Nurse Impersonators

[NancyRN]

Am I the only one who resents the "nurse impersonators" who abound in the health care field?

Everyone who works at a doctor's office or in a hospital wears scrubs and seems to pass themselves off as a nurse. Of course, the hospital doesn't mind. Visitors and patients don't realize how few nurses are actually on the unit if the unit clerks, nursing assistants, housekeepers, and technicians are all wearing scrubs.

It seems harmless enough, this generic flowered jacketed scrub outfit, until you think of the harm it does to nurses' reputation as a whole. I just wonder what people think when they see two or three "nurses" ambling around the hallways or sitting at the nurses station while their family member waits for pain medication!

I have to think the doctor's offices are the worst. The doctors will actually refer to the medical assistant as "the nurse". I wonder if a doctor would appreciate an employee passing himself off as a doctor?

Last month I was in a doctor's waiting room with my son when a man came in holding his hand wrapped in a towel. He announced that he'd cut his hand and needed to see the doctor ( ok- dont ask me why he didn't go to the ER!) . The "nurse" told him to have a seat. The waiting room was crowded and it was obvious he was in for a very long wait. I saw the towel becoming saturated, and I couldn't help going over to him and telling him to hold his hand above heart level, apply pressure, try some deep breathing, etc. I told the "nurse" to let him go in and be seen, but she said, "He has to wait his turn, it wouldnt be fair to the patients who had appointments."

Driving home, my son asked, "Why didn't that nurse help that man?" I told him, "Because she's not a nurse!" But I wonder how many people in that waiting room went home with the story of the nurse who wouldnt help a bleeding man.

I know nurses don't want to go back to the days of wearing caps (even though I love my cap), but shouldn't we be more concerned about people in scrubs making us look bad? Shouldn't a nurse on duty be as easily recognizable as an EMT, a Firefighters, or a Police Officer?

[tiger]

alot of the posts are degrading to cnas. they do very important work and are not idiots.they are part of the nursing profession. they just have not chosen to further their education for their own reasons. and alot of the posts are degrading to housekeeping or dietary. they too have chosen a different path but are not stupid. alot of times when i am busting my a$$ for a few more bucks i think their choices look pretty good. i'm not trying to cause any problem here but where i work------they have it much easier than the rns and lpns--just less pay. but not that much less really....the easy j0bs are in therapy depts. they also wear scrubs and get one on one time with the pts. imo

[Jessy_CA26]

Hey, the Pay for MA's is not bad Im at 19.00 a hour and Im not complaning.

[NRSKarenRN, BSN, RN]

from national council of state boards of nursing:

licensure is the process by which an agency of state government grants permission to an individual to engage in a given profession upon finding that the applicant has attained the essential degree of competency necessary to perform a unique scope of practice. licensing requirements define what is necessary for the majority of individuals to be able to practice the profession safely and validate that the applicant has met those requirements. this regulatory method is used when regulated activities are complex, require specialized knowledge and skill and independent decision-making.

certification is another type of credential that affords title protection and recognition of accomplishment, but that does not include a legal scope of practice.

http://www.ncsbn.org/public/regulation/licensure.htm

from international council of nurses

icn position:

the title of "nurse" should be protected by law and applied and used only by those legally authorised to practice the full scope of nursing.

http://www.icn.ch/pstitle99rev.htm

when can you call yourself a nurse ?

registered nurse assoc. of british columbia

http://www.rnabc.bc.ca/pracsupp/articles/callnurs.htm

registered nurses association of nova scotia

http://public.rnans.ns.ca/cgi-bin/actupdate

protection of terms

the designation of "nurse" or any related derivation, and the use of the term "nursing" to imply one's practice, is now limited to only those individuals who are regulated/licensed to provide nursing care (i.e., registered nurses, licensed/graduate practical nurses, holders of a temporary licence, students enrolled in nursing education programs, nurses on the certified graduate nurses list).

