Does this make me an "RN snob"?

[BuckyBadgerRN]

My BFF has started a new job recently and we were visiting about it last night. (We both work in dentistry, I graduated from an accreditated program, and sat for the national boards for certification in 2 specialites b/4 I decided to go back to school for nursing, I am now an RN. My GF was trained on the job (as SO many dental assistants are, and therefore was not eligible to sit for boards. She has a buttload of experience, as have I, and she definately knows her stuff orally. I love her to death and in essence this post is not about HER, but the practice where she works)

She's employed by an oral surgery group. They have NO RN's on staff---a few LPN's and the rest are assistants, I do not know the level of education or training that any of them have, there is no licensure for dental assistants. Anyway, the Dr's call ALL of the staff "nurses" and most of the staff do not tell patients any different. Yesterday she tells me that she pushes drugs into already established IV's. I must have had a horrified look on my face b/c she assured me that the Dr "is right there". We're talking Narcan, Atropine, "milk of amnesia"----everything!!!

Again, I love my BFF to DEATH, but am I wrong to feel a "little bit" irked that essentially untrained, unlicensed people are being allowed to do what I worked my tail off for the right to do?!

[classicdame, MSN, EdD]

agre with LobotRN. Ethics aside, it may be just plain illegal. Since none of the staff, including DDS or MD, has bothered to look up the nursing practice act they may be acting in ignorance, but that is no excuse when a patient is harmed. Not all MD/DDS tasks can be delegated to unlicensed personnel. (ex.:In my state it is not lawful for a non-CRNA to administer Ketamine, even if MD is at my elbow).

[DebblesRN, ASN, BSN, RN]

I don't get the attitude towards the OP at all. She IS concerned about safety for the patients, or she wouldn't have posted. She is ALSO concerned about the fact that staff with limited or no training are calling themselves "nurses" and pushing IV drugs used in conscious and deep sedation.

I don't think there is ANYTHING wrong with being upset or concerned about EITHER issue.

I worked HARD for my license, and it is disconcerting when someone off the street with little to no training waltzes into a facility and does things they have no business doing and have NO IDEA what to do to help the patient in the event a complication occurs. Because they are working under the "doctor's license."

It's not safe, ethical, or intelligent to do this kind of thing.

Yes, patient safety comes first, but isn't the fact that unlicensed and untrained staff are performing duties that they have NO BUSINESS doing the root of the problem??

Someone tell me which state allows LPNs to push IV drugs. In Florida, they are not allowed to push IV meds period, and they are not allowed to access central lines either, no matter what IV class they take. As a Team leader, I have to initiate all of their blood transfusions, do all admission assessments, handle anything that goes through a central line, and do all IV pushes with the exception of a saline flush to check patency. I have friends who work in several different states who say they have the same restrictions there.

[Sparrowhawk]

Yeah, Missouri we can't push IV meds either...

[emmanewgrad]

Besides having the right education to push or who's who?! , let's think more about patient safety !!

[kids]

The Board of Nursing has little to nothing to do with the situation in the original post. The BoN can issue position statement for anything but in reality they do NOT dictate the practices of non-nursing disciplines.

Like the BoN, State Boards of Dentistry/Medicine/Pharmacy/Veterinary set their own policies to govern their own area of practice.

[Altra, BSN, RN]

Mine is another state in which LPNs cannot push meds. And there is also language in my state's nurse practice act which specifically notes that RNs are not anesthesia providers.

Somehow I doubt that an OFM surgeon who is willing to have on-the-job trained assistants push IV drugs is adequately prepared for an unexpected occurence. Where is the airway bag during these procedures? When was the last time s/he intubated a patient?

And OP -- does your friend realize that when she gets to push Narcan ... it is not a good day?

[NursesAreAngels2]

There certainly can be reprocussions to the LPN staff who are practicing outside there scope of practice by BON.

[VICEDRN, BSN, RN]

In my state, LPNs can only push medications when an RN is on premises to supervise (ha ha) and can not push certain medications and blood products at all.

You need to report the dentist and the LPNs to their appropriate governing bodies.

I sincerely hope they have a code cart and are fully prepared to implement ACLS/PALS/RSI if needed.

[wooh, BSN, RN]

You can do pretty much anything the MD allows you to do in an office setting. It's all under the MD's license.

[NursesAreAngels2]

You can do pretty much anything the MD allows you to do in an office setting. It's all under the MD's license.

No you can't, you are responsible for knowing and staying within your scope of practice for the license you hold. Do you really think if something was to go wrong that the MD would save you, especially if it was something done outside your scope of practice? I don't think so, they would be throwing you under the bus so fast to save themselves.

[OCNRN63, RN]

Which would be? This OS group allows unlicensed, untrained personnel to give these drugs to clients who probably have NO clue about the level of licensure of the staff? That's pretty concerning to me. I apologize if that wasn't clarified in my original post =(

It wasn't. In the initial post, you just sounded jealous that you weren't able to give those meds too.

[merlee]

I am always annoyed when the term 'nurse' gets used to refer to anyone who works in a medical or dental area. I make it a habit to ask the person who is taking my vital signs if she is a nurse. If she says 'yes' then I ask where she went to school. It is at this point, if I find out that they are not really a nurse, that I inform them that it is not legal to use the title of 'nurse' .

I have been known to talk to administrators and office managers about this topic.

I, too, worked hard to be called 'nurse' and am protective of my title and license!