[NPInfo] NP working as an RN

Thu Feb 15 03:50:14 PST 2007

I agree with Rose. If it's not in your job description, you're probably not 
going to be liable for not doing it (such as putting in central lines as an 
RN, etc.) If a lawsuit occurred and the patient's attorney alleges that the 
RN on duty should have identified a melanoma because he or she is also an 
licensed or certified as an NP, it would be a long shot, in my opinion, for 
the patient to win the lawsuit because the NP was not the designated 
provider in charge of the patient's case.

Here's a similar situation: our local mental health center recently hired a 
forensic case manager to help chronic mentally ill patients who are in jail. 
The gentleman they hired happens to have a law degree, in addition to his 
masters degree in counseling. The job requires a masters degree in 
counseling. I don't think any court would hold the case manager liable if 
the mental health patients don't get good legal advice from their public 
defenders. The case manager is a lawyer, but isn't functioning as the 
attorney of record for the patient's case. His job is to advocate for good 
mental health care while the patient progresses through the legal system.

Of course, if I were working as an RN, and I saw a lesion on a patient that 
was suspicious for melanoma, I would report it to the patient's provider. 
Wouldn't every RN do that?

Best Regards,

Shelby Havens, ARNP

~Love is an act of endless forgiveness.~

-- Peter Ustinov

No trees were harmed in the sending of this message and a very large number 
of electrons were asked their permission to be terribly inconvenienced. And 
a party was thrown for them afterwards for being really cool about it.

