Bsn Grad To Work In Ltc

Jolie, BSN · May 31, 2007

I'm glad that you are enthusiastic about working in the US. But I have a few concerns, based on your post. Since you have not yet taken NCLEX, and are not yet eligible for licensure as an RN in this country, I do not believe that you can legally begin RN orientation. Most states require one to be fully licensed as an RN or at least hold a temporary permit to function in a professional nursing role, including orientation.

As far as your limitations, once you pass NCLEX and receive your RN license, you MUST familiarize yourself with your state's nurse practice act. It spells out functions that are within the scope of nursing practice. That, along with your facility's policy and procedure manual will guide your practice.

sly3274 · May 31, 2007

Thank you for your quick reply. Do you really think so? Then what should I do? Maybe I should talk to the DON and clarify things out. Maybe we had miscommunication. But I also read here in all nurses that new graduates also work. What do you think the kind of work they do? New graduates have no license too and yet they work in hospitals and facilities.

emmycRN · May 31, 2007

New graduates often request a temporary license from their state board of nursing that allows them to work for 3 months or so prior to taking the NCLEX. Nobody in any state may be employed as a nurse without some sort of licensure through the board in the state they are practicing.

I imagine that your DON stated you're overqualified since most bedside caregivers in LTC are LPN's. RN's typically hold supervisory positions, at least that has been my experience.

Perhaps the director you spoke with assumes you will act promptly to obtain licensure in your state and then work in the facility in a supervisory position.

kstec, LPN · May 31, 2007

I do not know what your DON meant by being over qualified. We have several RN, BSN's working on the floor at my LTC facility and they are not in management. Our ADON is a LPN. But I do know you cannot work unless you have a license to work. Around where I live you can't work the floor or work anywhere as a nurse until you pass your boards and have license in hand.

Jolie, BSN · May 31, 2007

It is possible that you DON intends for you to begin working in a nursing assistant or patient care technician role while awaiting your RN license.

You are correct that new graduates (in some states) work as nurses pending NCLEX results, but they do not function independently. They must be supervised at all times by a fully-licensed RN, and have other restrictions on their practice. Also, as emmycRN stated above, they must have the permission of their BON to do so.

You really need to clarify this issue with your DON and with the CA State BON before reporting to work. Working as a nurse without licensure is illegal may make you ineligible for licensure later on.

sly3274 · May 31, 2007

The DON told me also to learn everything I can about supervisory position. In this case, if the DON assumes that I will act promtly, can I work then as an RN then get my license. It's only a month from now that I will be taking my NCLEX-RN exam. Do you think I will be given that kind of consideration? Thanks!

sly3274 · May 31, 2007

Thanks everyone for all your advises. I think my burden is lifted now. I will clarify this matter to the DON before starting to work. And maybe I really just misunderstood things, since I was so nervous during my interview and all. It's okey for me anyway to work as a nursing assistant and work under the direct supervision of a licensed-RN. I have plenty of things to learn anyway since we have different methods of procedures in our country. And my time will come when I will also be the one doing the supervising. As for now, I am glad to open this matter to you guys. Your advises really help me a lot. Thank you so much!!!

RNGrad2006 · May 31, 2007

Hi everyone! I'm just new here and I would really love to hear your advise. I was a foreign nurse and currently migrated here in California. I will be taking my NCLEX-RN this coming July 2007. Anyway, I applied for a job in LTC and luckily will start my orientation tomorrow as an RN. Anybody know someone without a license work as an RN? or RN Resident? or new graduate RN working in LTC. The DON who interviewed me just told me that I am over qualified for a caregiver, since I have 7 years of experience in my country. What do you think will be my limitations in my duties as an RN. Is it okey for me to give an IV therapy? NGT? etc.?

I have another question regarding working prior to being licensed. What work status do you have? If you are from another country you usually require a visascreen in order to work and passing NCLEX and licensure is a pre-requisite to receiving the visascreen.

sly3274 · Jun 1, 2007

I am an immigrant so no need for me to undergo that kind of difficulty. I can work anytime here in US.

Daytonite, BSN, RN · Jun 1, 2007

sly3274. . .no one can work as an rn anywhere in the united states without a license! california does have an exception to that rule, however, called the interim permit. when you sent in your application to take the nclex here in california, did you ask for an interim permitee status? if you did and you received this document when you got confirmation that you could take the nclex in california, then you can work and do most of the tasks of an rn until the results of your nclex are known, but there has to be an rn on the premises to supervise you. didn't you know that? that is in the california nursing law. if you didn't ask for an interim permit then you have no choice but to work in the capacity of a nursing assistant with patients. that means you can't give medications, ivs or do ng tubes until you get your rn license.

when i worked in ltc (and i have a bsn and many, many years of acute hospital experience as well) i was still a charge nurse like my other lvn and rn colleagues. other than the fact that lvns cannot do a few things by law that rns can do, lvns are still charge nurses and many do a magnificent job of managing the patients under their care. an rn is still an rn whether they have a diploma, associate's degree or a bachelor's degree in nursing. a bsn doesn't put you in a better status over the people who are working in the same job category as you. if you pass your nclex and become a charge nurse, you will be on an equal footing with your lvn charge nurse colleagues. the fact is, however, that most ltcs many times are going to utilize an rn in a supervision or management position. i doubt that is going happen until you learn about the many laws regulating the nursing homes that ltc nurses must be aware of.

sly3274 · Jun 1, 2007

Thanks Daytonite for that view. I've learn my lesson the hard way. I'm so depressed right now but also overwhelmed that I did the right thing. First thing this morning, I went to talk to the DON and cleared everything. And you guys were right, they really did thought that I have my license. Anyway, they told me to have my exam first then come back.

Thanks to all of you. If I hadn't ask for your advise maybe I would have made a big mistake and would not have talk to the DON. It's a relief for me too having cleared my conscience. I will start tonight for another job as a nurse assistant while reviewing.

More power to all nurses!!!