I am a new FNP and have been working since May in a rural primary care/urgent care clinic. I don't want to sound like a winer, but I am exhausted. Most days I see 20-25 patients back to back no breaks. Sometimes I'm really scared because I have pts who walk in to urgent care who really belong in the ER - not our clinic.The patients are mostly medicaid and medicare, welfare and unemployed or disability patients with chronic pain issues. It is all paper charting which takes up a lot of time. I have call one night a week and every other weekend for 4 days straight. I feel like I'm always working.
The clinic is owned by an FNP and his wife, the office manager. All they seem to care about is making money. They schedule us full and tight.
They have a high turnover rate, lost 6 FNPs in the last year. I thought I could handle it but I'm burning out fast. Sometimes i want to chuck it all - just get on a plane leave it all behind and go where no one knows me.
Is it like this everywhere? This is much harder than being an RN, sometimes I really miss my job in labor and delivery.
I feel like I have to stick it out for at least a year so I don't look like a job hopper and so I can get experience as an FNP on my resume. I would really appreciate some advice on how to handle this. I know talking to my employer won't help...they told the others who quit - "this is how it is, if you don't like it then leave."
Did you report him after you left the job? I'm wondering what my responsibility is after finally getting out of a bad work situation (yesterday was my last day.) It wasn't just bad business practices or being horrible to employees...there are other ethical/legal issues that came up such as huge quantities of narcotics being given - amounts that are not humanly possible to ingest without being dead or in a coma, i wonder if they are being sold on the street!Do I need to make a report to the Board of Nursing? the Board of medicine? The DEA?
I contacted the Board of Nursing and told them about everything that I had witnessed. They told me to write everything down, including names, dates, etc. and report him. It's important to note that you HAVE to report this b/c if something happens in the future and it's found that you knew about all of this and didn't report it, then you could be in just as much trouble as them! I reported him to the DEA and the Board of Medicine. That was 2 years ago and this still hasn't been resolved. It's important to note that you need names of patients and specific information in order for the BOM to make a case. After I reported him, the BOM went to his office approximately 2 months later and requested several files which they copied. The DEA went to his office about a week later and checked all of his records (controlled substances are kept on the premises...versed, morphine, sufentanyl, etc) and the records checked out. Unfortunately for the doctor, he had been getting samples of controlled substances, such as Lyrica (a Schedule V), Provigil, Ambien CR, Lunesta, etc and they weren't keeping a log of them. He was fined and he had to turn over all of the samples to the DEA agents. He no longer accepts pharmaceutical samples of any kind.
Like I mentioned, it has been almost 2 years since I reported him and this still hasn't been resolved. I know things aren't looking good for him, because I hear that he has aged overnight and his disposition has changed dramatically. I talked to one of his former employees and she told me that after I left, there had been a "big change" in him, but she had no idea that any of this had occurred. The BOM contacted me a few months ago and they had me fill out a sworn statement detailing everything I had witnessed and have it notarized. Unfortunately, they don't give me any information, since it's all confidential, but I do know that the case was turned over to their legal department. If he is disciplined (SURELY he will be!), then I will be invited to the disciplinary hearing.
Something else, there was an ER physician who also contacted the DEA about this doctor. One of our patients had overdosed and the ER doc couldn't figure out why she was on narcotics, since there wasn't anything wrong with her. The doc kept calling our office to speak with my former boss, so I contacted her myself and told her to contact at the DEA's office. The DEA agent told me that they would have to rely on the Board of Medicine's decisions before they could take any further action.
This doctor was also kicked off of Humana a few months ago for performing unnecessary procedures. I hear that other insurance agencies are investigating him as well. The one thing that bothered me the most was that he was preying on elderly patients. I could kick myself for not taking detailed notes on all those poor elderly patients who were being set up for procedures without their knowledge. Unfortunately, it's just my word against the doctor, so he'll get away with all of that.
Something else, you mentioned that you saw massive amounts of narcotics being given to patients. Possibly, some are being sold, but remember that patients build up a tolerance to narcotics and they have to have higher doses in order for the drug to be effective. One of my former patients was taking 200mg of methadone per day with Lortab for breakthrough pain. He functioned quite well...yes it's possible!
ANPFNPGNP
685 Posts
I contacted the Board of Nursing and told them about everything that I had witnessed. They told me to write everything down, including names, dates, etc. and report him. It's important to note that you HAVE to report this b/c if something happens in the future and it's found that you knew about all of this and didn't report it, then you could be in just as much trouble as them! I reported him to the DEA and the Board of Medicine. That was 2 years ago and this still hasn't been resolved. It's important to note that you need names of patients and specific information in order for the BOM to make a case. After I reported him, the BOM went to his office approximately 2 months later and requested several files which they copied. The DEA went to his office about a week later and checked all of his records (controlled substances are kept on the premises...versed, morphine, sufentanyl, etc) and the records checked out. Unfortunately for the doctor, he had been getting samples of controlled substances, such as Lyrica (a Schedule V), Provigil, Ambien CR, Lunesta, etc and they weren't keeping a log of them. He was fined and he had to turn over all of the samples to the DEA agents. He no longer accepts pharmaceutical samples of any kind.
Like I mentioned, it has been almost 2 years since I reported him and this still hasn't been resolved. I know things aren't looking good for him, because I hear that he has aged overnight and his disposition has changed dramatically. I talked to one of his former employees and she told me that after I left, there had been a "big change" in him, but she had no idea that any of this had occurred. The BOM contacted me a few months ago and they had me fill out a sworn statement detailing everything I had witnessed and have it notarized. Unfortunately, they don't give me any information, since it's all confidential, but I do know that the case was turned over to their legal department. If he is disciplined (SURELY he will be!), then I will be invited to the disciplinary hearing.
Something else, there was an ER physician who also contacted the DEA about this doctor. One of our patients had overdosed and the ER doc couldn't figure out why she was on narcotics, since there wasn't anything wrong with her. The doc kept calling our office to speak with my former boss, so I contacted her myself and told her to contact at the DEA's office. The DEA agent told me that they would have to rely on the Board of Medicine's decisions before they could take any further action.
This doctor was also kicked off of Humana a few months ago for performing unnecessary procedures. I hear that other insurance agencies are investigating him as well. The one thing that bothered me the most was that he was preying on elderly patients. I could kick myself for not taking detailed notes on all those poor elderly patients who were being set up for procedures without their knowledge. Unfortunately, it's just my word against the doctor, so he'll get away with all of that.
Something else, you mentioned that you saw massive amounts of narcotics being given to patients. Possibly, some are being sold, but remember that patients build up a tolerance to narcotics and they have to have higher doses in order for the drug to be effective. One of my former patients was taking 200mg of methadone per day with Lortab for breakthrough pain. He functioned quite well...yes it's possible!