If you'll bear with me a moment I could use some advice. I am in the midst of a long and difficult career change from teaching to healthcare. At first I was going to pursue Respiratory Therapy but decided the field was too narrow. Then I applied to PA schools for two years and was denied by 17 schools. I am currently a medical scribe in a Pediatrics department at a large community clinic. I have finished all pre-requisites and have a 3.9 GPA for the last 70 units, and I expect to get into a BSN program in Spring or Fall 2016. My previous degree was in Economics from 1994 (I'm 44 years old.)

I love listening to patient histories and speaking with patients. I've been reading about triage nursing on this forum and I've been speaking with the RN who does triage for our Pediatrics department, and it seems to me that at some clinics with certain protocols in place a triage RN can become a sort of quasi-provider. Apparently some triage RNs see walk-in patients for things like UTI or sore throat (and present to an MD/NP/PA for them to order an antibiotic), do nurse only visits for immunizations and refill certain medications (with patient contact being both over the phone and in person as the situation dictates). And they also do patient education, which I know I would love.

My questions are 1) What are the issues with an RN acting in this manner? 2) Is this a viable career path (especially considering the general shortage of primary care providers), or is this a rare situation? and 3) While in nursing school how can I steer myself towards this career path and away from hospital nursing? I really do not like the hospital environment. (I was a nurse aide for a year.) I would prefer to get a position in a community clinic with minimal time spent in an in-patient setting.

Thank you so much if you read all that. I will read all replies carefully. Please do not private message me as I don't have the privilege of receiving private messages on this forum yet. Thank you!

P.S. It is unlikely that I would pursue NP after RN school because it would cost additional years of my life and a huge amount of additional debt, and I'll be 47 when I finish my BSN.

I can comment on some of this. We have triage nurses in my ambulatory clinics, and many of them do the sort of tasks you describe, while others work in our call center doing phone triage. This use of nursing personnel is becoming increasingly common in the larger ambulatory settings. The nurses perform these tasks under standing orders or protocols after first performing an appropriate assessment. They are not acting as independent providers but rather as an extension or delegate of, and under the orders of, the physician or non-physician provider, such as a NP or PA. Not all states allow this, however.

I do this all the time as a clinic RN. However, do not think for a second that we are "quasi-providers" - we cannot bill for our services, and we do not have prescriptive authority, or the authority to diagnoses or treat. We follow very specific protocols on which providers have signed off on and allow to call in prescriptions under their name, if the patient meets the requirements of the algorithm. Hospitals have things like this as well - they're called standing orders.

RNs are not providers. Not even "quasi-providers".