What am I missing here?

Nurses General Nursing

Published

Specializes in Med/Surg, Ortho, ASC.

I always thought that I had a decent understanding of the current evolution of certain parts of the healthcare delivery process: specifically the trend toward MD offices no longer hiring licensed nursing personnel and instead choosing to hire and train MA's to carry parts of the role of the licensed nurse. I have somewhat resigned myself to the trend, considering that (a) I have no choice in the matter, and (b) I deal with the fall-out day in and day out in my position as a pre-op RN in an ASC (i.e., dealing with patients who are totally unsuitable for an ambulatory surgery center, but no one who "assessed" them understood that). At the same time, I thought that the assistive personnel who were filling positions previously occupied by nurses understood the scope of their positions.

However, several recent posts have me wondering if I really do understand what's going on. There are MA's that sincerely believe that they are "doing the job" of a licensed nurse. They apparently believe that their MA courses are on a par with accredited nursing program courses. They do not seem to understand the concept or value of a professional license. And then there's the apparent turf war between MA's and CNA's...MA's rank higher than CNA's?

Am I seeing this trend accurately? I am seriously starting to question where healthcare delivery is headed.

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Specializes in MDS/Office.

Yes, you are right on target.

The same thing is happening in the city I live in.

The hospitals are buying up all the Physician Practices.

The RN's & LPN's are on their way out.

They are being replaced by Medical Assistants.

A friend of mine who is a Drug Rep, has been telling me this the past few years.

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In some states MAs need to be licensed. In several of those states, a licensed MA can draw blood and give a vaccination under MD supervision. I do not understand this. Especially since, in some of those same states, you can get a MA certificate and license without a high school diploma.

MAs serve a wonderful purpose, and within their SOP, are a fabulous part of a team. However, I have a feeling that many MDs are using these folks way beyond the SOP in the office setting, to save a buck.

As far as an MA/CNA turf war, I never worry about it. I am a CNA and was recently told by my neice that "CNAs are the bottom of the barrel in terms of medical personel" Hahahaha, well, it's okay. I am just doing the best job I can and working my way toward my dialysis certification. I Love patient contact and have zero desire to be doing anything else.

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Also; The need, or desire, to be more profitable in health care will just make it worse. Nurses are expected to have higher degrees, do more, and handle just about everything with ease, yet they are being replaced with CNAs and MAs at half the wages, who then are expected to pick up the slack from the loss of good nurses. A hospital in my area recently fired every LPN and replaced them with CNAs, but the poor RN now has no other nurse on the floor. Just a major disaster waiting to happen.

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Specializes in Oncology; medical specialty website.

I'm confused about MAs posting here, particularly about nursing issues. MAs are not nurses. I understand they work in the health care field, but again, they're not nurses. I guess I don't understand why they aren't posting on boards specific to their own practice.

I blame part of what the OP said on the physicians who supervise the MAs. How often do you hear doctors refer to MAs and other office staff as "nurses"? After a while, they start to believe that they are equal to nurses in ability and scope of practice.

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I currently work in a family practice/public health setting and we employ both LPN's and MA's. For the most part, we work parallel to each other. Matter of fact, an MA actually trained me. Also, we have some MA's that are certified and some that aren't.

In my state, Indiana, the MA's can administer vaccines but not medication, perform phlebotomy, referrals, and assist with various back office procedures. The thing I don't fully understand is, although their SOP won't allow med administration, our office does. So, basically they're operating out of the SOP and my employer apparently doesn't see anything wrong with it.

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Specializes in Trauma Surgery, Nursing Management.

OP, I am confused as well. There was a recent post...I think it was the one discussing resident physicians and their baseline knowledge...and an MA responded with a post that stated that she teaches residents how to suture. HUH?!? Since when was that allowed?

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Specializes in Med/Surg, Ortho, ASC.
I'm confused about MAs posting here, particularly about nursing issues. MAs are not nurses. I understand they work in the health care field, but again, they're not nurses. I guess I don't understand why they aren't posting on boards specific to their own practice.

I blame part of what the OP said on the physicians who supervise the MAs. How often do you hear doctors refer to MAs and other office staff as "nurses"? After a while, they start to believe that they are equal to nurses in ability and scope of practice.

I truly believe that they don't understand what they don't know. Apparently, MA's are being trained to believe that they are nurses.

That is what has led to my confusion (and my fear for the future).

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In many states, a physician may oversee anyone doing anything. For years many docs trained their unlicensed help to give all manner of injections, from vaccines to allergy shots, draw blood, get vitals, etc. This was on the doc's own license.

But PLEASE don't call them nurses. They are office help.

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Specializes in Med/Surg, Ortho, ASC.
OP, I am confused as well. There was a recent post...I think it was the one discussing resident physicians and their baseline knowledge...and an MA responded with a post that stated that she teaches residents how to suture. HUH?!? Since when was that allowed?

Frightening....

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Specializes in LTC.
In some states MAs need to be licensed. In several of those states, a licensed MA can draw blood and give a vaccination under MD supervision. I do not understand this. Especially since, in some of those same states, you can get a MA certificate and license without a high school diploma.

MAs serve a wonderful purpose, and within their SOP, are a fabulous part of a team. However, I have a feeling that many MDs are using these folks way beyond the SOP in the office setting, to save a buck.

As far as an MA/CNA turf war, I never worry about it. I am a CNA and was recently told by my neice that "CNAs are the bottom of the barrel in terms of medical personel" Hahahaha, well, it's okay. I am just doing the best job I can and working my way toward my dialysis certification. I Love patient contact and have zero desire to be doing anything else.

As a CNA you are so stinking important! I was a CNA for 6 years, I've been a nurse now for 2 months. I always make a point to thank the CNAs and let them know how much they are valued! Also, I have 20 pts to the CNAs 10 so they will often recognize a change in the resident no matter how subtle.

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Specializes in ED, MICU/TICU, NICU, PICU, LTAC.

Well, playing devil's advocate... ;) In some situations doctor's offices, etc may be taking advantage of the lower wages they can pay an MA, but still have them take on duties they'd normally leave to an RN. They can hire fewer nurses and expect the MA to pick up the slack, which, as some of the previous posters have mentioned, can then lead to them having to perform duties outside their SOP. That said, I've had experiences with MAs, CNAs, and PTs thinking they were a nurse; I've also met a few nurses who think they're doctors... and as the old joke goes, a few doctors who think they're God ;)

I've also worked with some pretty awesome people from all disciplines and levels of education :)

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