I'm working with a temporary license at my first job-I take my boards in a month. The director of nursing (DON) wants me to start passing meds on my own next week. Another nurse will be in the unit, but not working alongside me. Could I be risking my license by agreeing to do this alone before I take my boards? -A. P., N.M.
You're smart to be concerned about your license and the safety of your patients. Check with your state board of nursing and department of licensure to determine if you're allowed this type of autonomy with a temporary license. You might even educate your DON by asking her to help you clarify whether you can legally perform this role independently. It's always wise to talk directly with your manager before approaching outside experts.
If you find that you legally can pass meds on your own but are worried about your knowledge and experience level, discuss these concerns with your DON also. Nurses must know their own limits, and your letter implies that you don't feel competent to take on this role yet. Even with another nurse in the unit, you may still have to make most decisions on your own, which could place patients at risk.
Find out whether that other nurse would be specifically assigned to oversee you. Sometimes employers assume that a nurse will take on a responsibility without even discussing the risks and responsibilities with her. She might not realize that if she's responsible for supervising your work, she's also vicariously liable for any harm you may cause to patients, even if she's halfway across the unit.
If the DON persists in requesting that you pass meds alone, even if you say you aren't ready, ask to see the facility's policy and procedure or protocol for passing meds, including the language that describes the supervising nurse's role. This may be just the beginning of unreasonable requests with this employer. Now is a good time to clarify your employer's other expectations to determine if you can provide safe, high-quality patient care in this environment.