Working the floor after a job interview!? WOW!...

[CritCareTech]

Not a nurse, but I think this section fits perfectly! I come from EMS and started at a trauma center on the COVID unit as a PCT in 2020. 

I progressed into a more advanced PCT role in a different ICU which gave me a lot of experience. 

I applied on Tyesday for a Medical and Surgical ICU position (Senior PCT) at a local well-known hospital. The job was posted on Monday and I did my interview yesterday. 

I came dressed in formal attire and the interview was very pleasant. It was honestly more conversational and casual than anything else. She even said I could skip some "What if questions" if I wanted to, but opted to not skip any. We shared a lot of interest, such as military service and working EMS.

She toured the unit with me which was ramping with COVID. I did my peer review with the on-shift advanced PCT who thought during the whole time, I was an RN. I laughed and was like "Oh no, definetly not a nurse!".

The hiring manager (clinician) said "Oh I wished you brought your scrubs with you so you can jump in and help by working the floor for a bit". I go "Oh I did, they're in  my satchel". She was like "You don't need to if you don't want to stay" and I go "It's perfectly fine!" 

Fast forward, I changed into scrubs and helped work the floor for 2-hours. I was introduced to all the staff and had some pleasant discussions with the RNs and attendings!

Then the hiring manager goes "Oh the CRNAs bought everyone lunch, go eat" and I'm like "I'm just interviewing" and she goes "No, you're gonna go eat!" Like I was stunned to be included in so much. 

At the very end they thanked me for coming and giving them a hand, and said "We'll be in contact with you in a few days". 

Does it seem promising to you? I told them I have an interview on Monday with their primary level 1 trauma center ICU and they really talked down on it - so maybe it'll light the fire under them to hire quickly due to staff shortages? 

I'm a PCT/CCT with my EMT, BLS, PALS, ACLS, and TCCC which they seemed to be heavily surprised at. 

Thank you all and stay safe! 

[CritCareTech]

15 minutes ago, JKL33 said:

Emphasis on your very last words. They were responsible because they delegated completely inappropriately--not because someone did something.

Understand that hospitals are not the law. They are compromised entities through and through. You can't trust anything they say unless you can independently verify it. Many nurses and hospital employees know very little about laws and the interpretations of them and actually believe that whatever some authoritatively-positioned administrator tells them is correct and true. In reality hospital admins routinely misrepresent laws, dumb them down in incorrect/inappropriate ways, and confuse everyone about the truth.

I know that techs don't necessarily have a well-defined scope of practice or any legal scope of practice at all. That does not mean that they can legally do anything an on-duty RN tells them to do, and it doesn't mean that the patient's RN is responsible for everything a tech chooses or decides to do.

I wasn't going to get into it but here's another issue: Hospitals are fond of pretending that an individual on-duty nurse delegated everything that the tech does. They come to this false narrative with the same mistake you are making, which is that since techs can't legally make independent care decisions then by default their actions are delegated by an RN. In reality, hospital administration already decided what techs generally would be allowed to do in their facility and assigned those tasks to them, very often without any directive input whatsoever from on-duty staff. Maybe an RN (such as the DON or the nurse manager) will be responsible for what the tech does, but unless I actually delegated something, I individually will NOT be. That's just the way it is.

If your policy says that you will do tasks as delegated by the RN (implied: staff RN on duty), I would expect that to mean that every day the techs line up at the nurse's station to get their ordered tasks. Unless that is what is happening then their action are not being directly delegated. I wouldn't want to work as a tech or especially a nurse in a facility with the type of policy you are reporting. Remember, just because something exists doesn't mean it would hold up to a significant legal challenge.

And I cemetery agree. 

The techs everywhere I have been do not go to huddle. They are only present for rounds with the doctors and residents, that is it. 

A "task" would be say an RN comes up and says "Go put a 16 in the LAC of room 3018" for example. They're off the wall the tasks, and not the same day-to-day.

The tech position at this ICU is very... relaxed. 

Techs don't bath their patients, the RN does that. Typically the RN also cleans up the pt, and a tech is only needed if they need help rolling them. 

What I was used to do is very different here. Where I was doing the basic daily life tasks, those are now gone to where I will be more or less, on reserves for a code or helping with consults. 

[Closed Account 12345]

If I, as a patient, learned that my body was exposed to and clinically cared for by a non-employee, without a background check, with pending charges, without required HIPAA training, without a verification of certs/licenses, without an orientation to facility policies and equipment, and without anyone having verified his clinical competence first, I think I'd come unglued. Frankly, I would feel completely violated.

Patients consent to receive care by employees- not random people who are unknown to the organization and have no business assuming their care. Healthcare is a profession of trust.  If I found out my Foley had been removed by Joe From the Street, I'd want to pursue assault and battery charges. I would report any licensed staff who delegated my care to you to their licensing agencies. I would report the facility for a HIPAA violation for allowing a random person to view my records.  

