Nurse tech working as RN - page 2

So at my facility, a short-term rehabilitation center with a few long-term care patients, nurse techs can cover RN shifts, only if the shift is a NOC shift. Is this legal? Just want to make sure this... Read More

  1. by   TooManyCats
    You might also want to look into your states laws regarding medication administration. The facility might be fine with a tech doing it, but the state might want a qualified medication aid, and even then you'd need an LPN at minimum for injections. As far as assessments go, you're not yet an RN, assessing is outside of your scope of practice, so unless that RN would be checking your and verifying your assessment (with her findings in the MR), this is a no go.
  2. by   NurseRoRo
    That sounds like a sticky situation that honestly, if I were the RN that you reference, I would not take on that sort of liability to jeopardize my license. As loyal as I am to my employer, I know that if there were ever a lawsuit, my employer's best interest is not me. They would say I should know my scope of practice and yet I allowed a non-licensed person assume duties of a RN. If you are permitted to call doctors, do assessments, pass meds, how do you sign off on all those documents? If you get a telephone order, do you sign the order F.Lastname,RN? If so you are practicing illegally.

    If there were questions or suspicions during a board of health survey, it would be very easy for them to look at employee records to verify who is licensed, etc. If the facility is allowing this to happen and they take federal funds (Medicare, Medicaid), they are commiting a federal offense which is absolutely illegal.
  3. by   HeySis
    Quote from esrun77
    One last question though--if there is one RN plus me in the facility, can I complete RN duties under her guidance? I am certified with medications, as well as certified as a CNA.

    NO, you cannot, you are not an RN.... when you do things in school it is under the license of your school's clinical instructor, not the facility in which you are doing your clinical. For the state of Utah any RN overseeing you doing student nurse duties has to be "employed" by the school. This meant my preceptor even had to sign on as a contractor and was paid (a whooping $1, if you want to go to campus and pick it up) and she had to be present for everything I did.

    Your situation does not fit any of the criteria of a nursing clinical, so you should not be doing any RN duties. This is not an student internship... this is a job and you are not a nurse yet.
  4. by   TriciaJ
    The facility is cutting corners (major legal corners) if they are expecting aides (by any name) to function as RNs. There is probably a Nurse Practice Act in your state that spells out a nurse's scope of practice. Any unlicensed personnel trying to function in that capacity is breaking the law. Here is where it gets real sticky: does your facility have a written policy allowing aides to function as nurses? Probably not. They wouldn't leave themselves open like that. What they will do is throw you under the bus if they get caught.

    When there is a discovery by any overseeing body that aides are working as nurses, your facility will deny any prior knowledge of the fact and hang you out to dry for working outside your capacity. (I don't call it scope of practice, because aides don't legally have a scope of practice; they perform assigned tasks.)
    It's not unheard of for facilities to set inappropriate expectations and then not back their employees for trying to meet them. There are many threads on this site by people who are between that rock and hard place.

    Please get clear on what your employer expects of you and whether it's legal. For your protection and the patients'.
  5. by   Rose_Queen
    Quote from HeySis
    NO, you cannot, you are not an RN.... when you do things in school it is under the license of your school's clinical instructor, not the facility in which you are doing your clinical.
    No, this is a common misconception that is not true at all. The only person who works under a license is the person who is named on it. Students work under a certain exception that is granted by the BON for learning purposes. The only time an instructor's license may be at issue is if the instructor does something inappropriate, such as assigning a patient that is known to be above and beyond the skills the student has already accomplished.
  6. by   Julius Seizure
    Okay, so I can't quite tell what the scenario at your facility is.

    It sounds like on night shift, there is "usually" two RNs, but sometimes they will staff with one RN and one aide instead. Is that the case?

    So, that in itself is probably fine, as long as there is the one RN in the building. I don't know of any law that 2 RNs must be on site (this isnt my specialty, though).

    BUT if you are filling a gap in the schedule, that doesn't mean that you get to do more than you usually would be allowed to do. Doesn't matter if its days or night, you can only function as an aide. You, as an aide are not going to be able to do all the things that the second RN would have done. So the first RN will have to take on all those things that aren't appropriate for an aide to be doing. Thats the key part.

    It sounds like the facility might be wanting to act like that's the agreement on paper, but then turn a blind eye while you are pushed to do more than you should be doing on night shift. If you are going to work there, be very careful and advocate for yourself because the facility is not going to have your back if something bad happens. When in doubt, your best resources are the Board of Nursing where you will be able to find information about what an unlicensed assistant can do (or what can be delegated to them). I would look there, rather than ask your employer...I'm not sure they would give you the correct answer.
  7. by   esrun77
    Thanks, Julius Seizure. You're basically on point. There only has to be one RN in the facility, and it appears my boss may have dished out some false advertisement on the email he sent, stating that NTs can cover RN shifts. We're just acting as nurse techs during what is usually an RN's shift, but there's always an RN on duty
  8. by   TriciaJ
    Quote from esrun77
    Thanks, Julius Seizure. You're basically on point. There only has to be one RN in the facility, and it appears my boss may have dished out some false advertisement on the email he sent, stating that NTs can cover RN shifts. We're just acting as nurse techs during what is usually an RN's shift, but there's always an RN on duty
    Covering RN shifts is a different story. That is not the same thing as performing RN duties. You end up with one RN doing everything that needs to be done by an RN, and UAP doing everything that doesn't.
  9. by   Purple_roses
    Even if this *is* legal, I feel like it's a sly way to underpay you.
  10. by   the_murse_factor
    Seems like the facility is trying to find short cuts for staffing, but a nurse tech "covering" a RN shift hours don't sound remotely legal. I worked at a Nurse tech and barely got to do "nursing stuff".
  11. by   Julius Seizure
    Quote from Purple_roses
    Even if this *is* legal, I feel like it's a sly way to underpay you.
    I feel like its a sucky deal for the one RN on nights who now has the responsibilities of 2 RNs
  12. by   twinsmom788
    I'm trying to restrain myself here. Do you have any idea that what you are you are doing IS AGAINST the law. Oh, why bother to go to school and get the education and become licensed to become a professional nurse. Your facility is in jeopardy of losing it's Federal funding with you acting in an RN position. You can go to jail for acting in the position of a licensed professional. I'm a former state surveyor, staff at my state BON, state coordinator of the Certified Med Aide program, so please get your self together and don't believe what your boss is telling you.
  13. by   livelovelaugh22
    I think you should heed the advice of the previous commenters and get the he** out of dodge! Staying at this facility is endangering your future.

close