Reported to the BON

Published

Hello:

Wanted to post this, as a way to share my story, and help another practitioner avoid what I've gone through over the past few months. Many of you out there are probably too smart to land where I did, but then again, many out there who are new or who are cruising along just not thinking about it may benefit from my advice.

Earlier this year I was involved in a patient dispute, was terminated from my position, and the company reported me to the Board of Nursing.

There was no harm done to the patient -- more of a charting/billing issue in which I made an incredibly dumb mistake while working in a very pressured position in a retail setting and had zero administrative support to fall back on.

Anyway, a few lessons here I'd like to share:

1. FIRST AND FOREMOST -- get a malpractice policy and keep it current at all times, every minute while you are working. The malpractice policy will come in handy when you have to hire a lawyer to represent you in any dealings with the BON, even if you are innocent. Remember, ANYONE can report you to the BON -- a co-worker, a patient, a "friend," a doctor ....anyone.

2. Don't panic, and get a lawyer. There are lawyers out there who do this for a living and will counsel and advise you on how to present yourself in the best light to the investigators and/or board. Be prepared to fork out at least $2500 to start to retain them. It will go up from there if there are additional needs.

3. If you're in a bad job where you are not supported, or perhaps not really getting along with people you work with, or are unsure of their support, LEAVE as soon as possible and find a better job. Even if you are being paid well with outstanding benefits, etc. There is sometimes so much risk in what we do -- and patients are unpredictable and have the entitlement mentality going in many cases. Don't do patients any favors ...follow the policies of your employer at all times. Do not stay in a job where you feel you are being asked to do more than you can handle -- eventually something can and will happen. Call for help when you need it.

4. If you make an error, do NOT expect the company to come to your aid. They will throw you "under the bus" so to speak very quickly. And rightly so -- they have a company to uphold, and you are just not the priority to them. Thus, the malpractice policy, again -- very important.

5. Take care of yourself -- get counseling, get therapy -- whatever it takes. It's an intensely rough situation to go through -- you may be dealing with the loss of your income, the loss of your colleague support, the loss of your identity -- extremely rough thing. Was for me -- it just about killed me, literally. Luckily I had a wonderful medical provider (an NP who is fantastic) who recommended various steps for me to talk to get my equilibrium back, both mentally and professionally. Luckily I also have a wonderful spouse, family and friends who were there to support me. Luckily, my husband provides an income that we can get by on without my income. If this is not the case for you, you REALLY need to hear this.

6. Be truthful, and tell the story. Tell every detail, and don't try to cover up anything that you did. Yes, it will difficult and mortifying at times to admit what you did ...but this is what I did -- and in the end, the new doctor I will be working with knows the entire details of my story, and has been completely understanding. I had to go on many many interviews after being fired, however, and some of them were not pretty because I was just not ready to present myself properly. I also had to explain to the malpractice company what had happened to be cleared by them. I may receive a "reprimand" to my license soon, and it will follow me forever, unless I get it expunged from my record.

7. Know that you are in an extremely demanding profession and that you are held to an a very high standard -- higher than an RN. Go on the BON site and do a little CME for yourself -- look at the discipline process - look at the various types of discipline that can result from your errors. (for example, Getting a DUI is an instant LOSS of your license, etc.) Know that once you receive a public discipline, it will not only be reported to the state you worked in, but any other state in which you have a license. It will be public, and it will also be sent to a national data bank where anyone will be able to see it as long as you have it. It may make getting certain jobs very difficult.

8. While you may love and admire your colleagues, they are not your friends. They are sort of like that company you work for ....they'll help you to a degree, but when push comes to shove, everyone will have their own best interests in mind. You WILL stand alone to defend yourself. Be good, be friendly, but always keep that professional boundary with them.

9. Do the best job you can and do try to make a few contacts at your job who you may need to use later as references. I am thankful that I had a very good relationship with some of my colleagues and that they were absolutely there to support me through this ordeal. But that's because I always helped them when I could, and I tried to be a decent person at work.

Now that I have somewhat survived this ordeal and looking back, I'm not sure I'd change a thing -- I learned so much -- learned about the reality of the profession, learned about myself and who I am. Got knocked down from my very high horse (and I was on a high one -- I was a top clinician and producer for my organization and thought I could do no wrong). Learned how to handle a tough situation, learned the law, and learned that there are better jobs out there. Most of all, I learned that TRUTH is key ....be truthful in everything you do, even if it means letting a patient yell or get a little mad. Your license and your livelihood is at risk -- and really nothing is worth that, ever.

