How can hospital legally do this?

[RNsRWe]

I'm wondering about something, and although this has probably been discussed here somewhere, I can't find anything, so I'm posting it.

When I was studying for NCLEX, going over the do's and don'ts of licensure, I remember distinctly the BON stating that once a candidate takes the test and fails that (s)he must notify his/her employer immediately and within ten days CANNOT work as a GN any longer. If they have a permit, it's pulled immediately. When I got my Pass notice from Pearson, it said right on there that if my results were Fail, then I had to notify employer, cannot work, etc etc. Okay.

So why is it that I'm seeing people who I KNOW have failed the NCLEX (they've said so) and are still working as GNs? They still have the same patient loads, still doing assessments, admissions and discharges, nursing judgments, still passing meds and doing pushes that the LPNs who have passed their NCLEX's cannot legally do. They sign off as "Jane Smith, GN".

This is in two hospitals in the area that I know of. At orientation, the hospital I'm now in sounded positively retentive about JCAHO and policies and maintaining legal standings, but this is ok?? I know we're short-staffed (who isn't) but how come something as glaringly illegal as this gets ignored when not filling out a form in triplicate will get Compliance Dept down on your butt in a heartbeat?

[RNKay31]

Wow! All the best to you and hope everything works out fine.

[GrnHonu99, RN]

Guess I'm a little confused. If they were able to work before as GNs without even taking the NCLEX then why are they not allowed if they fail, their knowledge base is still the same. Stupid question probably. At my hospital now, I have not taken the NCLEX and I work as a nurse extern II. I can do everything except pass meds. I was told by my management that if I failed the NCLEX I would be able to keep my NEII status for atleast 6 months and if I failed a second time I would go down to a nurse aide position until I passed, but I was more under the impression that it was a salary issue bc they pay NEIIs quite a bit more than PCTs. Sorry new grad here, unfamiliar with the GN policy.

[ZASHAGALKA, RN]

Guess I'm a little confused. If they were able to work before as GNs without even taking the NCLEX then why are they not allowed if they fail, their knowledge base is still the same. Stupid question probably. At my hospital now, I have not taken the NCLEX and I work as a nurse extern II. I can do everything except pass meds. I was told by my management that if I failed the NCLEX I would be able to keep my NEII status for atleast 6 months and if I failed a second time I would go down to a nurse aide position until I passed, but I was more under the impression that it was a salary issue bc they pay NEIIs quite a bit more than PCTs. Sorry new grad here, unfamiliar with the GN policy.

Granting you the ability to work as a GN is based on the ASSUMPTION that you have the knowledge base to pass NCLEX.

Failing NCLEX is proof that you don't, at least, not at this time.

IN actuality, the concept of GN is outdated. It goes back to written boards where it might be up to 6 months before taking the test and finding out if you passed.

These days, there is not the time lapse to seriously justify GN status.

No matter what your hospital allows, your State Board does NOT allow you to continue to practice as a GN, or to use a title that infers you are a nurse, if you fail NCLEX. To do so risks sanctions or refusal by the board to grant you license.

Learn now to use and read your Nurse Practice Act to govern your practice. Dollars to donuts, there is a place that outlines the role of GN and under what circumstances and timeframe you must surrender such a title if you fail. I'll tell you the answer now: you must surrender that temporary title IMMEDIATELY upon receiving results, either to assume the permanent title, or to refrain from practice as a nurse, provisional or otherwise, UNTIL you pass NCLEX.

NO state allows six more months and a second try at NCLEX.

~faith,

Timothy.

[Altra, BSN, RN]

Guess I'm a little confused. If they were able to work before as GNs without even taking the NCLEX then why are they not allowed if they fail, their knowledge base is still the same. Stupid question probably. At my hospital now, I have not taken the NCLEX and I work as a nurse extern II. I can do everything except pass meds. I was told by my management that if I failed the NCLEX I would be able to keep my NEII status for atleast 6 months and if I failed a second time I would go down to a nurse aide position until I passed, but I was more under the impression that it was a salary issue bc they pay NEIIs quite a bit more than PCTs. Sorry new grad here, unfamiliar with the GN policy.

