Question about Boundary of RN License

Nurses General Nursing

Published

Specializes in ICU/ER/Med-Surg/Case Management/Manageme.

I work very part-time in a dual role for a well-respected agency in my area.  About every 60-90 days, I do brief RN assessments on a certain population of clients.  This takes about 2-3 weeks on average.  In the interim weeks, I work a few hours a week as an in-home caregiver, averaging about 4-6 hours per shift.  This role does NOT require any type of license.  It's perfect for a "retired" person who still has to pay bills, can no longer manage the hustle-bustle of the typical nursing roles, but continues to enjoy client interaction.  In this role, I wear a name tag with my first name, I'm the paid caregiver rate of pay, and unless I tell the client, I'm not identified as a RN.

But here's my question:  Because I am a licensed RN, am I held to those standards when acting in the caregiver role?  I sometimes feel I'm walking a tightrope.  Thoughts and comments are appreciated.

You are held responsible to the highest level of your education so in this situation yes, you are held to those standards. However, you don't have any orders to follow so your primary responsibility outside of normal caregiving is being able to recognize and assess any situation that requires a higher level of care and render whatever aid you can with the equipment you have on hand until such higher level of care can be obtained. 

Specializes in ICU/ER/Med-Surg/Case Management/Manageme.

Thank you!  That has been my assumption, but I wanted to be positive I was correct.  For example, I recently had a client who obviously needed professional wound care for her lower extremities.  While I couldn't contact her doctor directly,  I encouraged her to do so ASAP and request a wound care consult.  She did, she now has home health and a certified wound care nurse visiting. That situation prompted my question.  I just couldn't ignore her situation.  So again, many thanks for your quick response.  

I think your other option in that case would be to notify a family member or your company's manager of your concerns and that way you would have done your due diligence if the client was incapable of advocating for themselves or just put it off. 

Specializes in ICU/ER/Med-Surg/Case Management/Manageme.

Excellent point.  Sadly, many clients have uninvolved family members.  Fortunately, this particular client is very intelligent and probably more "cognitive" than me.  But your advice will be used for future situations.

I'm going to add this comment...back in the day when I was actively involved in nursing, I kept up with the legal ramifications, attended the seminars, etc.  Things were much simpler.  Today's nurses are nursing under different and sometimes highly stressful situations.  The things we didn't have to be so concerned about years back are now in the forefront of clinical practice.  That said, responses such as yours as well as others I read on this forum are greatly appreciated and respected from both newbies and oldies!  

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