I am a nurse practitioner, and I received a disciplinary warning that I feel was unwarranted. What should I do?

By | 2022-02-15T17:44:45-05:00 November 30th, 2011|0 Comments


Dear Donna,

I work at a private office as a nurse practitioner. I received a disciplinary warning notice for not taking the patients according to their waiting time (skipping the patients).

Sometimes when the load is high, I take two charts to save time, and my supervisor thinks it may disrupt the order. But charts are available to all employees, and sometimes medical assistants mixed them and clinicians have no time to check the order.

Very often we have a high workload, sometimes 200 patients are scheduled for our office and more than 100 of them for histories and physicals. This is a heavy load for two clinicians.

On a tough day, patients who waited more than an hour and a half became agitated and started to complain. Our supervisor called us and told us that some patients complained about waiting time and being skipped. Two weeks ago the same situation occurred, patients complained and the supervisor called again.

The disciplinary warning I received was a final warning. When I asked to see patients’ complaints, I was told they were verbal complaints. I asked why my supervisor thinks that patients complained about me specifically, and she told me “They described the person as a short woman with a haircut, and I am sure this is you.” There are several people in our office that can be described the same way — medical assistants, clinicians — who have access to patients’ charts on the front desk.

When I started working in this office one year ago, my mentor told me to take two charts to save time for the patients. I don’t think this is such a big violation of clinical policy that it warrants disciplinary action. This is my first job as a nurse practitioner, and I don’t want to start with disciplinary actions on my record. I now take only one chart at a time, but my supervisor insisted that I failed to meet clinical standards.

What should I do in this difficult situation? Should I sign a disciplinary warning notice with my written comments or just refuse to sign it?

Nurse Practitioner

Dear Donna replies:

Dear Nurse Practitioner,

You tell a very troubling tale. From the details you relate it sounds like your employer is looking for a scapegoat, rather than making an effort to improve the efficiency of the office. Additionally, the punishment appears harsh for the alleged infraction, and there doesn’t even seem to be proof that you were the cause of the complaints. I also don’t understand how this could be a final warning if you have never received a written warning before. Do you know what the employer’s policy is for discipline? Does it include a provision for challenging reprimands? You can ask to see the policy and make a copy.

Not signing the written reprimand does not accomplish anything. It will go in your record anyway and they will simply state you were informed and refused to sign it. I would draft a detailed response as you did in your post (get a friend or family member to help you with this if necessary) and submit it when you sign the reprimand. Make it clear you don’t agree with it and that you were not given any prior written or verbal reprimands. Keep a copy of this and get a copy of the written reprimand and any others that might be in your file. Keep detailed notes on any conversations and comments made, with dates, names, etc.

In the meantime, it appears to be a less than ideal work setting for you. It sounds like you are setting yourself up (or are being set up) for disaster or failure. I would suggest you start looking into other opportunities. Every workplace is different, and you don’t have to tolerate inefficiency, disorganization, tyranny and persecution. Opportunities for nurse practitioners are opening up all over the place.

I hope you belong to — and are active in — a nurse practitioner association such as the American Academy of Nurse Practitioners (www.aanp.org) for support, networking and ongoing learning. Read “New Credential, New Role” (www.Nurse.com/Cardillo/NewCredentials).

My best wishes,


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