But she's not a nurse!

[flowerchild]

I just started a new position running a clinic. The clinic is staffed by myself and one CNA. I am so happy to be working with this CNA as she has over 15 years experience working in this clinic and is a wealth of knowledge and help to me. I adore her. She is very nice and cooperative. I only have one problem with the entire situation. Everyone who comes to the clinic calls her, Nurse Judy. All of the employee handouts and printed information and brochures have her listed as Nurse Judy. They have me listed as Nurse Diane. As if we were one in the same. I am a RN and of course her supervisor. She is 20 years my senior and I really do have alot of respect for her. I just can't live with her using the Nurse designation. I know it is against the law and I'm thinking that is the angle I will try and to set the record strait. Other people who work in the company would never let thier assistants be called thier own professional titles. All of the other staff are non medical. They have worked with Judy for years, they trust her and love her. Any ideas on how to handle this?

[rebelwaclause, ASN, RN]

Originally posted by Mito

The situation does not sound that serious. I would just a name tag with the RN designation and move on.

Mito

Thumbs-up agree!

You'd probably be surprised to see how many really know Judy is a CNA/MA, just love her enough to call her a nurse.

-Rebel

[Q.]

Bottom line, Judy is NOT a nurse. It doesn't matter what the dictionary says, what matter is how we define our profession.

Judy may be all great and nice, but if we allow people to call themselves "nurses" who are not, that is allowing way too many people to be mislead. I don't care how long you've been there or how long you've been an assistant; bottom line is there is difference between her and I. And if someone walks up to Judy and asks a question and gets a retarded answer or inappropriate one, this patient will walk off with wrong information and assume it came from a nurse, when in fact, it did not.

I say change the pamphlets for legality and liability reasons, and that was the proper thing to do.

IF for some reason Judy gives wrong advice with all the best intentions, this patient could come back and sue you because she was under the impression she was speaking to a "Nurse," and she was not.

We have patients in my clinic who have gotten wacked out advice or just otherwise not always treated professionally by the MAs, and then people assume they were a nurse and it just downright doesn't reflect good on our profession. As a RN in the nursing profession, I only want NURSES representing us to the public, no one else.

[purplemania, BSN, RN]

In Texas the Board of Nurse Examiners sends out a newsletter to RN's with all kinds of info, including PICTURES and a short bio of people charged with posing as a nurse. It is against the law. If your BNE has such a newsletter or something similar perhaps you could show it to Judy and explain you are concerned that she is at risk legally, etc. Suggest a proper name tag or name sign at her work area. How about a banner featuring her picture to place in the reception area with a bio and how impt. she is to the staff as a nurse's assistant and years of service, etc.? Good luck.

[SKM-NURSIEPOOH, BSN, RN]

originally posted by micro

*nurse judy*.............diane, registered nurse

pays her the honour and respect she deserves for the time in and love and loyalty of the doc and patients.......

shows that you understand it.....

but also with difference in your designations.........pays you the respect and 'liability' that comes from being the supervisor and the professional rn.........

just by adding rn/bsn after your name in the brochure will definitely inform folks of your title & responsibilities...but beware, some people (patients, other office staff including docs) might see it as you wanting to flex your muscle in order to make you look "better" than or "resent" nurse judy.

question for you though...when you introduce yourself, do you state that you're the rn, or do you state that you're the nurse??? the reason that i'm even asking is that within the titles: cna/lpn/rn, the operative word is nurse...i do realize that cnas don't have the same education as lpns/rns nor do they hold licenses but they're certified to perform their basic "nursing" assistive duties...hence having to go through the basic education & hands on clinical hours in order to qualify, sit, & pass their certification exams. i know of many lpns/rns say that they're the "nurse" when they're introducing themselves to their patients without districting whether or not they're a practical or registered nurse.

now because the word nurse is within the title of cna, nurse judy & other probably don't see where there's a problem or maybe they just don't understand the difference...especially in a clinical or physician office setting where mas, cnas, uaps, & pcts perform basic nursing duties that the lpns/rns do except for maybe starting ivs & blood transfusing(which i don't see in a clinical/doctors' office setting anyways). perhaps because they do a lot more than what they would be allowed to do in hospital facilities because they're working under the direct supervision of the doctors & therefore work under their licenses...besides, like someone else said...they probably feel honored to be called a nurse, even though they know that they're not. i'm not saying that i agree with that...i just think that it would be too embarrassing to make any correction to patients at this point. i blame the doctors for allowing this to go on sooo long...but the damage is done...there really isn't anything you can do about it without looking like a twat. i wouldn't make any waves about having nurse judy's title change at this point. what i would suggest is to keep-on learning the ropes of that office from her & get your feet wet & firmly planted there....show them what you know & are made of...not want your title is. and if it still bothers you about her being called nurse judy, just ask the doctors to have name tags made with everyone's name & title...tell them that it would enhance the office & make everyone look more professional with their name tags & "official titles" on them....besides...the doctors aren't going to spend anymore money than what they have to in order to make corrections to their current brochure. just suggest whenever new ones are needed for printing that you want rn/bsn put behind your name & leave nurse judy alone. this way, it wouldn't appear that you don't like the fact that nurse judy has that title...otherwise, you'd might come off as resentful...i'm sure you'd wouldn't want that.

if you contact your sbon to find-out if nurse judy is illegally misrepresenting herself, please be very careful about disclosing any information about judy & your place of employment. just ask the question in a anonymously & depending on their answer, either have them inform your employers without disclosing who notified them (sbon) in the first place if the outcome is negative or tell them it's o.k. for them to tell the doctors because you wanted to know because of your license (whether judy is working directly under yourself or the doctors). if your not careful, you'd might come-off as being disloyal & you've just started there with a long ways to go....trust me, if you're seen as being resentful or disloyal to nurse judy, the doctors, let alone the patients & other staff, won't take too kindly to that & get rid of you instead. just be careful...be very, very careful. is your ego worth all this??? think it through!!!

