CNS and work as bedside RN?

Trauma Columnist · Oct 28, 2012

It is up to you. I would ensure you have your own malpractice insurance - they would also be able to answer this question.

buzzalong · Oct 29, 2012

Thank you! It was to my understanding that once you become an NP, you can't go back to bedside. So I wasn't sure if the same applied to CNS'. Is that an incorrect assumption about NP's too?

Trauma Columnist · Oct 29, 2012

No, as a general rule, I don't think its a good idea to work as a bedside RN once you are an APN. Per attorneys I've talked to, you are held to the highest knowledge base no matter what license you work with.

So, even though I'm a CNS, I also volunteer as a pre-hospital RN on my rural fire dept. Every call I go on, I know that I'm held to the standard of care of an APN, though my license is that of an RN.

I went to a call recently where there was an elderly lady who had a ground level fall. All she wanted wanted was a lift assist. As I'm getting her vitals, I casually asked what kind of meds she was on. She was on warfarin, ASA, Plavix plus a boatload of other meds including a beta blocker. Her apical heartrate was 46 bpm. So, as an APN, I should know that she is at risk for a bleed as well as syncope due to postural hypotension. Even though my fellow fire-fighters were okay with doing a refusal and climbing back in the truck, I was insistent that we have her transported as the risk of further injury or possible current injury was too high.

buzzalong · Oct 29, 2012

Valid point. I hadn't considered that. Thank you. Goodness...the thought of a law suit against me makes my skin crawl. Especially living in California, I feel like people are quick to cry "attorney". My hospital got sewed for a patient family member saying the nurse called her a cow when really the nurse was calling to another nurse to bring a Computer On Wheels ("Cow"). Sheesh!!

Thanks for the heads up.