Is the RN liable for other's actions???????

[nursemate19]

I'm an RN working in a rural outpatient clinic. Over the years the administration has reduced the number of RNs to 3 in a clinic with 9 providers onsite and 3 provider's at satellite clinics. They hire some MAs, CNAs, CMAs and in some cases, Jane Doe off the street. They "train" these new hires to check patients in, take histories, vitals and assist the physician with minor surgical procedures, start IVs and give injections. They are also "trained" to work the phone which involves appt scheduling, phone triage, dispensing medical advice regarding anything from constipation to chest pain and medications, calling test results-normal and abnormal. Not all of them call themselves nurses, but when a patient speaks to them, most of the patients assume they are talking with a nurse because of the way the office is set up. We're all referred to as "the nursing staff". I work directly for one physician, with an MA as my partner and a scheduler who also helps with some of the phone work. My question is how legally liable am I, as the RN, for actions by these co-workers, or information given to the patients by them? The clinic tells us we have no liability but it concerns me. Thanks for any feedback!!!!

[ICRN2008, BSN, RN]

Many states do not allow phone triage by RNs without specific physcian protocols. LPNs, because they cannot assess and evaluate, cannot do phone triage. I doubt that MAs can either

[shelly304]

CMAs fall directly under the physician-never a nurse.

[leslie :-D]

CMAs fall directly under the physician-never a nurse.

agreed.

and so, no liabilities whatsoever.

leslie

[Lovely_RN, MSN]

MAs in my state work under the direction of the physician and they are not allowed to administer any kind of meds or do injections.

[DusktilDawn]

CMAs fall directly under the physician-never a nurse.

If your delegating to them, than I don't see why you wouldn't be as accountable in a situation involving a CMA than you would with CNA/NA.

[Lovely_RN, MSN]

What I want to know is if an RN can be held liable for merely observing CMA/CNA and other unlicensed people doing things they aren't supposed to do?

If an RN works in a physician's office and witnesses MAs giving injections, starting IVs, and taking telephone orders etc does that RN have an obligation to report this to the correct authorities? Would that RN be risking their license even though the unlicensed people are working under the doc?

[nursemate19]

What I want to know is if an RN can be held liable for merely observing CMA/CNA and other unlicensed people doing things they aren't supposed to do?

If an RN works in a physician's office and witnesses MAs giving injections, starting IVs, and taking telephone orders etc does that RN have an obligation to report this to the correct authorities? Would that RN be risking their license even though the unlicensed people are working under the doc?

THANK YOU!!! This is exactly what I'm afraid of!!! You worded it much better than I did.

[BlueRidgeHomeRN]

have you thought about job-hunting?? this sounds like an unsafe place to work, even without any legal liability! i had to walk away from a clinic that had ma's delegating patients and paperwork to the rn's...

[Batman24]

What I want to know is if an RN can be held liable for merely observing CMA/CNA and other unlicensed people doing things they aren't supposed to do?

If an RN works in a physician's office and witnesses MAs giving injections, starting IVs, and taking telephone orders etc does that RN have an obligation to report this to the correct authorities? Would that RN be risking their license even though the unlicensed people are working under the doc?

It's not something I would take a chance on that's for sure. I do think you'd have liability here. I'd be looking for another job pronto.

[correctlywrong]

You are never liable for someone else's actions. You are only liable for your own action or inaction.

If you are in a supervisory role, you are liable for supervising them and seeing to it that they perform the actions that you delegate to them appropriately. If you see others exceeding their scope, you may be obligated to report that, and could be held liable for not doing so. But if you do fulfill that obligation, that should end your liabliity. You are not responsible for the outcomes of their acitons.

Job hunting isn't a bad idea, but you can also attempt to defend in place. Can you bring your concerns about scope of practice violations to the facility's director and advocate for change? What is the worst thing that can happen, that they could fire you for attempting to bring operations in line with regulations? (Actually, in my opinion, the worst possible thing that could happen would be that they take your concerns seriously, but put you in charge of organizing the necessary restructuring. There is no greater punishment for a whistleblower than being cursed with corrective resonsibility. ;-P )

[crissrn27, RN]

It seems that more and more md's are working with MA's instead of nurses. I once had an MA start an IV on me (thought she was a nurse, and was to sick to question at the time), of course she bungled it and I had to walk her through the whole thing.

I've had MA's try to give me orders over the phone without consulting the MD, exp

Me: the pt has blah, blah blah going on

MA: well, give her blah, blah, po 2x a day

Me: ummm, shouldn't you speak with the doc first

MA: no, that is what he always orders, just go ahead and order it

Me: don't think so, could I speak directly with dr. soandso

MA: NO! and why are you questioning me? I am dr. soandso's nurse, not you!

Me: are you an LPN or an RN?

MA: I am a Medical assistant! I took a 6 week course! I know what I am doing.

Me: Could I just speak with dr. soandso

MA: Click

That was a day, I tell you. I got the don involved and she ended up taking the order! I couldn't believe it! Well, at least my name wasn't on it. After that, I spoke with the BON in my state, and they basically said the MA's can do anything they want, they are under the MD's license. They did send her a cease and desist order for using the nurse title.