Can a MD maintain his nursing license while working as doctor. This would be for the purpose of picking up extra shifts?

[Nurse Beth, MSN]

No states expressly prohibit a medical doctor (MD) with a Registered Nurse (RN) license from working as a nurse. However, several factors could affect whether it's wise for an MD with an RN license to work as a nurse in a particular state or healthcare setting:

Scope of Practice 
When working as a nurse, the MD must adhere to the RN's scope of practice. As a physician, the MD is licensed to perform medical duties beyond the scope of nursing practice. However, if they are nurses, they cannot perform tasks requiring a medical license, such as diagnosing medical conditions, prescribing medications, or giving orders.

That said, in an emergency, it may be expected that the MD uses their medical knowledge, even if they are not officially acting as a physician. Failing to act could lead to legal, ethical, or professional repercussions, both as a nurse and as a physician, depending on the circumstances.

For this reason alone, I would not consider working as an RN if I was an MD.

Professional Consequences

• Nursing Board. If it becomes known that the MD, while working as an RN, failed to act appropriately in an emergency, the nursing board may review the circumstances to determine if the nurse violated any nursing practice standards. Although the MD is not practicing medicine in that role, their professional conduct may still be questioned.
• Medical Board. If the situation becomes more complex and the MD's failure to act in a medical capacity leads to patient harm, the medical board may investigate whether the MD failed to provide appropriate care under their medical license. Even if they weren't practicing as an MD, their medical qualifications could influence the board's decision.

Employer Policies
To avoid potential issues, it would be wise for any MD considering working as an RN to have clear guidelines on their role from their employer and ensure that both they and their colleagues understand when and how to intervene in an emergency.

Some healthcare organizations may have specific policies regarding employees holding dual licenses and whether they can work in both capacities. It's essential to check with the employer to ensure no conflicts of interest or legal issues.

Ethical Considerations
The MD would need to maintain appropriate professional boundaries and ensure that their RN role does not overlap in ways that could confuse patients or colleagues. For example, it's easy to see how an MD working as an RN could be confusing for a patient.

Professional Liability Insurance
The MD would need to maintain separate professional liability insurance for their nursing and medical roles, as the risks and coverage requirements are different for each.

In summary, while it is generally permissible for an MD to maintain a nursing license and pick up extra shifts as a nurse, they should double-check with the state nursing board, their employer, and potentially a legal advisor to ensure there are no issues with dual licensing and scope of practice.

Best wishes,

Nurse Beth