Hospital privileges... possible problems?

Trauma Columnist · Jul 28, 2008

I can certainly sense your frustration with this chain of events. I'm unsure if we can help you with this though....

yellow finch, BSN, RN · Jul 28, 2008

Heh. Thanks for the quick response before my edit. :) I'm just so unsure about the future and wondered if anyone knew of issues that can occur.

Trauma Columnist · Jul 29, 2008

I really think only the hospital administrators can answer this question and chances are they won't do so until you come to them wanting credentialling. Best bet might be to consult a lawyer trained in these matters.

core0 · Jul 29, 2008

Heh. Thanks for the quick response before my edit. :) I'm just so unsure about the future and wondered if anyone knew of issues that can occur.

Part of this depends on what department you are credentialled in. Most hospitals credential NPs under the medical staff, some credential them under nursing. Medical staff credentialing is supposed to be based on Medical merits. Ie. Are you safe to practice, have you demonstrated competence in your area etc. I doubt that most would even check with the HR department of the hospital or that if HR had any heartburn it would be allowed input. Have no idea how credentialling works for nursing (ie outside of medical staff).

This is in the perfect world. If this is a relatively large hospital or one that is part of a system then this is generally how things go. If this is a smaller hospital then all bets are off.

On the other hand if the physician is willing to go to bat for you then a lot of sins can be absolved. Especially if the physician has pull at the hospital. I knew one surgeon that got his "secretary" credentialled to assist in surgery so he could bill.

Good luck

David Carpenter, PA-C

caldje · Jul 29, 2008

you almost surely have to explain the circumstances. without a doubt. Most licensure boards will require it, the certification exam elligibility might require it, malpractice insurance will want to know, and the credentialling comittee will want to know.

IF you have a good explaination or if it was a long time ago it shouldnt be a big problem. Good luck.

core0 · Jul 29, 2008

you almost surely have to explain the circumstances. without a doubt. Most licensure boards will require it, the certification exam elligibility might require it, malpractice insurance will want to know, and the credentialling comittee will want to know.
IF you have a good explaination or if it was a long time ago it shouldnt be a big problem. Good luck.

I disagree. This is an employment issue. There are lots of employment issues that don't merit discussion on credentialing. This could be a contract issue, it could be leaving without giving enough notice. It could be quitting instead of taking an insane assignment. None of those is relevant to credentialing.

On the other hand if its something that involves a nursing license like showing up drunk for work than its a big problem. Realistically if it wasn't reported to the nursing board it may not even be a problem then.

I've been credentialed by around 25-30 hospitals. The hospitals contact the medical staff office of all the hospitals that you were credentialed at, all the licensing and certifying agencies, and the national practitioner data bank. RNs are credentialed by their hospitals so there may (emphasize the may) be some record there. As far as I know I have never had credentialing call HR for any of the companies that I have worked for. Remember the purpose of credentialing is to protect the hospital and patients from dangerous/incompetent practitioners. Unless an employment problem involves something actionable against a license or serious dereliction of duty it is unlikely to be an issue (see my previous post for exceptions). Even then if it is not reported to the appropriate board it is unlikely that credentialling will find it.

Now if the practice or hospital is smart they will call the references if they are smart but that has nothing to do with credentialing.

David Carpenter, PA-C

JDCitizen · Jul 29, 2008

I'll play devils advocate.

Lets all step back: it could very well depend on the "not eligible for rehire" I am not asking for details...

The hospital has two things on its mind protecting itself and protecting the patient.. Some place more weight on the former...

Pull of the doctor will have some weight but if the not eligible for rehire has reached the level of upper management (and some do) this may weigh in also. My credentials had to be approved by a board and than administration in every hospital where I ever had privileges. The very fact I had worked at one facility threw a kink in the paperwork (the DON didn't think it was appropriate)... Long story short I got the privileges.

As per a previous post.. The size of the hopital will probably have a huge impact also.

CraigB-RN, MSN, RN · Jul 29, 2008

In my previous life as a Director of Nursing, I sat on the credentialing board, so I know a little about the process.

To ad to the information that David put out there you have to add one more factor to the equation. Does the hospital do it's own research or do they contract it out. In the hospital system I was DON at we contracted it out. Iiii was always amazed at what they came up with and in some cases they came up with information that we couldn't use. Information like criminal charges that were dropped, etc. And they came up with an employment history that was more detailed than what the provider gave us, At any time there was an HR discrepancy, we took what it was into consideration, and in some cases asked for clarification, and in some cases ignored it.

In all cases, honesty is the best policy. It's always harder if they find something out and you have to explain it later.

yellow finch, BSN, RN · Jul 29, 2008

THANK YOU all for your comments!

I'll mention that the first hospital I *may* be listed at "not eligible for rehire" due to giving them only 2 days notice. It was a horrific job, my new position was offered on a Wednesday, and orientation started the following Monday, so I handed in my notice that Thursday. It never occurred to me that it may cause problems in the future as an NP.

The other one I'll post more details as the week progresses. Basically, I was falsely accused of "stealing syringes" this weekend and willingly offered a urine specimen. I'm freaked out about the entire experience and have no idea if it goes into my permanent record. I have prescriptions for all my meds and really don't have anything to worry about. It's the fact that this occurred in the first place. I guess I'll need to speak with an attorney in case they don't expunge it.

Cripes... being a bedside nurse can be extremely stressful especially when there's so much to consider for the future.

DaisyRN, ACNP · Jul 30, 2008

absolutely!

and you know, speaking of former employers... i only listed my "permanent" positions on my credentialing application and they did call me out on it. they asked me "didn't you work at xyz in 2003?" and i told them if i were only there 1 month, i didn't list it on my application... (i had a few job issues of my own as well)... but explained the situation and so they didn't make a fuss.

good luck finch... keep us posted! i'll be thinkin of ya...

yellow finch, BSN, RN · Jul 30, 2008

absolutely!
and you know, speaking of former employers... i only listed my "permanent" positions on my credentialing application and they did call me out on it. they asked me "didn't you work at xyz in 2003?" and i told them if i were only there 1 month, i didn't list it on my application... (i had a few job issues of my own as well)... but explained the situation and so they didn't make a fuss.
good luck finch... keep us posted! i'll be thinkin of ya...

thanks. several of the groups i'll be applying to have privileges at this hospital where i work right now. this is the reason i don't want this on my permanent record. i've done nothing wrong and would like things to proceed smoothly once all is said and done.

i've also decided to make the nurse my project upon return to work. she's going to have to face me now.