NP's with second jobs - page 3

by Designer NP 6,401 Views | 26 Comments

After observing many RN's go for there NP degree's I have noted that many still work as a RN on thier previous unit. One practioner I know completely quit her NP job and continued working as an ICU nurse. Why go though all that... Read More


  1. 0
    My , so take it with a grain of salt.

    How does it circumvent the BON you ask?

    It actually doesn't. I think the complaint must first be filed with the BON, the board investigates and if their findings conclude that the licensee actions violated the practice act then sanctions are made against their license. In a crimial court the charges will typically not be filed to the court until the board has found some negligence or deliberate action that has caused harm.

    To clarify this issue let's give an example.
    Nurse Betty is sued for failing to initiate MI protocols for a chest pain patient because the MD refused to order any interventions and the patient subsequently died. Charges could be filed against both the MD and Nurse Betty for gross negligence (manslaughter). However, before charges are filed by the district attorney's office some would argue that it would be prudent to allow the licensing board to investigate the complaint first. This would serve as evidence to the court in either defending or prosecuting the individual.

    Now if you ask me how this works on celebrity cases, such as the Michael Jackson case,well....I'm just as curious as you are to find out.

    The main issue in protecting licensure is being cognizant of the true issue at hand. The real issue here is Licensure/Certification practice guidelines VS. Institution Policy (job description and unit based policies). If you ever find yourself in between a rock and a hard place, my advice is to distinguish which of those two is driving your decision. My again, would be to always follow practice guidelines even when they conflict with facility policy. I would rather be fired for ignoring policy than be investigated and possibly risk disciplinary action and sanctions placed on my license for ingoring practice guidelines.

    :typing
  2. 1
    Quote from TX RN
    My , so take it with a grain of salt.

    How does it circumvent the BON you ask?

    It actually doesn't. I think the complaint must first be filed with the BON, the board investigates and if their findings conclude that the licensee actions violated the practice act then sanctions are made against their license. In a crimial court the charges will typically not be filed to the court until the board has found some negligence or deliberate action that has caused harm.

    To clarify this issue let's give an example.
    Nurse Betty is sued for failing to initiate MI protocols for a chest pain patient because the MD refused to order any interventions and the patient subsequently died. Charges could be filed against both the MD and Nurse Betty for gross negligence (manslaughter). However, before charges are filed by the district attorney's office some would argue that it would be prudent to allow the licensing board to investigate the complaint first. This would serve as evidence to the court in either defending or prosecuting the individual.

    Now if you ask me how this works on celebrity cases, such as the Michael Jackson case,well....I'm just as curious as you are to find out.

    The main issue in protecting licensure is being cognizant of the true issue at hand. The real issue here is Licensure/Certification practice guidelines VS. Institution Policy (job description and unit based policies). If you ever find yourself in between a rock and a hard place, my advice is to distinguish which of those two is driving your decision. My again, would be to always follow practice guidelines even when they conflict with facility policy. I would rather be fired for ignoring policy than be investigated and possibly risk disciplinary action and sanctions placed on my license for ingoring practice guidelines.

    :typing
    Speaking only for myself, I'm not talking about any sort of criminal or regulatory charges, but being sued for malpractice (professional negligence) in civil court. The standards of evidence and burden of proof are v. different in civil court than they are in criminal court.

    Again, the chances that any of us, as nurses, will ever find ourselves being sued for malpractice are v. slim. But I think it's part of our professional responsibilities to be aware of all the legal ramifications of the choices we make and actions we take profesionally.
    VegetasGRL03RN likes this.
  3. 0
    i agree that in most cases the two roles could interfere... i was thinking if i pursued FNP, since i work as an RN in Neonatal ICU there would be little role confusion if i chose to continue working as an RN. obviously most RNs train to provide advanced practice to patient population they have experience with. however, since it is possible to pursue FNP from pretty much any specialty... if one pursued it from NICU i wonder how much liability would be held against them... simply because only NNPs are trained to deal with that specific patient population. i don't see how could anyone expect an ANP or FNP to know what treatments to prescribe to a preemie or be held to that level of practice...
  4. 0
    So how many states require that you be licensed as an RN and as a APRN? Here in GA if you want to practice as a APRN you have to have both.

    I worked for two years after I graduated as an RN my job title was RN, I was identified as an RN and caring for patients as an RN. My training may have been higher and allowed me to identify problems that I may have not been able to previously identify... I would have had the obligation to contact the patients MD and if appropriate my supervisors to help provide proper care (RN or APRN). I did not have privileges to practice medicine in that hospital, I had no protocols to work under as an APRN in that hospital.

    Also noted law is different in civil and "criminal".... Lawsuits are civil matter and anyone can have a lawsuit at anytime frivolous or otherwise… That’s why I carry malpractice insurance of my own.


    Practice acts as well as the legal stuff will vary greatly from state to state and from courtroom to courtroom. What one jury finds as a negative another jury may find as a positive.. I would think one would need to know what their state laws have to say....
  5. 0
    I don't have anything to add as I'm still a student, but this is a very interesting thread and topic. I was considering working casual in my current facility after I obtain my APN-BC, but now I am reconsidering.
  6. 0
    Quote from scrabblern
    i agree that in most cases the two roles could interfere... i was thinking if i pursued FNP, since i work as an RN in Neonatal ICU there would be little role confusion if i chose to continue working as an RN. obviously most RNs train to provide advanced practice to patient population they have experience with. however, since it is possible to pursue FNP from pretty much any specialty... if one pursued it from NICU i wonder how much liability would be held against them... simply because only NNPs are trained to deal with that specific patient population. i don't see how could anyone expect an ANP or FNP to know what treatments to prescribe to a preemie or be held to that level of practice...
    Would that apply to an NNP should he/she practice as a bedside RN in the adult population?

    I have experience with both populations and vacillate between getting one versus the other, or getting BOTH.

    So...this thread is making me very...cautious....
  7. 0
    I would be very cautious at working as both an RN and APN. Best option IMHO is to have two jobs as an APN if that is the level of your license.


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