MA's calling in physican's orders

[monica f]

Last week I came across an interesting situation. I called a physicians office reguarding one of my pediatric patients. The "nurse" that I spoke with agreed to call in a medication for my patient. When I recieved the medication it was a time released capsule, which I was unable to give my patient because she recieves everything per gtube. I ended up taking the patient to the office to see the physican when I arrived I spoke with the "nurse" that I previous had spoke with, to my surprise whe was not a nurse but a MA. She still did not understand why the medication could not be given and was quite upset that I did not give the medication. Are MA's allowed by law to call in orders and present themselves as nurses? Who governs over the MA if the state board of nursing does not?

[MollyJ]

Hi Kansas Nurse,

This is an interesting question and I don't have an answer to it. Do you have a favorite pharmacist that you can ask this question of? Docs can often delegate an awful lot in their office and this may be a delegated task on his/her part but delegation always has its' risks. If you find out the answer, post it.

But this goes to the heart of the issue for all of us as consumers. INCREASINGLY medical offices hire MA's because they are cheaper and NONE of us can always know who called in our meds, so we always have to be alert and questioning consumers.

[Nancy1]

One way to know to whom you are speaking is to ask. There have been times that I was unsure, and I ask are you an RN? In Wisconsin it is against the law for someone to use the term nurse if the individual does not have the licensure.

I have actually heard some nurses answer the phone Name RN.

I thought that was a good idea, but I am sorry to say in my own practice I don't do that.

Any other ideas?

[maikranz]

Well, I've just administered a precordial thump to my own chest!

For one thing, MA's don't order the meds they call in; they can call in what they've

been instructed. Seems to me that the doc or hcp would've known what route of

medication administration his/her client required. Besides, even as a nurse, I might not necessarily know that a patient has a gastrostomy tube or some other altered body state, so it would be nice to be reminded in order to remind the prescriber.

As for the passing off one's self as a nurse, in any state it's against the law! Nancy1, I too ask if the person I'm speaking to is a RN (office/hospital) or the pharmacist (drug store). Conversely, I don't get upset if I'm asked that question by a caller.

Molly, you're correct that more hcp's are hiring medical assistants. Hopefully, they are hiring persons who have gone to school and learned the correct way to do things. No nurse I know of, RN or LPN, will work for $8-9/hour in an office and answer phones, code insurance, file, etc. in addition to the clinical tasks.

I refer you to both your state boards of nursing for their ruling on what can be done by unlicensed assistive personnel and its impact on you as a nurse and to your state's medical assistant society.

Good Luck!

[darla80]

Originally posted by monica f:

Last week I came across an interesting situation. I called a physicians office reguarding one of my pediatric patients. The "nurse" that I spoke with agreed to call in a medication for my patient. When I recieved the medication it was a time released capsule, which I was unable to give my patient because she recieves everything per gtube. I ended up taking the patient to the office to see the physican when I arrived I spoke with the "nurse" that I previous had spoke with, to my surprise whe was not a nurse but a MA. She still did not understand why the medication could not be given and was quite upset that I did not give the medication. Are MA's allowed by law to call in orders and present themselves as nurses? Who governs over the MA if the state board of nursing does not?

[xmasbabe]

A Medical Assistant can only call in what she has been instructed to call in by the prescriber. The prescriber/physician is the one to make all decisions re: medication, strength, dose, route, etc... He is the one responsible to know if a patient has a gtube or special circumstance. In my state, any one, assistant, nurse, receptionist, can call in pharmacy orders, as long as they have been directed to do so by a physician. The physician is ultimately responsible for that persons actions. As far as asking for what level or title the office asst has, I don't think it would really do much good. I have come across some really good CMA's, RN's and LPN's, and really dumb and lazy ones. It depends on the person, not on their title.

[WendyBSN2004]

I have been a medical assistant for five years and we were only allowed to call in meds that where okayed by the physician or RN. No, we were not allowed to pretend to be nurses. I would always let the caller know that I was an MA. As for the 8-9/hourly pay that is so true and that is why I have chosen to return to school to become an RN. BSN2004 Hopefully!!