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Question:

Dear Nancy,

I am primarily hospital trained. I recently became employed at a local nursing home. I am petrified of losing my license when I go to work. Do you have advice or suggestions to help me keep safe (other than looking for a more healthier environment to work)? I don’t know all the ins and outs of my job and support is minimal.

Mary Lou

Nancy Brent replies:

Dear Mary Lou,

It is important to keep in mind that one’s obligations as an RN licensee exist in all work settings, including nursing homes. Therefore, a review of your duties should include your state nurse practice act and its rules. There is no change in an RN’s scope of practice, maintaining standards of practice, and the mandates of delegation of nursing tasks that can be delegated, as examples, when one works in a nursing home. So, too, do other limitations exist as spelled out in the nurse practice act and rules, including the scope of practice of LPNs with whom one works.

It also would be important for any new employee to become familiar with the home’s policies, procedures, and job descriptions of all who work there. The employee handbook’s guidance and mandates would be an essential read as well.

Helpful national resources include the American Nurses Association’s Web site, www.nursingworld.org. Click on the Site Map link and identify information that would help you with your specific concerns. For example, the ANA’s Principles on Delegation, Principles on Documentation, and Principles on Nurse Staffing would be a good start. The link to the ANA’s Position Statements would be vital to your quest for support in your position.

State nursing home associations that include nurses as members would be worth exploring as well. These associations focus specifically on nursing home care and professionals that provide that care. Educational seminars and networking are but two benefits of membership in these organizations.

Last, but by no means least, should you have specific issues that need analyzing, a consultation with a nurse attorney or attorney of your choice who works with nurses and other healthcare providers in long-term care would be very wise. The attorney can guide you through the concerns with an eye toward protecting you, your registered professional nurse license, and the residents for whom you provide care. He or she can also advise you if another work environment would be better for you based on your concerns.

Sincerely,
Nancy

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Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.