Is it an ethical violation to quit a job before you start?

Specialties NP

Updated:   Published

I will try to be as succinct as possible:

a. I accepted a once per week job doing PRN disability exams on Sunday's. I signed a contract as a 1099 worker that did not specify any damages for breech, but said I could be terminated if my exams were not up to industry standard. It takes up to six weeks to get paid.

b. My "main job" was to pay me a 10K bonus which they concluded I was not in fact eligible for and will not be paid. Since I was "counting" on this income until my PMHNP practice was built up I am forced into the position of finding "part time" work. Thus, I was offered a Psych RN position on Friday, Saturday, and Sunday at $57.00 per hour. This would more than "pay the basic bills" until my practice on Monday, Tuesday and Thursday filled up.

c. I wrote the "disability exam" place and stated that I would not be able to start next Sunday week for the above reason (I need to earn money to pay my bills I need cash flow). I literally only have money for one more month's rent. They said I didn't have "an emergency" I pointed out that not only was I going to go late on my credit cards (for the first time in over a decade), but that I literally faced being homeless if I did not generate cash flow.

d. They stated they would pay me 50% of the $110 per exam when the exams were performed (the rest later), but that they considered me under an "ethical/legal" obligation" to perform all shifts signed up for (through the end of May) unless they could find a replacement (these exams are located all around the state of Washington). Furthermore, they said since patients have been scheduled for these appointments that failure to perform the exam would result both in civil litigation (for damages without regard to what the contract says which does not specify damages) and direct action against my license. They said that "unlike being an RN your obligation starts when you agree to do the exam" since I pointed out that as an RN the obligation started once you had accepted report.

e. I said that while I disagreed with their perspective (specific performance to perform work is generally considered to be a 13th Amendment violation which is why you can force someone into a Chap Seven, but not a Chapter 13 bankruptcy, basically you would be requiring them to work to pay their debts and this had been found to be unconstitutional in most cases-child support being a noted exception). Still, I pointed out that I had moved from Florida to Washington and did not even have the resources for an attorney so I would "go along" as they don't seem to be giving me a choice. I re-read my contract and there is nothing about damages for non performance. But that doesn't mean they couldn't take action against me anyway or with the Washington State Board (especially since they are a contractor to do disability exams for the state of Washington).

f. What if someone became ill or their spouse or child suffered a situation or they found they just couldn't do the job? Would they face sanction against their NP licenses? If someone can be held on the hook for disability exams three months down the line it seems a bit like involuntary servitude. Part of me just wants to "shut up and take what's due me for a poor decision", but the other part finds it difficult to take. Still, there is a point that people are expecting to show up starting next Sunday and see someone for their disability exams.

Specializes in Psychiatric and Mental Health NP (PMHNP).
1 hour ago, myoglobin said:

The job that I want to keep originally offered the bonus when I talked to the owner, but withdrew the offer at the time of the contract signing. It is still a great company and a good deal it’s just that my “cash flow” and part time job strategy has to reflect the shortfall. Meaning that I need to earn more than what the disability exams would pay.

You keep saying this is a great job, but it sounds like a sketchy outfit to me. I don't know why you paid them $1000 up front and they then didn't pay you the $10K bonus and will try to sue you if you leave within 12 months. This is a terrible arrangement. And you have to pay them every month! This is ridiculous. So you have already lost a lot of money with them. You would have been far better off taking a salaried position that paid less!

Are you an employee of theirs? Because if not, then there are no benefits and benefits are worth a lot.

I'd sit down with your supervisor at that place and explain your situation and then tell them they need to help you out. At this point, you are judgment proof and I think they would have a hard time suing you for quitting, anyway. You really need to talk to an employment attorney. As I have said, the first consult meeting is free and they will tell you if you have a problem or not. Washington is a "blue" state and such states generally take a very dim view of trying to enforce such an employment contract.

