SunshinesArt

Nothing at all, and they seem to understand those basics, but when they ask you to do things like give OTC medications to clients without an order, or sign a form on a line that requires a title that we do not hold, if we explain that it's illegal or outside our scope they don't understand and sometimes demand that it be done anyway.

I work as a drug/alcohol detox nurse. I have been doing this over a year in 2 different companies. The first company I worked for had no medical personnel above my Director who was an NP. We constantly had to explain to upper management details about the scope of practice for nurses including explanations of delegation, calling the Dr for orders (as opposed to just writing an order that the Dr would later sign no matter what it was) and other issues that would come up from time to time that required resources or orders and we were constantly having to say "I'm not willing to jeopardize my license.", which was met with hostility on many occasions. The sentiment expressed was that the clinical people we worked with (Social workers, Licensed Chemical Dependency Counselors, LPC's) also had licenses to protect and that we were being dramatic or overly sensitive. The policies and procedures were written by non-medical people. I do not discount the work that is required to be an MSW or an LCDC, but I do not believe that the license carries the same liability as a nursing license does. I have run into some of the same issues at the new company I work for. I don't want to seem disrespectful to anyone I work with. They are all educated people who do a lot of good for the population that we serve, but I just can't seem to find the right combination of words to explain why I have the right to, and will, question policies and refer to the ANA or BON or any other resource when someone asks me to do something outside my scope of practice, and why our licenses are not the same. The issue seems to be that they don't really understand the scope of practice for a nurse. I understand why they don't really "get" what we do and what all we are responsible for on a daily basis, but I would like to find a way to explain it without offending anyone or seeming difficult. Any advice? Thanks!

My advice to you is to find another job. If you do not feel like you are ready for the demands they are making of you, then that's Ok. You worked hard for your license and if you feel that it is in jeopardy then you have to do what you think is best for you. I have not been a nurse very long (3 years), but I have had several people in management positions tell me that it is expected that new nurses will change jobs a few times when they first start out until they find something that works for them. If you are asked about it in an interview, be honest. Tell them what overwhelmed you about the job and what you learned from the experience. Look for internships or residency programs that have more learning time built into the position while you are paid to work. I'm not sure that I would even list it on a resume, but I'm curious as to what others think about that. Good luck! Susan

I work in a residential detox facility. When a client comes in for detox, we work under Dr orders for their specific protocol and any PRN medications. Once their time in detox is over, they can transfer into our 30 day residential rehab program, but they are no longer under a Dr's care. It was explained to me when I started working here about a month ago that the policy is for the 30 day clients to come to the nurses station when it is time for their medications (both prescriptions that came in with them and OTC meds.) and that they are self-administered. The problem is that we do not have anyone who is unlicensed trained to do self-administration in our program, so even if we follow the self-administration procedure, it is still a nurse handing medications to clients. The nurses on staff came to me the first day I worked there and are all concerned that there is an implied nurse-patient relationship here and that we could be putting our license at risk by being the ones to hand the bottles to the clients, not so much the prescriptions, but the OTC meds. I have brought these concerns to management, but I am the highest level medical person in the company and I am told that it's "no big deal". I have attempted to explain the issue but it falls on deaf ears. I have put in a call to my state board of nursing, but I have not received a return call yet. The Dr that we work under for detox told me that he believes that there is an implication here and that it would be better if we were not involved at all. I have passed that along to management but they have requested documentation to that effect. What is my liability if I handed someone the bottle while I was on duty as a nurse and they had a reaction to the medication? Any suggestions on how to handle this with management, or resources that I can point them to that will help explain? Thank you! Susan

@LeslieWas - I would think that they asked about your CPR cert because they can get a group together and get a group rate. If you need a recommendation for taking the class, my former lab partner is an instructor and extremely reasonable. She is in the Woodlands, but will travel for a group. -Susan

My letter came yesterday - Sweet! :clpty:

JACoro, I thought the same thing! When I called to inquire, they said that the interviews were for people who needed to give some additional information on their application. I have no idea what that means. I know the letters haven't been sent yet, but that hasn't stopped me from stalking the mailman... Good luck! -Sunshine