How Would You Report This Illegal Work Situation??

[All4NursingRN]

Somewhat long, but very important please read!

So there was actually a thread on this not too long ago ( https://allnurses.com/nurse-colleague-patient/nursing-imposters-895231.html#post7674817 ) regarding those who pose as nurses but are not. As is known this is illegal but seems to be very difficult to enforce. I've actually never worked with or met anyone who claimed to be a nursing professional or rather falsely gave the impression of being one because after all you would clearly and swiftly be terminated or reported and face discipline, so of course most ''imposters'' are quite co-vert about their wrong-doings.

Like I have stated until now I have never been faced with such a person or situation. Unfortunately until now at my current job I work with one. I currently work with a nurse assistant who gives the false impression of being something she is not. Over my short time at this ''small research clinic'' I have learned that most people including some practitioners, staff in other departments, and most alarmingly patients have believed that she is either a nurse or doctor. She never identifies herself as an NA just tells people her first name, often-times never wears an ID and I have been told by my fellow co-workers that some patients will often ask her if she is the doctor or nurse and she will simply state ''no I'm not'' but will not identify her title. She has done this multiple, multiple times. A long-time patient even once asked me if she was a nurse or the clinic supervisor and I explained that she was not and her correct title. Many patients and other department staff unknowingly refer to her as one of the nurses. In fact I have witnessed her giving suggestive medical information to other employees from other departments because they some-times stop by and ask for info about something medical related.

Many of the MD's trust her because she has worked there with them for decades even when there were no nurses employed in the clinic and no nurse manager, so they have come to trust her over the high turnover of staff nurses and nursing management. That being said it seems as though they either truly don't know she's not a nurse or turn a blind eye to the fact just because she is getting the work done. I have been told by the only other staff member who has worked there as long as her (another NA) that the NA in question would take verbal orders from doctors and claim to be an LPN among other things. She herself said that she never knew she could speak up about someone posing as something they were not and so for many years stayed silent especially since often times there was no one to report it to.

I could not understand how management has allowed this woman to work there for the last 10+ years. What seems to be the catch is that this woman is seen as a model employee who can do no wrong and does whaterver the MD's ask for. But is very vague and crafty about what her actual job title is.

Unfortunately the current Nurse Manager knows about alot of this but does not want to take aggressive action because I believe she feels this employee has been there for a long time, alot of the MD's want her around, and she the NM believe because there are now nurses on staff that it is our issue and that if something were to happen patient-wise it's on us???

The real reason she does not want to discipline this employee is also like I said because she is a highly esteemed and long time employee who alot of MD's have worked with for a long time and one MD in particular will go after her (the NM) if she does anything to compromise the work this NA does for his research studies. I have even heard this same MD refer to this NA as the ''nurse'' to patients, and tell the patient that the nurse will come in to draw their blood and do the EKG. I have been told that this same MD has given this NA verbal orders to draw blood which is against policy.

This woman has also claimed to work at another hospital on an IV team, but as far as I know only nurses can work on IV teams? which leads me to wonder what other lies she tells people behind closed doors. I now feel more and more compelled to report this situation especially after recently hearing this MD refere to her a the nurse, I feel that enough is enough.

The problem is the NM is too scared to discipline or follow up on this NA and by her own admission especially does not want to ruffle feathers with a certain doctor. So basically I feel stuck between a professional obligation and current workplace culture. I have never worked in an environment where an NA had more clout over RNs just because her or she has worked their for a very long time and/or does a very good job at coming across as something she is not.

Because of this and a litany of other reasons I am trying to get out of there as fast as possible but I believe because of patient safety among other reasons I feel professionally obligated to report such a situation before something bad goes down, especially on my watch.

What would you do or what should I do?

[ArtClassRN, ADN, RN]

If she has the administration and staff on her side, you aren't going to change anything.

You can suggest standardized uniforms and mandatory wearing of name tags. Both of these items absolutely eliminated misrepresentation of roles at the clinic I use.

Let it go.

[All4NursingRN]

Thanks ArtClassRN, although I was wondering if outside reporting can be effective. Unfortuntately ''letting it go'' will probably be the immediate solution but I just don't think it is the best mentality to adopt especially since this person is in contact with patients and not just a randomn person walking around claiming to have a license. The funny thing is if something were to happen this administration would probably fire her immediately (because when **** hits the fan no-one cares about how long or hard you've worked) and also blame the nurses, as if they didn't know of the situation before we were even hired.

[Pangea Reunited, ASN, RN]

1. We can't fault this person for what other people believe she may be or for what other people may call her.

2. What is "suggestive medical information"?

3. What you "have been told" by other staff members about this NA may or may not be true.

4. This sounds more like a personal dislike than a concern about patient safety.

5. You seem pretty "vague and crafty", yourself.

[CrunchRN, ADN, RN]

Well, she can draw blood and stuff under a physician most likely.

Depends on whether your state requires they be a certified MA or just allows it under the MD license. This is pretty endemic in the office setting.

Just be careful how you go about things or it will end up with you (unfairly) out the door. Your nurse manager knows this.

Good luck!

