I have a question about an RN wanting to work as an LPN or Medical Assistant

caliotter3 · Feb 17, 2009

If the employer does not want to hire her under those circumstances she is most likely out of luck. It is up to the employer to set their standards for what credentials they want. They are probably trying to avoid possible future problems because they won't be paying her RN pay, and they don't want her to be complaining about it. Also, it makes it harder for them to pay her at the low end of LPN or MA pay if she is an RN.

I love my cat! · Feb 17, 2009

If the employer does not want to hire her under those circumstances she is most likely out of luck. It is up to the employer to set their standards for what credentials they want. They are probably trying to avoid possible future problems because they won't be paying her RN pay, and they don't want her to be complaining about it.

Thanks for the quick response!

Very true.

Do you know if there is an actual law (like on the books law) that states that an employer cannot hire an RN for an LPN/MA position because they do not actually have the LPN or RN license?

This woman told me she doesn't care about the pay. She's willing to sign a contract about pay, too. She told me she is more than willing to work and be paid according to the position she is hired for.

Can a person even hold both licenses?

When I passed the NCLEX and received my RN license, I still had a valid LPN license, but when I went online to check my licensing status, I was only listed as an RN-active. The LPN was shown as not active (actually, it has been so many years I don't recall what it specifically stated).

I just remember it did not show me licensed as an LPN anymore.

caliotter3 · Feb 17, 2009

Many people hold both licenses. Usually people have no problem working at the lower level because employers like bargains and they know that legally the person has to perform their job according to the standards of the higher license that they hold. So they are getting a bargain all the way around. There is no law about this. They would probably throw something at her about insurance requirements, but it is nothing but a poor excuse to hide the real reason. My husband had a problem getting work one time because he was overqualified. He was told confidentially after not getting hired by one firm that the attitude was that he would get dissatisfied after a period of time and leave because he wasn't working up to or getting paid at his true potential. It makes sense in one respect, but doesn't make sense when the person just wants a job and doesn't really care about the prestige or pay.

caliotter3 · Feb 17, 2009

I asked a question about this when I was in my BSN program. I was told that it is not a good practice to work below your license because of the legal implications. Since you are required to hold to the higher standards of the higher license, patients and lawyers can take advantage of this fact in a lawsuit regarding problems with care rendered. Therefore our instructors advised against the practice. I worked as a CNA with my nursing license because I needed a job. I will never do that again. Too many problems when I moved into the licensed nurse role at the same facility. I just won't put myself through that again.

pagandeva2000, LPN · Feb 17, 2009

I know plenty of people that retain both licenses. They feel that they have more options this way. Of course, they are held to the standards of the higher license, but, in order to gain employment, they are willing. I suspect that in these trying economic times, more people may opt to do this.

What she may have to do is challenge the NCLEX-PN exam to obtain that license. I know of a situation where two RNs that work in home care worked it out where if one is unable to go assess a new case, the other will be called and they would split the pay. I am assuming that they get to assess what sort of nursing services the patient would need and collaborate with the agency. Well, in this case, my collague was unable to go, sent her friend and it was decided amongest the agency's health care team that care can be rendered by an LPN. The partner happened to have retained her LPN license and I guess she saw that this would be an easy case, so, she took it. Now, my collague is upset because she felt they should have discussed this first. She also mentioned that her partner would he held liable to the higher license.

Putting the strife between these two to the side, my feeling is that while it is true, this person will be working as an LPN and be held to the standards of her RN license, but, in most cases, a home care case would be relatively stable, and would probably not involve complicated intervention like IV care (in my state, LPNs can only render IV care in a facility, not the home), chemotherapy, etc... and as long as she responds to the emergency by rendering CPR, calling 911 and keeping the patient safe, she should be okay. In addition, I believe this nurse figured that she would rather make a bit less money, but some is better than none, and take a second job that is less risky than her regular. As mentioned above, this nurse is not worried about prestige or pay, she just wants to work in an atmosphere that she perceives as less stressful.

I have another friend who told me that while she was an LPN, she saw more attractive opportunites for the RNs, so, she pursued her RN license. NOW...however, she said she is seeing more attractive positions for LPNs, and realizes that she has taken on more of a burden as an RN and she is thinking about reactivating her LPN license to (as she puts it), has more options. To each his own, I guess. I would probably do the same, to be honest, if I were to ever decide to become an RN.

Jokerhill · Feb 17, 2009

Most will not want to hire her because they believe once she finds a RN position she will leave, and they will be stuck training another person.

P_RN, ADN, RN · Feb 17, 2009

She should check with her board of nursing. Most times a nurse is held to the higher standard .....ie: the RN not the LPN standards.

taxifolia · Feb 17, 2009

In a medical office, if you are willing to work for a med asst pay, some providers are quite happy to then hire you as an RN, since that is what you are held to anyway, they just can't afford to pay you for it. I have done this and it can work out well for all involved if everyone starts out with a good understanding of the situation.

pagandeva2000, LPN · Feb 17, 2009

She should check with her board of nursing. Most times a nurse is held to the higher standard .....ie: the RN not the LPN standards.

In addition, in most states, if the nurse is disciplined on the higher standard, it affects BOTH licenses. In mine, I noticed that in the website of the Office of Professions, a nurse that was disciplined holding both licenses was penalized for both, and both license numbers were listed. If one's RN license was suspended, for example; the LPN license was suspended as well.

luvmy2angels · Feb 17, 2009

We had an RN that worked as an LPN, in fact she NEVER took a position as an RN for her entire career (and she has been a nurse for 40+ years).

I love my cat! · Feb 17, 2009

Thanks for all of the great responses!

I will definitely pass the information along.

I think I am going to call the BON myself and see what they say.

Many of the Hospitals in our area don't hire LPNs. She doesn't want to work in a Hospital as an RN, but wants a job. She is willing to take the pay cut for a job in a clinic.

Thanks for the info everyone...I knew I could count on you!