Medical Assistants in the office - page 3

This is probably going to open a can of worms.............but how do you all feel about replacing nurses in the office setting with Medical Assistants? How (if at all) do you feel it affects patient... Read More

  1. by   nadia562002
    I am a new RN working in cardiothoracic nursing at a hospital so I do not work office nursing. But I do play that rather uncomfortable and dreaded patient role from time to time. A few days ago, I went in to meet my new doc. Of course I met the MA first. She took the vitals and history. I found myself translating everything for her so she would understand. It seems to me that MA's also play a vital role but the final word should always come from the nurse.
    On a side note, I found this doc and the MA to be very respectful of my oppinions regarding my healthcare. Its just kind of nice to have someone to respect me as a nurse who is educated about my own plan of care. Heaven knows, I have had some bad experinces with other docs over the last 6 months.
  2. by   Vailgang
    I don't really have an opinion but on weither they should or shouldn't be in the office but have an incident I would like to get some feed back on. We have had students in our office for clinicals. So far it hasn't been really good but we said that we (the girl in front and I, since we deal with them mostly) would try it one more time.

    Anyway, we have had this one for a maybe three weeks. There are three people in our office and the office manager. (I am the nurse) This medical assistant STUDENT starts complaining on how I asked her to do something and why didn't I do it myself....and she continues to say that when I was gone she was able to do it and why didn't I. I was shocked. I thought that this was way out of line. Yes, she probably did have time since she doesn't do authorizations, answer phone triage, call in medications, talk to physical therapist, case workers and etc that I do since I have been doing my job for 3 years.

    So my question is what would you do? I wasn't mad because she was too stupid to be mad at. I know what I do and I know what she does. But what do I do now. I am going to go to RN school in January and the office has told her that we will need someone to fill in when I am gone to clinicals. Give me your thoughts....
  3. by   WA-Educator
    She might not be the best person for that job, but don't paint the entire profession of medical assisting with one or two bad experiences. Surely you have met some nurses that you don't care for, I certainly have! There are many nurses who are lazy, incompetent, stupid and dishonest. But we still greatly respect nurses and the profession of nursing, don't we??

    It also might be the school and the program in your area. Maybe it isn't the best. See if you can get involved with guest speaking or even teaching a class. Maybe serving on the advisory board. Maybe you could have a positive influence on the quality of their graduates. I assume the program is accredited with AAMA? If not, do not, I repeat, do not take any more of their grads. And make sure they know why. Mention the accreditation issue.

    You might also take a close look at your attitude, perhaps you decided early on that you weren't going to like this one since you didn't like the first one? In my position, I find that people will rise to the level of your expectations and when we treat people with respect and caring we are often rewarded with higher performances.
  4. by   Vailgang
    I looked and I didn't see that it was accredited. What does that mean?

    I feel like I had an open mind towards this girl, I even suggested that she may be right for the position in our office. I am going to school and need someone to cover when I am at class two afternoons a week. Also I need someone to learn my job as no one can cover if I am ever gone.

    I thought that everything was okay until the meeting and that is why I am blowen away and not sure how to handle it. I was asked to be on the advisor board and going to attend a luncheon on Friday.

    Do I mention this to her instructor? Do I just ignore it? I am just not sure. I do feel that it was very out of line and inappropriate for a student to question the way a person does their job after only a few weeks in the office. I have been there for 3 years and was even the office manager for a long time.

    I appreciate your feed back.
    Jill
  5. by   WA-Educator
    I definitely think you should talk to the instructor and/or program director. It's really important that students learn professional behaviors while they are in school. Once the student has graduated, there isn't much the instructors can do, but you can help make the program better by serving on the advisory board and make sure the program knows how important professional behaviors are! BTW - You can call AAMA (1-800-228-2262) to check on the accreditation issue.
    Good luck!
  6. by   Vailgang
    I called the instructor on Monday since she wouldn't talk to me all day. The instructor was glad that I called her and completely understood where I was coming from. She agreed that she was out of line to question how I do my job after being in our office only a short time. And she was upset that she went to the office manager and caused friction in our office. She is going to talk to her and let me know by the end of the week.
  7. by   WA-Educator
    Good for you. Students have to learn to behave professionally for the patients, coworkers and supervisors. I bet the instructor will be sure to emphasize better communication skills in the future. I'm sure she (the instructor) is grateful that you took the time to let her know!

