Nurses cannot take orders from MA's, what is your protocol?

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    I called a doctor today about his patient (labs) just to let him know a panic level. I was told by his "nurse" that she would let him know. I called back later because the IV came out and the patient said she was going home and wanted the IV to stay out. I called again. The "nurse" asked him, came back to the phone and said you can leave it out. I called later in the day to let him know that the lab value had gone up even further and did he want to cancel the discharge? The "nurse" came back to the phone and said cancel the discharge. Then she say's I'm tired of you calling. Were trying to see patients here and you're bothering the doctor. I am his nurse and the next time you call I'll decide if the question warrants asking. I wish you would quit calling. I said I'll call when I think it's necessary and I said you are not his "nurse" are you? She said yes I am. I said RN or LPN? It got quiet. I said you're an MA right? Yes she said. I said don't tell me that you'll make that decision. I am the nurse and you will ask the doctor what I tell you to or put him on the phone if I need to talk to him. She was really rude. Later the doctor called himself and I happened to answer the phone. We talked about the patient and then I told him about what happened with his "nurse". I told him. "You know Dr. Lee we as nurses here at the hospital cannot take verbal orders from medical assistants" and I would appreciate your MA telling me not to call and that she will make the decision as to what is or isn't important. He said "I'm so sorry, I promise I will talk to her about that and no I didn't know you couldn't take orders from a medical assistant". I talked to risk management then and they said I could take down her name and title and write the order then write the doctors name behind that but that we should be asking the doctors if they would be willing to sign orders behind the MA's. Do any of you have a protocol or a yes we can take their order or no we can't. I had never thought about it before. I did ask several doctors about it today and they said if I say something to the MA and she tells you what I said yes I would be willing to sign behind that order. Then how do you know the order has been conveyed word for word and nothing important missed in the translation? He said that I don't know. I am going to take this up with the CNO on Monday. Let me know how you handle this so maybe I can get some good ideas before Monday. Thanks!
    Last edit by DutchgirlRN on Feb 18, '05
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  4. 27 Comments so far...

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    I'm a new nurse who just started working, but I can tell you that I wouldn't take a phone order even if I knew I was talking to a nurse on the other end. Our hospital's protocol is that I can take orders from doctors, PA's, & NP's.
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    Sounds like you handled the situation very well.
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    Quote from 3rdShiftGuy
    Sounds like you handled the situation very well.
    THANKS TWEETY !!!
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    I think this is a very real issue with hopsital nurses these days. The office "nurse" many times is not a nurse at all. There ar times with me when I will call the physician and I know the MA or the RN, LPN on the other end .... my call is generally information for the physician, but 9 times out of 10, I need additional orders. The physician knows that the RN at the hospital can not take verbal orders from another nurse or from the MA.

    I agree with Tweety that you habdled it correctly and certainly having a meeting with the CNO to clarify the issue is a good thing. Physicians tend to blur the lines when it comes to MA's and what their general scope or practice is in relationship to talking with the nurses over the phone.
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    Quote from rnmi2004
    I'm a new nurse who just started working, but I can tell you that I wouldn't take a phone order even if I knew I was talking to a nurse on the other end. Our hospital's protocol is that I can take orders from doctors, PA's, & NP's.
    ITA. I would never take orders from an office nurse, even if she were actually a nurse. In fact, the only time I've ever taken orders from an MD via an RN are when the MD in question is scrubbed into surgery and I'm on speakerphone talking to him.

    You are a professional nurse, and when you need to speak with an MD, speak with him/her, not an office surrogate whose credentials you are unsure of.
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    First thing i ask is for the last name (and first) and the job title of the "nurse" i'm speaking to, to make sure the person i'm talking to is an LPN or an RN.

    (We have a policy against taking VOs through and MA.)
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    Okay, our policy is that we can take phone orders from a PA or an NP, but... well, what exactly is the difference between an MA and a PA?
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    Quote from RealNurseWitch
    Okay, our policy is that we can take phone orders from a PA or an NP, but... well, what exactly is the difference between an MA and a PA?
    The difference is 6 years education in a university. An MA or medical assistant may go to a school like you see advertised on TV "you too can be working in the medical field in as little as 5 months". Some have never gone to any school just on the job training. A PA or Physicians Assistant is like a Nurse Practioner. They have an MSN and have to pass advanced boards and are able to write prescriptions.
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    Quote from dutchgirlrn
    the difference is 6 years education in a university. an ma or medical assistant may go to a school like you see advertised on tv "you too can be working in the medical field in as little as 5 months". some have never gone to any school just on the job training. a pa or physicians assistant is like a nurse practioner. they have an msn and have to pass advanced boards and are able to write prescriptions.
    well, no, actually, they don't. and, in fact, early on, many pa programs offered, at most, a bachelor's degree. the pa program associated with stanford actually runs through a community college, so guess what? associate degrees for them! over the years, more and more pa programs have gone to (appropriately, i think) offering master's degrees. like master's in nursing (msn), the pa masters have their own set of initials, it is not considered to be a master of arts or masters of science degree.

    nursefirst


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