Can a RN fill a CNA slot?

kcochrane · May 1, 2009

There are two different scenarios here and how liable you are depends on your state.

In NYS if you have a CNA certification and a nursing license, but you are hired as a CNA, that is the parameters you must stay within. Believe me if that wasn't true, you would have a lot of facilities hiring RNs as CNAs in order to save money if they could still function as a RN.

If you are a hired as a RN and asked to do a CNA assigment, you are still a RN and are responsible for that whole patient, if needed. You can't use the statement, "I was only working as a CNA", which yes I have heard before.

Of course this is my understanding.

Honestly you really do need to contact the board of nursing and get specific answers, because you could be putting yourself in a bad position if you don't know what you legally can and can't do.

elkpark · May 1, 2009

A lot of facilities won't hire someone with a higher level of education & licensure to fill a lower level job, because it does create some legal questions/difficulties. If an RN is working in a CNA position, yes, the facility, for its own protection, requires that you not act outside the scope of the job description. However, you as an individual RN will be held accountable for your highest level of education/licensure by the larger society and legal system -- e.g., a client or family could sue you for malpractice because you failed to respond as a prudent, careful RN would in a given situation which resulted in a bad outcome for the client. That puts you, the RN, in a difficult position -- damned if you do and damned if you don't -- if the doo-doo hits the fan. If that situation were to arise (a long shot, granted, but do you want to take the chance?), a civil court would not buy the explanation that you were working as a CNA and therefore only had to do what a CNA is allowed to do. Your professional licensure is independent of your employer, and you are accountable, professionally and legally, for your own practice regardless of what your employer tells you to do (the same as you would not be protected if you performed actions outside/above your legal scope of practice because your employer told you to ...)

classicdame, MSN, EdD · May 1, 2009

Better check your BON about the accountability and responsibility thing. I know in my state you are held to the highest level of licensure regardless of the job. The idea is to protect the patient from people who should know better. As for Nminodob's situation, could be that the other nurse was not aware of what the law says. A lot of people interpret the nurse practice acts by committee, not by examination of the law.

sunray12 · May 1, 2009

there are two different scenarios here and how liable you are depends on your state.
in nys if you have a cna certification and a nursing license, but you are hired as a cna, that is the parameters you must stay within. believe me if that wasn't true, you would have a lot of facilities hiring rns as cnas in order to save money if they could still function as a rn.
if you are a hired as a rn and asked to do a cna assigment, you are still a rn and are responsible for that whole patient, if needed. you can't use the statement, "i was only working as a cna", which yes i have heard before.
of course this is my understanding.
honestly you really do need to contact the board of nursing and get specific answers, because you could be putting yourself in a bad position if you don't know what you legally can and can't do.

that's the thing. taking advantage of desperate rn's and hiring them at the lower wage is basically exploitation even if it's voluntary on the rn's part. so while it might seem like a good idea to just take a cna job if that's what's available i don't think it is. op is better off moving at least temporarily someplace where she can get her first year of experience.

kcochrane · May 1, 2009

That's the thing. Taking advantage of desperate rn's and hiring them at the lower wage is basically exploitation even if it's voluntary on the rn's part. So while it might seem like a good idea to just take a cna job if that's what's available I don't think it is. OP is better off moving at least temporarily someplace where she can get her first year of experience.

I agree..I think as everyone has pointed out, working as a CNA is probably not the best ideas for this poster.

kcochrane · May 1, 2009

http://drl.wi.gov/boards/nur/pap/pap07.pdf

Just found this for those in WI. Someone had posted it before on allnurses.

Nurses who practice at a level below that of their licensure are expected to function according to the position description for which they are employed. For example, a licensed practical nurse (LPN) who is employed as a home health care aide or certified nursing assistant (CNA) should not exceed the scope of the duties of that position, although the nurse may have education and/or training beyond that required for the position. Similarly, a registered nurse (RN) who accepts a position as an LPN or an emergency medical technician (EMT) should limit their practice to the job description and not act beyond the scope of those duties. However, in the event that the nurse voluntarily acts beyond the scope of the position description, the nurse may be held to the highest standard of care for which they are licensed.
A nurse who practices at a level below that of their licensure may also be held accountable to a higher standard of care if they knew or should have known, based on their education, training or licensure, that the failure to act would cause harm to a patient, unless the employer has clearly prohibited the nurse from taking any action.

Batman24 · May 1, 2009

I wouldn't go this route. Have you checked work in clinics, doctor's offices, schools, LTC, etc.?! I would go that route instead.

gcupid · May 1, 2009

I am sorry to here about your circumstance. I wouldn't have a problem with anyone or myself acting as a CNA while a RN but I would want us to be paid as a rn.

I know you have to do what you must, but I hate the situation. It's degrading to the nursing profession.

Because you must be held to your license even while under the job title as a CNA, you will have no choice but to perform some role as a nurse or be held liable if anything happens.

Hopefully it won't last too long, because Next thing you know, slowly but surely you will be pushed up or encouraged to admin meds, perform admits & initial assessments, triage & etc. Because you are a new grad someone is going to try you by saying,"The only way you're going to learn is by doing it."

This is exactly what administration would love to do. The recession is now trying to validate the reason for paying nurses less. If Administration could hire someone off the street without a license they would. Hopefully we all wont be making 10 dollars an hour before its all said & done.

tracel1 · Oct 14, 2010

then a chance to lose your RN license as a cna without even getting paid the big rn bucks.... I suggest working as a mental health aide or something in health care that doesnt require being certified by bon.