Can an APRN practice as an RN

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If someone is an APRN and they decide they like floor nursing better, or if they want to pick up per diem shifts on the floor as an RN for extra money are they able to do that.

I thought I heard someone at work say that once you are an APRN that's it, you cannot go back and they take away your regular RN license.

Is that true?

Oh well; to answer the Op's question... There are NPs who work PT as RNs....

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Here are some sample statements from various BONs on this topic that I was able to find in a quick Google search in the past when this question came up. The statements are about RNs working as LPNs or CNAs, but the legal principle is the same.

New York: Can a Registered Professional Nurse (RN) or Licensed Practical Nurse (LPN) work in a position that is below his/her level of licensure?

Answer: Yes. A licensed nurse may work in a position that he/she has the training to do and that is within his/her scope of practice. RNs have the training to perform LPN, Certified Nurses Aid and Home Care Aid functions and therefore could accept a work identified for these levels. An LPN has the training to perform Certified Nurses Aid and Home Care Aid functions, and could accept work identified for either of these positions. However, the nurse that does so would still be required to act prudently based on his/her educational preparation and would be held to that standard.

[COLOR=#003366][COLOR=#003366]http://www.op.nysed.gov/prof/nurse/nursepracticefaq.htm

Wisconsin: IF I HAVE AN RN LICENSE, BUT CAN ONLY FIND WORK AS AN LPN OR CNA, IS IT ACCEPTABLE FOR ME TO WORK IN A POSITION BELOW MY LEVEL OF LICENSURE UNTIL I CAN FIND OTHER WORK? THE SAME WITH AN LPN WORKING AS A CNA?

The Board of Nursing does not regulate CNAs, so questions regarding the practice of CNAs should be addressed to the Wisconsin Department of Health Services. It is important to note that while working at a lower level, you may be held to a higher standard of care due to advanced education, training and experience. Also, you must hold the credential for the profession in which you work.

[COLOR=#003366][COLOR=#003366]http://dsps.wi.gov/Documents/Board%20Services/Position%20Statements/Registered%20Nurse.pdf

North Carolina:Can a LPN or RN work in a position that is below his/her level of licensure?

A licensed nurse may accept and work in a position that he/she has the training to do and that is within his/her scope of practice. A RN has the training to perform LPN and NA functions and therefore could accept a position identified for either of these levels. However, the nurse that does so would still be required to act prudently based on his/her educational preparation and would be held to that standard.

[COLOR=#003366][COLOR=#003366]http://www.ncbon.com/dcp/i/nursing-practice-faq--nursing-practice

Iowa: Q. Can a LPN or RN work in a position that is below the level of his/her licensure?

A. There are no laws or Iowa Board of Nursing rules that prohibit a licensed nurse from working in a position that is below the level of his or her licensure. However, the board has previously determined that the nurse who does so is held to the highest level of his or her education. If a nurse is working in a position lower than the nurse's licensure and fails to act prudently based on education preparation, the nurse's license would be subject to sanction by the board.

[COLOR=#003366][COLOR=#003366]http://nursing.iowa.gov/faq/practice.html#b1

　

Maine: Practice Below Level of Licensure

A licensed person who agrees to be employed in a position which requires less knowledge and skill than that for which s/he is prepared may find several problems:

1. S/he may be expected to perform at the level for which s/he has been prepared even though classified at a lesser level; and

2. S/he will be held to the standard expe cted of the higher licensure level should legal problems occur in that health care facility, no matter what the job classification.

The practice of employing licensed individuals to work below their level of preparation, as defined in the LAW REGULATING THE PRACTICE OF NURSING, places that licensed nurse in potential legal jeopardy and is of serious concern to the Board. (1985)[COLOR=#003366][COLOR=#003366]http://www.maine.gov/boardofnursing/questions/questions_general.htm

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Specializes in NICU.

I guess what I don't understand is as long as you are doing your job and you have your assessment skills, what is really so different? They wouldn't expect you to write your own orders or prescribe. You would just document your findings that were concerning and notify the provider. Which is what a nurse would do anyway.

In any case, I asked this question of a RN who was also a JD in Pennsylvania. She said that you wouldn't be held to a NP level, at least in that state.

