NPs, do you know if this is true?

Specialties NP

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Specializes in Emergency, Cardiac, PAT/SPU, Urgent Care.

If you have passed any of the certifying NP exams, does this mean that if you choose to work as a staff RN (for example in the hospital as a bedside nurse, not an NP) and are named in a lawsuit, that you can be held to the standards of an NP even though you are employed as a staff RN?

I have heard this mentioned a few times from colleagues who have become NPs and was trying to find info on this but have found none.

Just wondering if any of the NPs here have heard of the same thing.

Thanks! :)

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my friend just told me this yesterday, because i am a new grad NP and might do some travel nursing as a RN, and was just telling me to be careful.

She is in a masters program and is taking a legal class and that's where she learned it.

i don't have any reference either, if anybody knows and has reference that would be great.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.

This issue revolves around the fact that companies will assess your liability premium to the level of a nurse practitioner even though your job description is that of a staff RN and not an NP. This in turn, may discourage employers from hiring you because of the increased cost of liability. I am not aware of actual cases involving a nurse practitioner working as a staff RN being named in a malpractice lawsuit and what the outcome came out to be. SirI, being an LNC may have some input on this and maybe core0 too.

A Medscape Q&A addressed the issue in this article: http://www.medscape.com/viewarticle/506277_7

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oh...okay.. so buying the $100 nso insurance for travelling won't cut it?

I have pay the $1300 for private FNP insurance as a travel nurse even though i won't be treating pts as a FNP, no diagnosing, prescribing, etc..?

Sounds wierd...

But I want to protect myself.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.
oh...okay.. so buying the $100 nso insurance for travelling won't cut it?

I have pay the $1300 for private FNP insurance as a travel nurse even though i won't be treating pts as a FNP, no diagnosing, prescribing, etc..?

Sounds wierd...

But I want to protect myself.

pretty much, yes.

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I would probably go for the higher coverage; just to be safe.

I don't know about other states but here in GA APRNs are double charged by the Board of Nursing: You have to have your RN license and the APRN license... I wonder if they can tell that APRN still has RN in it???

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Specializes in Maternal - Child Health.

You don't get to check your education and license at the door. You will always be held (legally) to the standards of your most advanced degree and license, regardless of your job description or assigned duties.

The same applies when an RN floats to an unfamiliar unit to act as a CNA. While her duties for the shift may be limited to checking vs and assisting with ADL's, she will be expected (legally) to use the judgment and provide care on par with other RNs. So she can't just chart a B/P of 200/100 without following up as an RN would, or document a BS of 20 without following the appropriate standard of care that a nurse would follow.

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I'm still not sure what this means 100%.

So does it mean if the BP is 200/100 I have to not only call the doctor but tell him what I think as a FNP should be done? What medicine to prescribe?

Sometimes we did this as RN's esp.with docs who had no idea of Peds dosages.. but just because I am a FNP does not mean i know everything about everything.. as a new grad I will/have to look a lot of stuff up.

Meaning I may not know what exactly should be done for a BP of 200/100 depending on the situation, say a person in renal failure waiting on transplant, something i have minimal experience with.

So will the courts say I should have went to my NP books and looked something up and told the Doc what to do?

This is what is confusing for me.

I def. want to work as a NP, but leaving my current NP job, I thought it would be a good idea to do a travel job for 3 months while i apply to for some NP licenses in different states since that can take awhile.

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Another thing is this, why this seems confusing to me, and why i would like some proof.

If you are employeed as a RN you are not allowed to work outside your scope of practice. So why would I be held to a standard outside my current position?

Anyways, Mainly if you are doing the best job you know how, then how can you get in trouble?

I guess if you end up in court and they say, "you should have known" my only argument to that is, as a new grad, i may or may not have known, and if i were working as a NP, i obviously would go look up stuff. So am I expected to slug all my NP books to a RN job to think like a NP in that role, even though I am only acting as a RN??

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Specializes in Maternal - Child Health.

I don't think it is necessary or appropriate to tell the doctor what needs to be ordered. However, if you were to receive an inappropriate order, it would be your responsibility to question it, going up the chain of command as necessary to get the appropriate care for your patient.

If this topic is confusing or concerning to you, it might be a good idea to consult with an attorney who is well versed in health care law.

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Specializes in Pediatrics, Nursing Education.

you are always held to your highest education and certificaton, and will be judged re: what a prudent nurse with a comparable education and background / certification would do.

so, yeah - you would be held to the NP standard. for instance, NP's are required to have advanced assessment skills above that of a staff nurse. therefore, if there was something major missed... then you'd be held to the NP standard, not the RN standard.

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I don't think it is necessary or appropriate to tell the doctor what needs to be ordered. However, if you were to receive an inappropriate order, it would be your responsibility to question it, going up the chain of command as necessary to get the appropriate care for your patient.

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okay well that is what we should be doing as a RN as well? I don't see how that is holding a NP to a higher standard.

I guess what I am getting at is, if I work as a RN (which i did for several months after i was licensed as a NP) do i need to be doing differently?

If i am doing the best job as I can, putting patients interest first I don't see how I can get in trouble..

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