[HouTx, BSN, MSN, EdD]

In my state, we still have 'permissive licensure' which allows a physician to delegate (basically whatever they want) to an unlicensed person (UAP) as long as s/he is directly supervising... the physician retains liability. This only works if that person is actually working for the physician and the UAP has to be credentialed via med staff to perform those duties in the organization. That ONLY works if the UAP is employed by the physician. If the UAP is employed by the organization, it must ensure all the normal stuff.. competency, licensure, compliance with P&P, etc.

The rules vary by state - best to check with yours and get some clarification before you decide that this is a hill you want to die on.

[Nurse SMS, MSN, RN]

You definitely can not and will not "win" in this situation. Pursuing this can only harm you and your career. If she has been there decades her reputation and trustworthiness is well established. You will come across (and I am sorry to say do come across) as petty, vindictive and jealous. There just isn't any meat in what you are saying. Short of signing her name with RN or LVN behind it, it is also unable to be proven and therefore the BON (the only agency outside of the office that will care) is not going to much care.

Her status and the loyalty she has earned is making you unhappy and jealous. I suggest you either truly get over it and make friends with her (far more politically wise on your part than to go head to head) or go find another job where you are more likely to have the status you crave. I wish you all the best.

[LadyFree28, BSN, LPN, RN]

Short of signing her name with RN or LVN behind it it is also unable to be proven and therefore the BON (the only agency outside of the office that will care) is not going to much care. [/quote']

THIS.

Unless you have actual "proof" where this individual is stating that she is a licensed nurse, including signing information as a licensed nurse, there isn't anything you can do about it.

As we all know, "Nurse" is a protected title, and in some instances where the title is thrown around incorrectly, sometimes by doctors; unless there is a push for a scrub color requirement, then this will continue; also your nurse manager should be pushing for this, and have a meeting on making sure people who are the proper personnel and title should be shown, and notifying members if they don't do so, they will be considered out of uniform; that decreases confusion, and would be an option to solve the problem; otherwise, it seems to be slightly unprofessional to be talking about a known seasoned professional, who, by your own account, has stated she is NOT a doctor or nurse, where based by your post if anything, has been professional and had some expanded knowledge, due to her being there for a number of years, exposing her to a broader knowledge base, which includes blood drawing and IV starting-a skill obviously taught to her and approved.

[Been there,done that, ASN, RN]

I don't know what you mean by " a small research clinic". Could you elaborate?

Find out what state regulatory agency directly oversees the clinic.

Make an anonymous complaint.

Just because the almighty MD's want her around and management is complacent, it doesn't make it right.

[Been there,done that, ASN, RN]

You definitely can not and will not "win" in this situation. Pursuing this can only harm you and your career. If she has been there decades her reputation and trustworthiness is well established. You will come across (and I am sorry to say do come across) as petty, vindictive and jealous. There just isn't any meat in what you are saying. Short of signing her name with RN or LVN behind it, it is also unable to be proven and therefore the BON (the only agency outside of the office that will care) is not going to much care.

Her status and the loyalty she has earned is making you unhappy and jealous. I suggest you either truly get over it and make friends with her (far more politically wise on your part than to go head to head) or go find another job where you are more likely to have the status you crave. I wish you all the best.

I did not hear any of that in her post. Jealous??? I think not.

Frustrated for sure. Concerned for employees possibly receiving medical advice/ patients receiving care out of her scope... that's what I hear.

[Esme12, ASN, BSN, RN]

I did not hear any of that in her post. Jealous??? I think not.

Frustrated for sure. Concerned for employees possibly receiving medical advice/ patients receiving care out of her scope... that's what I hear.

I think you quoted the wrong post I I get what you are saying....

[Esme12, ASN, BSN, RN]

Thanks ArtClassRN, although I was wondering if outside reporting can be effective. Unfortuntately ''letting it go'' will probably be the immediate solution but I just don't think it is the best mentality to adopt especially since this person is in contact with patients and not just a randomn person walking around claiming to have a license. The funny thing is if something were to happen this administration would probably fire her immediately (because when **** hits the fan no-one cares about how long or hard you've worked) and also blame the nurses, as if they didn't know of the situation before we were even hired.

She walks a fine line. You even admitted that when asked she states not I'm not...so she isn't misrepresenting herself. unless you have heard her claiming she is licensed and she isn't there isn't really much you can do. She is operating under the MD and in outpatient office settings she essentially can.

I know I corrected a MD at a large academic center recently and he got very angry with me for calling him out on his referring to his MA staff as nurses. He said the "nurse will be in to give you your TB test"...I said..."she is NOT a nurse". He said "I beg your pardon?" I said..."she isn't a nurse but a MA and it is illegal to refer to someone as a nurse when they have not graduated from an accredited from a nursing program, passed NCLEX, and has a license registered from the state". This MD then said..."I don't know why you are being non compliant and difficult (non compliant? What the heck???) If you have difficulty with my staff maybe you should find another doctor." I told him ..."I have no difficulty with your staff but they are not nurses and you can't call them nurses. I'm just clarifying the facts. Does this person you are referring to hold a license in the state to practice nursing?" The MD said no. Then I said "they are not a nurse are they?" He stormed out of the room and slammed the door....the MA then came to plant the Mantoux...didn't form a wheal (which I reported and was told that the wheal is not a big deal, really?) and gave my entire arm cellulitis...I am waiting for another appointment at another center.

Find another position when you can...you can try the state or accrediting body of the clinic you work. Maybe the board of health. But to fight the system you will end up on the wrong side of the stick.