Does the board of nursing over ride union?

  1. 0
    Hi fellow nurses,

    I have a question. Does the board of nursing over ride union specifics?

    Here is the scenario:

    A Psyche nurse for a particular instituion, not necessarily a psych hosp, or specifically a psyche institution, but they have an "area" covered by psych nurses for pscyhe patients. In any case, their union request that they ONLY assess, provide care, in a mental health format. In other words, if there is something medically wrong, they are not the first responders, they have to call medical. Even for something as simple as a breathing treatment, vitals, stopping bleeding etc.

    In the meantime, the patient's condition can possible get worse while medical is in route to the area...does this sound okay? I'm having difficulty accepting this, and according to their union this is fine. However, if someone dies because, Medical couldn't reach them in time, wouldn't the Psyche RN's license be in jeopardy? I would think so! Any thoughts? Thanks.
  2. 7 Comments so far...

  3. 3
    why don't you pose this question to your state board of nursing?

    Here's a hint, from who does the nurse obtain a license to practice as a nurse?
    HouTx, lindarn, and MN-Nurse like this.
  4. 4
    There are at least three separate concepts at play here.

    A union contract is simply a legal, binding contract between two parties - the employer and the collective of workers in one or more job titles - spelling out wages, work rules, benefits, etc. It has nothing to do with nursing licensure, but it can certainly delineate which nurses will perform which duties within an employer-organization.

    The requirements for nursing licensure and the scope of nursing practice are regulated by the state's board of nursing. The scope of practice determines what knowledge base, interventions and assessments are required of nurses.

    The third concept that applies to your scenario is that of professional negligence or malpractice as a breach of nursing duty. You appear to be asking if a psych nurse who is with a patient when a medical emergency occurs is required to perform x, y or z intervention. The legal standard that generally applies in civil or criminal cases is, "what would a prudent nurse have done in that situation."

    There are many, many forms of nonclinical nurse practice. Even in acute care settings, there may be many nurses who are involved in a patient's care by way of consulting or ancillary disciplines, but responsibility for a patient remains with the patient's assigned nurse.

    A word of caution: if the patients in your scenario are at some location away from their primary assigned nurse when the psych nurses see them ... if the issue is pushed you may find that primary nurses will then be required to accompany patients to that location. You may determine that that is the best, safest course of action, but think carefully about the staffing implications of that, and what it means for the safety of patients who remain on the home unit.
    Esme12, lindarn, nicurn001, and 1 other like this.
  5. 0
    Thank you Ultra for your comments, very helpful.


    As for Tewdles. Really?
  6. 0
    This is a really, really good question!! My off the cuff thoughts are relevent to a scope of practice issue, and I would look to your state Board of Nursing for direction. Seems as if this particular psych facility is using RN's as mental health aides to make themselves look quite professional "we have RN's on staff" whilst limiting your scope as to not pay you an RN wage. That would have to be negotiated in a union contract (RN's paid as RN's no matter what the scope). However, my question to the BON would be what liability and obligation do I have as a licensed RN in a limited scope of practice in a facility? Also, it they do not have the tools you need to be successful, (ie:nebulizers, code carts, etc) then your only choice would be to send the person out with EMS. (much like a LTC situation, although some interventions can be started at most LTC's and it doesn't seem like the case here).
  7. 0
    Quote from Altra
    There are at least three separate concepts at play here.

    A union contract is simply a legal, binding contract between two parties - the employer and the collective of workers in one or more job titles - spelling out wages, work rules, benefits, etc. It has nothing to do with nursing licensure, but it can certainly delineate which nurses will perform which duties within an employer-organization.

    The requirements for nursing licensure and the scope of nursing practice are regulated by the state's board of nursing. The scope of practice determines what knowledge base, interventions and assessments are required of nurses.

    The third concept that applies to your scenario is that of professional negligence or malpractice as a breach of nursing duty. You appear to be asking if a psych nurse who is with a patient when a medical emergency occurs is required to perform x, y or z intervention. The legal standard that generally applies in civil or criminal cases is, "what would a prudent nurse have done in that situation."

    There are many, many forms of nonclinical nurse practice. Even in acute care settings, there may be many nurses who are involved in a patient's care by way of consulting or ancillary disciplines, but responsibility for a patient remains with the patient's assigned nurse.

    A word of caution: if the patients in your scenario are at some location away from their primary assigned nurse when the psych nurses see them ... if the issue is pushed you may find that primary nurses will then be required to accompany patients to that location. You may determine that that is the best, safest course of action, but think carefully about the staffing implications of that, and what it means for the safety of patients who remain on the home unit.
    Well said.
  8. 0
    Answer: who DOESN'T the State Board override?

    Your union should be your client, because that is NUTZ!
  9. 0
    Quote from determined2doit
    Hi fellow nurses,

    I have a question. Does the board of nursing over ride union specifics?

    Here is the scenario:

    A Psyche nurse for a particular instituion, not necessarily a psych hosp, or specifically a psyche institution, but they have an "area" covered by psych nurses for pscyhe patients. In any case, their union request that they ONLY assess, provide care, in a mental health format. In other words, if there is something medically wrong, they are not the first responders, they have to call medical. Even for something as simple as a breathing treatment, vitals, stopping bleeding etc.

    In the meantime, the patient's condition can possible get worse while medical is in route to the area...does this sound okay? I'm having difficulty accepting this, and according to their union this is fine. However, if someone dies because, Medical couldn't reach them in time, wouldn't the Psyche RN's license be in jeopardy? I would think so! Any thoughts? Thanks.

    Psyche was the mortal with whom Cupid fell in love.


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