I would explain the bind that rescinding the $10k put you in and that you are simply unable to survive financially, and have resorted to taking 2 part time jobs. This is not conducive to you providing them with a good performance. Homelessness doesn't help, either.

Negotiate a deal. Maybe they can pay you $5K and waive the fee for 6 months or some such. Be creative. But I wouldn't be afraid to walk away from them. Don't be so afraid of threats about lawsuits. It is not "free" to sue someone - they will need to hire a lawyer, spend a lot of time and money. And they can only sue for damages. What damages? They have no damages! This is bullsh*t.

Also, I do veteran disability exams and have no such punitive contract. I tell them when I am available and they schedule appointments. I just had to reschedule an appointment, gave one week notice, and they were fine with it and are working on rescheduling the vets for that day to the new day. I missed a day because my computer power cord broke and they didn't threaten me or anything. (I have to take my own laptop)

Do you and your partner discuss these types of decisions? I'd be shocked if she thought this adventure was a good idea

Isn't there a lawyer on this forum that answers legal questions? Maybe you should write to her.

As far as "ethical" and reporting you to BON, that is also BS. Contact the BON and ask them - they are supposed to provide support. You might also contact your national and/or state NP assocation - hopefully you belong to AANP. And also the APA.

Specializes in ICU, trauma, neuro.

Of the four companies that I talked to in the Seattle area all of them had arrangements very similar to the one I went with (about $1000-1500 in fees plus 600-800 per month). Now one that I found “late in the game” is paying me 70 percent with no fees (in fact they are giving me a 3k advance). This will be the job that I work on Friday and Saturdays. Part of the reason for this is that NP ‘a are IP in Wash. They are billing me for software, marketing, billing, and front office support. and office space. My first insurance companies Cigna and Regence don’t come on board until March 1 and they still had me booked with four Evals per day last week (I work three days with them by contract) paying cash for $300.00 one hour evals. Most Seattle area insurances reimburse at about $150 for a 30 min medical management appointment. Thus, if you can see say 60 patients per week at $150.00 per then the math is fairly attractive at 70 percent even with those monthly fees. Also there is no state income tax. Also those fees are tax deductible. My only beef is with the Sunday job (which will actually take several hours each of the following days to write the reports) threatening my license. Also the only job offer with benefits that I received above 140k was in Plattsburgh NY ata place called BHSW for about 175k, but it didn’t come until two months after I interviewed there.

On 2/18/2020 at 2:02 PM, myoglobin said:

Keep in mind they are holding me to the end of May not just this week. I gave up 175k with benefits in upstate NY to come to Wash ( perhaps a poor choice). Many of the NP’s at Mindful earn well over 200k, it’s just that in my case I am both cash and credit poor.

I have not met entities of any kind who empathize or sympathize with my cash and credit poor status. Individual representatives will tell one to their face that is the result of poor management of ones personal life. Not saying this to be critical, just stating what I have found to be fact. (Got my annual rent increase today and must add more hours to my second job, just to pay the rent; so, I do empathize with your situation).

Specializes in Former NP now Internal medicine PGY-3.

After reading a few of this persons posts I feel much of this is failure to be personably responsible. This along with from what I believe I read was lack of health insurance coverage for extended periods, high credit debt, school debt, and a lack of savings in middle age. Now stuck in a contract he or she wishes to void after singing. Not here to judge but you just need to make better financial decisions. No company will likely empathize with this nor should they. External circumstance is probably some to blame but much of this feels like personal choice issues

Specializes in ICU, trauma, neuro.

I agree that most if not all of my financial situation is the result of choices. However, that is precisely why I moved across the United States to live by myself in an Airbnb bedroom and will work until I’m 80, dead or demented. The potential to earn over 200k means at least some opportunity to address my financial challenges in a positive way. The operative situation which prompted this post is whether or not Pontum can successfully threaten my licenses for not being able to do a job/shifts that I had agreed to do when I thought I would have more time to devote to the task. I met with them yesterday and received my laptop and am supposed to see my first clients tomorrow from 0600-1800. Frankly, I don’t at this point even care if they pay me and I expect that it will take me more like two weeks rather than one to generate reports that are probably of a lower standard than they would like.

