RN scope of practice in urgent care

[whatevah]

Hi all,

I'm a recent grad (BSN) and have been hired in an urgent care clinic in GA. I have a few questions about my scope of practice vs. the expectations of my role.

I am expected to perform suturing of lacerations after a rather informal training process. I've been unable to find specific information regarding this on the GA BON website. Is this a generally accepted practice?

I will also be expected to perform incision and drainage, which in my mind is a surgical procedure, and thus outside my scope of practice.

Lastly, in the computer documentation of patient visits, I enter the MD findings under the "physical exam" portion. I recently realized that my name is listed there, and it appears that I performed the physical exam. The MD does signify at the end of the chart that he read and approves of the findings. My concern is any legal liability on my part should there be an issue with the patient visit.

Thanks!!!

[Altra, BSN, RN]

Read your NPA. Call or email the BON if you don't find what you're looking for. And make sure that you haven't misunderstood your employer's explanation of expectations.

Though I am not in GA, I'm fairly comfortable saying that suturing and I & D are not within the RN scope of practice ... and the facility cannot bill for a provider exam based on attestation of an RN assessment if the provider has not actually performed an exam.

Yikes.

[Been there,done that, ASN, RN]

You are being used and abused, not to mention what's happening to the patients.

I will second that "yikes".

[roser13, ASN, RN]

With regard to entering the physician's assessment: with the advent of EMR, I have noticed a new entity in charting - the scribe. The scribe can be anyone. I've seen PA, RN, & MA scribes, Even folks with no medical experience whatsoever can be a scribe. There will always be a disclaimer at the beginning, end, or both, of the dictation/assessment that makes note of the fact the "Mary Smith, RN, was scribe for Dr. John Doe." Dr Doe then electronically signs the document and it is acceptable as "his" assessment.

[whatevah]

Thanks for your responses! For some reason, the GA BON/NPA is not very specific in nature regarding issues like these, and even says they will not answer specific practice questions.

I haven't actually done any suturing yet as a new hire, but it is expected in the future. Likewise, the I & Ds.

The MD does perform an exam, I just record his findings.

I like the idea of documenting as "scribe", and will look into that further. When I tell them I'm not going to do suturing and I & D, they may not desire my services any longer, anyway!

[Dranger]

Suturing is a grey area but still not usually in scope.

I have never seen a nurse do an I/D. The MD is pawning his work to you.

Scribing is within scope

[Altra, BSN, RN]

Agree - scribing is different than the provider trying to use your assessment as a substitute for provider physical exam.