So why even bother with getting an RN?

[netglow]

[h=2]Saw an ad for urgent care wanting to hire MAs. They want you to be able to provide compassionate nursing care, assessing patients & taking effective action. They also want you to be able to triage critically ill patients and prioritize patient care appropriately as well as have skills in assessing, prioritizing many requests by patients, families, physicians, staff. You have to have skill in their EMR & infection control. You gotta coordinate care between clinic and other facilities such as hospitals or physician offices & do telephone triage and call backs ...among many & assorted other requirements.[/h]

[exit96]

No, our MAs do a great deal more than that. I'm very comfortable with their performance and scope. They do a great job and we could not operate without them. We also have one nurse. The only point of my post was the correct the misimpression that one must possess a MD degree to direct MA activities. It may be thus in some states, but not in mine.

I don't identify my location, but there are less than 20 states with completely independent NP practice, so that should narrow it down for you somewhat.

There is a long tradition of MA disdain on this website. My experience with them has been nothing but positive. However, I have only worked with 6 in my entire career, lol. Those 6 have been outstanding members of our team and I've never had any reason to want to replace them. There has never been anything in a primary care office that I have needed that made me wish my MA were a nurse. We don't need nurses in the office. The nurse we have is a wonderful person, but spends most of her time ordering doing inventory and ordering supplies and does very little actual nursing activity. She really is unnecessary, and when she graduates from her NP program and resigns, it has already been decided she will not be replaced, and her responsibilities will be assumed by the office manager.

How about they utilize the RN, pay a respectable RN wage, and get rid of the MA? Answer, it's all about the money. Sad, very sad...

[BrandonLPN, LPN]

I don't see anything wrong with MAs in a doctors office setting. But then, I've never worked in any sort of ambulatory care, so I have no idea what a nurse's duties might be in such a setting.

What I do think is that medical assistants and other UAPs increasing role in healthcare is a very slippery slope. I see medication aides in LTC. I see "techs" of various sorts in acute care. Right now many nurses seem to say "well they free us from the 'tasky' stuffy so we can concentrate on the 'nursey' stuff.". Well, okay, but how many tasks are you going to give up before your job becomes extraneous? They will always need a nurse to supervise, assess, whatever. But they sure as heck won't need as many. If it becomes the new norm for hospitals to include stuff like med administration or wound care to a $13/hr tech's job description (don't laugh, that day is coming), why on earth would they continue to pay a RN $30/hr to do it?

[Fiona59]

Brandon, up here RNs are at $50/hr and LPNs are $33.

[duskyjewel]

If RN jobs are threatened I would love to see government/Unions protect my trade. One of which I went through college for, worked very hard at, and my family suffered through it with me, pt's are also effected. I am possibly a few years older than you, so my mindset is not of the current postmodern relativism kind.

Postmodern relativism? Really? With your support of regulation and unions, you're the liberal here, not me. I am about freedom and the minimum government regulation it takes to organize society. I'm no anarchist, but I believe in limited government....which makes me a radical these days, it seems.

As to regulations and job loss, talk to some small business owners. Ask them the impact of regulation on their hiring decisions. And here's a read on the topic: http://www.forbes.com/sites/waynecrews/2012/12/12/regulation-vs-jobs-assessing-the-employment-impact-of-rules-and-regulations/

[nursel56]

I don't think MAs have a scope of practice. In California you can be an MA without ever attending any type of training, you do what you are trained to do by the doctor and work under their supervision. Some malpractice insurers require that their insured hire MAs who have passed a certification exam administered by the American Association of Medical Assistants.

There will always be those who risk their own practice by having the MA perform procedures that require specialized training, whether they are listed specifically in their state government's regulations (or not) pertaining to medical assistants.

I don't think there is disdain for them here, only an objection to one trained as an MA calling themselves a nurse, the training is entirely different but that doesn't place a negative value judgement on what they do at all.

[exit96]

Postmodern relativism? Really? With your support of regulation and unions, you're the liberal here, not me. I am about freedom and the minimum government regulation it takes to organize society. I'm no anarchist, but I believe in limited government....which makes me a radical these days, it seems.

