MA in charge of clinic?

Nurses General Nursing

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I work for a primary care clinic in TN. I am finding that I am having a very difficult time swallowing the fact that my clinical supervisor is a Medical Assistant. When it comes to the administrative side of the house I have zero qualms with receiving correction or guidance. On the other hand, when it comes to clinical practice or assessing my clinical competency I cannot seem to process how I am under the supervision of someone who does not have a license. I have looked up the Nurse Practice Act for our state but cannot find anything that gives a direct answer. If anyone can tell me their experiences or if this is even legal/acceptable or if I am being unreasonable not wanting to take direction clinically from a Medical Assistant it would be greatly appreciated. Thank you in advance!

I once read on my state's nursing board website a position paper on the subject of licensed nurse supervision and responsibility over unlicensed assistive personnel. I have never read anything about the opposite. I would get the situation straight with the clinic management, or I would leave. It is one thing to run the admin side of the house, it is quite another to try to tell you what to do on the clinical side of the house when you hold a license. That is how I see it.

I would send an email to your BON asking for an answer to this question asap.

Specializes in critical care, ER,ICU, CVSURG, CCU.

The ma may have administrative direction , over you, but not scope of practice, regards to your state NPA, by the BON

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

Can you give us some examples of how the MA has exerted her "clinical supervision" over you? When I started in the clinic setting, while they did not have supervision over me, they were able to show me things, clinically, that I did not have knowledge of or had forgotten from nursing school. I had no problem with that. In what ways is this MA your supervisor? Training/orienting, Discipline, performance reviews, approving PTO requests...?

Addressing her and our other clinical supervisors that are also MAs clinical supervision are things like signing off on clinical competencies such as: injections, catheters, triaging, and signing off on vitals for check offs. These skills have to be signed off on for evaluations and raises as well. They also address us in the administrative capacity like time punches, hr issues, and requests off but also if we have questions about proper procedure of a skill they are designated as who we go to. This does not sit well with me and I cannot understand how someone that is not licensed can tell me if I am doing something in the clinical realm correctly.

Also, when patients come in that need to be triaged they are the ones doing the triage, with no training in assessment,and not the nurses that are on staff.

Specializes in critical care, ER,ICU, CVSURG, CCU.

It is a different world in various healthcare scenario , example my corporate MDS supvisor. Was a LVN, I am a RN, therefore I chose to preform at a level above her necessity to give me direction......

in DR. Offices, the Dr. Is "captain of the ship"....thus delegating, as he so sees fit, The "double blade comes" in situations as yours, I would entertain their direction (administratively)....as long as it did not conflict with my states NPA, according to my states BON

best wishes, I don't know if I have helped you, or made it worst...

Addressing her and our other clinical supervisors that are also MAs clinical supervision are things like signing off on clinical competencies such as: injections, catheters, triaging, and signing off on vitals for check offs. These skills have to be signed off on for evaluations and raises as well. They also address us in the administrative capacity like time punches, hr issues, and requests off but also if we have questions about proper procedure of a skill they are designated as who we go to. This does not sit well with me and I cannot understand how someone that is not licensed can tell me if I am doing something in the clinical realm correctly.

...but do these tasks require a license? Vital signs, for example ...why can't an MA "in charge of a clinic" sign off that a nurse-employee is competent to take vital signs (since they are also trained and competent to take them)?

MA's should definitely NOT be triaging patients

I would be gone already.

I understand that they are competent in taking vital signs and other skills but when there is a dispute on procedure and whether or not something is being done correctly I have a hard time understanding how someone without a license can override someone that does, especially when it comes to patient care.

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