    Cheers!
  8. by   oncologymanager
    I AM AN ONCOLOGY PRACTICE OFFICE MANAGER. I AM NOT A NURSE BUT DO HAVE SOME ISSUES REGARDING MEDICAL ASSISTANTS. WE ARE A VERY BUSY ONCOLOGY PRACTICE WITH 6 RNs. AS OUR PRACTICE GREW AND SEVERAL YEARS AGO WE DECIDED TO HIRE A MEDICAL ASSISTANT TO HELP THE RNs WITH THINGS LIKE, TAKING VITALS, GETTING PATIENTS READY FOR DOCTORS VISITS, SCHEDULING TEST, DRAWING BLOOD, AND RUNNING CBCs. SINCE THAT TIME WE HAVE HIRED ANOTHER MEDICAL ASSISTANT (AS WE HAVE 2 LOCATIONS). THE ONE MEDICAL ASSISTANT HAS BEEN WITH US SINCE THE BEGINING AND HAS BECOME ALL OF THE RNs NIGHTMARE. SHE IS A VERY HARD WORKER AND HAS TAKEN ON MANY NEW DUTIES THAT IS VERY HELPFUL TO THE PRACTICE, HOWEVER SHE ALSO WANTS MORE. WE HAVE EXPRESSED TO HER THAT SHE SHOULD GO ON TO NURSING SCHOOL AS SHE WOULD MAKE A GOOD RN, BUT SHE IS CONTENT. SHE IS CAPABLE OF DOING OTHER DUTIES BUT IS IT RIGHT? SHE IS ALWAYS WANTING TO DO MORE (LIKE START IVs) AND IS ANGRY THAT WE WILL NOT ALLOW IT. SHE SAYS (AND IS PROBABLY RIGHT) THAT SHE IS CAPABLE AND COMPITANT. WE JUST KEEP TELLING HER THAT WE DO NOT NEED HER TO DO THIS. WE NEED A MEDICAL ASSISTANT, NOT ANOTHER NURSE. I KNOW SHE WANTS TO ADVANCE, BUT SHE HAS ADVANCED AS FAR AS SHE CAN WITH US. I HATE TO LOOSE HER, BUT I DON'T KNOW HOW TO KEEP HER SATISFIED WITH HER TITLE "MEDICAL ASSISTANT". WHICH IS A VERY IMPORTANT JOB ALSO.
  9. by   Sekar
    Well, someone out there will probably flame me for this BUT I think you are taking the right stance in this instance. You have 6 Nurses on staff, you don't need a Medical Assistant doing nursing tasks. While it is true that the law allows medical assitants to do whatever tasks the doctor feels they are capable of doing, that is in reality a very dangerous practice. This issue has debated ad infinate nauseaum in the "medical assistants giving IV medications" thread. Your MAs role is clearly defined by YOU, your Medical Director, and hopefully with some input from your Nurses. She is filling a vital role in your clinic. If she is feeling too limited in that role, then she needs to get further education and get her Nursing license. If she doesn't want to do that, then she will have to settle with her current duties. You should stand firm on your position. She is NOT a Nurse, you have made it clear that she won't be allowed to do certain levels of Nursing duties, that is the end of the discussion.
    If she is very valued employee, you could offer to assist with tuition, allow time to attend classes, things like that. That way you are not stopping her upward mobility, just making her getting an education a requirement of it.
  10. by   ImaEMT
    I am a medical assistant and have been for 7 years. I can say most adamantly that CMA's should NOT be doing IV's in any way shape or form UNLESS they have taken a certification course to start IV's and run hydration. When I worked in Virginia I was given the opportunity to take an IV class through the clinic/hospital system that I worked for, but would only be allowed to start them as part of an "IV team". I would not have been allowed to hang any meds, except for NS to keep the line. As an EMT who does IV's and runs NS, lactated Ringers and boluses some meds, I know the dangers of IV's, and how to manage them. These are not things CMA's are taught or usually have experience with.

    With all my work experience, I still have very mixed emotions about the whole CMA/LPN/RN issue. I feel I definetly have my place in the clinic where I work. I do injections, triage, handle all my own patient care...but there are several times every week where I run into something that is not in my scope and I need the RN to help me. I work with a lot of OB patients, and I can't help them with their IV hydration for hyperemesis, or help my urology patient with a cath. It's just not stuff I learned, not what I'm paid to do, and frankly, not what I'm comfortable with.

