Nurse Practitioners Closing or Leaving Practice

Nurse Practitioners Closing or Leaving Practice – Temporarily or Permanently

Nurse Practitioners (NPs) have a professional obligation to provide safe, competent, and ethical care for clients and to establish therapeutic nurse client relationships (TNCRs) that are culturally safe and equitable. TNCRs are foundational to the practice of an NP; however, circumstances may arise (e.g., planned or unplanned) that may lead to the discontinuation of the NP-client relationship. These circumstances require careful consideration and reflection.

An NP may close their practice or leave their current position/practice setting either temporarily or permanently (e.g., maternity leave, retirement, relocation, resignation, extended absences, close their self-employed practice, etc.). Regardless of the circumstances surrounding the NP’s need to leave practice, the NP must proactively plan for unexpected or planned closures and take reasonable measures to reduce the impact of a closure or leave from practice by facilitating continuity of care and minimizing interruptions to care. The NP must employ their professional judgment and clinical reasoning to determine what is reasonable and expected in their practice setting. The NP must:

• comply with all relevant employer policies and processes (if applicable) to assist in the transfer of client care and client information. In the absence of employer policies, advocate for employer policies that enable the facilitation of a seamless transition of care in the interest of the client
• inform the client, employer, referring health care providers (as appropriate), and colleagues at the earliest opportunity to allow reasonable notice and subsequent arrangements to be made accordingly
  • the NP tailors each notice period after careful consideration of matters such as the availability of alternative health care providers in the client’s community and the client’s immediate health care needs
  • literature indicates that there are varying timeframes for providing notice to the client(s) that the NP is leaving or closing their practice. A minimum of three months is generally considered reasonable time to allow clients to make alternative arrangements. If the NP is in an employment situation, the NP should notify the employer as soon as possible, or according to employer policy, to provide sufficient time for the employer to find a replacement and make arrangements for the transfer of the client roster/panel to another practitioner
  • College of Physicians and Surgeons (CPSNL) currently requires physicians to give clients a minimum of 90 days of a planned closure of practice or leave from practice. The College would consider this a reasonable timeframe, but the NP must use their clinical judgment to determine if this timeframe is appropriate in their context
• communicate directly to the client the date of the planned closure or leave from practice
  • direct communication can be supplemented through one or more channels (e.g., letter-mail, email, telephone, outgoing voicemail message, virtual, or in-person scheduled appointment, etc.)
  • document notification or communication with the client in the client’s health record

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