As to regulations and job loss, talk to some small business owners. Ask them the impact of regulation on their hiring decisions. And here's a read on the topic: Regulation Vs. Jobs: Assessing The Employment Impact Of Rules and Regulations - Forbes

Never, have I ever been accused of, or aligned myself with liberals. I have no faith in either party, nor do I believe in any difference between parties. My position is that we, better understand that no one cares about us anymore.

[exit96]

Here's a liberal position for you, tell everyone to kiss your rump. Whether they are so called " democrat or republican" they do not care. The top echelon that has the money pulls the strings.

[hiddencatRN, BSN, RN]

How about they utilize the RN, pay a respectable RN wage, and get rid of the MA? Answer, it's all about the money. Sad, very sad...

Well, of course it is, but why it is sad I'm not sure. Offices shouldn't be expected to operate in the most expensive way possible. The RNs I know who work in office settings work almost exclusively in a case management capacity. Tons of phone triage, dealing with insurance, following chronically ill patients. Looking at what I see MAs doing in the office setting, I would be bored and feel like I was underutilizing my education if that were my job.

I wonder how much worse the PCP shortage would be if they were required to use RNs instead of MAs.

[exit96]

Well, of course it is, but why it is sad I'm not sure. Offices shouldn't be expected to operate in the most expensive way possible. The RNs I know who work in office settings work almost exclusively in a case management capacity. Tons of phone triage, dealing with insurance, following chronically ill patients. Looking at what I see MAs doing in the office setting, I would be bored and feel like I was underutilizing my education if that were my job.

I wonder how much worse the PCP shortage would be if they were required to use RNs instead of MAs.

Hmm...interesting.

[BlueDevil,DNP, DNP, RN]

double post

[BlueDevil,DNP, DNP, RN]

How about they utilize the RN, pay a respectable RN wage, and get rid of the MA? Answer, it's all about the money. Sad, very sad...

Why would we do that? It is completely illogical. In a primary care office, the skills and education of a registered nurse are unnecessary. Overkill, of you will, lol. Furthermore, the RN cannot perform the jobs of 2.25 MAs, which is how many one could hire for approximately the same hourly wage, simply because she cannot be in two places at once, cannot answer a phone behind a desk and room a patient in another room simultaneously, while also filing or faxing something, or whatever else someone multitasking might do while talking on the phone.

In this office all the providers share the cost of the RN, but we each pay our own MA directly out of our pocket. We agreed not to layoff the RN now, b/c we like her, and we all respect how hard she has worked to get her BSN and now go back to NP school (single Mom with a 4.0 average) after her deadbeat ex abandoned them. We are basically keeping her own as an act of charity, which she does not know/will never know. When she is gone, we simply won't replace her.

She has cut her hours back gradually as NP school has become more and more demanding, and as she has entered clinical training. It has only been since she has been gone so much that we realized that we don't need a licensed nurse in the clinic after all. She is basically gone 2.5 days a week (we pay her for 4 days, a .8FTE, because we are nice guys, and not evil money grubbing scum bags). One whole day she is here is "shot clinic." She is no "use" to us on that day, because all she does all day is immunizations/depo injections. Yes, we bill for that and it makes money, but we don't need a RN to do those injections. A MA can do them with orders. Another whole day is nothing but inventory and ordering. MAs can inventory and the office manager can order. The other half day she apparently spends returning phone calls. Again, a MA can do that.

I will concede that the nurse (especially this nurse) can probably answer more questions without asking us than the MAs will be able to, and that this saves us time. However, it is a pretty expensive way to avoid taking a few moments once in a while to answer simple questions. Paying a registered nurse to do functions that are well beneath her training and education is impractical. It is almost insulting to her if you think about it. If it turns out that we are wrong and we do need a nurse to return phone calls after all, we might hire a LPN for one day a week. But a FT RN? No way.

This is a primary care office, not an ICU. We encounter emergencies about twice a year. When we do, there are three physicians and two NPs and sundry medical students around to handle it. We know how to do CPR, start IVs, hook up the O2, the AED, and dial 911.

Remember, I am a nurse too. I will defend nursing practice, ardently, when it needs to be defended. This is not one of those times. This is MA practice, and the MAs I know are very good at what they do and deserve to be respected and defended as well.

[netglow, ASN, RN]

Another question. Why on earth would any primary office want an NP? Too costly I'd think for not quite enough bang for your buck - a job (especially primary triage) that an RN could do and has for decades.

Hmmm.