How do you explain RN vs MSW?

[SunshinesArt]

I work as a drug/alcohol detox nurse. I have been doing this over a year in 2 different companies. The first company I worked for had no medical personnel above my Director who was an NP. We constantly had to explain to upper management details about the scope of practice for nurses including explanations of delegation, calling the Dr for orders (as opposed to just writing an order that the Dr would later sign no matter what it was) and other issues that would come up from time to time that required resources or orders and we were constantly having to say "I'm not willing to jeopardize my license.", which was met with hostility on many occasions.

The sentiment expressed was that the clinical people we worked with (Social workers, Licensed Chemical Dependency Counselors, LPC's) also had licenses to protect and that we were being dramatic or overly sensitive. The policies and procedures were written by non-medical people.

I do not discount the work that is required to be an MSW or an LCDC, but I do not believe that the license carries the same liability as a nursing license does.

I have run into some of the same issues at the new company I work for. I don't want to seem disrespectful to anyone I work with. They are all educated people who do a lot of good for the population that we serve, but I just can't seem to find the right combination of words to explain why I have the right to, and will, question policies and refer to the ANA or BON or any other resource when someone asks me to do something outside my scope of practice, and why our licenses are not the same.

The issue seems to be that they don't really understand the scope of practice for a nurse. I understand why they don't really "get" what we do and what all we are responsible for on a daily basis, but I would like to find a way to explain it without offending anyone or seeming difficult.

Any advice?

Thanks!

[sailornurse]

What's so hard about explaining that RNs/LPNs do not order medications or diagnostic tests?

[SunshinesArt]

Nothing at all, and they seem to understand those basics, but when they ask you to do things like give OTC medications to clients without an order, or sign a form on a line that requires a title that we do not hold, if we explain that it's illegal or outside our scope they don't understand and sometimes demand that it be done anyway.

[elkpark]

Nothing at all, and they seem to understand those basics, but when they ask you to do things like give OTC medications to clients without an order, or sign a form on a line that requires a title that we do not hold, if we explain that it's illegal or outside our scope they don't understand and sometimes demand that it be done anyway.

In those situations, I would be inclined to suggest that if they want it done so badly, they do it. When they say they can't, I would ask them why not.

[amoLucia]

I'd like to ask them how much individual malpractice insurance do they carry???

[TriciaJ, RN]

Can you get them a copy of your state's Nurse Practice Act? They need to see that it's spelled out and not nurses just being obstinate or capricious. Most non-nurses (even so-called professionals) have no idea what is required to function as a nurse.

[APRN., DNP, RN, APRN, NP]

I would respond that in a court of law, you are held to a standard of what a prudent nurse would do.

Going further to explain that the judge and jury are not going to take into consideration what the MSW et. al. are/are not willing to do based upon their licensure for an action that you did/did not do.

Tell them that you don't make up the law, you only follow the law.

[elkpark]

I'd like to ask them how much individual malpractice insurance do they carry???

Other mental health providers (besides nurses) typically do carry professional Liability Insurance. Was that your point, or were you sincerely asking how much they carry? I'm not an expert on this, but I believe the amounts they are recommended to carry are about the same as recommended for generalist nurses.

[RNOTODAY, BSN, RN]

I would think it was the medical directors

( in your case , NP?) responsibility to establish policy/ protocols to Adress all medical issues

otc meds etc