Can an MA legally supervise BSNs and RNs? - page 2

I'm a BSN RN in Illinois at a 5 physician family practice. The doctor in charge of the practice just named an MA as the "Nurse Manager"? Is this legal? Recourse?... Read More

  1. by   caliotter3
    I would certainly like to see the "The MA is my nurse supervisor" defense in a criminal or civil lawsuit or an administrative action before the nursing board. Bet that would go over very, very well. Better yet, I would like to see that MA nurse supervisor on the witness stand, justifying her actions in supervising licensed nurses. Now that would be interesting to say the least!
  2. by   netglow
    Anyone can be an office manager. This person however can not manage any aspect of the clinical practice of an RN.
  3. by   psu_213
    I guess the question becomes in what way is she the nurses' supervisor? As someone mentioned, if she is setting clinical policy, then big no-no. On the other hand, not a problem if she is in an adminstrative capacity only--schedule, non clinical policy (e.g. dress code), payroll--then I can't see a problem other than a poor choice of titles.
  4. by   ♑ Capricorn ♑
    Are you sure the doctor meant "Nurse Manager"? To me, I'd believe "Office Manager" but in no way would I feel an MA would be qualified for a Nurse Manager position. That just doesn't seem right to me. I'd be insulted by this and would question the doctor's reasoning in wanting to make an MA a Nurse Manager.
  5. by   traumaRUs
    I work in IL, my supervisor is the Practice Manager - a person with an MBA who manages the practice. She does my reviews on an annual basis after consulting with the physicians who are on my collaborative agreement.

    An MA can supervise an RN in a nonclinical fashion but can't be called "nurse" anything.
  6. by   Esme12
    Some states do regulate the use of the title "Nurse" to be used only by licensed personnel. Anyone can "supervise" anyone if for strictly administrative purposes. The non licensed manager has no jurisdiction over clinical policy and responsibility. Technically the title "Nurse Manager" in this case is a misnomer. Just as the "Nursing supervisor" who is not a nurse is the supervisor but can't supervise clinical duties as the higher license prevails.

    " California law, which specifically addresses the scope of practice of a medical assistant. California law defines a medical assistant as "a person who may be unlicensed, who performs basic administrative, clerical and technical supportive services in compliance with this section...for a licensed physician and surgeon or a licensed podiatrist, or group thereof, for a medical or podiatry corporation, for a physician assistant, a nurse practitioner, or a nurse-midwife...or for a health care services plan, who is at least 18 years of age, and who has had at least the minimum amount of hours of appropriate training pursuant to standards established by the Division of Licensing."

    If working with a medical assistant, or if you are a medical assistant, check your state's statutes and regulations to determine the scope of practice for a medical assistant. In some states, medical assistants are overseen by the board of nursing and the law can be accessed through the board's Web site. In others, it is board of medicine which oversees medical assistants. In some states, there is no agency overseeing medical assistants. In that case, practices should write a policy stating what the medical assistant may do (and may not do), and stating that the physician in charge delegates the stated duties to the medical assistant.
    Medscape: Medscape Access

    I would check with the State Board of IL whether a MA can legally supervise a nurse reguardless of what degree the nurse holds it's the license that is legally binding.

    NYS Nursing:Practice Alerts & Guidelines:FAQ
    Can a Licensed Practical Nurse (LPN) be a charge nurse or supervisor in a nursing home or outpatient clinic? Answer: An LPN may not assess (interpret clinical data) or develop nursing care plans. To the extent that charge nurse or supervisor responsibilities require ongoing assessment, LPNs accepting such positions could have a disciplinary charge against their license for working beyond their lawful scope of practice.

    So that makes me question how a MA supervises the RN or LPN.

    Medical Assistant Scope of Practice - Medical Assistant Net
    MAs are not licensed to make independent medical assessments or give advice. Physicians must determine the skill level and capabilities of each MA they supervise and take into account liability risk and quality control when assigning them their responsibilities. Physicians should provide initial direct supervision and periodically assess the quality of their work. In practices with nurse managers, medical assistants can receive additional supervision coordinated to maximize workflow in a practice. Communicating the MAs' roles to other staff and clearly delineating their responsibilities is important in maximizing the productivity of the health care team.
    What a Medical Assistant Can Do for Your Practice - Apr 2005 - Family Practice Management

    As far as calling her the NUrse is Illinois statute

    Other states are more inclusive of the specific titles they are reserving to the licensed nurse only. Examples include

    No person shall ... use any words, abbreviations, figures, letters, title, sign, or device tending to imply that he or she is a registered professional nurse including the title or initials "Registered Nurse," "Professional Nurse," "Registered Professional Nurse," "Certified Nurse," "Trained Nurse," "Graduate Nurse," "PN," or "RN," or "RPN," or similar titles or initials with intention of indicating registered professional nurse. Illinois Nurse Practice Act Section 6(e).Who can be called a "nurse"? | AORN Journal | Find Articles

    Some states will make unauthorized use of a title referring to an RN a misdemeanor; others may simply label it as unlawful or unprofessional conduct. Some states extend their enforcement to the employer of the person, or to any other person who aids or abets the misrepresentation, and makes such action a misdemeanor (in some cases, it may be considered a felony). Depending on the state, violation of any applicable title protection provision in a nurse practice act can result in a fine or criminal conviction of not only the person using the unauthorized title but also of others who employ or otherwise aid or abet the unauthorized use. So, in the example posed in the member's question, it is possible that not only is the office assistant acting unlawfully, but so too is the physician who refers to her as his nurse and/or the employer who allows her to use the term. This is assuming, of course, the state prohibits use of the term "nurse" in the first place.
  7. by   classicdame
    check your nurse practice act.
  8. by   DixieRedHead
    Quote from SuesquatchRN
    The BSN has nothing to do with anything. You can have a BSN and flunk the boards. But the MA is not a nurse anything. She can be a manager of nurses, but not a nurse manager. Her management cannot comprise any clinical practice matters.
    As usual, Squatch has it exactly right.
  9. by   mkol
    Hi All. Thank you for your thoughtful responses.

    I have clarified with the practice that the MA will be in charge from a scheduling/administrative standpoint and not clinical supervision. She is very capable as a supervisor and at those kinds of administrative responsibilities. I have never observed her stepping out of her clinical scope of practice in any way. I am totally fine reporting to her in this capacity.
    At this point I'm pleased to be where I am! The practice is in good hands with her in this role and me in mine!

    Wishing you a great 2012!
    Last edit by mkol on Jan 5, '12 : Reason: typo
  10. by   Esme12
    Good I'm glad it all worked out!
  11. by   Franjcamp
    I found it totally impractical to make a Physical Therapist with a MBA as the director of orthopedics. All other directors in the facility are RNs. He may have a MBA and know business, but he knows nothing about nursing. Unlike the PT's nurses have mutiple roles and are expected to multi-task several issues at once. We do not have 15 minutes to transfer a patient or wait for a patient to move from point A to point B when the patient in the next room may be taking their last breath. I feel if you are going to be over nurses you should know what they go through daily thus you need to be an experienced nurse.