NP being used as an RN

[Adam18]

I was hired to work as a nurse practitioner in an outpatient clinic/ambulatory surgery center. The nurses were going to be let go, and I was asked to serve as the OR and pre-op post-op holding nurse on days that there is surgery in an effort to cut costs. I will also be writing scripts for the patient's to take home after surgery. After the surgeries of the day are over, I'm expected to see patients as an NP until the clinic closes. This was not included in my contract, and I will be getting my same yearly salary instead of a hourly salary. Sometimes, the surgeries run hours past closing and there has been no mention of compensation for the additional hours. I'm also concerned about any legal aspects of serving in both roles and the confusion that it may bring to the patients. Have any of your employers ever used you in a dual role to cut costs? What do you think about this? I appreciate the responses.

[BostonFNP, APRN]

Honestly I'd just find another job, but before that, I'd have a candid talk with my employer about my concerns from salary to hours to role.

[Jules A, MSN]

There is no way unless this was my dream job AND the docs were doing it also.

There isn't any concern from a practice standpoint, hell you could double as the janitor and mop the floors also if you, like many NPs seem inclined to do, but no way I'd agree to this even on a temporary or emergency basis.

[BCgradnurse, MSN, RN, NP]

Agree with the above. Don't work for free. Talk to your employer first, but be prepared to start looking for another position.

[Adam18]

Thanks for the quick responses. This is my first job as a new graduate. How would I go about looking for a new job without my current employers knowing or getting called. I want to make sure that I have something nailed down before I quit. I would also have to pay them my relocation allowance if I quit this soon. They would also probably blackball me if any future employer called. I feel like they do not care about my professional growth. I moved because of the opportunity to first-assist and they keep saying that they cannot afford for me to leave the clinic and stop seeing patients to scrub-in. They already have another provider assisting. I have talked to them before about having Dragon or some dictation device to finish my notes faster and they have refused because they did not want to pay for another Dragon certificate. Everything that I keep bringing up falls on deaf ears. I feel trapped, abused, and have been depressed about this.

[Adam18]

I think their idea is that if they cut costs with the nurses, they will be able to train me. Furthermore, this is not a huge facility. It's the doctor that owns the clinic and enough employees to count on one hand.

[caliotter3]

..... They already have another provider assisting...... Everything that I keep bringing up falls on deaf ears. I feel trapped, abused, and have been depressed about this.

Look for another job. If you get called on the carpet because someone calls for a reference, be ready with a firm response.

[wondern, ASN]

WTH, Adam??? You have 1 year experience and are willing to take over the whole outpatient surgery clinic as the only nurse there? The employer sounds like a total fool.

It's not always about saving money immediately. Look at the big picture of what you describe, e.g., your licensure. Please take some time to get more experience before you think of feats most experienced nurses wouldn't even consider. Patients pay dearly for their care.

How many nurses are you replacing???

[Jules A, MSN]

I think their idea is that if they cut costs with the nurses, they will be able to train me.

Really?

[Dodongo, APRN, NP]

H*LL. NO.

Under NO circumstances is this acceptable. Absolutely not.

[aprnKate]

Find another job SOON first and get your ducks in a row and then quit. Hopefully you didn't sign anything that can tie you in. Just tell them that you either are a NP or your a RN but not both. If they don't listen to you, then they do not value you or respect you. No ifs, and & buts. Besides why stick around being a RN when you can become a NP. Why don't you tell those docs to recover their own patients as well? They are just really taking advantage of you. Trust me, I've been in the same situation once where they tried to use me as a RN. I didn't hesitate to say anything (but of course, I was traveling back then).

[Adam18]

I'm happy to know that I wasn't ridiculous in thinking the same as you all have. This is a difficult situation because there is only one doctor and he is the sole owner of the center/clinic, 2 of us mid levels. The other has been with him over 15 years. They haven't been able to hold down a second NP in all those years. There is 1 MA, 1 office manager, 1 medical trascriptionist, 1 receptionist, and that's it. The last medical transcriptionist was also doing billing/coding and serving as MA checking in patients when the MA was out. She was MA and transcribing for all 3 of us providers and was fired because she Refused to serve as a scribe for the doc on top of what she was already doing. There is one Pre-op, one OR, and one post-op Rn. The same day surgeries are all simple ortho surgeries. In the pre-op RN role, I would have to start an IV, fluids, EKG, check if the consents are complete and all the pre-op paper work then in the OR, help the doctor scrub in and out and document the surgery. There are about 5 patients only a day. During post-op role, I have to explain home care instructions, Write the prescriptions for the pain medicine, vital signs, discarge Home paperwork. I don't know if this makes it any better. On top of that, I was urged to send the other nurses home as soon as I felt confident to do these tasks all on my own. It seems like I'm left to do the dirty work that the office manager should be doing. The nurses shouldn't be disposable.