Question:
Dear Nancy,
I am a palliative care NP. I was told I will not be a palliative care NP at this time due to visiting nurse RN shortages. Instead I will go to patient?s homes and function as the RN. I was told I will not function as an NP in this role. What is the liability for an NP functioning as an RN?
Alicia
Dear Nancy replies:
Dear Alicia,
The liability you face as an NP practicing as an RN can be complex. As had been stated many times in this column, one does not lose their education and expertise when functioning in a lower professional capacity. Should there be a patient injury or death while you were working as an RN, your standard of care would not be what other RNs would do in the same or similar circumstances in the same or similar community. Rather, you would be judged by what other NPs would do in the same or similar circumstances in the same or similar community.
In addition, it would seem tempting to want to do more for the patients for whom you provide care due to your NP education and expertise. If you would cross the line and perform a nursing responsibility that was that of an NP and not an RN, not only might you face liability if the patient were injured, the employer may decide to terminate you because you exceeded the policies and procedures in place for the RN visiting nurse in the home.
Hiring you as an RN rather than an NP also demeans your additional education and experience. The agency gets to pay you as an RN, a salary that is most probably lower than that of a palliative care NP.
You might want to consider discussing this issue with your NP colleagues and especially if you know of one or two who have decided to function as an RN rather than an NP.
It is difficult to turn down a paying position that you would like to have. However, don't sell yourself and your education short. Be sure to check other employment possibilities in the role you have successfully achieved before agreeing to function in a capacity that is less than the contributions you could make if you were practicing as an NP.
Regards,
Nancy
