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As an agency nurse I often find myself working with RNs who are not licensed in the state where we are working, and I am expected to sign for all their work. What can I do if I am presented with this situation again?

Friday February 15, 2013
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Dear Donna,

I have been working as an agency nurse. More often than not I find myself working with nurses who are not licensed in the state where we are working and I am expected to sign for all their work. I have a real problem with this. Even as a graduate nurse I signed all my work, but it needed to be cosigned by another nurse. I called the board of nursing and they said only nurses licensed to work in this state are legally allowed to sign. I did let the agency know about this, but they don't know the staffing situation at each facility. Some of these places are very reputable facilities. What can I do if I am presented with this situation again?


Dear Donna replies:

Dear Concerned,

I'm wondering how you know that these nurses are not licensed in the state. While this is both illegal and unethical (unless working in a Nurse Licensure Compact state), not to mention dangerous — if anyone were actually doing it, it's usually something they would keep quiet about. Since you state it seems to involve more than one nurse and more than one facility, I can't help wondering how and where you are getting your information and if it is accurate.

For your information, the Nurse Licensure Compact is something that some states participate in. The NLC allows nurses licensed in one participating state to work in another participating state under their own state license. Learn more here and see if your state participates at www.ncsbn.org/nlc.htm.

If in fact you ever learn that a nurse is truly working without a valid license, you have an obligation to report that immediately to your state board of nursing. It's not OK to turn a blind eye to this activity, if it actually is as you describe. Nor is it OK to participate in fraudulent activity, regardless of who asks or tells you to do so. You can be held liable in either case.

You may want to consult a nurse attorney for further advice and counsel on this issue.

Best wishes,

Donna Cardillo, RN, MA, well-known career guru, is Nurse.com’s “Dear Donna” and author of “Your First Year as a Nurse: Making the Transition from Total Novice to Successful Professional” and “The ULTIMATE Career Guide for Nurses: Practical Advice for Thriving at Every Stage of Your Career.” Information about the books is available at www.Nurse.com/CE/7010 and www.Nurse.com/CE/7250, respectively. To ask Donna your question, go to www.Nurse.com/Asktheexperts/Deardonna. Find a “Dear Donna” seminar near you: Call 800-866-0919 or visit http://Events.nursingspectrum.com/Seminar.