Licensed as a NP but working as a RN

[SierraBravo]

For those who are licensed as a NP, have you ever worked per diem as a RN? I've heard that if you are licensed as a NP and work as a RN then you are held to a different standard (clinically) because you have a higher level of education and licensure. I've searched my state education dept.'s website but can't seem to find anything in writing about it. I'm located in NY. Thanks in advance.

[elkpark]

Here is a post of mine from a recent thread on this same topic. The statements from the various BONs are regarding RNs working as LPNs, but the principle is the same. I'm a psych CNS and I have worked as a staff RN in psych in between CNS jobs in the past. I'm not saying people definitely shouldn't do it; I'm just saying people need to understand and accept the accountability and potential risk involved.

Please note that the statement on this topic from the NY BON that turned up in my Google search is below.

Here are some sample statements from various BONs on this topic, that I was able to find in a quick Google search. There is no mystery about this. The reason why this is a dicey thing to do is that, while the employer holds you to the scope of the position in which you're working (generalist RN), if anything goes pear-shaped enough to end up in court or in front of the BON, the courts (and BONs) will hold you to the standards of your highest level of education and licensure.

New York:Can a Registered Professional Nurse (RN) or Licensed Practical Nurse (LPN) work in a position that is below his/her level of licensure?

Answer: Yes. A licensed nurse may work in a position that he/she has the training to do and that is within his/her scope of practice. RNs have the training to perform LPN, Certified Nurses Aid and Home Care Aid functions and therefore could accept a work identified for these levels. An LPN has the training to perform Certified Nurses Aid and Home Care Aid functions, and could accept work identified for either of these positions. However, the nurse that does so would still be required to act prudently based on his/her educational preparation and would be held to that standard.

[COLOR=#003366]http://www.op.nysed.gov/prof/nurse/nursepracticefaq.htm

Wisconsin:

IF I HAVE AN RN LICENSE, BUT CAN ONLY FIND WORK AS AN LPN OR CNA, IS IT ACCEPTABLE FOR ME TO WORK IN A POSITION BELOW MY LEVEL OF LICENSURE UNTIL I CAN FIND OTHER WORK? THE SAME WITH AN LPN WORKING AS A CNA?

The Board of Nursing does not regulate CNAs, so questions regarding the practice of CNAs should be addressed to the Wisconsin Department of Health Services. It is important to note that while working at a lower level, you may be held to a higher standard of care due to advanced education, training and experience. Also, you must hold the credential for the profession in which you work.

[COLOR=#003366]http://dsps.wi.gov/Documents/Board%20Services/Position%20Statements/Registered%20Nurse.pdf

　

North Carolina:Can a LPN or RN work in a position that is below his/her level of licensure?

A licensed nurse may accept and work in a position that he/she has the training to do and that is within his/her scope of practice. A RN has the training to perform LPN and NA functions and therefore could accept a position identified for either of these levels. However, the nurse that does so would still be required to act prudently based on his/her educational preparation and would be held to that standard.

[COLOR=#003366]http://www.ncbon.com/dcp/i/nursing-practice-faq--nursing-practice

Iowa:Q. Can a LPN or RN work in a position that is below the level of his/her licensure?

A. There are no laws or Iowa Board of Nursing rules that prohibit a licensed nurse from working in a position that is below the level of his or her licensure. However, the board has previously determined that the nurse who does so is held to the highest level of his or her education. If a nurse is working in a position lower than the nurse's licensure and fails to act prudently based on education preparation, the nurse's license would be subject to sanction by the board.

[COLOR=#003366]http://nursing.iowa.gov/faq/practice.html#b1

　

Maine:Practice Below Level of Licensure

A licensed person who agrees to be employed in a position which requires less knowledge and skill than that for which s/he is prepared may find several problems:

1. S/he may be expected to perform at the level for which s/he has been prepared even though classified at a lesser level; and

2. S/he will be held to the standard expe cted of the higher licensure level should legal problems occur in that health care facility, no matter what the job classification.

The practice of employing licensed individuals to work below their level of preparation, as defined in the LAW REGULATING THE PRACTICE OF NURSING, places that licensed nurse in potential legal jeopardy and is of serious concern to the Board. (1985)[COLOR=#003366]http://www.maine.gov/boardofnursing/questions/questions_general.htm

[Hi2Jenn]

I agree with elkpark. My hospital does not allow you to work as an RN once you are working as a NP. You are caught between a rock and a hard place. You are working as an RN and the hospital expects you to stay within the parameters of that job. However, you are held to the standard of the NP. Some people have done it, but depending on where it really puts you in a no win situation.

[elkpark]

Yes, lots of employers have policies of not allowing people to work below their level of licensure because of the weird liability/accountability issues. Probably, statistically, nothing is going to go seriously wrong, but if it does ...