2nd job drawing blood-will i be held accountable as a RN if something were to happen?

Ivanna_Nurse, BSN, RN · Apr 4, 2011

I'm pretty sure that regardless of the job description, you are held accountable to your level of training and scope of practice. I would check with your BON to be sure. :) Ivanna

NPinWCH · Apr 4, 2011

I don't know about working as a phlebotomist, but I know when I went to a legal conference they discussed working as an unlicensed person with RN license and they didn't recommend it since you will be held to your highest license. In the example it was as a tech. I don't know if you could really prove that you had a duty to the person...unlike when you a tech, working in a place where the hospital/LTC/other facility has a duty to ensure patient safety and what not. In your case, if there is no duty to the patient beyond blood draws you might be okay, but I'm not 100% sure on that.

I posted this on another thread, but I'll post it here again:

I couldn't find the information about my own state, Ohio, available online because it was in a legal conference I went to, but I did find information from New Jersey and I'll assume that many states have similar rules and laws.

UAP care directly for patients. Employment is based on the premise that the nurse will perform duties below the level of licensure and remaining within the scope of practice of an unlicensed position.

Terms of this type of agreement are in direct violation of the current statutes governing nursing scope of practice. In accordance with the New Jersey law (N.J.S.A. 52:14B-5.1c, Ch.37, 5.6), "a licensee shall be held to the level of practice associated with his or her licensure.regardless of his or her employment status."1

Based on the existing statute, nurses are liable to provide care in all instances to the level of their existing scope of practice. The healthcare facility is placing the licensee in circumstances that my lead to negligence or malpractice if held to provide care under the constructs of the assumed position. Plawecki & Amrheim explain professional nurses must research the liability involved in positions of less responsibility, and weigh the risk for potential grounds for litigation.2

Link to article: http://nursing.advanceweb.com/Studen...Personnel.aspx

elkpark · Apr 4, 2011

I don't know specifically about Illinois, but, in general, the problem with working "below" your level of licensure is that, if anything goes wrong enough to end up in court, you will be held by the courts to your highest level of education and licensure, regardless of what your job title/description was at the time. If you are licensed as an RN, you are an RN 24/7 and you don't get to "turn off" your RN licensure and forget what you know just because you take a healthcare job with a different job title and scope.

I know that a few people in the past have posted here that their state BONs have rules/regs specifically prohibiting working below one's level of licensure. Most states don't have actual rules against it, but quite a few BONs have issued statements discouraging nurses from doing this (for the reason above). Here are a few examples:

"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 expected 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)

[The DATA BASE /The Bulletin /Spring 1985]"

http://www.maine.gov/boardofnursing/questions/questions_general.html#practice

"1. 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."

http://www.ncbon.com/content.aspx?id=1218#nurse_work_level

"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."

http://www.iowa.gov/nursing/faq/practice.html#l1

roser13, ASN, RN · Apr 4, 2011

As the previous posters mentioned (and provided research to support), I believe that you are held to your highest licensure, regardless of the actual task or job description that you are performing.

Do you have Liability Insurance?

HickoryRN · Apr 4, 2011

wow. Thanks so much for the info, guys! I do not have Liability Insurance and since i feel like i have to protect my license with my life, i think i won't be taking that job after all!! I appreciate all your comments and your research. It was an easy decision. And thank you for your concern and knowledge!! Guess i'll just have to wait a little longer to take on a registry job or something like that for some extra income. Thanks again!

elkpark · Apr 4, 2011

If, as you say, you're concerned you "have to protect (your) license with (your) life," why on earth don't you have Liability Insurance? I would never consider working a single day without my own coverage -- it's the best ~$100 I spend every year.

coolcode · Apr 4, 2011

i am also from illinois and in the same dilemma. im working as a cna and have my rn license. i called IDFPR just to make sure that I can do both jobs. I was told that yes.....as long as I don't go outside my scope while working as a cna. But call them(IDFPR) just so you can get the info from the horses mouth. Best Wishes!!!!!!

HickoryRN · Apr 5, 2011

i have spoken to my hospital and risk management and have done some reasearch and they carry the insurance for us and provide lawyers if a nurse were to be in some type of legal issue. That is the only reason why i have not gotten insurance. I might just do it to be on the safer side, but i have also heard that if you have your own insurance the hospital won't cover you and it's even more of a mess. I don't know what to believe at this point. Any info for that? I would definitely have it if i were to take the phlebotomy job but it's not necessary for my hospital job. thanks!

Batman25 · Apr 5, 2011

Get your own insurance pronto. Don't ever depend on the hospital to back you and/or pay for you. That aren't legally obligated to do so and they could just as easily use you as scapegoat.

You don't announce to everyone you have your own insurance. I don't share that with my employer, co-workers, etc. That's your own business and you keep that info to yourself. Pls protect yourselF. It's pretty cheap and worth every penny. Here's a link for insurance:

http://www.nso.com/

roser13, ASN, RN · Apr 5, 2011

OP, trust us. You need to carry your own Liability Insurance.

NPinWCH · Apr 5, 2011

Get insurance for all the reasons Batman gave as well as others. If you give advice to your neighbor and they sue your employer's insurance won't cover you. If you work somewhere else, even volunteer somewhere and something happens, that insurance won't cover you either.

A personal policy keeps YOU safe. YOU are their primary responsibility, not the hospital. Don't think for 1 minute that if the hospital's lawyer thinks he can pin fault on you and in return keep fault from the hospital that he won't. The HOSPITAL is his priority, not you. Also, if something happens and your license is at risk from the board of nursing, your own policy provides you a lawyer for that as well, but a hospital policy will not.

Get insurance, don't listen to HR...they have their interests at heart, not yours.