Can an NP work as an RN?

Can an NP work a second job or pick up hours (evenings/weekends) as an RN in a hospital or other setting?

[kanzi monkey]

awsmfun said:

You are right- you can't put in orders on your pt. But in terms of assessment and other areas you are held to the standards of the highest license you have. So if you are working as an EMT and also have an RN license, you would be held to the standard of RN. You may only be able to work at a BLS level while working as an EMT but your assessment, reporting and decision making would be judged as "reasonable and prudent" for an RN, not an EMT.

Similarly, if an RN is working in the role of a CNA (this sometimes happens in SNF's because they don't want to cancel the RN for a shift due to retention issues--they would rather assign them to be a CNA and cancel the CNA) they are judged at the level of an RN as far as assesement and decsion making goes.

I think the comparison between the RN working as a CNA and the NP working as an RN is not quite equal. For example, it isn't a CNAs job to assess a patient, so if an RN working as a CNA fails to recognize a problem that would only be found on a directed physical assessment, s/he shouldn't be held responsible. NPs, whose scope of practice includes diagnosing and treating patients, still carry out orders written by other providers when working as an RN. As NPs they may disagree with some of the treatment plans or meds, but unless they are identifying a safety issue (which is also part of the RNs scope of practice), it's not their role to change a prescribing clinicians orders. If an NP working as an RN would have made different choices, and the patient has a bad outcome, s/he has no more responsibility than any RN in the same situation would have. As a new NP still working as an RN, I am very aware of times that I may have done things differently--but I may not have all the information the prescriber has, and I haven't been invited to round or provide input on the patient (which stinks, but it is what it is). I try to have a good relationship with the MDs I work with so that I feel comfortable approaching them with my ideas. But that's really my own intellectual pursuit. If I strongly believe a patient is being treated inappropriately and my attempts to discuss this with the physician get blown off (in all fairness, they're wicked busy), I'll talk to my nurse manager who will either agree with me and help me advocate for the patient, or tell me to take a chill pill.