Unlicensed personnel performing RN functions

[Tigerlily8]

Hi, 

 I have a few questions for the nursing universe. The acute care psychiatric facility at which I am employed has recently started using a remote service to obtain physician orders. They are using unlicensed personnel to communicate electronically with physicians in order to obtain admission orders. I was originally told that an RN would complete the general health history section but the information would be transcribed and sent to the "teledoc" for orders. Yesterday, they started having unlicensed personnel (MHTs) perform the health history, request orders electronically. I am concerned that this is a scope of practice issue and the average MHT is not familiar with medications. What does everyone else think?

[JKL33]

Sounds pretty sketch to me but the devil is in the details as always. You'd have to check your state NPA and regulations that pertain to your particular care setting.

[gcupid]

this is crazy. But get ready for them to assign that role to you as opposed to hiring an additional nurse to offset this illegal mess they having going on. 

[FolksBtrippin, BSN, RN]

 

1. Using a remote service to get admit orders? Why? 

2. MHTs doing admits by themselves? Oh hell no.

Sounds very bad, IMO.

 

[Tigerlily8]

Yes, apparently this remote service is much cheaper than our on-call physicians. 

[DNPStudy, MSN]

I don't know work in that environment so I'm just curious to know. It seems to me that it would depends on your state and the scope of practice given to the MHT. For example, in Colorado a CNA can take the QMAP course and be allowed to administer medications as a certified medication aide. The CNAs I have worked with in MD were allowed to do trach care, place IV, Foley, draw labs etc..while CNAs in other places cannot even perform a blood glucose check.

I read that MHT are responsible to evaluate patients' physical and mental states, taking VS, be involved in crisis resolution and management as well as admitting patients, and that licensure is not required by most states despite such responsibilities. I'm sure the facility do not want to get sued and have already looked into ways to be legally compliant. Why don't you ask management? I would question them especially if it makes staff uncomfortable. Advocate for yourself, your team and your patients.