Manager threatening patient abandonment

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Specializes in NP.

Does my manager have legal backing for claiming patient abandonment towards me? Still on probation, less than 2 months working at this company. Working in a private transitional company doing visits once a week for 1 month after hospital discharge, not as primary care provider or home health agency. I gave 1 week for letter of resignation, offering to still see patients with upcoming appointments for the next week. Appointments are made 1 week at a time. They have other NPs that can cover after I leave but manager is claiming she won't have people to cover and will report me as abandoning patients. Original job contract is at will, no notice needed for termination of employment. Making me nervous and anxious.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.

What does the contract say about giving notice if the employee wants to leave the job?

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Specializes in Vascular Neurology and Neurocritical Care.
24 minutes ago, juan de la cruz said:

What does the contract say about giving notice if the employee wants to leave the job?

The contract may be important, but what it says is not controlling. Abandonment is defined as terminating - effectively or constructively - the physician/NP/nurse-patient relationship without endorsing care to an adequately credentialed provider to assume care. So even if you leave without adequate professional notice, if you have arranged for another provider to assume care, it is not abandonment. Unfortunately, a lot of managers like to throw this word around for intimidation purposes. As long as you have done the professional duty of endorsing care of your patients or making other arrangements for another provider to take over and follow up results, tests, appointments etc (since you likely cannot really "endorse" 1000 primary care patients) you're fine. At most you would be guilty of the professional no-no of failure to provide adequate notice.

So don't stress too much.

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Specializes in NP.
1 hour ago, juan de la cruz said:

What does the contract say about giving notice if the employee wants to leave the job?

The contract is at will, employer and employee can terminate at anytime. This is my first NP job, so I’m worried since I don’t know the repercussions of leaving while still having a panel of patients, less than 20 patients seen at home visits

1 hour ago, Neuro Guy NP said:

The contract may be important, but what it says is not controlling. Abandonment is defined as terminating - effectively or constructively - the physician/NP/nurse-patient relationship without endorsing care to an adequately credentialed provider to assume care. So even if you leave without adequate professional notice, if you have arranged for another provider to assume care, it is not abandonment. Unfortunately, a lot of managers like to throw this word around for intimidation purposes. As long as you have done the professional duty of endorsing care of your patients or making other arrangements for another provider to take over and follow up results, tests, appointments etc (since you likely cannot really "endorse" 1000 primary care patients) you're fine. At most you would be guilty of the professional no-no of failure to provide adequate notice.

So don't stress too much.

Thank you. It’s less than 20 patients and they have more than 5-6 NPs to cover and one coming back from extended time off with no patient load currently. It was just shocking for them to throw that term out to me to stay longer

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Specializes in ICU, trauma, neuro.
4 hours ago, Neuro Guy NP said:

The contract may be important, but what it says is not controlling. Abandonment is defined as terminating - effectively or constructively - the physician/NP/nurse-patient relationship without endorsing care to an adequately credentialed provider to assume care. So even if you leave without adequate professional notice, if you have arranged for another provider to assume care, it is not abandonment. Unfortunately, a lot of managers like to throw this word around for intimidation purposes. As long as you have done the professional duty of endorsing care of your patients or making other arrangements for another provider to take over and follow up results, tests, appointments etc (since you likely cannot really "endorse" 1000 primary care patients) you're fine. At most you would be guilty of the professional no-no of failure to provide adequate notice.

So don't stress too much.

So where does that obligation end? I currently have over 350 clients as a 1099 PMHNP many of whom waited months to get an appointment to see me in the greater Seattle area. There is no guarantee that I would ever be in a position to find these clients another provider to meet their needs in many cases even if I devoted a year full time to the task (especially since I take all insurances except for Medicaid, but including Medicare). Does this mean that I am obligated to "work there forever"? What if my parent company should decide not to renew my contract (meaning that I could no longer bill insurance or even have access to the software system that I use to chart on my patients).?

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Specializes in Vascular Neurology and Neurocritical Care.

Think about clinicians retiring, for example. The obligation is to send formal notice by mail that your practice is closing, relocating, etc. The usual practice is to give 30 days notice that they need to find a new practice. Your duty is to provide good a way to provide access to the medical records after this period. Don't quote me, but I believe you have to maintain those records for 7 years. There are secure HIPAA compliant companies to whom these records can be turned over. 

So no, there's no obligation to continue working beyond your desire. Just give the notice and it's up to them to find a provider. You might make some suggestions. But people retire, leave, relocate all the time, so it's fine. This is different from the OP's situation. 

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Specializes in ICU, trauma, neuro.

So it sounds like anything over a month is safe from the abandonment accusation. I would be curious how many have been sanctioned over this. If I had the resources I might publish a monthly newsletter entitled something like “RN and NP licenses won and lost” which would cover the nitty, gritty details of specific cases all over the country of allegations against RN’s and NP and might also shed light on more effective approaches to “license defense”. 

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Specializes in school nurse.

Why the one week's notice? People talk and this could come back to bite you...

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Specializes in Dialysis.
16 minutes ago, Jedrnurse said:

Why the one week's notice? People talk and this could come back to bite you...

Thats what I was thinking. Most bedside positions require 2wks to 1 month, management and APRN usually require a month minimum

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On 11/21/2020 at 9:39 AM, joonkilee said:

The contract is at will, employer and employee can terminate at anytime. This is my first NP job, so I’m worried since I don’t know the repercussions of leaving while still having a panel of patients, less than 20 patients seen at home visits

Thank you. It’s less than 20 patients and they have more than 5-6 NPs to cover and one coming back from extended time off with no patient load currently. It was just shocking for them to throw that term out to me to stay longer

Has any of the other NPs agreed to take assignment of the patients? Have you spoken to the NP returning directly and asked if they're willing to accept the patient assignments? Communication with the other NPs in the company would really help you in this situation. Just my $0.02.

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I was tempted to resign immediately from my currently employment. Things have gone downhill over the last few months. I tried to do some research on this matter and I am still not clear what does and does not constitute patient abandonment.  I had a lot more clarity on this matter as a bedside RN.  I need to be more educated about it as an NP.

As a result I gave them 30 day notice. 

I read some information similar to what  Neuroguy posted. I also read info on this site. The writer here seems to think reporting the provider (MD) to board was appropriate

https://www.jucm.com/the-consequences-of-a-medical-provider-quitting-without-notice/

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How about reading the APRN information on your state's BON website? That would be the best place to find the information you're seeking. Or consult a labor law attorney in your area.

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