Specializes in Psychiatric and Mental Health NP (PMHNP).
9 hours ago, caliotter3 said:

I have not met entities of any kind who empathize or sympathize with my cash and credit poor status. Individual representatives will tell one to their face that is the result of poor management of ones personal life. Not saying this to be critical, just stating what I have found to be fact. (Got my annual rent increase today and must add more hours to my second job, just to pay the rent; so, I do empathize with your situation).

3 hours ago, Tegridy said:

After reading a few of this persons posts I feel much of this is failure to be personably responsible. This along with from what I believe I read was lack of health insurance coverage for extended periods, high credit debt, school debt, and a lack of savings in middle age. Now stuck in a contract he or she wishes to void after singing. Not here to judge but you just need to make better financial decisions. No company will likely empathize with this nor should they. External circumstance is probably some to blame but much of this feels like personal choice issues

My point is that this organization promised a $10K sign on bonus then reneged at the last minute. That is not right and is shady. Even if the $10K sign on is not permitted to contractors, it could have been structured as a retainer or some such.

Whether or not myoglobin is a good manager of his finances, and it appears he is not, an employer should not treat people this way. Given the shortage of mental health providers in the Western US, it is also stupid on their part. Not exactly the way to attract and retain talent.

Myoglobin, I don't say this to be mean, but you really, really need to increase your financial literacy and develop a solid footing in practical reality. I suggest you consult with your partner and some trusted friends in the future when making these types of decisions, and for goodness' sakes, listen.

At this point in time, you are not in a position to engage in these financial adventures. Just get a freakin' FT job, save your money, and get your finances in order. You don't need to make $200K per year to do that.

If I were you, I would:

1. Consult with a lawyer about the disability exams. Again, the first consult is free. Also talk to the BON and NP associations. That outfit Pontum is full of BS. And for goodness' sake, READ contracts before you sign them and don't sign any with such ridiculous terms!

2. Immediately look for a FT job with benefits. It will pay less, but it should, given you are getting benefits. You should seriously look in other parts of Washington that are more affordable than Seattle. Also look for jobs in other states where you have a license. Take a FT job with benefits that will pay you fairly and give you a good solid learning experience. Don't just focus on money right now.

3. You have to consider cost of living when looking at pay. You're far better off making $150K per year in an affordable area than $200K per year in an expensive area like Seattle or Silicon Valley. You will have more money in your pocket.

4. Again, stop obsessing about making a boatload of money right now. You can do that after you have 2 years of PMHNP experience. If you had taken that job in upstate NY, you'd be far better off than you are now. $170K with benefits would allow a great lifestyle in upstate NY. Bluntly, your greed has cost you a lot of money and provided you with a lot of anxiety and suffering.

5. Why not take a job in Florida for now? You already have a home there. Even if it is less money, it would be far easier than what you are going through. After 2 years, you could then do telemed like your partner.

6. There is nothing wrong with working until you are 80. Retirement is a recent invention and was never the norm until about the 1950s. My own doctor worked until he was 84! Studies have shown that people who continue to work, assuming they have a physically comfortable job, live longer, are healthier, and are happier.

7. If you are worried about retirement, then look for a job with a good retirement plan. Some large organizations have excellent 401K plans with 100% matching. Also look at government jobs like the VA, which is always looking for PMHNPs. If you are licensed in one state, you can work in any VA anywhere. Some state governments have great retirement, better than the feds. In California, CALPERS offers fantastic retirement and you only have to work for qualifying agency for 5 years to get it. Here, if you work for a county mental health facility, prison, or school (college) you will get it. Yes, they pay a little less, but you have to look at the big picture.