[NRSKarenRN, BSN, RN]

SKM-NURSIEPOOH....you said exactly what I was trying to get across. Great reply.

[bblou]

Originally posted by mark_LD_RN

...the MA's and CNA's should be just as responsible.

... the doctors are just as much to blame they hire people and dress them as nurses and mislead the public into thinking they are.

I agree with Mark and the others who rightly believe that false representation should not be allowed. To be called by a title out of affection or respect is fine as long as the person being called by that title clarifies his/her capacity and does not overstep his/her boundaries.

I worked with a secretary who allowed patients to think of her as a nurse, but did things she was not qualified to do and made mistakes that could have had dire consequences. At the time, I was more afraid of patient harm than I was of the effect it might have on my license.

I also worked with a medical assistant whom patients thought was a physician's assistant. She's very good at her job and is well-liked by all. But, when patients would call and ask for the physician's assistant, I (not knowing at first that this assumption was permitted) would correct them. Even after I caught on that assumptions like this were allowed in that office, I continued to inform patients of correct titles and responsibilities. The staff did not like this and tried to set me up to get fired.

Ah, well, live and learn, huh?

[REDWOMANRN]

I WORK IN A SMALL URGENT CARE CLINIC.

THE MA'S DO IT ALL!!!!!

SHOTS, MEDS, TRIAGE --THE WORKS!!!!

AND YES, THEY ARE CALLED "NURSE"!!!!

I JUST TAKE THE PHILOSOPHY THAT AS LONG AS THEY ARE NOT WORKING UNDER MY LICENSE, THAT IS JUST HOW IT IS!!!!

I WOULD, HOWEVER, REALLY LIKE TO KNOW WHAT THEY ARE TECHNICALLY ALLOWED TO DO--I KNOW INJECTIONS IS NOT ON THE LIST!!!!!

[Flo1216]

Oftentimes when I am at work, pts assume I am a nurse and ask me for things that I can not help them with. I wonder if this happens with "Nurse Judy" I of course, correct them. I also AlWAYS wear my ID. It infuriates me when people don't wear ID..especially if I am floating to an unfamiliar unit. Our LPNS and RNS dress exactly alike and I don't know who does what because I don't know who the hell they are. Arrgghhh!

[BBelle]

Um excuse me RedwomanRN, but CMA's are allowed to give injections. We are also technically allowed to draw blood, draw up meds, triage, EKG's, vitals, assist the doctor(s), call in prescriptions, cath, waived testing such as dipsticks for UA's, ovulation testing, ESR's, spun microhematocrit and blood glucoses. We also do gram staining, throat cultures rapid strep tests, etc.

CMA's also are trained to run a front office of a physician's practice. And some of us are office managers.

CMA's do a a lot of things that a nurse can do. MA's are trained to work in a doctor's office. We are nationally accredited by the AAMA and we too have to sit for an exam.

Just because we don't have the word nurse in our title(like CNA)doesn't mean that we aren't trained to do some of what nurses do.

And why do CNA's get so much recognition when they can't even give injections? They are trained to work in nursing homes.

[Q.]

BBelle,

No disrespect, but listing off a slew of monkey skills does not impress anyone. And, the CMA's I work with can give injections yes, but only deltoid IMs. All other deep IMs have to be given by a licensed nurse. Also, they are unable to give any controlled substances via injection. MAs (certified or not) are also by no means qualified to triage or assess anything! (at least in my clinic) and as far as I am concerned, it should stay that way. The last time a CMA triaged anything in this state it resulted in a girl going into kidney failure and being blind as a result of BCPs; the MA taking the call was unable to process the connection between the hematuria, blurry vision, and newly dispensed BCPs.

MAs should be allow to report findings only to a nurse or physician, but certainly not assess nor triage. I have only seen horrible patient outcomes when an MA attempts to do this.

Again, bottom line, many people can mimick a nurse and copy what she does - psychomotor wise, but they are still NOT a nurse. You are a nurse when you sit for the nursing licensing exam. And until the public doesn't identify "nurse" with a licensed one, I feel that no one under any circumstances who is NOT licensed as a nurse should call themselves one.

[Flo1216]

Medical assistants go to school for less than a year. It's NOT the same thing. And in my opinion, MA's have NO business doing triage. No offense.

[Q.]

Originally posted by BBelle

And why do CNA's get so much recognition when they can't even give injections? They are trained to work in nursing homes.

I don't know of any CNA who gets the recognition she deserves; hell I don't know of many RNs or LPNs either. But CNAs are valued here because they work in nursing homes, which takes a kind heart and skilled hand to do - and CNAs also work in hospitals - ACUTE CARE- and are getting down and dirty giving basic bedside care to very ill patients.