Serious scope of practice concern

[newtress, LPN]

Hi all, I may need to post in the MDS coordinator section but will put this out there as the general nursing forum is looked at the most I believe. Here goes. Less than 4 wks ago I was glad to be hired into an LTAC as an MDS coordinator with a part timer coming in 2 days a week for support. I am an LPN. I very much wanted the experience and certainly was a big increase in hourly pay. Recently, the regional director, DON, and ADON have also incorporated me into additional areas of responsibility that I am not comfortable with and feel may be outside my scope of practice. Aside from having to take call a full week every 2 wks, they are having me conduct care plan meetings with family members/doing all the PT OT ST therapy reports/clinical standards reports and as of 2 days ago after the Licensed Social Worker quit have been told I now have to do her job also. Sign the MDS section for her, do her social work assessment needs, do referals out to specialist doctors, return to community housing etc. They have incorporated 3 other depts on to me and I do not want to do RN, rehab and social worker responsibilities on top of all the MDS as I feel it makes me an imposter. I know I can do MDS as an LPN but I shouldn't be made to do initial skin assessments etc.

Can my state board determine if this is wrong or illegal for me if I contact them. I am ready to give my notice as I know I can't humanly take on all these duties and do MDS at the same time. They won't even let me get the MDS done by the due dates or allow me to spend any time in my little office on the computer. Anyone know what recourse I may have or if LPN's can be doing social work without a degree!!

[MedSurgeMe]

I'd contact the board.

[Nascar nurse, ASN, RN]

Any licensed nurse can complete the social service section of the MDS. No where in the RAI manual will it designate that certain people MUST do certain sections (aside from the RN signing for completion of the MDS). I have frequently completed both dietary and SS sections when needed.

But, with that said, you need to get them to clarify your job description. You can legally do everything listed (at least in my state an LPN can do an initial skin assessment) BUT it will be impossible to actually do all of that.

[Nascar nurse, ASN, RN]

And forgot to mention...contacting your state board of nursing isn't going to do you much good as their is nothing outside of your scope of practice...it's just to much work & that has to be fixed at the facility level

[newtress, LPN]

I thought this might be the case. But still not at all ok with doing the social workers aspect with individuals discharging out into the community. I don't have the experience, knowledge or contacts to arrange those types of things. Unfortunately I think in my best interest and not having to work 2 to 3 hours overtime every day I should consider giving notice. I had to work 18 hrs one day/night because a 3-11 nurse didn't come in and I had to hit the floor on med pass. This occurs a lot there. Just too bad it isn't what was presented to me at interview time. Classic.

[FLArn]

Depending on the state in which you are located you may be able to perform SW functions if your facility is under a regional SW Director who has a Masters in SW. I would be more concerned about signing off on assessments. I know in Florida you must be an RN to sign assessments. Many LPNs do awesome assessments but if the practice act says RNs must sign..end of story. Maybe if your DON/ADON are RNs and cosign with you that may satisfy the requirements. That is a lot of maybes and ifs, so checking your practice act is a must.

[iceprincess492]

Unfortunately it sounds as though you work for a company/facility that does not quite understand the importance of having the MDS coordinator be an MDS coordinator. Everything they have you doing is legal but not the best way to be using your time.

The company that I work for is very very understanding of the whole MDS process. Our administrators and DON's attend all of the seminars that we attend. They spend a lot of resources making sure we have the tools and the knowledge to do our jobs. We are rarely "pulled" to do anything extra. I have been in my current facility for almost 3 years (with the company for 12) and have never worked the floor or had to take "on call" I also make a large amount of money for my facility by having the time to do my job properly and capture everything possible for reimbursement. I am very lucky because I actually love my job :)

[Batman25]

My biggest concern reading your post is that you are doing the work of 4 people with the salary of 1 person. They are taking advantage of you because they think they can. No human can do all that they are requiring of you. Either go in and make your feelings known or start looking for a new job. You will need to be polite but firm here. You didn't sign up for all this and don't want it nor should they even be asking. I wouldn't let another day pass under these ciurcumstances.

[BrookeeLou_RN]

My biggest concern reading your post is that you are doing the work of 4 people with the salary of 1 person. They are taking advantage of you because they think they can. No human can do all that they are requiring of you. Either go in and make your feelings known or start looking for a new job. You will need to be polite but firm here. You didn't sign up for all this and don't want it nor should they even be asking. I wouldn't let another day pass under these ciurcumstances.

Yeah, it sounds like it might be legal at least in some states, but the issue is not really the legality of it..it boils down to expecting you to basically run the LTC single handed! Not right for you from so many angles. I agree you must go in and make your feelings known. And I would be prepared to re-sign at that meeting. I doubt if they will care enough to change things but at least you are being the Professional here. Unbelievable,, just unbelieveable. Last LTC I worked out MDS was a RN with MS in a wheelchair... she did MDS and MDS only period.

Good luck with this.:)

[Bella'sMyBaby]

This facility is using you. MDS Coordinators are too busy to be doing other department jobs. Get as much MDS experience as you can as fast as you can & get out. Companies are begging for MDS Coordinators with 3.0 experience. MDS Coordinators should not be involved with other duties outside of the MDS Dept & should not be under nursing or taking call. There are Companies out there that do not allow it. :)

[elprup, BSN, RN]

I thought this might be the case. But still not at all ok with doing the social workers aspect with individuals discharging out into the community. I don't have the experience, knowledge or contacts to arrange those types of things. Unfortunately I think in my best interest and not having to work 2 to 3 hours overtime every day I should consider giving notice. I had to work 18 hrs one day/night because a 3-11 nurse didn't come in and I had to hit the floor on med pass. This occurs a lot there. Just too bad it isn't what was presented to me at interview time. Classic.

Yes "Classic" is the right word. Hope you find something else.

[Kooky Korky, BSN, RN]

I thought this might be the case. But still not at all ok with doing the social workers aspect with individuals discharging out into the community. I don't have the experience, knowledge or contacts to arrange those types of things. Unfortunately I think in my best interest and not having to work 2 to 3 hours overtime every day I should consider giving notice. I had to work 18 hrs one day/night because a 3-11 nurse didn't come in and I had to hit the floor on med pass. This occurs a lot there. Just too bad it isn't what was presented to me at interview time. Classic.

Your pay should be about $50 per hour. They are just looking for a patsy, a malleable jack of all trades, someone to anything and everything at a moment's notice.

I guess your decision to stay there or move on depends on how badly you dislike being maltreated and lied to, conned and duped.

What a sleazy outfit.

I wish you the best in your decision.