8. If you have student loans, then get a job at a facility that qualifies for federal or state loan repayment. The VA also offers loan repayment, as do some other large organizations.

I'll say this one last time. As a new PMHNP, you need to focus on learning to be a good PMHNP. Through greed, you have put yourself in a position where you are very miserable and distracted, and unable to focus on your #1 priority. There is no good reason to put yourself through the stress of trying to be an independent contractor and doing 2 other part time jobs and still being broke and afraid. Take a deep breath and take the steps necessary to get yourself out of this mess. Quite frankly, you need counseling, so get a good job with health insurance.

Honestly, I just don't understand what your problem is. I was offered a psych NP job in Redding CA in 2017 for $150K a year plus up to $14K in bonus. They also would pay for relo. They had such a hard time finding PMHNPs that they were willing to train NPs like me. I could have rented a nice little house for $1200 to $1400 or a basic apartment for $700. I also have student debt and credit card debt, and even so, on $150K per year, I would have been very comfortable and could have saved plenty of money. That deal fell through because their insurance company changed their policy and required them to only hire PMHNPs. I ended up taking a good primary care job for a lot less money and still lived very comfortably!

Specializes in ICU, trauma, neuro.

1. Good advice and I did consult with my SO before taking this job. In fact she is in the process of leaving a 1099 tele health job to work for the same company(they never did offer her a bonus even though she has been a psych NP since 2016 also tele health wasn’t an option for me since I have less than a year of NP experience). 2. Florida really isn’t an option I turned down about three 130k jobs with benefits because I didn’t want to have to see patients in 15 minutes (as is common in Florida) and have my license contingent on the whims of an MD. 3. Since my credit is poor (and getting worse) Seattle is actually good because I can at least rent Airbnb for about 1k per month with no deposit or credit check. Also if my car should die I can take public transport or even bike/walk/run to work. 4. Going home to my SO isn’t really an option the deal is pretty much “come back financially stable or don’t come back” (that may not be her opinion but that is certainly mine). Unless, Florida passes IP or I get a tele job like my SO I will not be working there (indeed my original plan was to do like she did and get an 85.00 hr tele job straight out of school 1099. It’s just that I could not find one). 5. I’m going to give Mindful Therapy (my main job) and Lightheart counseling my best effort since they already have me booked with clients and I am under contract with both (in addition to Pontum for the disability exams which was the focus of this threads question). Perhaps I should have made different choices but given my limited finances it seems reasonable to at least maximize those that I have made especially since Lightheart has promised me a 3k advance this Friday when I start.

Specializes in Psychiatric and Mental Health NP (PMHNP).
31 minutes ago, myoglobin said:

1. Good advice and I did consult with my SO before taking this job. In fact she is in the process of leaving a 1099 tele health job to work for the same company(they never did offer her a bonus even though she has been a psych NP since 2016 also tele health wasn’t an option for me since I have less than a year of NP experience). 2. Florida really isn’t an option I turned down about three 130k jobs with benefits because I didn’t want to have to see patients in 15 minutes (as is common in Florida) and have my license contingent on the whims of an MD. 3. Since my credit is poor (and getting worse) Seattle is actually good because I can at least rent Airbnb for about 1k per month with no deposit or credit check. Also if my car should die I can take public transport or even bike/walk/run to work. 4. Going home to my SO isn’t really an option the deal is pretty much “come back financially stable or don’t come back” (that may not be her opinion but that is certainly mine). Unless, Florida passes IP or I get a tele job like my SO I will not be working there (indeed my original plan was to do like she did and get an 85.00 hr tele job straight out of school 1099. It’s just that I could not find one). 5. I’m going to give Mindful Therapy (my main job) and Lightheart counseling my best effort since they already have me booked with clients and I am under contract with both (in addition to Pontum for the disability exams which was the focus of this threads question). Perhaps I should have made different choices but given my limited finances it seems reasonable to at least maximize those that I have made especially since Lightheart has promised me a 3k advance this Friday when I start.

