Demoted from GN to TECH

elkpark · Sep 10, 2005

Hospitals cannot legally allow you to continue to practice as an RN (even as a GN) once you have taken the NCLEX and failed it. Most hospitals allow their GNs who don't pass the NCLEX to continue to work as a CNA/tech -- but they are basically doing this as a favor to you, to give you the chance to keep getting a salary for doing something, rather than just firing you.

"Graduate Nurse" status is a temporary permit/grace period that some BONs allow between finishing school and taking boards, on the assumption that you will be passing boards. Once you take boards and don't pass, you are, legally, just another person who doesn't have a license to practice as an RN. Some states do not even offer a "GN" status, and you can't work as an RN at all in those states until you have passed NCLEX and received your license.

If you don't like working as a CNA while you are waiting to retake the NCLEX, you have the option of resigning, but then you will have to start from scratch looking for another job after you get your license ...

Yes, I'm sure it is v. frustrating and discouraging, but try to keep in mind that the hospital is trying to do you a favor. Best wishes on your next try on the NCLEX!

caroladybelle, BSN, RN · Sep 10, 2005

In most states, you are only permitted to work as a GN until you have taken the NCLEX at the first reasonable opportunity and passed it. If you do not pass, you no longer are qualified PER LAW to work as a GN.

This is not a facility policy in such states, IT IS THE LAW.

For this reason, also, some states/facilities no longer have GNs as many new grads can write the NCLEX and get results rapidly, as opposed to years ago when the test was only offered twice per year and you waited 8-16 weeks for the results.

Working as a GN is a privilege that is offered under very limited terms. If those limited terms are not met, the privilege is forfeited. And in most locales, your facility does not determine that, the BON does.

lady_jezebel · Sep 10, 2005

Because you are NOT a nurse until you have the license. Some states don't even permit GNs to work until they pass the NCLEX. It's a safety issue.

MissJoRN, RN · Sep 10, 2005

The last two posters are right, not sure why your hospital didn't just explain that to you and save you some hurt. Your temporary practice permit is revoked as soon as your test is scored. BTW- they should not have let you work as a GN prir to your graduation, if that's what you were saying?

I understand your frustration and disapointment- you didn't pass, have to go through that stress again, and now "demoted" If you feel you need to you can talk to your manager/HR people and ask to take a leave for increased studying, etc or you can continue to work as a tech. What you get out of your experience to work as a tech really depends on you! You'll still be working with pts and can use your time as a sponge, still asking professional nurse level questions while providing basic care and really honing your dressing change and VS taking skills, you'll learn about delegation from the other side, etc. I'm sorry to sound harsh and parental but you have a touch of an entitlement attitude that I suspect pre-dates your NCLEX. It's not always a bad thing, I'm sure it helps you be assertive and a "go-getter"- very good qualities but if the techs you're now working side by side with pick up on this (and they will!) you're going to find them giving you an attidude back when you take NCLEX again and pass and need their help!

As to verbal order readbacks, they are a pain in the butt but every hospital requires every RN to do them under JCAHO rules. Even RNs that have worked side by side with the same MDs and know their routines inside out. If you had had to take TOs before this policy you might appreciate it more...it has made things a little safer and in some instances easier. Some policies are BS, others are not...that's another "lecture"

skwirlygirl · Sep 11, 2005

can i ask you all what your current titles are and long you all have been working under your title? Also what states do you all reside in?

mye614 · Sep 11, 2005

can i ask you all what your current titles are and long you all have been working under your title? Also what states do you all reside in?

Hi, I too was offered a nurse tech position after I failed my fisrt exam in July. Prior to that I was hired as a GN with a temporary permit issued by my state, but state law stated that if I fail the exam my permit will no longer be valid and that I will not be able to work as a GN. I was aware of it when I was hired so as soon a I found out my result, I immediately notified my HR and my director and they have offered me the Nurse tech position until I get my license then I can go back to working as an RN. Personally, I did not accept the offer for the reason that I'd like to be able to concentrate on studying and preparing for the board. I do not have anything against Nurse Tech ( I have a great respect for them) but it was my own choice not to do it.

