UAP acting as "nurse" in doctors office!

[cc01183]

I have a question that I can't seem to find the answer to...is it legal for a person with out proper training or licensure to be acting as an office nurse? I work in a doctors office in NC where they do not have a nurse there all the time. I am an LPN soon to be RN and while I am in school the office manager hired a girl to fill in. She has no qualifications but yet is allowed to give injections, run a "coumadin clinic", give advice as though she is a nurse, call in medications, pt education, etc. At one point she was trying to give me orders 3rd person via the doctor..to give shots..such as "pt in room 1 needs a gram of rocephin". She is leading pt's to believe she is a qualified nursing professional by telling them she went to school for nursing-not telling them she did not finish and it wasn't even nursing school it was x-ray!Ugh! Someone please give me direction here as North Carolina's laws on this are not clear. The docs and management seem to think this is ok to the point that a comment was made the other day that a nurse is not even needed in a doctors office!

[highlandlass1592, BSN, RN]

If she is representing herself as an RN...then that is not allowed. And the BON should be notified. However, as for skills...giving injections, taking TPR's, drawing blood..for those skills, she's acting as an MA and is working on the license of the MD she's working for. Advising as a nurse and giving 3rd party delegation is also out.

I'll be honest with you, many doc offices don't utilize RN's or LPN's..they utilize MA's (whether they've received professional training or not) because they are much cheaper. This means these MA's are operating on the license of the MD they work for...so if they mess up, the MD is liable. Many offices blur the line by attempting to represent the MA as "the nurse" but not only is that unethical, it is illegal. But who's going to report them?

I'd urge you to contact the BON for further guidance. When I lived in NC and was licensed there and I had a question, the BON was very, very willing to offer guidance and counsel. Seek out a practice representative in Raleigh.

But honestly, what do you hope to gain by this besides knowledge? I sincerely doubt this MD will change their practice based upon your findings. Be prepared for that and even possibly losing your position because you "stirred things up". Just be careful...jobs today are tough.

[AirforceRN, RN]

Yeah...I'll jump in here...

Call your state's BON and report it. Get a new job before something goes wrong and you end up involved in something you don't want to be.

[P_RN, ADN, RN]

Tis illegal. HOwever UAP workd under the doctors' licende. It's the referring to her/him as licensed that's illegal.

[DogWmn]

I'd call the BON. NO ONE is allowed to "pass themselves off" as a nurse RN or LPN. It's way off the charts illegal. I do know that Doc's who want to be cheap will hire someone off the street and train them and they work under their license, but they can't refer to them as "nurse" they can say something like assistant, office staff ect. but not nurse.

[ohmeowzer RN, RN]

call the BON asap .. she has no right to call herself or act as a nurse,,,, i would never take an order from her or anything.... go directly to the doc giving the order and get it that way... report her ..

[cookienay]

She is behaving way out of her scope of practice. She cannot give you orders. Is she assessing? Assessment is clearly in nurse's scope and in no way the MA's. Being in a doctor's office doesn't make you a nurse any more than being in a garage makes you a car.

[cjcsoon2bnp, MSN, RN, NP]

As most people have mentioned, this person is probably an MA and because in the primary care setting most LPN/RNs are not being used as much anymore and are being replaced with MAs the line between a Medical Assistant and a Nurse is being blurred. I would strongly strongly suggest you contact your states BON and find out the legality of this situation. It sounds to me like this person is misrepresenting herself as a nurse which is always illegal because she doesn't have the degree and license to back it up but I would contact the BON and find out for sure. The only way to stop this sort of thing is to have it reported.

!Chris

[Meraki]

My new doctors office has MA's rather than nurses. The ones in this office have no formal training - all their training is in house by the physicians. I asked them to expand on what that training entailed but they wouldn't say. They seem to pretty much fill the role of a nurse. They do assessments, injections, patient education etc.. I have never heard any of them identify as a nurse - that is a big issue - but I have often heard patients referring to them as the nurse and I don't think they correct them.

I get injections there on a weekly basis - some of the MA's are great at it and others could use a little more training! I have to hold my tongue and not point out things they are doing 'wrong' from a nursing viewpoint.

Definitely if they are misrepresenting themselves that should be followed up on.

[VegRN]

This needs to be reported to the BON. Can't you report while remaining anonymous so that it will not affect your job? Perhaps you could give information to the BON which is general enough (or a limited number of specific situations) so that they could investigate.

I agree with the other posters, this is way illegal. Trying to give you orders? Wow.

I also can't believe that someone with no formal training can give injections after they are "trained" by a doctor but I guess if the state allows that, that is another story. Seems risky on the Dr's license and potentially unsafe for patients.

[classicdame, MSN, EdD]

the individual is responsible for their own actions. So in this case the "nurse" should be reported to the BON. That is why they exist, to protect the public from people like her. As for the MD, you cannot work under someone's license and call yourself a nurse. No such thing. You have to have your OWN license. So someone needs education and a letter from the BON. The nurse practice act is an ACT OF CONGRESS (state legislation). They no doubt define what a nurse is and what it takes to be one. Sorry, I get really peeved about this-----------