NOT a litigious minded person.

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This is insane. 😒

I agree with getting a lawyer.

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Specializes in Oncology; medical specialty website.
Get a lawyer. If you were truly reported to the BON for failure to properly make MEDICAL diagnoses, I'd be tempted to sue the hospital. And I am usually NOT a litigious minded person.

Yeah...this is just wrong all the way around. He graduated from a nursing program and passed NCLEX. He's met the standard to have a license and practice nursing.

It's one thing to require new hires pass a medication/drug test, but hat the OP describes? That's over the top.

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The American Association of Nurse Attorneys has a referral service for attorneys experienced in dealing with matters before the Board: TAANA Executive Office - Home

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Specializes in MDS/ UR.

This is just crazy.

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This is happening all the time, and I believe I know which hospital is doing this because it has happened to me. My situation is a bit different in that I was 8 weeks in and felt I was not a good fit so I resigned. Next thing I know I get a letter from the board. I am not a happy new grad nurse. I will fight for my license but I am being asked to be placed in a PIIP program by the OBN, at my cost of course, and be monitored for the next year! Its going to take a YEAR to figure out that I am a safe nurse! I am not sure what I will do at this point since my meeting is next month.

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