I have been an RN for 27 years and thought I had seen every type of misbehavior by an MD (and company) that was possible.

But after accepting my 1st job as an NP, I soon realized that there was more to learn!

In my state of North Carolina, the NP must work under a supervising MD with a Collaborative Practice Agreement as the binding document.

So I signed such an agreement with one of the MDs in the practice. The other MD signed on to be my "back-up physician".

That means that when the primary MD is absent or unavailable, I am expected to use the back-up MD as a resource for questions and concerns.

Well, the primary MD had sold the practice to an out-of-state company and was nearing the end of his contractually guaranteed employment.

He began to openly criticize the other MD and to issue directives to the clinic staff stating that the NP could only see his patients.

As he was out of the clinic more than he was present, I, as the NP, needed to see his patients and assist the other MD with routine patient issues and patient overflow.

Under the primary supervising MD's directive, the back-up MD was expected to assist me when I needed it but I had been instructed to refuse to assist her with her patients.

Worse still, office staff, who were also in the personal employ of the primary MD, were instructed to prevent me from assisting with patient care and to report to the primary MD if I attempted to do so. (These staff were therapists and receptionists - not RNs, NPs, PAs or MDs.)

I contacted the company's HR Department by phone and email and provided details that indicated that the patients and I were now the pawns of a power struggle between the 2 MDs. I received email thank yous and assurances that steps were being taken to address the problem.

I contacted my state board of nursing to apprise it of the situation and asked how I could follow the order of the primary MD and refuse to follow the orders of the back up MD and still function. Clearly, I could not.

So 4 days after the last email received from the company's HR director assuring me that a resolution was imminent and 1 day after receiving telephonic reassurance by the corporate MD liason, I was summoned to the office and terminated. The reason cited was a financial downturn in the economy.

Despite specific statements in the Employee Handbook stating that no severance package was permitted for terminated employees, I was given an 8 page severance contract offering me $5,000 if I agreed not to pursue any litigation related to the work situation and to not make derogatory (although factual) comments about the company or its employees.

Thankfully, I have the telephone recordings with the HR Director, the taped recording of the face-to-face meeting with the primary supervising MD when he stated that he could dictate any constraints on my patient care independent of the NC statutes governing NPs, and the 5 documents the supervising MD issued to the other MD, to the office staff, and to me relating to his imposed constraints.

The whistle blower law is now going to be tested and I offer my experience to all NPs as a warning of how treacherous and malicious an MD and a company who states they support excellence in patient care can actually be.

I have even offered the details to my alma mater to use as discussion material for student NP preparation to practice forums.

Anyone have any comments or similar experience?

nellwolfe