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.

[Jules A, MSN]

I'm becoming more upset every minute that I think about this. The opportunity to first assist is a huge reason why I was sold on the job while interviewing. I have moved hundreds of miles away from friends and family.

I would tell him this and see what he has to say.

He is doing something that isn't uncommon for those with minimal business acumen. Losing dollars in the effort to pinch pennies. It makes no sense to utilize someone he is paying six figures to do the tasks he could be paying someone $60,000 to do. It is likely he doesn't have the business he thought he would in which case you will need to move on. Its unfortunate but it is what it is. Please keep us updated.

[choughlesRN]

Not an NP yet, but I have left jobs before. I can imagine a response going something like, "I feel that my role has expanded far beyond my contract, and I haven't been able to modify my contract to fit the expanded role. So I have had to look for another position where I will be able to better conform my contract to my role." Or something along those lines that makes it clear that the reason for leaving is due to work conditions.

[Tony1790, BSN, MSN, NP]

I had a recent issue come up where I work with 4 MD's, 1 RN coordinator and myself as the only NP. When the RN went on extended sick leave, they wanted me to pick up her duties. I said I'm a provider, I was hired as such and I will work as such and if I'm not needed, then I will go elsewhere. However, I did agree to do some of her duties, after hours for time and a half OT, so I get to be perceived as taking one for the team and getting some extra cash. I'm already having to fight to not to be regulated to the duties that the MD's don't want to do, definitely didn't want to be working as an RN versus what I was hired to do as an NP.

[inthecosmos, BSN, MSN, RN, APRN]

Just no.

[LibbyJo]

No way. If I went through all the school to be an NP, I'd be darn sure I was at a happy job. Of my choice that I love.

If they can't keep a position filled, then I'm pretty sure they have a reputation within your community. I wouldn't worry one bit about getting a reference from them. If you have other references, that will be fine. Once you get another job, stay there for awhile. Eventually you can leave this hellhole off your resume.

I was asked to do to much once at a job and i said no

They were annoyed, but didnt fire me. I just started immediately looking for a new job. It felt good to be assertive. Like, "No. I'm not doing that." Can you go to an agency or something till you get a better job? There are thousands, thousands of jobs out there.

Your employer knows what he's doing is wrong and you owe him NOTHING.

Also, you learned a big lesson here. Sometimes those "good opportunities" are there because no one else wants them. Research the heck out of your next employer before accepting. Lots of good sites online.

[angel337, MSN, RN]

They need to stop being cheap and hire a RN immediately. If you were not there, they would have no choice. They can use a nurse agency. the stories are endless of how organizations want to double dip with NPs by using them to cover 2 roles. Unacceptable.

[Here.I.Stand, BSN, RN]

I also have not received my raise after my 6 month probationary period[/Quote]

Was this raise written in your contract? If so, you may want to consult with an employment attorney... I wonder if you are truly on the hook for relocation costs, if they broke your contract first?

To answer your original question, NO. I'm not an NP nor do I have a burning desire to be... and it doesn't sound reasonable at all. Think about it: that would be like me as a bedside RN being hired into a LTC facility, then DON notices they're in the red and deciding to fire a CNA and have me do the job of both.

You worked hard and probably spent a lot of $$$ to further your education. Why would you do that if you wanted to work as a regular RN?

Plus, you are salaried as an NP. RNs are typically not. If you are working your NP contract, PLUS nursing hours with no pay adjustment, you're basically working for free. I'm of the radical opinion that with the exception of volunteer work, we shouldn't work for free.

[CardioQueen]

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.

Find a new job...as an NP. What you describe is unacceptable.

[Troll_Patrol]

Totally see this every day! A couple of the attending a I work with would like to use me as a Glorified RN or scribe... I have heard "o it doesn't matter what you write as long as there's a note in the chart" I take offense to this and refuse since it's my license on the line

[FullGlass, BSN, MSN, NP]

A suggestion - please review your contract carefully. If the doctor has not fulfilled the terms of the contract, you do not owe relocation reimbursement. I doubt if he would have the time and energy to collect, anyway. As another poster suggested, talk to an employment attorney. They will do an initial consult for free. Good luck.

[Dodongo, APRN, NP]

Totally see this every day! A couple of the attending a I work with would like to use me as a Glorified RN or scribe... I have heard "o it doesn't matter what you write as long as there's a note in the chart" I take offense to this and refuse since it's my license on the line

It sounds like you need a new job as well. Haha. The jobs you posted on another thread sound terrible.

[Julia77]

While you are still at the job is there any way to get training? Can you get training from the other NP? Is he or she an ally? Can he or she provide insight or advice? ((())) Julia