You keep getting caught up in the weeds. You need to learn how to be a PMHNP! Working 2 separate PMHNP jobs and then doing disability exams on the side, while worrying about finances, is not going to allow this. In order to be a good PMHNP, you need to be at your best. And it will take 1 to 2 years to become competent.

I don't know how you even think you can actually do the necessary work. For the PMHNP jobs, you have to learn how to be one, plus learn the EMRs and practices in both organizations. I don't know about the rest of you, but it took me about 3 months to become reasonably efficient at writing chart notes as a new grad NP and not having to spend 2-3 hours every night after work finishing up. After a year, I was able to complete my notes with 30 minutes to one hour of extra work.

I also had to still research and look up a lot of stuff the first several months of practice, and I did this on my own time.

Disability exams take a boatload of time and you scheduled yourself for 12 hours?!!! The actual exam isn't long, but there is a lot of research and paperwork required for each person. That 12 hours is at least a total of 24 hours of actual work, probably more since you are new to this.

You basically will have no time off and that is not conducive to learning and high performance. This is an unsustainable schedule and is not fair to your patients.

Here is what I would do:

1. Immediately start looking for a FT PMHNP job with reasonable pay. Don't be greedy.

2. Consult with an attorney about Pontum. And talk to the NP associations.

3. Once you get a FT PMHNP job, quit those other jobs and tell them you are sorry, but the situation was just not financially tenable for you. Talk to an attorney about those contracts, too. When you give notice, just nicely explain that you need a FT job with benefits and you tried to make it work, but just couldn't. End of story. For goodness' sake, you are not their slave. You're not even an employee! It is a free country.

4. Don't be greedy. Focus on becoming the best PMHNP you can for now. One of my mentors told me something I'll never forget: "Do good work and the money will come." That was when I was a consultant billing at $450 an hour! Goodness, if you can't live on $150K a year, even with debt, then I don't know what to say.

5. Don't be so easily scared of lawsuits. Those are empty threats. Do you know how expensive and time-consuming it is to sue someone? And you can only be sued for damages. Why is this so hard for you to understand? Your credit already sucks, so who cares if they sue you? You can't force someone to perform independent contractor work that they haven't been paid for! Nor can you charge them fees for expenses that have not been incurred. Any first year law student will tell you that. Just watch The People's Court or whatever.

6. Go find and follow the Dave Ramsey program for financial independence.

7. If you have student loans, get a job that qualifies for federal or state loan repayment, or work for a place like the VA that offers loan repayment. The VA is desperate for PMHNPs and they also have PMHNP residency programs.

8. Ethics - there is nothing unethical about quitting if reasonable notice is provided. So let Pontum complain! Who cares? Honestly, what if you died? Would they sue your estate? What if you were in the hospital? They are just making empty threats. Grow a backbone.

For my amusement:

Can you imagine this to Judge Judy?:

Plaintiff: Judge, myoglobin quit and now I'm suing him for 10 months of work that will not be done. Plus I'm suing him for 10 months of monthly fees.

Judge Judy: Was myoglobin an employee?

Plaintiff: No, an independent contractor.

Judge Judy: Did myoglobin give you reasonable notice?

Plaintiff: Yes, he gave us 1 month of notice.

Judge Judy: What have you paid myoglobin?

Plaintiff: He worked for 2 months and we paid him for the 2 months of work he did.

Judge Judy: So what are your damages? (Getting irritated)

Plaintiff (whining): We want our 10 months of monthly fees and now we have to go find someone else to do the work. Who is going to see those patients?

Judge Judy: Don't you have other providers?

Plaintiff: Yes

Judge Judy: Then you can pay those providers to do extra work!

Plaintiff: But we had a contract!

