Help when a non-nurse steps over Nursing bounds!!!

  1. I am a MDS coordinator/charge nurse at a long term facility. I write care-plans, conduct assts, etc. to turn into state so that the facility can be paid. We have a regular floor in our place plus an enclosed alzheimer's unit. Over the unit there is a coordinator (non-nurse). I was called "to the mat" today because I, as a nurse, stepped on the coordinator's toes by conducting psychotropic medication asst. on "her" resident's .

    Instead of talking to me first she spoke above me to the administrator and all HE** broke loose. She stated that I don't respect her nor do I value her degree (B.S. in Psychology). I have the same degree as well plus a master's but I did not bring that up during her tyraid. :angryfire

    I want to know when a unit coordinator became licensed to pass medications, answer doctor's questions regarding interactions, or take orders????? I give the respect that you deserve not what you want but you have earned. If she were to lose her job, she can find another job....if I lose my license because of her mistakes I LOSE MY CAREER. BIG DIFFERENCE!!!!!!!

    How would anyone else handle this situation? I am at a loss. We are supposed to be there for the resident. Not worry if I offend someone I work with because I don't "respect" her degree. PLEASE ADVISE!!!:trout:
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  2. 11 Comments

  3. by   bargainhound
    You are placing yourself in harm's way with BON if you stay in your job
    with this happening.

    It is just a fact that people cannot practice nursing without licenses.

    The Facility itself is also placing itself in harm's way for fines from state
    for these infractions.

    Her ego is going to take you all down, the administrator included.

    As long as you are aware and do not report the problem and continue
    to be there..........I think you are in danger of losing your license and/or
    going before the BON yourself.

    Protect yourself.
  4. by   Batman24
    I am not a nurse so I am answering this due to my managerial experience.

    How did the Administrator respond?! Were you reprimanded or defended?! Was this woman advised that you handled your job appropriately and were totally within your professional bounds to handle the situation as you did?! Was the woman also told that her expertise is much different than yours and there are things by LICENSE AND LAW that you can do that she can't do?! These would be my initial concerns.

    I would also not hesitate to point out your own education which exceeds hers. I don't see this as being conceited or showy. This would just prove that your eduction and expertise surpasses hers on a medical and professional level. You not only hold her degree, but one superior to hers. It seems perhaps she is the one being disrespectful.

    If you were treated fairly and fear no negatiove consequence then you could let it go. If something is being put in your file I would fight until the cows come home. I suggest you call a meeting with your supervisor and hers to discuss the situation between the three of you alone. It seems she has a self-esteem problem not to mention no respect for proper professional boundaries.

    And if her actions are breaking any laws I would have it reported and documented. As a nurse you will end up on the short end of the employment stick. Good luck. I am sorry this is happening to you.
  5. by   bargainhound
    You must document all this for your own record if nothing else, so that
    when/if state does come back on you----you will be able to have
    details to give them.

    They will have no mercy. Your only hope is to get out of that situation,
    since the administrator is backing the other person. BON will come after
    you.
  6. by   bargainhound
    Believe me, state will come back on you----and it may be a year from
    now.........when you think all has blown over.
  7. by   Batman24
    I was just coming back in to say what Bargain said...document everything in writing. Be sure to have supervisors initial letters or send them certitified mail for a signature by said person. If they are taking this person's side then you need to start and keep a paper trail.
  8. by   mizzou_ivy
    Thank you for your kind words and advice. I have documented and am looking for another job as we speak.

    Just wondering if there is ramification for her practicing outside her scope?
  9. by   NRSKarenRN
    All depends how the Alzheimer's unit is regulated by the state.
    If is considered an assisted living or group home setting, some states do not have regs over who can take orders.
    If is classified as SNF, as getting federal Medicare/Medicaid monies to care for patients then definately overstepping bounds.

    Look at state regs under Deptartment of Health for answers....many states have list of licensed facilities.

    Word to the county ombudsman on the way out the door might be helpful to future residents too.
  10. by   reneemcsquared
    I think the facility might be at risk if they are, in fact, letting her give medications. Can she discuss care with doctor? Why not? She doesn't have a nursing license so she is not playing by the same rules you are. If your accrediting agency or state agency has rules that limit certain tasks and activities based on license, the facility is at risk. You did not delegate tasks to her, you are not her supervisor, and I am not sure how your license is at risk because of what the facility is letting her do to other residents. Annoying, yes, inappropriate, maybe, but a hazard to your license, don't think so. Just my opinion.
  11. by   Daytonite
    Report her to the agency within your state department of health that licenses the facility and conducts surveys. They are obligated to investigate.
  12. by   bargainhound
    Since she is RN aware of the practice, that is how she is liable with the BON and state.
  13. by   Antikigirl
    Not meaning to scare...but it will be the RN who will pay dearly for NOT reporting this practice since we are obligated to point these issues out...even if we just 'feel' this may be wrong.

    I too worked at a LTC/ALF where this was becoming beyond acceptable! The management was made up on Non nurses but making nursing policies and mandating we do what they advised...and many time we had to correct them on various issues involving HIPAA, and general safety. They not only didn't listen, but threatened to fire anyone that dared question their authority!

    Once I offered advice on a safety issue...I was basically shunned by administration and none of them would even talk to me or acknoweledge I was there, and nurses were scared to be seen talking to me because they were warned that I was a trouble maker!!!! BYE BYE I said...and took a risk on agency nursing that panned out so nicely! Then they got a visit from the BON for their audit...they thought I called them into the BON..so again they were harrassing me and still does today by many of the friends I had working there not speaking to me because they can get fired by being seen talking to me. (they had many issues by the BON btw!!!!!!).

    Then just this last month I was tending a pt and he was the head of the organization I worked for, but when I was working there he wasn't so I thought nothing of it. He reported me and had me written up for being rude, unsanitary, unlady like, and if he got an infection he was going to sue the hospital and me! Ummmmmm...lucky for me I was training a CNA and she was with me the whole time I ever was tending to him, and proved him absolutely psycho!

    Then I discussed with my management team that he was angry at me for suggesting that we do a real fire drill at their facility because I feared nonmoble folks lived on the second floor and I didn't think our staff would have a clue as to what they need to do to get these people out when the elevators don't work!!!! I was in deep do do for even suggesting this, because one, I was a woman and knew nothing of firefighting or EMS (yeah right...went to school for both idiot!!!) because that was a mans job...and that I must be a rebel rouser because I didn't respect the authority of the administration by even opening my mouth! Well after that I had the chief of the fire department speak to them, proved I was right...and they have been ticked ever since...and they failed fire safety regulations so many times the fines were huge (again I listed all the infractions I had seen and asked for them to be fixed before fines were involved or lives lost...gee, I guess I don't know anything..the chief agreed with me totally!!!!).

    SOOOOOO...get out, get out soon...and report this to your BON. I should have reported things to the BON so I wouldn't have gotten 2 years of harrassment from that employer that still doesn't get it that I am not their Pee On anymore!!!! (I have lots of documentation still !).
    Last edit by Antikigirl on Dec 8, '06

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