Bird2 · Sep 11, 2005

I took the NCLEX last month and did not pass! Not only was I disappointed, but to top it all of I was demoted from GN to a TECH. I was hired back in March as a GN before I even graduated in May. I began work at beginning of June and took the NCLEX in July. Under hospital policy if a GN does not pass the NCLEX the first time they are the demoted to a Tech and their pay decreases accordingly. I, as well as the nurses I had been supervised under as a GN, can not see the logic behind that policy. As a GN, you are always working side by side with a licensed RN. Being demoted has restricted so many of a practicing RN's duties that I have really have lost the desire to even go to work. I am no longer able to take order's from physicians, contact physicians when a patients condition warrants, administer any meds, including hanging IV's, count the meds coming or going off shift. I asked my manager to give me the policy that outlined my duties as a nurse tech and still haven't received that. I just don't understand..... my mangers say it is for safety purposes....and hey I'm all about safety, don't get me wrong but I had more responsibilities as a student than I do now. Safety? I was supervised as a GN with every med I passed and every assessment that I performed. I had to have my preceptor listen on the phone line when I was taking orders from doc's. It evidently was not adequate enough, that policy requires you to repeat any VO's back to the dr. to verify correctness, that this is required. O.K. I can get over that too.....policiies, policies, policies! O.K. I'm done venting..... anyone's comments about how demoting me to a tech is supposed to benefit me, my skills, and routine, etc. as an RN? All I basically do is assessments, and dressing changes. I feel as though I'm being pushed backwards and not encouraged to grow forwards.

Your school should have educated you on the Nurse Practice Act. I'm sorry that you did not pass the NCLEX but believe me many nurses fail the first time around. I'm surprised that they let you do assessments and dressings as a tech. I'm from Illinois and if the NCLEX is failed the GN has the option of working as a CNA until they pass or reapply for a nurse position when they pass.

CseMgr1, ASN, RN · Sep 11, 2005

Your school should have educated you on the Nurse Practice Act. I'm sorry that you did not pass the NCLEX but believe me many nurses fail the first time around. I'm surprised that they let you do assessments and dressings as a tech. I'm from Illinois and if the NCLEX is failed the GN has the option of working as a CNA until they pass or reapply for a nurse position when they pass.

Exactly. By the time I had graduated with my class and received my Temporary Permit, we had been well-versed on our state's Nurse Practice Act

on this scenario, and it's a shame that you weren't told. Best of luck to you on your second exam! :)

suzanne4, RN · Sep 11, 2005

Sorry, but as stated above, it is not your hospital policy but the Nurse Practice Act of your state. The GN title is only good until you take your NCLEX exam, it actualy goes away once the results are out. You are either an RN, or not an RN. You cannot administer medications, hang IVs, any of those things that you were doing before. Any type of invasive procedure in most cases, etc. For the other nurses to want you to continue doing so could actually get them in trouble with the BON in your state. Perhaps you can suggest that someone from the BON come and do an inservice there on what and what can't be done by a GN, etc., or someone who is not longer a GN, no matter what the length of time is. Even for one week..............

caroladybelle, BSN, RN · Sep 11, 2005

can i ask you all what your current titles are and long you all have been working under your title? Also what states do you all reside in?

Why should it make a difference what our titles are, how long we have been licensed and what states we are in? It makes no difference as to the law or the policies of where you are in employed.

I have been a registered nurse for 11 years now. And I am a legal resident of the State of Florida, where I originally passed Boards. As a traveler, I hold other current licenses in Georgia, Massachusetts, Pennsylvania, and New York. I have been certified in my specialty for 6 years.

The policies explained to you by us, are standard in many places that I have worked. Except for some places that would layoff/fire people that fail the NCLEX or demote them to NA status (lower pay than a tech and less skill use).

As long as you do not hold a valid license, you must abide by the policies set by the state and the facility. What you did as a student is irrelevant as your school took the burden of responsibility for any errors that you might make. You are not a student now and do not have a license so the facility would have the burden of any errors that you might make.

And as far as protesting it too much, the more people that harass a facility on enforcing these policies, the less likely the facility is going to offer GNs the opportunity to work in the future...because they will tire of having to deal with the hassle.

I regret that you do not like our input. It might behoove you to review your BON's policy on this in your state.

finchertwins, BSN, RN · Sep 11, 2005

I am sorry that you did not pass your NCLEX exam but as many of the others in this thread have pointed out in most states GN are not allowed to practice as an RN until they pass their boards as is the case in my state. I hope that I am wrong in what I read in your post but I felt as if working as a tech was somehow a job that is a punishment to you and below you. I hope that is wrong because the techs that work around you will see this and when you do pass will be less inclined to help you. As a nurse I have worked as a tech when needed and as a secretary. I know I was paid the same as an RN but all the same I am not above doing a techs work. None of this is written to flame you or to tick you off, I hope you pass your boards and get the position and title you have worked hard to get. I too am proud of signing my name and putting RN behind it. I have found that the nurses who will do the tasks that techs, unit clerks, housekeeping do find getting others to help them when you (the RN) need help much easier. Good luck on boards, just remember your attitude good or bad show to those around you and a positive attitude goes a long way when you depend on team work to ensure good, safe, and effective patient care.