“I’m not putting my license on the line”

How many times have you heard this mentioned in casual conversation amongst healthcare providers?Perhaps during a heated exchange on television, or when talking about doing things we aren’t comfortable doing to our patients. Perhaps you have even mentioned it yourself.

The fact is, it takes a lot – A LOT – to lose a medical license or license to practice. Yes, bumps along the road in our career can happen, but realistically speaking, what licensing board would have a vested interest in removing providers from an already strained healthcare system?

The Reality of Losing Your Medical License

Providers who lose their license to practice have a reason to lose it. The causes are egregious and demonstrate a pattern of behavior that cannot be rehabilitated, are consistently unsafe, and paint the picture of a person who should never be permitted to touch patients in any situation.  Think of people who intentionally kill their patients, try unproven experimental treatment and have bad outcomes, or use drugs and alcohol and are impaired at work without any reasonable possibility of rehabilitation.  The irony is that the people who are most concerned about losing their license are probably the most focused on preventing harm to their patients – and by definition the LEAST likely to ever face discipline over their license.

There seems to be a common notion amongst Nurses (and their advanced practitioner counterparts) that losing a license is a common thing that should be feared, and that providing care that is not agreed upon by all parties will cost the loss of this cherished, sacred, yet somehow fragile license to practice.  Even amongst those who are supervised by a licensed physician, and under a collaborative agreement to follow orders or collaborate on care, is there a fear that somehow, in some way, a bad outcome due to bad decisions will cost someone their license.

Despite years of clinical experience, post graduate training, intensive review of evidence based practice, papers and capstone projects, and hands on management, the loss of a license is still mentioned as the final blow to a career so fragile that the thought of chart review, consultation, careful decision making, and collaboration with our colleagues renders losing a license to practice an inevitability.

Confidence improves your care. That is the point of this rambling diatribe. When you practice and make unsure decisions, you begin to doubt the decisions you make. This doubt can become a pervasive poison into other areas of your practice, and even allow you to second guess your own management. It can blind you from not knowing what you don’t know. It can lead you to question everything, and drive your clinical mind to the point of no return, rendering you helpless to make confident medical decisions again. And at the end of that pathway lies a patient, who is the unwitting recipient of our uncertainty, and fear of losing a license.

Knowledge is Key

There is only one cure for the fear of losing a license- confidence- and the only way to improve confidence  is to improve your knowledge base. Knowing what you don’t know is the first step in a long journey of lifelong learning that improves your clinical skills, adds to your confidence, saves your patients from countless unnecessary tests, and makes you a strong, self sufficient, and excellent provider. We at Provider Practice Essentials can help you!  By exposing you to areas not taught in depth in standard curriculum based programs – such as intensive radiology, hands on procedures, and presenting patients to accepting specialists, we can help elevate your skill set and remove the unknown from your practice.

Rachel Beatty, FNP-BC, AGACNP-BC