Can an APRN practice as an RN

Editorial Team / Admin · Jul 21, 2015

Depends on the state on whether the lower level license will expire and not be eligible for renewal. However, I am of the opinion that it is not the wisest idea to work below one's highest level of licensure- the job will hold you to the scope of the role you are hired for while the BON will hold you to the level of the highest license you hold. Could lead to issues where one must choose between the job or the license. I'd prefer not to be in that situation.

B,RN · Jul 21, 2015

In my state, you can work another job as a bedside RN in addition or instead of your role as an APRN. However, it would not be wise to do so in the same facility or healthcare setting since you are held to your highest title. It's a gray area for sure, but have several friends that do so without any troubles.

elkpark · Jul 21, 2015

Depends on the state on whether the lower level license will expire and not be eligible for renewal.

Can you point us to any states in which that's the case? AFAIK, every state requires that advanced practice nurses maintain an active license to practice as an RN in order to be eligible for advanced practice licensure.

OP, it is true that there are some potentially tricky legal issues involved, and, for that reason, a lot of employers won't hire someone to work below their highest level of licensure, but there is typically nothing legally/administratively preventing someone from doing this if they choose to. I'm a psych CNS and I have worked as a staff RN in psych in the past, in between CNS jobs, without any difficulty or incident (the facility was delighted to get me as a staff nurse, haha).

I certainly recommend that anyone wanting to do so understand the legal/professional issues involved.

Libby1987 · Jul 21, 2015

What's an example of a NP being board disciplined for not performing to their scope when in a staff RN position?

They notified the MD re change in condition in a timely manner but didn't order the CXR themselves?

Serious question, where would the prudent staff RN decision/action not cover their license?

Trauma Columnist · Jul 21, 2015

The issue, at least is the assessment standard. An RN licensed as an APRN is going to be held to the higher assessment standard.

VANurse2010 · Jul 21, 2015

People do it all the time when they get licensed as an NP but haven't started their jobs yet.

Trauma Columnist · Jul 21, 2015

Moved to APRN nursing

AllIcanbe · Jul 21, 2015

I have couple friends still working as RNs on the weekend but work the clinics as NP on weekdays. Their employers told them all they needed to do was fulfil their job duties as RN.since they do not have priviledges to work as APRN at their wknd job; they are not held to that standard...

elkpark · Jul 21, 2015

I have couple friends still working as RNs on the weekend but work the clinics as NP on weekdays. Their employers told them all they needed to do was fulfil their job duties as RN.since they do not have priviledges to work as APRN at their wknd job; they are not held to that standard...

But that's the "Catch 22" -- their employer tells them they can only function as an RN because that's their job description -- but, if something goes sideways enough to end up in court (and I freely admit that is largely a hypothetical concern, but it could happen at any time), the courts will hold you to the standards of your highest level of education and licensure, regardless of your job description at the time or what your employer said. So your employer tells you you can only function as an RN, but, if a case ends up in court, you'll be in trouble for not acting as a careful and prudent advanced practice nurse would in that situation.

I'm not saying people shouldn't do it -- I've done it myself. But I think it's important to understand the potential legal issues and risks involved before making the decision to do it.

AllIcanbe · Jul 21, 2015

I believe the court will hold you up to your expected job duties.

elkpark · Jul 21, 2015

I believe the court will hold you up to your expected job duties.

You can believe that all you want, but it's not true. The courts have repeatedly, over time, in multiple locations, held people to the standards and expectations of their highest level of education and licensure, regardless of what their job title or job description was at the time. You don't get to "turn off" your education and licensure. It's the same for RNs working in a CNA role. Several state BONs have statements about this on their websites, cautioning nurses about this.