It is one thing to have non-employees shadow staff, with full disclosure to patients of their role and patient consent.  It is quite another to turn patients over to someone who could've caused harm and who certainly took advantage of patients' trust, even if they were unaware of the violation.  

Shame on the manager and staff for entrusting vulnerable patients to your care without any precautions.

Congratulations on landing the job. 

[chare]

8 hours ago, CritCareTech said:

[...]

What I was used to do is very different here. Where I was doing the basic daily life tasks, those are now gone to where I will be more or less, on reserves for a code or helping with consults.

What exactly will your role be during a code?

And, in what manner will you be "helping with consults?" 

[payitforward]

So you Basically gave them FREE labor…

[Hopeful RN]

On 10/9/2021 at 10:48 AM, CritCareTech said:

Fast forward, I changed into scrubs and helped work the floor for 2-hours. I was introduced to all the staff and had some pleasant discussions with the RNs and attendings!

I'm a new RN and I'm wondering... is it common for an employer to let you work the floor when interviewing? ?

[chare]

9 minutes ago, Hopeful RN said:

I'm a new RN and I'm wondering... is it common for an employer to let you work the floor when interviewing? ?

Participating in a non-patient care shadowing is done at some facilities.  This, donning scrubs and providing patient care during a shadowing event would be very unusual, not to mention a major liability.

[Rose_Queen, BSN, MSN, RN]

Duplicate threads merged

[2BS Nurse, BSN]

"So we can theoretically do anything a nurse does- as long as they're aware of it".

Outpatient setting: Sadly, in my state the MA has a WIDE scope of practice. They are practicing under the MD's supervision (not the RN's) and can pretty much do anything the provider asks. Said provider is supposed to assess the competency of the delegated skill, but they never do. The brand new provider grads don't even know the scope of practice laws. MAs are not supposed to engage in phone triage or teaching but they do it anyway (no RNs to float for PTO). Supervisors and managers know this is happening and they look the other way. The astute MA who refuses is looked down upon and is seen as a "complainer". The martyr MA will do anything that is asked of him/her.

[Hoosier_RN, MSN]

2 hours ago, 2BS Nurse said:

"So we can theoretically do anything a nurse does- as long as they're aware of it".

Outpatient setting: Sadly, in my state the MA has a WIDE scope of practice. They are practicing under the MD's supervision (not the RN's) and can pretty much do anything the provider asks. Said provider is supposed to assess the competency of the delegated skill, but they never do. The brand new provider grads don't even know the scope of practice laws. MAs are not supposed to engage in phone triage or teaching but they do it anyway (no RNs to float for PTO). Supervisors and managers know this is happening and they look the other way. The astute MA who refuses is looked down upon and is seen as a "complainer". The martyr MA will do anything that is asked of him/her.

It's like that in pretty much every state with MAs. They work under the direction of the MD, and directly under their license, that is their scope. I cannot imagine that a pct has no defined scope in the state the OP is in, or that the facility doesn't have a defined job description. I believe PA was the state mentioned, and that the JC and/or other entities involved (varies by state), would have a field day otherwise

[2BS Nurse, BSN]

21 hours ago, Hoosier_RN said:

It's like that in pretty much every state with MAs. They work under the direction of the MD, and directly under their license, that is their scope. I cannot imagine that a pct has no defined scope in the state the OP is in, or that the facility doesn't have a defined job description. I believe PA was the state mentioned, and that the JC and/or other entities involved (varies by state), would have a field day otherwise

Have you worked in outpatient? In my setting, there is a defined scope (policy) that everyone pretty much ignores and gets away with ignoring (give someone an inch and they will take a mile) or they loosely interpret the scope of practice. As far as the JC goes, I've never seen a single person set foot in our clinic buildings. I have only worked in buildings that are not physically connected to a hospital. Maybe the JC evaluates those?

[BeatsPerMinute, BSN, RN]

I have mixed feelings - especially with the whole liabilities issue. Following 

[Hoosier_RN, MSN]

8 hours ago, 2BS Nurse said:

Have you worked in outpatient? In my setting, there is a defined scope (policy) that everyone pretty much ignores and gets away with ignoring (give someone an inch and they will take a mile) or they loosely interpret the scope of practice. As far as the JC goes, I've never seen a single person set foot in our clinic buildings. I have only worked in buildings that are not physically connected to a hospital. Maybe the JC evaluates those?

I work outpatient dialysis. I haven't worked in a hospital for 10+ years, but have friends who do. JC rules acute care facilities. State generally gets everything else. Let someone get caught practicing out of scope, and heads will roll