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I would rather risk working as an RN with a nurse practitioner license then a CNA with an RN license. As a CNA I suppose you would have to stop and report changes to the MD when it's not at all in your job description? With NP/RN your expected actions for abnormal findings would at least be in the same vein?

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I agree with babyNP. I find it difficult to imagine many scenarios that you could have legal liability working as a nurse, as long as you adequately assess the patient's needs and report those findings to the appropriate provider. I cannot see how there could be legal ramification for you not prescribing or diagnosing something that is not within your purview to do so within the context of your RN job.

I see that Maine is cited above and uses some strong language to describe the legal risk of working below your license. I wonder if this has to do with autonomous practice laws? In my state, my NP scope is directly tied to my job. If I leave my current job and do not have another collaborative practice agreement, I no longer have the legal right to diagnose, prescribe, or treat at an advance practice level. Furthermore, my scope can be adjusted at the will of my supervising MD. If they want to change the collaborative practice agreement to take away prescriptive authority, it can be done by modifying that document. In my state, working a job as an RN, that is not covered by a collaborative practice agreement, means that you don't really have an advanced practice scope in the first place.

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Specializes in Internal Medicine.

You are absolutely allowed to work as an RN even if you are an APRN, however, depending on your jurisdiction you can be held to a higher standard of care. For example, something happens to a patient when you are working the floor of a hospital, you go to court, and the court can claim that your higher level of knowledge and expertise should have prevented the incident from happening.

Overall though, you can work as an RN, and if you work within the job role provided by your facility you will be fine. I worked for several months as an RN before starting my first job as an FNP while I was waiting for my prescriptive licenses (DPS, DEA, etc) with no issues.

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Specializes in Family Practice.

In California they state that NP's scope does not go beyond a RN but has specialized training with standardized procedures etc. So with that being said how would that be an issue. If you work on the floor you work at the capacity of a RN not an NP.

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Wouldn't any ARNP who is working as an RN hold themselves to the higher standard anyway?

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Specializes in Acute ICU/ER, Cardio-Vascular, Thoracic.

In the State of Texas, one has to possess an RN license to obtain an APRN license. In other words, every APRN licensee in Texas, be they be NP, CNS, CRNA, or Certified Mid-Wife... they possess both a RN and an APRN license. If you take a step down job holding an APRN license, I personally do not believe there is any court in the country which will not hold you to a higher level of care as well as higher level of presumed knowledge based on your higher education and higher level of license. One cannot leave their brain behind and switch of their higher level of license and the responsibilities that comes with just because you are in a different venue, circumstance, or situation. Ignorance is not an excuse especially if you have the education and the state has issued you a license for a higher role.

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If you are an NP, working as an RN at a hospital, if you do not have privileges at that hospital, I would think that as long as you report any pertinent findings to the pt's provider, that would cover it.

I would think that your assessments would be expected to be at the NP level.

I do not know these things for sure, though.

Maybe consulting an attorney who specializes in nursing/medicine would be a good idea.

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In the State of Texas, one has to possess an RN license to obtain an APRN license. In other words, every APRN licensee in Texas, be they be NP, CNS, CRNA, or Certified Mid-Wife... they possess both a RN and an APRN license. If you take a step down job holding an APRN license, I personally do not believe there is any court in the country which will not hold you to a higher level of care as well as higher level of presumed knowledge based on your higher education and higher level of license. One cannot leave their brain behind and switch of their higher level of license and the responsibilities that comes with just because you are in a different venue, circumstance, or situation. Ignorance is not an excuse especially if you have the education and the state has issued you a license for a higher role.

A RN caring for a patient is not expected to stick a chest tube in a patient who is tamponading just because you have a Aprn licence. The question is do you have APRN privileges at this facility?

I work with new grad CRNAs still job hunting... They do not automatically intubate a patient during a code.. They wait for the CRNA s in the code team

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You can definitely work as an RN and an APRN. As long as your skills are up to date you should have no problem. I don't know what your specialty is as a NP but you should also be able to pick up hours that way too...unless you're just dying to work in a hospital again.

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