WhatNext?

Thank you for sharing your experience. I had an encounter with my BON ten years ago, yet I remember it like it happened yesterday. Unlike you, I knew it was coming. Still, the shock of receiving the letter, which took eleven months after the incident, made me sick to my stomach and emotional beyond my ability to function. Getting a lawyer is the best thing I did. I got a referral from my State Nursing Association for an attorney who was familiar with license issues. He was so much help. It took the Board 11 months to take action and they wanted a response in 10 days, then they took another month to act on the response. The charges were dismissed without a hearing and no action was taken against me. The blow to my career and my identity as a nurse was there, though. I couldn't find work in my field. I worked per diem in a hospital for a while, then home care. But I couldn't shake the feeling that any decision that I made would come back to haunt me. I "retired" from nursing 2 years ago. I did not renew my nursing license last year. I decided that 40 years as a nurse is enough. I hope that you can move through this experience with the BON. I hope that you can continue to work and flourish in the profession.

I went through a process with my state BON. It was unpleasant and painful, even though I came through it with my license intact. The letter from the BON comes through registered mail. It took them nearly a year to follow up on the complaint that was made. Before I contacted them, I hired a lawyer to guide me through the process. He provided guidance about what was enough information to disclose and what was too much. The referral came from my state nurse association. They know professionals who deal with licensure issues. While I do not have chemical use issues, I do deal with depression and anxiety. At the end of the review, the BON suggested that I might benefit from participating in the Professional Assistance Program but it was not a condition of continued licensure. Get a lawyer. That is my first and best suggestion based on my experience. And good luck getting through this experience.

I agree with the advice here. I also agree with the nurse at the agency to stay on at your current employer on a per diem basis. The agency I work for only pays for visits made. I have never had a guaranteed work load in the 2 years I've worked there. When I was the "office nurse" I was scheduled for 2-3 hours of office time per week but not to do case management for my clients. Advice I would add to the quote above: keep records of your time slips and compare them to your paychecks. And find out the backgrounds of the owners of the agency, particularly their experience in health care education and delivery. I do like HHC. I like the independence and the case coordination that I do with the doctors, social workers and other agencies that are involved with my patients. I like the connections that I can make with the patients and their families. It can be very rewarding. Good luck to you.

I concur with everyone's advice about taking a vacation, time away from nursing. I want to hightlight the other suggestions too: meditation, massage, intense self-care to replenish the well from which we draw caring. I would also add regular exercise and stimulating your sense of humor with frequent causes for laughter, the more ridiculous and outlandish the better. :lol_hitti: I've been a nurse for 35 years. In my heart, I will always be a nurse. But nursing is not the profession it was when I got into it. I am unemployed, again, and considering a career change away from anything involving any form of customer service. I never realized that other nurses also withdraw from human contact on their days off. I don't feel so weird anymore. One last point, if the break and the self-care aren't enough to replenish you and you still don't care, take it as a sign that this is not the job for you and look for one in a different setting. It's always better to leave on your own terms.

I'm 55 years old. I was fired from a job 2 years ago and was reported to my state Board of Nursing. I was unemployed for three months until I found a job in home care. A year after I was fired the Board contacted me to respond to the complaint. My experiences leading to the firing and then dealing with the Board shattered my sense of competence, and I was unable to deal with the stress of working and writing my response to the complaint. My license is clear now, but I am having a hard time finding a new job. I have just finished temp work giving flu shots for the past 6 weeks, but I need to find a "real" job with health care benefits. Part of the problem in finding work is that I have been blackballed by the hospital system that fired me. Another contributing factor is that I know too well what I will and will not do. I know that Critical Care is not where I function well, that vents and all the other machines have changed since I got out of that field. Home care did not work out well. Telephone work is not to my liking. So now I'm a grown up and don't know what I want to do and I find that my choices are limited.

My lawyer asked me why I didn't quit a job that became toxic and eventually ended when I got fired. The lesson I took away from that comment is that it is better to leave a job when you realize you can't seem to do anything right (another view of being targeted).

I would suggest doing a test drive to the location during your actual commute hours to get a real sense of what the traffic will be like. I did home care for a year and grew to hate the driving along several stretches of road due to congestion both during the day and at rush hour. It taught me to look for work near to home. BTW, I got great gas mileage, but had to fill up twice a week anyway.

rn/writer Thank you for post #61. :bowingpur Awesome, sensitive and professional... Wish I could have said what you said as well as you did. Patients with borderline personality disorder suffer terribly. Their families and friends suffer as well. We do them a huge disservice when we disrespect them by calling them names and collude with a work culture that does not look beyond their behaviors.

The system I worked in for 20+ years always talked about financial problems and had lay-offs and unit closings. I went through five of them, and finally lost my job with the sixth. It is such a perennial issue that it becomes meaningless. I have become pretty cynical about health care systems' financial problems. Having said that, there are problems with reimbursements from Medicare, the State of Minnesota Medical Assistance, and Managed Care Companies. Medicare reimbursement is based on DRGs, as is MA and MnCare. Managed care means that the the insurance companies are given deep discounts on costs in order for the hospitals, doctors, etc. to be considered providers for a particular insurance. The amounts of the discounts are deep secrets from the public and usually from employees as well. You would be amazed at the discrepancy between the "charges" for items and services, and the actual amount of money that is paid to the hospitals and clinics. The state budget that was approved in 2005 slashed health benefits to thousands of MnCare subscribers. In order to keep the governor's campaign promise of no tax increases, money was slashed from education, health and social services. Please reallize that this is my own opinion of what is going on. Health care is a business now. Everything is about the bottom line.

Are there studies that show that borderline personality disorder does not occur in third world countries? Does it only occur in industrialized societies? Haven't thought this through. Throwing anyone into a third world country against their will or better judgement is simply duplicating the experience of violation and abuse. Particularly not beneficial to people with borderline personality disorder. BTW, I spell it out because BPD means Bi-Polar Disorder in my practice and acronyms are confusing. And they are people with a disorder and are not simply the label!

How is it helpful to you as a professional to think of these clients as "manipulative drama queens"?

In the years that I have worked with people who carry the diagnosis of borderline personality disorder, I have found that understanding their view of the world as a scary and chaotic place is key to establishing the trust relationship that is critical to working with them effectively. For myself, IMHO, I like to avoid using loaded (judgemental) words like "drama queen" and even "manipulative." Those are words I use when I am tired and frustrated and they are neither helpful to me nor to the client. As hard as it may be to understand, something in the pattern of behavior is meeting an internal need for the client. The client 's view is that this is somehow adaptive in their world, even though it may not appear that way to anyone around them. The hospital is not the place where anyone is functioning at their best--if they were doing well, they wouldn't be there. It helps me to remember that as well. In the land of managed care where I have practiced these past couple of decades, I've seen the in-pt focus change from doing exploration and uncovering of past traumas (which usually resulted in extended hospital stays) to rapid stabilization of the crisis and return to out-patient care. Out-patient setting is where the bulk of the work is done anymore. I have seen remarkable progress in clients who have participated in Dialectical Behavior Training (DBT). It is education and practice in self-care and self-nurture, something that is deeply needed by these clients. There is so much to say about working with these very challenging people. Kindness, boundaries and consistency on the part of the professional really goes a long way to interrupt the chaos that is often present in the client's daily life. Thanks for restarting this thread.