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?!

[VolunteerCPR]

A 4 year old died in a Chicago dental office where this type of thing was going on, she was too heavily sedated and did not make it. I would report the facility.

[Jolie, BSN]

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.

Allie, you are correct that RNs, and LPNs are bound to the Nurse Practice Act, regardless of the setting in which they practice.

If I may be so bold as to speak for wooh, I believe she is correctly indicating that physicians may employ unlicensed personnel in their offices and "deputize" them to do just about anything, because they are regulated by the state medical board, not the state nursing board. Most states allow MDs to delegate just about anything to unlicensed office staff because those unlicensed personnel are operating under the MD's license.

Just insert "Board of Dentistry" and "unlicensed personnel operating under the dentist's license" and you've got essentially the same situation.

The BON does not regulate any profession other than nursing, so don't employ nurses or don't assign them these tasks, and there is probably nothing illegal going on.

Unsafe, yes. Unethical, probably. Illegal, doubtful.

[AnnemRN]

I wanted to add this link regarding the use of the title "nurse".

http://www.nursingworld.org/MainMenuCategories/ANAPoliticalPower/State/StateLegislativeAgenda/TitleNurse_1.aspx

[Creamsoda, ASN, RN]

I think what they are doing is illegal. They are not licensed or trained. No no no no no. I would first tell her to stop doing what shes doing. Shes risking loosing her job, hurting a patient, among other legal implications. Something horrible could happen. It makes me cringe that they are doing that. How would you feel if you were a patient and what is basically an assistant was pushing drugs into your IV? I think this needs to be reported, but where im not sure. Talk about malpractice lawsuit.

[NursesAreAngels2]

Allie, you are correct that RNs, and LPNs are bound to the Nurse Practice Act, regardless of the setting in which they practice.

If I may be so bold as to speak for wooh, I believe she is correctly indicating that physicians may employ unlicensed personnel in their offices and "deputize" them to do just about anything, because they are regulated by the state medical board, not the state nursing board. Most states allow MDs to delegate just about anything to unlicensed office staff because those unlicensed personnel are operating under the MD's license.

Just insert "Board of Dentistry" and "unlicensed personnel operating under the dentist's license" and you've got essentially the same situation.

The BON does not regulate any profession other than nursing, so don't employ nurses or don't assign them these tasks, and there is probably nothing illegal going on.

Unsafe, yes. Unethical, probably. Illegal, doubtful.

If it's not illegal it should be. There is a reason for the schooling involved in nursing and most of it is directly related to patient safety. Anyone can do a direct IV push thats easy, its all the complex information that you learn about outside the actual action of pushing the med that is critical the patients safety. I just don't understand how a MD can delegate nursing procedures to a non licensed person, to me that is crossing a line. No irritation meant to be directed towards you, this just kind of upsets me. I would be extremely mad if I was told someone was something they were not and had no business being without the proper schooling whether they were under an MD license or not.

[PMFB-RN, RN]

I imagine those dentist's insurance agent would have a stroke if he knew. Talk about a malpractice lawers dream come true.

[diva rn, 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.

By the way...Oral Maxillo surgeons are NOT MD's they are DDS or DMD (which are still Dentists..) they went to dental schools NOT medical school..and took residencies...BUT they are dentists not medical doctors....(I have been in the dental field since 1975 as an RDH besides being an RN and I was Married to an Oral Surgeon for many years)...so, I really don't think they have the pure medical training the MDs do....

[boushie87]

By the way...Oral Maxillo surgeons are NOT MD's they are DDS or DMD (which are still Dentists..) they went to dental schools NOT medical school..and took residencies...BUT they are dentists not medical doctors....(I have been in the dental field since 1975 as an RDH besides being an RN and I was Married to an Oral Surgeon for many years)...so, I really don't think they have the pure medical training the MDs do....

The Dr. I work for (an oral surgeon) is also an MD. He is a DDS, MD. So it just depends on their education as if they are DDS, DMD. DDS, MD etc.

[PinkRocksLikeMe]

I wouldn't be so much worried about "look what she can do and she has no license but I do and worked my butt off for it" aspect. That IS what you said you were upset about, I would be concerned for the PATIENT that is getting the meds given, high alert meds at that. Your post come off that you are ticked she is doing what you are doing. I think you have your priorities wrong, just my 2 cents.

[BunnySan27]

In Texas LVN can push approved medications, in med surg and Others if they have Acls and work in ICU. I think the OP is hating....yes its unsafe to if you are not licensed or trained to do such pushes, but the last thing you were concerned about was the patient....

[belgarion]

Actually in Texas there are very few specifics regarding what an LVN can or can't do including IV pushes. It's pretty much up to each facility's comfort level.

Nursing boards only regulate the practice of nurses. In most states, CNAs and other non-licensed personnel are regualted by other agencies such as the department of health. Doctors by the state Medical Boards. Why is it that whenever an issue like this comes up everone starts screaming "CALL THE BON" when the BON has no control over that area? If you want to complain, find out what agency can actually do something about it and complain to them.

[wooh, BSN, RN]

Why is it that whenever an issue like this comes up everone starts screaming "CALL THE BON" when the BON has no control over that area? If you want to complain, find out what agency can actually do something about it and complain to them.

Exactly. Maybe it should be illegal. But a random person walks in off the street and starts working in a doctor's office, and pretty much the only thing they can't do, if the doctor lets them, is call themself a nurse.