RN working at a UNlicensed drug rehab

Nurses General Nursing

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Hi Everyone, I found out these details after I got hired: I was hired on as a RN for a residential rehab facility. They do not have any other nurses working there, just me and unlicensed staff. The role they want me to play is not a management or supervisor role over the unlicensed personnel. They want me to help them organize everything, make their policies better, take orders from md, transcribe orders into mar, chaperone patients when they are seeing md, and inventory and ordering. I am worried because I tried to search online, and saw they were not licensed. Could I get into trouble for working here? Any ideas or thoughts? Thanks for your time.

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Specializes in Emergency/ICU.

Just make sure that if you are responsible for establishing policies and procedures that you don't inadvertently violate state/federal ethical and safety standards/laws. If you will be "making policies better" you'll need to do a lot of research on how to set these up. Is there a director? Usually they are familiar with regulations concerning this type of practice and can guide you on what you need to know.

I'm not sure about getting in trouble for working there. I'd be interested to read others' thoughts and experiences. Is anyone passing out meds? I'm guessing you'd be doing meds and assessments too if there are no other nurses there?

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Just make that if you are responsible for establishing policies and procedures that you don't inadvertently violate state/federal ethical and safety standards/laws. If you will be "making policies better" you'll need to do a lot of research on how to set these up. Is there a director? Usually they are familiar with regulations concerning this type of practice and can guide you on what you need to know. I'm not sure about getting in trouble for working there. I'd be interested to read others' thoughts and experiences. Is anyone passing out meds? I'm guessing you'd be doing meds and assessments too if there are no other nurses there?

I am not passing out meds, they have unlicensed employees doing that. They told me (and i have it in writing that I have nothing to do with dispensing, or supervising med dispensing). There is a medical director and a MD that I will be collaborating with on the policy's. They are trying to tell me the unlicensed staff "store the meds, and just set them on the counter for the pt to self administer". This seems questionable to me.

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Run. Quickly.

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Specializes in Oncology; medical specialty website.
I am not passing out meds, they have unlicensed employees doing that. They told me (and i have it in writing that I have nothing to do with dispensing, or supervising med dispensing). There is a medical director and a MD that I will be collaborating with on the policy's. They are trying to tell me the unlicensed staff "store the meds, and just set them on the counter for the pt to self administer". This seems questionable to me.

Yeah, sure...until something goes wrong or someone screws up.

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Specializes in Psych ICU, addictions.
I am not passing out meds, they have unlicensed employees doing that. They told me (and i have it in writing that I have nothing to do with dispensing, or supervising med dispensing). There is a medical director and a MD that I will be collaborating with on the policy's. They are trying to tell me the unlicensed staff "store the meds, and just set them on the counter for the pt to self administer". This seems questionable to me.

In some states you do not have to be a licensed nurse to handle meds; CNAs and MAs can complete a medication certification course.

I do not know if you would get into trouble with the BON for working in an unlicensed facility...after all, there are many community settings that nurses work in, and not all of them are medical facilities. The big question is whether you are working in accordance with your state's Nurse Practice Act as well as providing safe and competent care.

I don't like how it sounds. In all the addictions settings I've worked in, one or two things was done. Either we (nursing) administered the medications just like we would if it were inpatient. Or--this was more common in outpatient/partial hospitalization settings--patients would keep possession of their own medications at all times and were responsible for their own dosing. We never "stored and then set them out." Remember that these are addicts; it's rather common for many of them to be med seeking. And if meds are left about so casually, what's to stop Patient A from helping himself to Patient B's meds?

I agree with OCNRN63. It's all fun until something goes wrong, and then guess who will be thrown under the bus. Hint: it's not going to be the medical director or MD. And just because it's in writing doesn't mean you have bulletproof protection if something happens.

I would pass on this job, IMO.

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In some states you do not have to be a licensed nurse to handle meds; CNAs and MAs can complete a medication certification course. I do not know if you would get into trouble with the BON for working in an unlicensed facility...after all there are many community settings that nurses work in, and not all of them are medical facilities. The big question is whether you are working in accordance with your state's Nurse Practice Act as well as providing safe and competent care. I don't like how it sounds. In all the addictions settings I've worked one, one or two things was done. Either we (nursing) administered the medications just like we would if it were inpatient. Or--this was more common in outpatient/partial hospitalization settings--patients would keep possession of their own medications at all times and were responsible for their own dosing. We never "stored and then set them out." Remember that these are addicts; it's rather common for many of them to be med seeking. And if meds are left about so casually, what's to stop Patient A from helping himself to Patient B's meds? I agree with OCNRN63. It's all fun until something goes wrong, and then guess who will be thrown under the bus. Hint: it's not going to be the medical director or MD. And just because it's in writing doesn't mean you have bulletproof protection if something happens. I would pass on this job, IMO.[/quote']

I did not explain the meds in a good way. The staff stores the meds in a locked cabinet, and the staff puts the meds down for one patient at a time, then the next patient will come in and they will get their meds put on the counter. I agree with everyone, i feel like i may get thrown under the bus if something happens.

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Thanks for the feedback. You helped confirm my suspicions. I'm running now!

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Specializes in Critical Care; Cardiac; Professional Development.

I have never felt it okay to simply quit by not showing up for another day of work.....until now. I would quit immediately and without notice.

Best of luck to you. Your intuition is worth listening to!

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I agree that this is a suspicious situation. You are risking your license for a facility that isn't even licensed themselves. If they get in trouble for anything it will be very easy for them to scapegoat you as the individual in charge of writing their policies. I know jobs are hard to come by these days, but there has to be something safer than this one.

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