And lastly, do not affix your identity to this job. For me, I had to re-learn that my worth as a person is not defined by what I do, or how much money I make, etc. This is probably one of the hardest things I had to re-learn and face. Love your job, but love your God, your spouse, your family, your life that make life worth living ... these are the things that will ultimately sustain you in the end.

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Specializes in Nephrology, Cardiology, ER, ICU.

Thanks for a very sobering post. The fallout from being reported to the BON and/or terminated has huge repercussions. For me, as it seems for you, the emotional toll it takes on a practitioner is unbelievable. Providers who make mistakes are often the second victim. And for those of you who still sit on your high horse (as I once did), it CAN HAPPEN TO YOU! No one is bulletproof.

I've been sued and a claim was paid out on my behalf because of an error I made.

I wish the students and new APNs could understand that though we are paid well, have great benefits and respect, that when push comes to shove, you WILL stand alone.

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Sorry whatever you went through, Trauma -- I know it had to be hard. Agree about the emotional toll -- I think I will just be forever changed by it, down to the deepest parts of my psyche. It was a struggle to also not want to quit being an NP, to quit being a nurse. At times I do feel we are held to an impossible standard .... we just are expected not to make mistakes .....ever.

What I never realized is the permanent nature of your discipline. If it's a public reprimand, it stays public in our state for three months, and then remains in the system available to anyone in healthcare organizations who have a need to know forever. You can hire a lawyer again to get it expunged, and there does yet another few hundred dollars.

If you LOSE a license, forget it. It stays on the roles for 50 years and can effect your ability to obtain any other type of job which requires any sort of license.

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Specializes in NICU, ICU, PICU, Academia.

OP: Powerful post. But everything you said pertains to every level of nursing, not just advanced practitioners. Getting fired was the most emotionally devastating thing that ever happened to me- and I learned so much from it. It made me a better nurse.

Thank you for sharing this.

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Oh yes, it absolutely makes you better, and stronger .... But you're gonna go through some extraordinary pain to get there. í ½í¸ží ½í¸”

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Specializes in Nephrology, Cardiology, ER, ICU.

@SOM - yes, any discipline stays on our state's BON site FOREVER and it flashes a bright RED like some sort of beacon when you do licensure lookup.

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Specializes in Progressive, Intermediate Care, and Stepdown.

While I'm not an APN, this really validates my feelings about holding . I've spoken to a few nurses out there and I keep hearing, "It increases your likelihood of being sued because the lawyers find out who is insured. " Thus, pulling a Jerry McGuire and "show me the money." I feel it's better to be safer than sorry and I'm a travel nurse so I'm put in very unfamiliar situations all the time. Sorry for the struggle but I appreciate your thoughts.

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Oh gosh ... a travel nurse ought to have a triple policy.... so much risk, especially also not knowing your staff all that well. I have to wonder about the lawyers, too. Mine never asked if I had insurance -- but I wish I had.

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Oh gosh ... a travel nurse ought to have a triple policy.... so much risk, especially also not knowing your staff all that well. I have to wonder about the lawyers, too. Mine never asked if I had insurance -- but I wish I had.

The facility will throw the travel nurse under the bus any chance they get!

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Specializes in CTICU.

Thank you for sharing your experience. I often think about what incredible responsibility is on my shoulders in my work position. It does not take much at all to make an error, especially with an electronic record where clicking one wrong button can mean something very different gets ordered. I am sorry for your struggle and I hope you are on the upswing now.

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@SOM - yes, any discipline stays on our state's BON site FOREVER and it flashes a bright RED like some sort of beacon when you do licensure lookup.

This made me think of the red lights outside of houses of ladies of the night. Meant to fend off business, instead of attract business though.

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Thank you -- that's incredibly nice of you to say. I really am grateful for the non-condemning attitudes here -- I wasn't sure what would happen if I shared what I could, but it's been so painful I just can't stand the thought of anyone else going through it.

We do have incredible responsibility as nurses, and even more as NP's. And it's just so easy to miscommunicate with patients. I'd just say -- always make sure you and they are on the same sheet of music -- fully explain, fully educate, and document that you did. Same goes for insurance charges also .... because they will come back more than anything if they're upset about a charge.

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