ana: title protection for nurse

outline of different states rules protecting the name "nurse/rn"

http://www.nursingworld.org/gova/titlepro.htm

from nysna:

prohibition on the use of the title "nurse" is needed to assist patients in understanding who is delivering their care. current law prohibits use of the titles "registered professional nurse" and "licensed practical nurse" except by persons licensed under the nurse practice act. there is no such limit on the title "nurse." unlicensed staff members have been given titles such as nurse technician and been given name badges that only identify the individual as part of the nursing department. this pattern is prevalent in all health care settings, from the person that advertises their services as "baby nurse" to assist parents with newborn care to the medical office receptionist who is called "doctor's nurse." these practices have led to the mistaken assumption by patients that unlicensed persons are actually licensed providers of nursing care.

http://www.nysna.org/programs/leg/mos/0102/a2581.htm

nursing is a helping profession. it has the public's trust -- a trust that has been earned because nurses have worked hard to ensure that all those who practice nursing meet standards for the profession and follow a code of ethics. through licensure you have accountability to the patient, other nurses and to the public at large that you are meeting minimal standards for safe nursing practice---without licensure you have no such protection.

if a licensed nurse causes harm to a person through negligence or failure to act, they will lose their license to practice within that state and almost never regain it.....along with losing the ability to move to another state to practice for most states will not grant licensure once its known that license suspened/revoked in another juristiction...along with the potential to lose property, posessions and be financially wiped out due to a lawsuit.

all other non-licensed personal who perform nursing functions don"t have that same level of responsibilty/accountability/loss of livelihood facing them if something goes awry while performing care!

let's stop diluting the workforce with all these other healthcare provider terms. it's time to return to just three levels of nursing caregivers:

1. rn's

2. lpn's/lvn's

3. certified nursing assistants/certified home health aides

let everyone else involved in care giving fill these positions and stop muddying the healthcare roles. by organizing care into these roles you would have clear delineation of levels of care and responsibilities, can create a career track to move from one role to another and regain accountability over each groups actions.

[P_RN, ADN, RN]

This is not a discussion of personalities or peoples qualities.

I was a MA for seven years. This is not the question. I was a nursing assistant for 3 years. I have been an RN for 28 years....and ONLY those years was I a NURSE.

The point at hand is who may be called a NURSE. For example:

Minnesota

Only licensed nurses (RNs and LPNs) may use any abbreviation or other designation such as "nurse" which implies licensure.

South Carolina: It is unlawful for any person to practice as a registered nurse or a practical nurse, to use the abbreviation "R.N." or "L.P.N." or any sign, card, or device to indicate that a person is a registered nurse or a licensed practical nurse, within the meaning of this chapter, in this State, who fails to comply with the provisions of this chapter, to include a lapsed license, an inactive license, a voluntarily surrendered license, and anyone violating any of the provisions of this chapter is guilty of a misdemeanor and, upon conviction must be fined not less than five hundred dollars or imprisoned for a period of not less than thirty days, or both.

California:AB 1439, authored by Assemblymember Brett Granlund (R-Yucaipa) and co-authored by Helen Thomson (D-Davis) at the request of the California Nurses Association, requires that caregivers disclose their credentials on their name tag while providing patient care. It also prohibits any person other than a registered nurse or licensed vocational nurse from using the term "nurse."

This is ALL this discussion should be about. All boards have similar regulations.

ONLY licensed NURSES may be called or call themselves NURSE.

It is NOT LEGAL to do otherwise.

P

[P_RN, ADN, RN]

Hey NurseKarenRN

Once again great minds think alike!!!

