Unlicensed Psych tech supervisor over R.N.???

bookwormom · Sep 25, 2008

Is the psych technician making clinical decisions? If so, I'd consult with my board of nursing.

mytoon38 · Sep 25, 2008

Is the psych technician making clinical decisions? If so, I'd consult with my board of nursing.

Well yes and no. They don't have authority to say what meds a pt. needs or gets, but they do make decisions in regards to admissions being accepted to our facility and how to handle agitated patients. Example: Our pt's are allowed to go out on scheduled smoke breaks, if a pt. becomes agitated and is a smoker and requests a cigarette to help them "Calm down", it is their decision. Basically, any decsion other than meds, they make!

ocb_dave_ocb, LPN · Sep 25, 2008

Not sure where you are, but in TN anyone can be a supervisor, BUT can't make clinical decisions..

hb4hikes · Sep 25, 2008

sounds frustrating, I agree with the previous post that the tech should not be influencing clinical/medical judgement. Is there a team process for decisions affecting care that include other professionals? I would find it personally difficult to work "under" a psych tech and would probably move on.

grnidgrl2009 · May 28, 2009

it sounds as if the psych tech is acting in a behavioral specialist capacity, which depending on the state can be a supervisor to licensed staff. while it is frustrating, if they are not making any clinical judgment calls, there is nothing wrong with it. you have to remember though that you are licensed and have to abide by your conscience, if you are asked to do something against your clinical judgment then don't. if you are that uncomfortable, maybe it is time to go.

showbizrn · May 28, 2009

no disrespect...

kiss this job

good-bye

or you might

be kissing your license

good-bye:twocents:.

much success to you!!

Orca, ADN, ASN, RN · May 29, 2009

I would say good bye. Unlicensed personnel should not be supervising nurses.

The story is interesting, because I worked on a hospital mental health unit where we had psych techs. The techs generally performed functions similar to those of a CNA on a medical unit, with a few additional responsibilities. They had to have at least 30 semester hours of college in a social science to qualify. They were also unlicensed. One of our techs believed that, because she had a BA in psychology, she ought to be supervising everyone ("I have more education than any of you", she would boast) and that she should be administering behavioral therapy. I was her shift manager. I finally got enough of her complaining and told her that the people she believed she should supervise were licensed by the state to practice their professions, and she was not. I also told her that if she wanted to compare transcripts I would be happy to do it (I also have a BA in psychology, but I went back to school to get my RN because the BA only qualified me for dead-end desk jobs). This tech was eventually fired, in large part because she was clandestinely conducting one-on-one counseling sessions that she was neither qualified nor authorized to conduct, and because she referred a patient to an outpatient treatment facility (on her own) that was not covered by the patient's insurance. Needless to say, our unit psychologists and program director were incensed.

We never found out what she was telling patients (she especially targeted young females), but once she held one of her "sessions" these patients wouldn't talk to any staff other than her. I have often wondered how much damage she did before our administration finally stopped her.

tconlgirl · May 29, 2009

I would say good bye. Unlicensed personnel should not be supervising nurses.
The story is interesting, because I worked on a hospital mental health unit where we had psych techs. The techs generally performed functions similar to those of a CNA on a medical unit, with a few additional responsibilities. They had to have at least 30 semester hours of college in a social science to qualify. They were also unlicensed. One of our techs believed that, because she had a BA in psychology, she ought to be supervising everyone ("I have more education than any of you", she would boast) and that she should be administering behavioral therapy. I was her shift manager. I finally got enough of her complaining and told her that the people she believed she should supervise were licensed by the state to practice their professions, and she was not. I also told her that if she wanted to compare transcripts I would be happy to do it (I also have a BA in psychology, but I went back to school to get my RN because the BA only qualified me for dead-end desk jobs). This tech was eventually fired, in large part because she was clandestinely conducting one-on-one counseling sessions that she was neither qualified nor authorized to conduct, and because she referred a patient to an outpatient treatment facility (on her own) that was not covered by the patient's insurance. Needless to say, our unit psychologists and program director were incensed.
We never found out what she was telling patients (she especially targeted young females), but once she held one of her "sessions" these patients wouldn't talk to any staff other than her. I have often wondered how much damage she did before our administration finally stopped her.

That is really sad. I think two things about this 1) clearly defined roles are a must (nurses too!) 2) the nurses should have a nurse manager that they are accountable to, trying to explain a nursing problem to someone who knows nothing about nursing process or rationale is like ??? confusing

I love techs, we couldn't do what we do without them, but making nurses accountable to them is kinda sickening... The mental health system really is BROKEN:o

Orca, ADN, ASN, RN · May 29, 2009

I have worked in a couple of hybrid systems (the hospital I mentioned above was one of them) in which the program director was a psychologist hired by a management company who ran the program end. The nurses and the nurse manager were employed directly by the hospital. While the program director oversaw the operation of the unit and handled marketing, I did not answer to her. My immediate supervisor was the nurse manager. The nurse manager and program director were on the same wavelength, so things worked very well. Programs didn't try to run our area and we didn't try to run theirs, and there was open dialog between the two groups when it came to problem solving.

The second hybrid system didn't work quite so well, because the command structure was the same as above except that the nurse manager worked for the management company while the nurses all worked for the hospital. This meant that the nurse manager had to help the program director with marketing the program in the community, and she was basically serving two masters - the management company and the hospital. I was offered the position of nurse manager at one time and I considered it - until I found out all that was entailed in it, and that the management company (in exchange for all this extra work plus 24/7 on call) was paying the position about half what the other nurse managers in the house were making. As a matter of fact, I was making more annually as a per diem relief charge nurse than they were offering me to be nurse manager.

the nurses should have a nurse manager that they are accountable to, trying to explain a nursing problem to someone who knows nothing about nursing process or rationale is like ???

At the latter facility I had this experience several times. Because they got what they paid for, the nurse manager position was repeatedly vacant, which left the program director to run everything. The program director tried, but she just could not grasp a lot of nursing concepts. She wanted us to do things that made sense to her, but many of them were either outside our scopes of practice or violations of the Nurse Practice Act. Trying to explain this was an exercise in futility.

blondnursey · Jun 4, 2009

i would get out while you still have your license.

been there done that, turned out to be a disaster!!:angryfire

tempest · Jul 9, 2009

well where I work, the head psych tech (now in administration) works with the nurse manager in every aspect including interviewing and hiring. She has 30+ years experience (to my 4 months) and she knows more about the drugs than most nurses, and most definately more about how to handle psychotic pt's than most nurses just due to the length of time on the job. I personally would have no problem "working under" her at all. I relished the opportunity to learn from her. I will take experience over a title and book knowledge any day!