Can CNMs (and other APNs) still work as RNs?

[BetterSafe]

I'm finishing my ADN this summer, and considering my options for further education. The idea of becoming a CNM is very appealing to me, for so many reasons. I am wondering if CNMs (and other APNs/NPs) can also still take work in hospitals and other settings as "RN". Say, for instance, I was to live and work in a very small town, where the need for a CNM might be limited, can I work "under" my scope of practice at the hospital, functioning as an RN? Or once an APN, can I no longer work as an RN (just as an an RN, one can no longer work as an LPN or CNA capacity?)

Thanks!

[CEG]

I currently do both. As far as I know there is no issue as long as you practice within your scope at each job (i.e. don't diagnose patients at your RN job). One thing to check on is whether your state requires an active RN license to get an APN license. Some only require you to have an RN license to get your inital APN license and then you just have to maintain the APN license BUT if you move to another state you may have to take the NCLEX again or jump through some serious hoops to get an APN license there.

[elkpark]

In most states there's nothing legally preventing you from doing this, but there are some things to consider. Many employers simply won't hire people into positions "below" their licensure, because of liability and scope of practice concerns. If one is, for example, an APN working in a staff RN position, you are obligated by the employer to work within the staff RN job description. However, if something goes wrong (wrong enough to end up in court), the courts will hold you to the standard of practice of your highest level of education and licensure, regardless of what your job description was at the time.

[CEG]

However, if something goes wrong (wrong enough to end up in court), the courts will hold you to the standard of practice of your highest level of education and licensure, regardless of what your job description was at the time.

I'm curious if you have a source or something for this? I ask because it applies to me in my current situation:) It doesn't seem right to me- what circumstance would there be where I would have been expected to function as a CNM while working as a staff nurse? The only issue I see is working above the license level that I am hired to do, so I don't do CNM things while working as a nurse. Thanks for any clarification.

[Green turtle]

I am also wondering if there are problems working as an RN with an APN.

I have APN licensure and certification as an FNP, but haven't found a paying job as a new NP. I had planned to fall back on my RN experience and start searching for a prn job as an RN to pay the bills and the student loans.

[sirI, MSN, APRN, NP]

Here are a couple threads about this issue:

NP's with second jobs

Can an NP work as an RN?

[CEG]

Thanks for those links! Guess I will just have to hope I don't get sued- as am working as an RN, working as a CNM, and teaching BSN students. Yikes!

[ERNURSEDAD]

I am going to politely agree to disagree. If an APN is working in an RN capacity, they should NOT function as an APN in that role, nor will they be held to that standard of care. They will be held to the standard of care of an RN with perhaps a Master's degree. Perhaps opposing counsel would seek an expert witness with matching credentials, but as someone has pointed out, if as a CNM, I am working as an L&D RN...I cannot and should not function as a CNM. Now, because of what I know as a CNM, that certainly augments what I know as an RN...which would empower me to use confront situations (assertively of course; out of the way of the patient and others of course; wink) that perhaps an RN w/o the same experience or education of a CNM might not. I might employ the chain of command sooner. I might make management suggestions to a willing provider. Etc. But I certainly could NOT be expected to supercede a provider when employed in an RN capacity just because by license or certification I am a provider as well.

That all being said...I think I'm pretty safe. My "RN" work was in an ER while my APN certification is as a CNM. It's a long story, but after getting my arm twisted into teaching med/surg/gero to BSN students (classroom only...no way was I doing it clinically) after 17 years in women's health (OK, I had 6 months on a surgical floor right out of school...but that was 16 1/2 years prior!), I reconnected with a long ago interest in becoming an ER nurse (it was my "backup plan" in case OB didn't pan out since I'm a man). The hospital where I worked per diem as a CNM had some openings in the ER when my academic year finished, so I took the plunge, got oriented and added to my skill set. That further solidified my interest in pursuing my FNP certification to complement my CNM.

[klone, MSN, RN]

We have several APNs (WHNPs, CNMs) who work as staff RNs at my hospital. The hospital does NOT require them to work at their highest level of training, and if they did, they'd get into HUGE trouble.

[LoveANurse09]

I wonder if this varies by state. I know a few people who were told they "couldn't" work as CNA's any longer once they were licensed RN's. Of course with the job market as it ,they are now umemployed when they would have continued working until they found an RN position.