P

[tiger]

good for you jesse. keep up the good work. i do hope they will make up their minds and differentiate between the duties of each level of nursing. at my job now-- they are making alot of changes. no one knows really what they should or shouldn't do. i work in rehab and we have a new billing system that relies heavily in fim scores. at one point we were told that fim scores were assessment s and had to be done by an rn. then they say well, the lpn can do it if the rn is not available. i have been at my job 11 yrs and lpns always did physical assessments/charting. now all the sudden they are not allowed. but they are allowed if needed. gimme a break. now they divide up the pts . and give the lpn most so the rn can do paperwork--but the lpn is still responsible if they are back-up and the rn didn't do it. i don't mind team nursing but i prefer it more clearly defined. we do not have a boss now for like 6 months and things are a little wild. the acting manager/charge nurse is not rational. anyway-- sorry to ramble.....

[Jessy_CA26]

Deleted.. cuz its not worth it.. I just wish you would realize that Yes MA's and CNA's work very hard.. and it seems as if we get more respect from Doctors then Nurses.

[NRSKarenRN, BSN, RN]

No one is saying that MA's and CNA's don't work hard. I've been all levels Nurses Aide -LPN- RN. We are saying that it's a different level of responsibility.

When the s..t hits the fan, the RN is the one left being held responsible. It might seem to some were just paper shuffling but a lot of decisions/delegation and accountability comes with those papers-- ALONG with a LEGAL right to appear in court.

It's the INDEPENDENT judgement/decision making skills to know when NOT to follow orders, deviate from the norm that is important...especially when swimming against the tide/other staff members are saying.

[pandora]

I agree with what you're saying NRSKarenRN. It's us that take the rap at the end of the day if anything goes wrong.

I have the education and experience to make professional decisions about the nursing care I give my patients. That's why I did 4 years at college. I have the knowledge to advise and educate - because I am a qualified nurse. Before I started my nursing degree programme, I spent a few months working as a healthcare assistant in hospital. I know, first hand, that there is a BIG difference between what I did then and what I do now as an RN. I don't undervalue the work of HCAs, but I think they they are deluding themselves if they think it is the same job that I do. I feel very strongly about the way some people try to pass themselves off as nurses. It misleads the public and should be taken more seriously by employers. I would never try to pass myself off as a doctor just because I work in a hospital! In fact, I think I would probably end up in front of a disciplinary board if I did.

[NRSKarenRN, BSN, RN]

Im petitioning at the end of this year. After two years of being a C-MA (not just a MA) you can petition the LVN board for a licence. And if you have the C-MA they will let you on board.

Jessy_CA26:

Jessy can you tell me which state you live in? I am not aware of any state that allows one to transition from C-MA to LPN. Where would you have received training in nursing theory, which is a seperate issue from nursing tasks/skills?

In order to be a licensed nurse, one has to take the NCLEX licensing exam and pass it before a state will grant a license along with completing nursing training for a specific number of months/hours.

I am interested in learning if there is a different way to move into the LPN role.

Thanks, awaiting your response.

[CJM]

Many times now uap or nurse's aids are forced to impersonate nurses because of how there job decriptions are written. Invasive tasks that only a real nurse should do should be stopped and written into state's laws by state nurseing boards.

[mattsmom81]

Doctors created medical assistants because they didn't want to pay a nurse's salary. We are our own profession and I think it bugs the h*** out of docs! PCA's and other unlicensed assistive personnel are in the hospital cathing patients and doing invasive procedures for the same reason--MONEY. Hospitals don't want to pay for the nurse. I see only more of this in the future, unfortunately. I have worked with some great PCA's, MA's and CNA's who are a joy to work with. Nurses do not look down on you, we are just concerned about our legal liability when health care facilities stretch us too thin. Thanks Karen for posting all those great links , I hope some of you MA's and CNA's who are offended by nurses will take time to read these links and see where we are coming from. For example, did you know I can lose my RN license if I ALLOW a doctor to harm a patient? I can be criminally prosecuted for giving a drug which harms a patient, even if the DOC has ordered it?? Nurses are the final responsible party in our health delivery system. Hope this helps clarify our position a little. Best wishes to all..Mattsmom81