NP working as an RN?

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Hi,

I am sure that this question has been asked before but a few of the threads I've seen date back to a few years ago. I am about to graduate from my MSN program as a pediatric NP but still have a desire to work in a hospital setting as an RN. However, I have been told by many people that no one will ever hire me as an RN the moment I get my PNP license because of the liability issue.

I am looking mainly in the northern California region -- what if I were to work as an RN on a geriatric or adult-unit? It would be out of my scope of practice as a pediatric NP so the overlap would be less.

For those of you out there who may be in my similar position (or are currently NPs who work as RNs, if any) what are your thoughts and comments on this? Or what are your expeiences with finding a job as an RN while waiting for a NP job or while you are working as an NP?

Thank you!

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Hi there.

On my unit in the ICU we have a NP that works as a floor RN for what she claims is for "better benefits" for her and her family.

And then on the side she works as a FNP in a clinic I believe. It works out nicely for her, so it can be done.

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The liability issues are the same, regardless of setting.

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Specializes in Labor and Delivery/Post Partum.

I work labor and delivery and we have a couple of nurses who are CNM or NP and work on the floor as L&D RNs.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.

OP, noticed that you are in Berkeley. Northern California NP here. There are NP's working as RN's in area hospitals here and I know that for a fact. In some hospitals, their presence is even flaunted as a way to brag about the high level of education their staff nurses have. In some units, I've seen plaques that have the names of staff RN's with advanced graduate education (from CNS to NP to any other MS concentration) similar to how some ICU's display a plaque of RN's who have obtained CCRN certification.

I am not sure if it's a California thing. The Scope of Practice for NP's here state that unless the NP enters into a contractual relationship with a physician via Standardized Procedures, your role is no different than an RN. However, as a rule, any nurse is bound by the standards of their highest education in terms of liability. An NP working in the capacity of an RN will be assessed to the higher liability (NP) by companies (as would an RN working as a CNA, not that this would happen)

This is an excerpt from a Medscape Q&A:

I am a family NP (FNP) and am wondering if I can work as a non-advanced practice RN at a local nursing home? I plan to function as any other RN. Would I be held to higher liability standards?

From a regulatory standpoint, you are always legally entitled to work under your RN license, as long as it is current and you meet all RN requirements. However, insurers agree that someone with advanced practice training and certification needs to be insured at the higher level, regardless of position. See the NSO newsletter answering this topic at: http://www.nso.com/newsletters/advisor/2000/np/npra5.php#qa.

Role validation is a large component of scope. If you take such a job, you will need to ensure that the role validation of the RN, rather than that of the NP, is the face you hold out to the public. The setting where you are employed can also help match your role validation, by keeping your job title, job description, duties, and activities crystal clear. The most conservative advice would be to avoid working in areas that share the specialty of your advanced practice focus (such as a nurse midwife working as a labor and delivery nurse). Taking such a position is asking for role confusion, and that, in turn, affects your ability to practice appropriately with your patients.

Source: http://www.medscape.org/viewarticle/506277_7 (must log in as a member to view or create a profile)

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