Supervision by unlicensed staff

[Guest1216118]

Hi all. I currently case manage for a small hospice with a plethora of issues I'm not going to get into right now. I've been a nurse for 18 years and have prior hospice experience. My question is this: the clinical manager quit right before I was hired. A field stna who is in nursing school was given her position. This person signs emails as "team supervisor" and delegates duties to me "you need to go do this admission, we need you to put an order in for so and so" and now I have to ask her or the clinical director if I am allowed to order DME for my patients before I order it. The clinical director was off work for a week and the STNA "team supervisor" was left in charge. This does not seem legal but I feel like they are skirting around that by saying that she is acting as the CD assistant. This has caused a plethora of issues, including me admitting a patient last week that we didn't even have an actual order to consult for. (I questioned this 3 times and was told they had gotten an order). Those of you who have done this job know that as a CM, I should not have to triple check these things. My part comes after the office has received all paperwork, made a determination that the patient is clinically appropriate based on diagnosis, labs and tests, etc, and gotten an order to consult. I feel the need to report this but I'm not sure who I would report it to. The company has no HR department. The clinical director is the end all be all. And yes, I am actively seeking employment elsewhere. 

[klone, MSN, RN]

What exactly are you wanting to report? Other than 

Quote

admitting a patient last week that we didn't even have an actual order to consult for

There is nothing illegal or wrong with a non-licensed person being an office manager and directing staff in their duties. What SPECIFICALLY do you think is illegal?

I have worked for multiple healthcare organizations where, in the ambulatory setting, the clinic manager (who is the direct supervisor of RNs, LPNs, and MAs) is not an RN, or even holds any kind of healthcare licensure. There is nothing illegal about it.  

[Guest1216118]

No, I believe you are wrong. According to the nurse practice act of Ohio, licensed staff cannot dictate things to others that is outside of their scope of practice. This was actually confirmed by the vice president of the much, much better employer that hired me yesterday, as well as many other things they are doing very wrong. Now I'm going to see myself off this site because I've stayed away for well over a decade because of the toxicity so I should have known better than to come here now. FYI, telling a nurse to put orders in for things is not "office managing". 

[klone, MSN, RN]

Toxicity? Because I said something you don't agree with? Okay...

[JKL33]

Burntout18 said:

Now I'm going to see myself off this site because I've stayed away for well over a decade because of the toxicity so I should have known better than to come here now.

Why would you respond this way? You could have asked for advice specific to your interpretation of Ohio nursing-related laws, but you did not.

Not with regard to your post specifically but in the past there has appeared to be at least some degree of misunderstanding about what is/isn't allowed with regard to the topic you posted about (who can supervise an RN, etc).

Burntout18 said:

According to the nurse practice act of Ohio, licensed staff cannot dictate things to others that is outside of their scope of practice.

And is the person you mentioned in your OP "licensed staff?"