Does this make me an "RN snob"?

Nurses General Nursing

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Specializes in HH, Peds, Rehab, Clinical.

My BFF has started a new job recently and we were visiting about it last night. (We both work in dentistry, I graduated from an accreditated program, and sat for the national boards for certification in 2 specialites b/4 I decided to go back to school for nursing, I am now an RN. My GF was trained on the job (as SO many dental assistants are, and therefore was not eligible to sit for boards. She has a buttload of experience, as have I, and she definately knows her stuff orally. I love her to death and in essence this post is not about HER, but the practice where she works)

She's employed by an oral surgery group. They have NO RN's on staff---a few LPN's and the rest are assistants, I do not know the level of education or training that any of them have, there is no licensure for dental assistants. Anyway, the Dr's call ALL of the staff "nurses" and most of the staff do not tell patients any different. Yesterday she tells me that she pushes drugs into already established IV's. I must have had a horrified look on my face b/c she assured me that the Dr "is right there". We're talking Narcan, Atropine, "milk of amnesia"----everything!!!

Again, I love my BFF to DEATH, but am I wrong to feel a "little bit" irked that essentially untrained, unlicensed people are being allowed to do what I worked my tail off for the right to do?!

My issue is that you appear to be upset for the wrong reasons.

I'm not okay with that and I don't think it makes you (or me for that matter) a snob. At my last nursing job my boss said as far as she was concerned even the aides (not all of them were even cnas) were nurses. I was insulted.. As you said I worked hard to earn the right to call myself a nurse and people have certain expectations on knowledge and level of education when you call yourself a nurse, as they should be able to. Unless you hold a license you are NOT a nurse.

Specializes in HH, Peds, Rehab, Clinical.
My issue is that you appear to be upset for the wrong reasons.

Which would be? This OS group allows unlicensed, untrained personnel to give these drugs to clients who probably have NO clue about the level of licensure of the staff? That's pretty concerning to me. I apologize if that wasn't clarified in my original post =(

Agreed, the strongest argument would be one with concerns about safety.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

she's employed by an oral surgery group. they have no rn's on staff---a few lpn's and the rest are assistants, i do not know the level of education or training that any of them have, there is no licensure for dental assistants. anyway, the dr's call all of the staff "nurses" and most of the staff do not tell patients any different. yesterday she tells me that she pushes drugs into already established iv's. i must have had a horrified look on my face b/c she assured me that the dr "is right there". we're talking narcan, atropine, "milk of amnesia"----everything!!!

*** that is scary!!!! and dangerous as is gets. i work in a hospital with an oral maxillofacial surgery residency. i am the rapid response nurse. i dread it when one of their patients has problems. they are dentists, they do not do icu rotations like the general surgery residents do. they have no idea what to do about regular medical problems and are useless in an emergency situation. our hospital recognizes this and when i am responding to one of their patients with an emergency i am supposed to call the house officer (an internal med physician) for orders. the omf residents just stand around, getting int he way and looking scared and uncertain.

that the doctor is "right there" while she is pushing propofol is like "so what"? who is going to save the patient? the dentist doesn't have the expeince or skill and you just told us your friend doesn't either. there should be a crna doing that job. in my hospital rns push propofol but only in the icu, in a monitored enviroment by specialy trained nurses who have vast icu experience and with a crna a 2 min call away.

again, i love my bff to death, but am i wrong to feel a "little bit" irked that essentially untrained, unlicensed people are being allowed to do what i worked my tail off for the right to do?

*** what you should be irked about is the danger that practice is putting those patients in.

These guys often hire off the street assistants and train on the job. I figure, since the assistant has no license, they work under the dentist's license, OS being ususally a DMD. If those guys want to take a ride on the wild side fine. The LPNs however work under their own licenses, whether or not they can push IV meds is up to the state they work in.

You have to be careful even as an RN these days. As soon as you go looking to work for a MD private practice you have to be on your toes. Some of them really don't remember that as an RN you can't work for them as an assistant, where they can just have you do what ever floats their boat. I have heard a few cases where the line gets even more confused. Due to the economy or whatever, I am hearing of situations where MDs are letting their PA's go. They don't want to pay for them. So, an RN is hired and expected to take the responsibilities of the PA for less money. Unfortunately, we can't do that.

If it's illegal then I would report the facility to the proper officials because this puts patients lives at risk.

Specializes in Psych ICU, addictions.

My issue is not the lack of RNs, as many medical outpatient practices are run very well with LPNs (who ARE nurses) and/or MAs, without an RN in sight. What concerns me is what they are doing based on what you describe.

Your issue should be less about the "No RNs!" and more about the patient safety risks.

Specializes in Med Tele, Gen Surgical.

I'm not sure what state you are in, but this sounds like "practicing nursing without a license" in terms of the exact skills you mentioned (e.g. pushing iv drugs). Our NPA is very specific that RNs may push IV drugs (LPNs may not) and that in any case only appropriately licensed and trained persons can do so. If, indeed, you are very concerned for pt safety, perhaps a call to the BON to clarify scope of practice and put a bug in their ear about what is happening?

I don't know what state your in but in Maryland I am a student and we are not allowed to PUSH ANYTHING no one but the nurse and doctor is allowed to! They told us that the first day of clinical! :redlight:

Specializes in LTC/Rehab.

I'm licensed in AZ and NY as an LPN. We can absolutely not push any IV med and we are limited in what we can even hang on a peripheral. That being said if it was me I would be reporting it to state. There are so many things that can go wrong and real quick, that is why they don't want us to do direct IV pushes. We aren't trained to handle a situation should it go bad, and seeing that its pushed directly into the blood it will go bad fast where taking immediate action may be required to prevent damage or death to a patient. It's absolutely wrong to be misleading these patients into thinking the staff is something they are not. I think this needs to be reported, I know this is your bff but these patients deserve to be getting treatment in a safe manor.

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