Some states have no such thing as a GN - you can't work as a nurse until you pass NCLEX (this sounds like it might be your situation in OH). But in those states that issue a temporary/interim/whatever you want to call it permit, you can work as a GN before taking NCLEX. You cannot do tasks that are restricted solely to RNs (one example in my state - hanging blood), and you must be supervised directly by an RN who is the licensed professional responsible for you, but you work as a nurse and can do whatever your employer will allow.

Again, this may well vary from state to state, but in my state PA (and from the OPs post - NY) your temporary permit is only valid until your NCLEX results are reported. Here in PA, as soon as your results are reported your permit is null and void, whether you pass or fail. If you pass, it is replaced by an RN license immediately. If you do not pass, you have no legal standing to work as a nurse.

Here in PA, the temp permits are valid for up to 1 year (before you take NCLEX), but realistically ... no employer is going to "carry" you that long without taking NCLEX.

[GrnHonu99, RN]

Some states have no such thing as a GN - you can't work as a nurse until you pass NCLEX (this sounds like it might be your situation in OH). But in those states that issue a temporary/interim/whatever you want to call it permit, you can work as a GN before taking NCLEX. You cannot do tasks that are restricted solely to RNs (one example in my state - hanging blood), and you must be supervised directly by an RN who is the licensed professional responsible for you, but you work as a nurse and can do whatever your employer will allow.

Again, this may well vary from state to state, but in my state PA (and from the OPs post - NY) your temporary permit is only valid until your NCLEX results are reported. Here in PA, as soon as your results are reported your permit is null and void, whether you pass or fail. If you pass, it is replaced by an RN license immediately. If you do not pass, you have no legal standing to work as a nurse.

Here in PA, the temp permits are valid for up to 1 year (before you take NCLEX), but realistically ... no employer is going to "carry" you that long without taking NCLEX.

i think you are right. Im actually in AZ now but we arent called GNs and we don require a permit. We are called Nurse Externs level II. We cant pass meds so I would guess we cant hang blood either. I also get paid less. Although I think it is the same in Ohio. I have a friend from Indiana who is working on my floor as an NEII as well and she was very upset that we didnt get our full pay and that we couldnt pass meds/etc. I think in Indiana you must be able to work as a GN until you pass NCLEX bc she keeps telling me, "in Indiana once you graduate from NS you get your full pay and can do everything an RN can you just dont have the title yet". This was foreign to me bc in AZ and OH you work as a glorified PCA, if you will, until you pass NCLEX. I am able to do things that a PCA/PCT cant do but im always under the supervision of my preceptor. Im thinking this is diff. than the GN staus the OP is referring to.

[cardiacRN2006, ADN, RN]

i think you are right. Im actually in AZ now but we arent called GNs and we dont require a permit.

. Im thinking this is diff. than the GN staus the OP is referring to.

Beat me to it....Az doensn't have GNs. I couldn't even get hired until I passed NCLEX.

[RNsRWe, ASN, RN]

ok, ok, I did my ethical duty and told someone who was in a position to care that if that person were interested in protecting the hospital, that person would be sure that GNs who are working as such haven't failed the NCLEX. That while I wasn't going to provide names, it wouldn't take a rocket scientist to narrow it down some, after all, how many GNs are not yet RNs?

Told that person how insanely uncomfortable I was in even bringing the subject forward, but I had been convinced it was my legal, ethical duty to DO so, so there it is. Still feel like crap about it. Just because it's the right thing to do doesn't mean I don't feel like a real b*tch right now.

I believe (hope?) confidentiality will be kept for me; I already told that person that if it was to NOT be kept confidential who brought it forward that they can have my resignation now. I wouldn't be able to deal with the aftermath that would likely get thrown my way by other employees. I was assured that wouldn't happen, they take ethics violations very seriously, yada yada. Let's hope so. I like my job!

[Altra, BSN, RN]

Good for you OP ... that took courage.

Let us know how it turns out.

[RNKay31]

That was very nice of you, although you feel bad about it, it is worth feeling bad about a good thing than feeling worst about your license being revoke, all the best.

[Jarnaes]

Very proud of you.

[RNsRWe, ASN, RN]

Thanks for the replies. Hopefully it'll all go down smoothly. And without me being further involved.

[ZASHAGALKA, RN]

Remember this: when people do wrong things and you call them on it, it's not YOU being the social/ethical bad guy, it's them.

~faith,

Timothy.