Nurse tech working as RN

Nurses General Nursing

Published

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 is okay before I agree to anything. Nurse techs have been doing this for a long time before I ever got hired, which was recently. Still, I want to make sure.

Specializes in Pedi.
Okay. Well there is another RN in the facility. I take back my question, I'm sorry, I think this would qualify as somewhat of an internship type position. I'm working as an RN, but only during NOC shift and never without an RN nearby

You are not an RN, therefore you cannot "work as an RN." Practicing nursing without a license is against the law. Suppose in your night shifts "working as an RN" you miss a critical lab value or a subtle change in assessment or an IV infiltrate that then turns into compartment syndrome and a sentinel event results? Do you think the facility is going to have your back when the state comes in, runs an audit and finds that the "nurse" caring for the patient is not a licensed nurse at all? No way would I, as a licensed RN, agree to be the only RN on a shift and have a nurse tech "functioning as an RN" working with me. When I worked in the hospital, our rule was 2 RNs at all times, even if there was only one patient on the floor. As I was told, this rule came from a night many years earlier when there were only 2 patients and only 1 RN was kept on. She had to go off the floor with 1 patient and then there was no one on the floor to watch the other patient.

If the facility did not want to hire an RN for that position that they are letting you cover then they should at least hire an LVN just to be on the safe side. At least an LVN/LPN can take MD orders, do focused assessments, put in orders on the MAR etc. It's probably all about the budget, facilities will do this to "stay in budget" but this is unacceptable and I'm actually more worried for the RN that's working there and delegating her tasks to you (if that's what she's doing). Good luck to you.

Okay. Well there is another RN in the facility. I take back my question, I'm sorry, I think this would qualify as somewhat of an internship type position. I'm working as an RN, but only during NOC shift and never without an RN nearby

Uh...stuff happens on night shift. Not sure what that has to do with anything except the convenience of the facility who likely can't get night shifts filled.

Is there an arrangement with the school? If not I'd assume the facility is just trying to get warm bodies to fill scheduling holes.

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.

Absolutely NOT. There are steps in nursing school before you can do any nursing tasks, even with a licensed RN watching you, like right there in the room. For example you can't, AS A STUDENT take a blood glucose reading until you've done it in lab, mastered the clinical reason behind the actions (book study with testing) AND your clinical instructor AND preceptor think you are ready. This is how it was in my school in Washington State, anyway. But in this case you are NOT a student and don't have all those structures in place to protect you and your patients.

:wideyed: I have never heard of this...

Yes, in Washington State we have a nurse delegate designation. A CNA with extra training and certification can pass certain meds to stable patients in certain scenarios.

Specializes in Med surg..

Any LTC faculty that lets this fly is waiting for a lawsuit or even worse patient harm or death. This totally blows my mind to be honest.. Unless you have been to NURSING school and passed NCLEX you should not be preforming ANY RN duties even with somebody "supervising" you... What is going on wherever you are working is illegal plain and simple.

Actually, in the state of Texas GN and GVN do have licenses...they are just temporary. And the hinge on passing the NCLEX. We can practice as nurses under the supervision of an RN but they ARE licenses.

+ Add a Comment