>From: "Rose Moran-Kelly" <rosemorankelly at gmail.com>
>Reply-To: NP Info <npinfo at nurse.net>
>To: "NP Info" <npinfo at nurse.net>
>Subject: Re: [NPInfo] NP working as an RN
>Date: Wed, 14 Feb 2007 21:53:31 -0500
>
>I also think that having been  an experienced RN in the  ED...the RNs
>and NPs are ACLS and PALS trained the same...so ... as far as
>lifesaving measures....both would be expected to perform as well as
>someone with the same training.  That said.  ....  Being an RN/NP and
>practicing intubation at all of the courses over many years, I cannot
>imagine being liable for having difficulty when it has never been in
>my job description  either as an RN or NP.  Anyone can sue  us but
>they probably will not win over that.
>Rose
>
>On 2/14/07, tb1016 at aol.com <tb1016 at aol.com> wrote:
>>I dont know if I agree with this... if you have the skill in putting in a 
>>central line but you are not credentialled at that hospital to put in a 
>>central line... I think you should not be putting in the central line... 
>>thats the state of affairs in Connecticut anyways...
>>
>>Terri
>>
>>-----Original Message-----
>>From: dave at mittman.us
>>To: npinfo at nurse.net
>>Sent: Wed, 14 Feb 2007 3:42 PM
>>Subject: Re: [NPInfo] NP working as an RN
>>
>>
>>The way I understood it if someone had a melanoma on their back and you 
>>are
>>the "chaperone" RN in the room with a male PA/NP/MD and  you clearly saw 
>>her
>>back and you did not notice the melanoma, as an RN you reasonably would 
>>have
>>not have been expected to but if they knew you were an NP (which they 
>>easily
>>would find out) you would have been expected to dx it.
>>Or another, working as an RN in an ER and someone needed a procedure that
>>could be done as an NP but not an RN, you were there, you would have to do
>>the procedure if it saved the patient's life.
>>Anyway, that was the gist and as you can see, I am no lawyer.
>>Dave
>>   On 2/14/07 12:57 AM, "Carla Anderson" <carla_rayne at yahoo.com> wrote:
>>
>> > David wrote:
>> > We did an article a few years ago with Clinician Reviews. "If someone 
>>knows
>> > you are an NP even if you are working as an RN you are held to the 
>>level of
>> > care an NP would deliver."
>> > Dave
>> >
>> >
>> > To David and others- are we speaking "legally" held to the level of
>> > care/knowledge/license in the case of an event? I was speaking about 
>>the level
>> > of care for the job descriptions I witnessed as an RN. In fact, the 
>>docs/staff
>> > knew the NP was an NP but there was an unwritten law that the NP could 
>>not act
>> > like an NP, she had to practice at the RN scope/level for the position 
>>in the
>> > ED.  At the time I was an RN, working my job, the 
>>administration/physicians
>> > did not want/welcome NPs in the ED, and this NP was hired as an RN for 
>>an RN
>> > position, which did not include documentation of advanced assessment, 
>>or plan
>> > of care as a provider. She was to take orders from the physicians, and 
>>act in
>> > every way as a non provider.  Now LEGALLY, I am sure if there was an 
>>event she
>> > would be held to the highest standard of knowledge, what is prudent, 
>>etc.. and
>> > her highest license.. any help from those on the list out there in the 
>>legal
>> > profession? Carla/Portland
>> >
>> > David Mittman <dave at mittman.us> wrote:
>> > We did an article a few years ago with Clinician Reviews. If someone 
>>knows
>> > you are an NP even if you are working as an RN you are held to the 
>>level of
>> > care an NP would deliver.
>> > Dave
>> > On 2/13/07 5:34 PM, "MSERN at aol.com" wrote:
>> >
>> >> I believe in Texas it is the License/Degree. This has the potential to
>> >> become sticky. With advanced assessment skills comes advanced response 
>>to
>> >> what
>> >> the assessment finds. That can be more than the position allows.
>> >>
>> >>
>> >> Which level of accountablity are you held to? License/Degree or 
>>position?
>> >> I thought it was license/degree but maybe I am wrong.
>> >>
>> >>
>> >>
>> >> -----Original Message-----
>> >> From: Nosna at aol.com
>> >> To: npinfo at nurse.net
>> >> Sent: Tue, 13 Feb 2007 7:56 AM
>> >> Subject: Re: [NPInfo] NP salary vs RN
>> >>
>> >>
>> >> Working as an NP...and an RN can bring up a whole new discussion. 
>>Check
>> >> into the legal issues of being an NP and working as an RN before you 
>>do it.
>> >>
>> >> _______________________________________________
>> >> NPInfo mailing list
>> >> NPInfo at nurse.net
>> >> http://lists.nurse.net/mailman/listinfo/npinfo
>> >> *****************************
>> >> 
>>________________________________________________________________________
>> >> Check out the new AOL. Most comprehensive set of free safety and 
>>security
>> >> tools, free access to millions of high-quality videos from across the 
>>web,
>> >> free AOL Mail and more.
>> >> _______________________________________________
>> >> NPInfo mailing list
>> >> NPInfo at nurse.net
>> >> http://lists.nurse.net/mailman/listinfo/npinfo
>> >> *****************************
>> >>
>> >>
>> >>
>> >> _______________________________________________
>> >> NPInfo mailing list
>> >> NPInfo at nurse.net
>> >> http://lists.nurse.net/mailman/listinfo/npinfo
>> >> *****************************
>> >
>> > _______________________________________________
>> > NPInfo mailing list
>> > NPInfo at nurse.net
>> > http://lists.nurse.net/mailman/listinfo/npinfo
>> > *****************************
>> >
>> > _______________________________________________
>> > NPInfo mailing list
>> > NPInfo at nurse.net
>> > http://lists.nurse.net/mailman/listinfo/npinfo
>> > *****************************
>>
>>_______________________________________________
>>NPInfo mailing list
>>NPInfo at nurse.net
>>http://lists.nurse.net/mailman/listinfo/npinfo
>>*****************************
>>________________________________________________________________________
>>Check out the new AOL.  Most comprehensive set of free safety and security 
>>tools, free access to millions of high-quality videos from across the web, 
>>free AOL Mail and more.
>>_______________________________________________
>>NPInfo mailing list
>>NPInfo at nurse.net
>>http://lists.nurse.net/mailman/listinfo/npinfo
>>*****************************
>>
>_______________________________________________
>NPInfo mailing list
>NPInfo at nurse.net
>http://lists.nurse.net/mailman/listinfo/npinfo
>*****************************

_________________________________________________________________
Laugh, share and connect with Windows Live Messenger 
http://clk.atdmt.com/MSN/go/msnnkwme0020000001msn/direct/01/?href=http://imagine-msn.com/messenger/launch80/default.aspx?locale=en-us&source=hmtagline