Judy Judy (angry and yelling): We no longer have legalized slavery or indentured servitude! People are free to find other jobs and life happens - people may need to quit for all sorts of reasons. Myoglobin was not even an employee! He gave you reasonable notice so you can find someone else. You can't charge him for monthly fees when you have not incurred those expenses and you will get someone else to do the work and pay those fees in his stead. This is not a valid and legal contract. JUDGEMENT IN FAVOR OF THE DEFENDANT!!!

Specializes in ICU, trauma, neuro.

Except that I am so busy and overwhelmed that I probably wouldn’t even file an answer or show up and they would win a default judgement. Also keep in mind these are psych only exams I literally don’t touch the patient. I plan to try them and give my other jobs about three months. My SO had to learn on her own as a tele provider with even less support than me. At least I have Epocrates, UpToDate, Dr Puder’s Podcast, The Carlat Report, and an SO I can text 24 seven. If learning to be a “good” provider means loading patients with benzo’s and multiple antipsychotics and seldom ordering labs or therapy (as was the practice of many MD’s where I did clinical) I’m not certain the experience would facilitate me being that much better.

Specializes in Psychiatric and Mental Health NP (PMHNP).
2 minutes ago, myoglobin said:

Except that I am so busy and overwhelmed that I probably wouldn’t even file an answer or show up and they would win a default judgement. Also keep in mind these are psych only exams I literally don’t touch the patient. I plan to try them and give my other jobs about three months. My SO had to learn on her own as a tele provider with even less support than me. At least I have Epocrates, UpToDate, Dr Puder’s Podcast, The Carlat Report, and an SO I can text 24 seven. If learning to be a “good” provider means loading patients with benzo’s and multiple antipsychotics and seldom ordering labs or therapy (as was the practice of many MD’s where I did clinical) I’m not certain the experience would facilitate me being that much better.

Doing disability exams requires filling out a boat load of paperwork. You are also usually given a large history file that you have to go through. The exam itself is easy. It is doing the required paperwork that is hard and time consuming.

Honestly, I am rather alarmed at your view of what it takes to be a good PMHNP. When I said find a job that is a good learning experience, that means finding a job where the other providers are good and can teach you. You can't just look up stuff and assume it will be okay. As a new grad, someone needs to review your work until you are up to speed. That is why good clinics have chart reviews and onboarding programs for new grads.

Anyway, I'm done. This is like watching a train wreck. However, you gave a great example of what not to do as a new grad NP and the dangers of greed.

Specializes in Dialysis.
1 hour ago, FullGlass said:

Doing disability exams requires filling out a boat load of paperwork. You are also usually given a large history file that you have to go through. The exam itself is easy. It is doing the required paperwork that is hard and time consuming.

Honestly, I am rather alarmed at your view of what it takes to be a good PMHNP. When I said find a job that is a good learning experience, that means finding a job where the other providers are good and can teach you. You can't just look up stuff and assume it will be okay. As a new grad, someone needs to review your work until you are up to speed. That is why good clinics have chart reviews and onboarding programs for new grads.

Anyway, I'm done. This is like watching a train wreck. However, you gave a great example of what not to do as a new grad NP and the dangers of greed.

@FullGlassI'm not a NP and share your thoughts. The OP has many posts on here that make me ponder their motivations. All I can say beyond that is wow, just wow

Specializes in ICU, trauma, neuro.

I’m not sure about the greed part. I just want to be able to take my time with patients and focus on the lifestyle and CAM aporoaches that many MD’s would never let me emphasize. If I make enough to pay my minimums and occasionally take a walk/hike and maybe read a book I’m fairly content. I doubt anyone will ever consider me a great (or perhaps even good) charter but my clients will likely understand that I never give up on anyone and will see virtually anyone even if they cannot pay. Look I just drove 3500 miles over four days (last week) to take jobs that I spent months to get credentialed for, spent thousands, and discussed with numerous individuals. I hope you can understand my being reticent to throw all of that away especially when I have essentially zero leads on a salaried position anywhere close.

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