    I don't think CMA's should be used above their scope,and I know they often are. This is one of the BIG reasons I'm back in school. I want the responsibility of being an RN, and I want the skills, but not before they are rightfully mine. I know LPN's and RN are frequently frustrated with CMA's being used & referred to as nurses. I work with a lady who is a "regualr joe" off the street w/ no medical exp or training who has been in-house trained and is called and paid like a CMA/ I know how mad I get everytime I think about that. So, I know how the nurses feel.

    Hopefully CMA instructors will start emphasizing the difference between the professions and start preparing students accordingly. ANd hopefully employers will to.

    Lisa
  11. by   Hellllllo Nurse
    Originally posted by Darlene K.
    In our urgent care facility we utilize RN's, LPN's, MA's, and X-ray techs. I believe there is a need for all of us. The important thing to remember is your scope of practice and too make sure that the patients are care for and safe for harm.
    Good post. I once had dealing on a job w/ an NP, whom I mistakenly called "doctor." He never corrected me. I think he liked it.

    I had several interactions w/ an MA who kept referring to herself as "Nurse Polly". My husband was to have a physical and some labs for a life ins policy. This girl kept calling the house leaving messages, calling herself "Nurse Polly". When I called her back, I told her that I'm an RN and asked how a nurse gets a job working from home for ins companies, like she had.

    She expalained how she got the job, then said "I need to get a urine sample form your husband for an AIDS test and a blood sample to check for nicotine."

    I told her that the blood was for the AIDS test and the urine was for the nicotine test. She started arguing w/ me that she was correct- that it was the other way around.

    I finally asked her if she had a license to practice nursing. She said "No, I'm an MA." And she had referred to herself as "Nurse Polly" several times!

    Well, we declined the ins and told the company that we would not purchase ins from a company who had an MA calling herself a nurse in their employ. They really did not know what we were talking about.

    It has nothing to do with ignorance, elitism or ego. I know some nurses who are sharper than doctors, but still, none of these nurses would ever refer to themselves as a doctor.

    A legal sec'y is not a lawyer.

    A security guard is not a cop.

    A nurse is not a doctor

    And an MA (or CNA) is not a nurse.
  12. by   Hellllllo Nurse
    Originally posted by ImaEMT
    I am a medical assistant and have been for 7 years. I can say most adamantly that CMA's should NOT be doing IV's in any way shape or form UNLESS they have taken a certification course to start IV's and run hydration. When I worked in Virginia I was given the opportunity to take an IV class through the clinic/hospital system that I worked for, but would only be allowed to start them as part of an "IV team". I would not have been allowed to hang any meds, except for NS to keep the line. As an EMT who does IV's and runs NS, lactated Ringers and boluses some meds, I know the dangers of IV's, and how to manage them. These are not things CMA's are taught or usually have experience with.

    With all my work experience, I still have very mixed emotions about the whole CMA/LPN/RN issue. I feel I definetly have my place in the clinic where I work. I do injections, triage, handle all my own patient care...but there are several times every week where I run into something that is not in my scope and I need the RN to help me. I work with a lot of OB patients, and I can't help them with their IV hydration for hyperemesis, or help my urology patient with a cath. It's just not stuff I learned, not what I'm paid to do, and frankly, not what I'm comfortable with.

    I don't think CMA's should be used above their scope,and I know they often are. This is one of the BIG reasons I'm back in school. I want the responsibility of being an RN, and I want the skills, but not before they are rightfully mine. I know LPN's and RN are frequently frustrated with CMA's being used & referred to as nurses. I work with a lady who is a "regualr joe" off the street w/ no medical exp or training who has been in-house trained and is called and paid like a CMA/ I know how mad I get everytime I think about that. So, I know how the nurses feel.

    Hopefully CMA instructors will start emphasizing the difference between the professions and start preparing students accordingly. ANd hopefully employers will to.

    Lisa
    Lisa,
    Great post. I admire your attitude. I bet you're great to work with.
  13. by   ImaEMT
    Thanks! I do have a great time at work and we all get along great! I think for the most part we all know whats expected of us!

    When I'm the RN, I hope it's still as easy as it is now to work along side the CMA's and LPN's in our office. Politics is starting to get in the way of that, but we'll see how it all pans out!

    Lisa

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