Medical Assistants in the office

[SHELLYBELLYRN]

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 care?

Do any of the MA's in your offices refer to themselves as "nurses"? Have you had any problems with the knowledge base of the MA's? How are they with patient education?

May be just my situation, but I have run across some significant problems in this area................and not sure how to address it...........or even if I can address it.

[Fun2, BSN, RN]

Wow this is a mess. I totally respect the nurses and what they have gone through with schooling to have all that knowledge and skills, its an honor to be able to call themselves "NURSES". MA's and CMA, CNA's they all do their work and what they have been trained to do and should not go beyond their scope of practice and not let patients get by with calling them the "nurse". They should audomatically correct them and say "oh I am a medical assistant, not the nurse". I think that is the appropriate way. And doctors should be taught to recognize the difference and refer to them in the correct way.

I think this is a very important issue. When you go to the doctor I automatically assume that person that admits me and gets info from me is a nurse however these days that has changed. All nurses, MA's, CNA, and CMA's should wear a badge stating their correct position. It would be nice for the patients to note who they are talking to and what questions to ask whom. For instance when the person admiting me asks about my meds I list them off with dosages and such and then is amazes me that they start to say and you take that med for? What?! You don't know. That makes me uncomfortable.

But really I am not trying to belittle anyone. I myself am a student nurse, CNA, and when I worked in the hospital and a patient called me nurse, I automatically said, "no I am the nurse's aid, would you like me to get the nurse or can I help you?" As long as it is in my scope of practice, it was okay for me to do. I think everyone should study their scope of practice and abide by it.

Anyways, I don't want to get anyone mad at me and hope I didn't say anything offending. I just like the idea of people wearing badges saying their title at all times and just practicing within what they have been trained and certified to do. :)

That's funny, after being a Dr.'s office medical assistant, I assume most are MA's not RN's nowadays. As a pt., I asked a "nurse" if she was a medical assistant, and she said, "No, I am an RN." oops :chuckle Good thing she and I got along well. :)

[alintanurse]

I worked at a clinic where the MA's far out numbered the licensed nurses. They did refer to themselves as nurses to the pts. Most of them had attitudes as though they were superior to the licensed staff. The manager encouraged this behavior. I left when I was told by the nurse manager that the MA's were working under the RNs license--making the RN responsible for any error the MA might make. Too dangerous for me! :chair:

[Fun2, BSN, RN]

I worked at a clinic where the MA's far out numbered the licensed nurses. They did refer to themselves as nurses to the pts. Most of them had attitudes as though they were superior to the licensed staff. The manager encouraged this behavior. I left when I was told by the nurse manager that the MA's were working under the RNs license--making the RN responsible for any error the MA might make. Too dangerous for me! :chair:

WHAT???? As far as I know MA's work under the Dr.'s supervision, not the RN's.

What crap.....the management you had must have been a MA at one time, or was never accepted into nursing school.

[alintanurse]

I was told by the nurse manager (who was an RN) that overseeing the proper administration /dose of IZ's along with other functions performed by the MA's fell under the RN's license. I did not want to be responsible for any errors that might occur.

[Standardethics]

Here, medical assistants can pretty much walk in off the street and be hired. I am not opposed to paraprofessionals doing a great many things if they have been properly trained and are properly supervised. However, that is not the case. Comments made by medical assistants indicate that, at least one, doesn't question that she should not be assisting in an OR. No, dear, you may be able to "do" "all that stuff" but you do not know why you are doing it, nor what the results might indicate. Ignorance is dangerous. I was, and remain, a patient advocate. I was also a medical paraprofessional. It's a good thing that close tabs were kept on all of us, as we did not know what we did not know. In the situation where I worked, which was unique, there was constant and direct communication and interaction between licensed medical professionals and the paraprofessionals - not email.

No one but a licensed R.N. should be referred to as such. And, medical assistants who are registered or licensed medical assistants should be noted as such - as another poster stated - people should be labeled. I also advocate for abandoning the first name business. This is "Tiffany." "Tiffany" just happens to be the leading physician, but you'd never know it - a bit of an exaggeration, but "Sharon," unless she states this is nurse - meaning R.N. "Sharon" - could be anyone.

The BSN nurses and MS nurses should have all rights and privileges afforded their investment, intelligence and successful completion of their education, as should two-year RNs, medical assistants who are certified/registered.

[klone, MSN, RN]

This is a ten year old thread.

[Standardethics]

And an important one.

[mohs rn]

Well said! Amen!!

