I am a nurse practitioner/back office manager in an OB/GYN office. A few weeks ago, we had to let go my medical assistant so we are work short handed until a replacement is found. She was also the "float" in the office. One of the other MA's this past week was off on vacation as she was getting married. THEN, another was out because her son was admitted emergently to the hospital. That left us with 2 for 4 physician's. The good thing is that usually there is one physician off per day and I can handle my own patients. SO-We had asked our triage RN to fill in and help be an MA for the day. She refused, initially, stating that it was against her licensure to be an MA (and go downward?) The position includes getting weights, blood pressures, stand by assist if needed. Clean the rooms. I have even filled in when the situation has arisen. I don't ask anyone to do anything that I, myself, am not willing to do. This particular day, I was to do my job, my MA's job, and by the phone triage person as well. She was angry because she also stated that such duties were not in her job description, however, the "clause" is performs other duties as necessary, especially in effort to assist, learn from and take direction from managers. Also included in the job description is clinical duties which are not performed by this nurse which now she states she is unable to perform because she has "now not been a clinical nurse for 35 years." "I was hired to be a triage nurse and a triage nurse only." She called in sick on Friday. This woman will be asked to fill in only one day this next week, as the MA that got married will be returning and the one with the ill child will still be out for another week. Any thoughts? Am I out of line in my expectations?
You are not out of line in your expectations. That nurse needs to get in touch with reality. I am sure that you could find an RN who would love to have an office job and who would do what is expected of her/him. Your office does not need dead weight.
Shoot, I am an RN at a middle school. Sometimes, you see me sitting up front covering for the secretary! No big deal as long as it does not interfere with my resposibilities as the nurse! Yes, if it became a problem......then, I would speak up!
AND......... a big part of my job is heights, weights, and blood pressures. Well within my scope as an RN. I have never felt these tasks were "beneath" me.
Think about the paradox in this argument. RN's are quickly having their scope of practice eroded by LPN's as well as people with very little education being "delegated" to do tasks that used to be the province of RN's only. Follow the money, and when a facility can hire an unskilled person to perform a task at $8 per hour why should they pay more for a skilled, licensed person? Some of the people in doctor's offices have no training except what the doctor gives them and that is perfectly legal.
Having said that, the triage nurse is lucky to have a job requiring skilled knowledge and judgment. When she needs to pitch in to do other tasks that the MA normally does, that just goes with the territory. She needs to be grateful that the doctor does not replace HER with a MA that the doctor trains and who will receive a fraction of her salary.
Great point! Instead of being upset - she could use the opportunity to show off the difference between an MA and an RN. We know the WHY of taking a blood pressure and the impact an abnormally high or low reading can have. Plus, we know what quick interventions can be taken to lower or raise said blood pressure. No offense at all to MA's ( I was one in another life).
Hmmm has anyone thought that possibly this nurse is unsure of herself and instead of chopping her head off for not being a team player someone MIGHT ask her why she really feels this way? If she has been out of clinical nursing that long she might have a insecurity problem. How about being a team player and find out her side also? ORRRRRRRRRRRRR encourage her to discuss these feelings? I have found there are often reasons for people to act out as she did. Heck she may even become a good team member if someone makes an effort to include her feelings and fears. What may seem unfair today could be a missed opportunity to help a nurse in need. Just a thought.
TuTonka
It is the RN's responsibility to do whatever it takes to keep up all his/her skills to maintain the license. There are refresher courses offered all over the States. It is part of the license to be able to perform any duties listed under their licensure. If this "nurse" states she is uncomfortable performing duties of a nurse then she should havea deadline as to how long she has to brush up her skills or be reported to the Board of Nursing.
All the duties you have states are basic duties for CNAs and LPNs... you are not asking the nurse to do a physical exam--- which is in her line of licensure. Sounds like she has an attitude that needs to have an adjustment into what the TEAM means. If one nurse calls in sick- the patients are still there and must be cared for. Can the ER close just because one called in sick... NO! Nurses are suppose to be team-players.
I think you need to sit the entire team down and divide up the tasks that the missing person would have done so it doesn't fall completely on one person and everybody on the team understands that itwill be a matter of working together to get through the temporary shortage.
Finally a Thank You when the team players does survive goes a long way to the next time it occurs.
In reply to some of the messages I have received- We have no union here. While she was asked to fill in as an MA, that was the only position she was expected to fulfill at the time. Me, however, as the NP/Supervisor, filled in as the triage nurse for her, AND saw my patients as well AND served as my own MA (cleaning my own rooms, filling out lab slips, washing specs etc.). We always have had an RN/LVN in the role of triage and MA's to assist the docs. Where I came from in the west, no MA's, only RN's/LVN's in the office setting. It took getting used to MA's. If I can, at times, I clear my schedule and assist the docs. I enjoy it. Change of pace, but I don't like to inconvenience patients. Makes more sense on those RARE occasions for her to fill in rather than me.
I have read many of these replies and I wonder why if this is a rare occurence why was the thread even started? That alone does not place either professional in a good light? If this is your first post who placed the thread in the first place? Did I miss something here?
TuTonka-Yes, my first post, and I started the thread. I just wanted some advice from some other nurses, since I don't get alot of contact with other RN's since I work in private practice and have for many years. I wasn't sure if my expectations were out of line and if current practice had changed or was I reasonable to expect some help from my team mate. If I did wrong here, I sincerely apologize to ya'll!!!
You do not owe anyone an apology. I was just very confused about who did what. I certainly did not mean to sound critical although when I reread it it might have sounded that way and for that I offer an apology to you. This forum is to help people with a problem and you presented one.
caliotter3
38,333 Posts
You are not out of line in your expectations. That nurse needs to get in touch with reality. I am sure that you could find an RN who would love to have an office job and who would do what is expected of her/him. Your office does not need dead weight.