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.

Specializes in Nephrology, Cardiology, ER, ICU.

What people don't realize is that "THEY" can become "YOU" so quickly.

Don't feel anyone is immune....

OP: Thanks for sharing. Very humble and helpful of you. I am sorry you have to endure this ordeal, and I am proud of the person you are for wanting to share it in hopes of helping others.

Thanks so much- it got me out of a bad job, that is for sure. I did get hired by a new employer and am doing fine!

Thank you for sharing your experience and I am truly sorry you had to endure this, but what doesnt kill us makes us stronger! Do you mind sharing which retail health clinic you were working for? I only ask because I am with Minute Clinic and would like to know if it was them. Thanks!

I'm sorry -- can't share beyond what I already have.

Having worked now, however, in a more traditional primary care office, I can say that the same situation definitely would not have likely even occurred. I do believe the risks in retail are very specific -- but there are also risks elsewhere. Again, just make sure your insurance is updated, anywhere you practice.

Well, yes -- and I may add -- the board doesn't exist to protect nurses .... it exists to protect the general public! (From nurses and other healthcare professionals, and while some errors are more administrative, some are absolutely endangering and/or highly unethical) So, no -- they are definitely NOT there to do you any favors .... they are a disciplinary body.

Specializes in Family Practice.

Thanks for this post. I work in retail and your post is a sobering reminder that these companies certainly don't care about their staff to any degree. I've noticed recently that the chart audit team has become much more active and is sending nastygrams about the most minute things. I practice with my patients' best interests in mind but perhaps I should scale back to protect myself. It's unfortunate is has to be that way, to only practice 'inside the cookie cutter' or be at risk. :(

It is 100 percent true -- follow the guidelines to the letter and you're fine -- problem is, patients sometimes want the same type of care they receive at their PCP -- I would explain to them that you are NOT their PCP, and you have to follow the guidelines of your employer -- 100 percent at all times.

Thank you again for enlightening many of us on this subject. Ironically as a new grad RN I did purchase my own 1 year insurance policy on the advice of my critical care professor, because he scared the dickens out of us with stories, yet as an APRN we walk into job interviews assuming that the they are offering as part of their "stellar competitive package" will always be there to provide relief if ever found in this situation. It is definitely disheartening to learn that the health care entity can decide you practiced out of scope or didn't follow guidelines and choose not to cover you with your work malpractice. Because of your post I have started researching malpractice insurance for myself on the side, because as you demonstrated this can happen to anyone and the companies are out for themselves. I do have a friend working as an APRN for a county health dept that had this exact thing occur and she is leaving because they didnt back her even though she did nothing wrong and it was a potential hazardous SE from the procedure.

I appreciate that we all come together and share honest stories form practice with one another on here. Its hard to connect with colleagues in the workplace and often times NP and PA's dont want to openly discuss these things. This was very sobering and I thank you for sharing your experience. Good luck with your new job and remember that this was just a bump in the road and it does NOT define you as an NP.

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