Liability issues

AddictionNP, MSN, RN, NP · Dec 5, 2019

I'm an NP and work as an NP and still have my old RN job as per diem. I may go once a month to work because they are usually short staffed. While I am there my contract explicitly states that I am an RN. I do not change medication orders or start new ones unless I have an order- but rarely does this situation arise anyways. If I think something is wrong with a patient, I call the on-call provider and we always have a discussion on the next course of action, if they order a medication over the phone to be given it goes in as an order they gave and me as the transcriber- this is a correctional facility so the RNs have a standardized procedure anyways which requires minimal input from a NP or MD unless it is an emergency in which case the hospital is 2 minutes up the road from the jail.

WestCoastSunRN, MSN, CNS · Dec 5, 2019

If you are not credentialed by an institution as a provider, I don't see how anyone can hold you liable for not writing/changing orders on a patient (which no one can do unless they are credentialed/privileged by the institution) -- and this is really the crux, IMO. Any good RN should question something that is not right - and this includes APRNs who may be working in an RN role (and who will probably have deeper insight into appropriateness of medical orders). So I suppose we can all be held accountable for what we should know - but that has always been the case for every level of licensure.

Now, I have heard that some states forbid APRNS to work in an RN role. I do not know which states these are, but I have heard this, and this is different. In this case, an APRN will not be offered an RN job in the first place (except in the unlikely scenario the hiring organization does not know the law -- so know your state's laws).