Washington state to make Medical Assistants work under RN license? - page 3

by Psychtrish39

Hi all. This is for Washington state RNs in particular and I am sure in coming years other states are going to attempt this in state BONs. The DOH ( which is our BON here in Washington ) has proposed draft rules about... Read More


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    There's a role for everyone. MAs, LPNs, ADNs and BSNs. If certain people's goal of having the only level of nursing be the BSN.... well, that's going to leave a vacuum that's going to be filled by.... what? Employers are NOT going to fill the old LPN/ADN slots with BSNs. At least, not for long. By making the nurse too expensive an option for LTC, clinics and, eventually, hospital floors, we will see MAs and techs rise up to replace them.
    Marisette likes this.
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    I'm not sure I truly get the mentality of this. Yes, we all know it revolves around cutting expenses--BUT--weren't LV/LPN or CNA's less expensive? They definately have more clinical time than any MA program. I speak from experience as I have taken an "Clinical Medical Asssiting" program and had the added course of Phlebotomy CPT-1 in California. I am waiting on my CPT-1 (phleb lic) to come in the mail from the state but did not even sit for my national certification exam for MA ( I still can if I wanted to). I did not feel a non licensed position was my best bet. I did learn some pharmocology, but not contradicitons, side effects, indications--just names, common generics, general classification and main reason for use (not really indications as it only addressed a dx and not symptoms). I would actually feel better having an MA just take vitals (and am not really sure on that one too) As for the phlebotomy course, that was quite different. I had to understand A LOT more and had much more rigid testing and clinicals. I had an externship that req'd 100 blood draws at a minimum and most of these were the elderly with poor veins and "ex" junkies with no veins. My skills at blood drawing are excellent and that is ONLY due to my training and practice. Here is the thing, an MD can say HE trained the MA in the skills of phlebotomy. HUH? Really, I wonder how long teh MD had in training for blood draws much less for training others WHILE he is at the office?

    So, we left the trained LVN/LPN's behind in many hospitals and are now going to the poorly trained MA? So why did they get rid of the LVN's then? Don't get it. They were already saving money paying a nurse--lower level than ADN or BSN but still a NURSE. BTW, I do feel even more confident in my EMT skills from the course I am currently in. I have had the full semester of Anatomy and trying to get into the full semester of physiology for prereqs. That helps my understanding a lot too. I just don't have trust that an MA has the skills.

    I also thought they were supposed to be there to assist setting up patient rooms and doing vitals but the MD was the one doing the exam. If you have a nurse in a hospital doing these things SHE IS examining the patient and relaying it to the doctor. She gets to make some nursing based decisions. An MA is NOT trained to do this. So, now nurses won't be going into see their patients just telling the MA to do it and overseeing it? Or do the nurses follow the MA into the room and tell the MA what to do? See, the MA may go in first to set up, but the doctor always goes in to assess.

    Hope I can figure out what to do when I get my BSN that is not pencil pushing! I did not want a desk job. Hoping for NP eventually but in emergency care setting. (I think) Those with the know how and licensure should protest this. Hahaha maybe all the MA's and doctors can work at the hospital now and we nurses will retire or just do the paperwork.
    herring_RN and BrandonLPN like this.
  3. 0
    I know of a medical practice who let their medical assistants administer vaccines. When I worked in that state, I was able to review the records via the state immunization registry because they were often mutual patients. The number of vaccine administration errors we came across from that practice was substantial and concerning.
  4. 0
    In the Chicago area they have been doing this for several years now in a few hospitals. Remote Doctors and NPs etc. who run ICUs consulting via video and computer in each room. They watch an RN treat a patient and the RN can speak directly with the consultants if they push a button and visa versa. It's only a matter of time when the RN will be eliminated and replaced with a tech who need not think, just do.

    Also one large network hires a few RNs for a call center that handles all incoming patient "nursing" triage for it's physician offices. All the physicians are employed by the network. A patient calls his primary or specialist office expecting to talk to nursing staff that they have met and are comfortable with and believe know their condition, but instead the call is picked up by a call center RN who triages him and makes an appointment or not. This way the individual practices, all owned by the network, have no need for a local triaging RN - they have the call center. Also and more importantly, the MD has no control over his schedule. He has to work as long and as hard as the call center (network admin) decides. His productivity, his metrics are controlled. This eliminates "the talk" about needing to produce that went on just a year or two ago when MDs joined the networks. Back then they could sort of control office volume as employes of the networks, but that was not working for the network. So, now patients are scheduled without MD control, and that MD needs to keep up with the volume given him or lose his job. I remember reading blogs where MDs would talk of mysterious big brother calls checking on doctors and whether or not they were scheduling as productively as the network expected, with bogus patients (checking to see if they tell the patient no there's no room on the schedule today, when admin knows that there is - all computers are linked). Now it's out of their control completely.

    So this is proof of the change. Nursing is already on it's way out. Just think. If most of the MDs in your area work for a large network, then as a nurse you're screwed as far as job prospects go. All of it, acute care, SNF, HH, H, primary care, all of it is controlled by the network and all you can do is apply on that one website for a job - which means you have no job prospect at all. When I first got my license I tapped my references (some MDs) who said sure they'd get me a interview because it's all about who you know, all very excited to be of help. Funny how they all learned that they have no "status" anymore and are considered grunts, whose referral means nothing - I will always remember the defeated conversations with them, on how they were ignored and couldn't get even a return phone call or a quick meet with HR or a NM to give a reference. Times have changed.
  5. 0
    The patients I take care of already pooh pooh the LPNs and CNAs who enter their room. When they have a question about their care, they request the "head nurse" or RN. I don't see the patient population embracing the proposed option.
    I guess if it's part of the new healthcare that's coming, none of us will have a choice. I just don't see it flying in all parts of the country.
  6. 0
    Bump it up
  7. 0
    in my state, techs can start Ivs, start foleys and administer meds as an ma in a doctors office. I can tell you some horror stories of necrotic limbs and adverse events from techs pushing meds when they shouldn't when the temptation is there. After all, they can start a line so why not use it? And why not have a paramedic triage the patient too? The truth is nurses aren't proud enough of what they do to try and protect it and ultimately it's not a good thing.
    Last edit by Esme12 on Dec 2, '12 : Reason: TOS/removed txt talk.


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