Orienting Without a License

[Nurse Beth, MSN]

Dear Nurse Beth,

I am a new LPN grad currently and not so patiently awaiting my ATT. I am working as an STNA while I wait to test. I have been here for 3 years and they offered me a position as soon as I pass my boards.

The DON has asked me if I want to orient as a nurse before I test that way I am ready to go as soon as I get my license. I was just wondering if that's even a thing? Also, what would I be allowed to do/ not do? I know that I am not allowed to give meds but would I be able to use any of my skills or not? Would I be strictly limited to learning?

---

Dear Orienting Without a License,

Congrats on graduating!

The DON is trying to rush things along but there is a definite liability here.

You cannot practice as an LPN before you are an LPN. Right now you are neither a student nor an LPN.

You are an STNA (state tested nurses aide). note: Some states have Interim Permits for registered nurses.

Just think if you inserted a feeding tube into a patient and they aspirated. They develop pneumonia, die, and the family sues the facility.

The prosecuting attorney would want to know why an STNA inserted a feeding tube.

You will need and deserve an orientation as an LPN. It sounds like speed of on-boarding you is paramount, and not your orientation.

You are right to be concerned.

Best wishes,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!

[Lunah, MSN, RN]

Some states will allow you to step into your new role once you receive your ATT for the NCLEX. Virginia, for example, has an "RN Applicant" (RNA) role that allows you to start orienting to an RN position. I received my ATT for the NCLEX-RN in mid-July 2008, started in an RN position as an RNA during the last week of July, and took my NCLEX-RN on August 6, 2008, with a couple of weeks of orientation already under my belt. The downside to this was if I had been unsuccessful at my NCLEX attempt, I would have been removed from that RNA role.

Check with your state BON and see what they allow. As Nurse Beth mentioned, it might be a matter of a temp license or interim permit.

[Soxchica]

Orientation before you're licensed may be more things like the endless computer orientation, getting acclimated to the facility and/or floor, or simply shadowing. There are lots of necessary orientation aspects of a new position that aren't specifically nursing. Get a clear idea of what she has in mind before you decide.