[hayest]

In my opinion, Medical Assistants should NOT replace nurses in a Physician's Office. Our office has gone through 11 medical assistants in 3 1/2 years. The MD's seem to choose the wrong people for the positions. I have told the MD to stop hiring the first person who walks through the door. I have suggested to the MD to hire a nurse, an actual RN who can run the office without any help. Someone older and mature compared to the young ones they have been hiring who are worthless. IF they feel they need a medical assistant to assist the nurse or physician, they should not be allowed to draw labs or give injections. They should not be allowed to call back patients, they are not allowed to do triage, they should not call in Rx's. I would suggest they room the patient, ekg test, eye test, and that's about it. I have indicated on this site before, I will sit and watch and listen to the medical assistants at the doctor's office and they don't want to work. THey don't know how to speak to adults or representatives who will walk in. They are loud and are more worried about their phone or the computer googling, than actually working. Mistakes are made. I've been at the end of the mistakes and so have my family. One medical assistant almost gave my daughter the wrong injection. When the medical assistant wiped her arm, took the cap off the syringe and said "you are here for your birth control shot"? My daughter had the sense to say "no, I'm here for my last gardacil shot". The medical assistant replied "oh, I will be right back". When I approached her on what took place, her excuse was "we always verify the medication we are about to give". I said "yes, I understand, but you should have looked at what the schedule said (which said gardacil) and not bring in a prefilled syringe, wipe my daughter's arm and pull the cap off and then ask what she was here for". Too many mistakes have been made and the MD's dont want to hear them. I would not want a medical assistant to touch my family or me. I don't and have refused them to call me with results. I only want to hear from the MD. I've actually told the MD to get rid of his employees except for the receptionist. With a concierge practice, he can do it all. He does with me. Calls me to the room, vitals, exam, hands me Rx's, etc. If any member of my family need a shot, he will do it -- -we will refuse the medical assistants to do it. I actually feel these schools should stop offering medical assistant training. LPN's are already off the radar. Hospitals will not recognize LPN's. LPN's are seen at nursing homes.

[Oedgar]

I am sure there are plenty of well-trained, hardworking MA's out there. However, I am shocked at the idea of anyone who is not a nurse calling themselves a nurse, or the MD referring to them as a nurse. Would not happen at my office. I think the problem with MA's as people are describing is that they are often quite young when they graduate their training program.... and perhaps variations in the quality of training? You might not find the quality issue with nursing programs, because they are accountable to the State BON. If their graduates don't pass boards, their program is gone.

I was very young when I graduated LVN school. Turned 21 the week I began the first job. However, in LVN training you are working in a hospital with sick and surgical patients. At least for us, the seriousness of what were were doing was very apparent. Not sure this is getting through to the young MAs?

I had a recent experience with one at my doc's office. Was making an appt for the third in my Hep B series. I could tell by when the young lady booked me that she did not understand what I wanted....at a different time of day from when they make shot appts. (what ever happened to looking it up in the chart if she did not understand?)... Got there, had to tell her 3 times what I was there for. And still, she asked me quite loudly, "So you are here for your birth control shot?"

When I got to the back I was relieved to find the same nurse I have been seeing. I still double checked with her that she knew what I was there for.

So, I don't know if this is more a statement about MA's or young people!

[klone, MSN, RN]

Or maybe just dumb people

[hayest]

I had a recent experience with one at my doc's office. Was making an appt for the third in my Hep B series. I could tell by when the young lady booked me that she did not understand what I wanted....at a different time of day from when they make shot appts. (what ever happened to looking it up in the chart if she did not understand?)... Got there, had to tell her 3 times what I was there for. And still, she asked me quite loudly, "So you are here for your birth control shot?"

When I got to the back I was relieved to find the same nurse I have been seeing. I still double checked with her that she knew what I was there for.

So, I don't know if this is more a statement about MA's or young people!

It's both, the MA who almost gave my daughter the wrong shot was 33 years old. One of the younger ones acted as if she knew everything, but didn't know anything - she was 24. She left me a message and laughed indicating I didn't know what I was talking about. Well, I did know what I was talking about, as I already talked with my MD. I left my MD listen to the message and he wasn't pleased on how she spoke to me on the phone. The 33 year old MA made many mistakes. It took the office to finally terminate the 24/25 year old due to all the mistakes she made and the patient complaints that came in. She would call out wrong dosages on Rx, as well as the wrong Rx. They hired one who only lasted two days because she could not type. It's both, MA's and being young. One MA never went to school, the MD trained her.