MA working beyond scope of practice - page 5

by Catedi 11,304 Views | 44 Comments

I'm not sure what to do here. Someone I know told me this week that her employers allow her to work beyond her scope of practice. I always thought she was a Surgical Tech, although, she never went into details about what she did,... Read More


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    Quote from BLOWINGBUBBLES
    I recently posted this on another thread:

    Let me start by saying I just took and passed NCLEXPN, just waiting for my license to come in the mail. I've been working as a medical assistant for 13 years and recently I got a job at a clinic and I really love the work but I'm afraid if I stay there I could lose my license, please let me know what you would do. So first off NO ONE respects HIPPA, the sign in sheet always shows everyones name, charts are turned where anyone can read the name. Second NO one wear's a name tag (which is illegal in my state) Third ALL of the M.A.s call themselves nurses the docs also call them nurses, theres even business cards that say nurse (illegal in my state), Fourth Im not sure about this but all of us draw blood but none of us have a phlebotomy license (not sure if this is legal) Fifth my supervisor is an M.A. her title is "nursing supervisor", is that strange to anyone else? Sixth EVERYONE triages even the front desk girls! Seventh there's no log for the frig temp and no quality control log for the glucometer (illegal) Eighth the MAs interpret TB tests (illegal in my state) I dont know guys, Maybe im just uncomfortable being the only nurse there because if the medical assistants F up its on the docs BUT if I F up its on me. If I got liability insurance would that help my situation? Also our office manager, the one thats responsible for the WHOLE clinic (15 docs) is a medical asst. so no one has or understands nursing knowledge. WHAT WOULD YOU DO?


    I know ALL about the medical assistant issues and I have know idea why it continues to happen, I actually had more freedom as an MA than I do as a LVN in my state California.
    Most things are knowing how and what to document. Policies (who does triage, who reads TB tests, etc..) must be within the scope of practice of the staff. When they are not, the Medical Director who signed off on the policy is liable as are the managers/supervisors.

    Bottom line, if an unlicensed individual is trying to tell you what to do or make a clinical judgement, it is always valid to state that they are not competent to make that decision. DVRs are your friend, especially if your state is a single-party-knowledge state.
    lindarn likes this.
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    @Rob I always document different from the MAs, they ask me why and i tell them "thats the way i was taught" . It's really strange on our system because when anyone gives and injection and you try to document it, you cant type your name, it automatically puts "injection given by RN" theres no RN at my facility. The first time i saw that i almost tossed my cookies and they say "thats just how we do it", I'm like "that looks like im saying im an RN" but again thats the way they do it. I am gonna talk to my boss about changing it, Ive even been asking someone else to do the injections because i cant stand to do them and have to chart it. I have found that its really just ignorance and they honestly dont know, i remember before i went to the VN program i was doing IV's and all kinds of crazy stuff because i just didnt know. I really believe that ALL doctors in every state should have to have at least 1 LVN or RN on staff.
    lindarn likes this.
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    Hm... in WA state, the Dept of Health has it clearly spelled out in writing what the scope of practice for an MA is. MA's are not even legally allowed to do phone triage in clinics (though it happens all the time, since doctors are hiring them now instead of LPN's or RN's). They cannot do narcotics counts, they cannot start IV's, they could in theory scrub during surgery IF they did online cert test and were trained, and.. omg NO they could absolutely NOT do anesthesia. Nor could they recover a patient. This should be reported to the State Nursing Board, to the Scope of Practice Advisor- that would be a good place to start. I do not think in any state that an MA is protected only because there's no 'defined scope.'... makes no sense at all. This makes my blood run cold- the woman sounds dangerous.
    lindarn likes this.
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    That sounds very much like an undefined scope of practice. Most "medical" people have a defined scope. The Medical Assistant's scope can vary from pretty much whatever the Physician approves of, to only certain tasks that may be delegated. Does anyone have a problem with Navy Corpsmen doing their jobs? They're not PA or RN or LVN/LPN licensed or certified... yet they can have an incredibly wide scope...

    Also, just remember that just because an RN has it in their scope of practice does not automatically mean that RN's "own" that task or procedure. Remember that just because an RN can't delegate that task to an "unlicensed" person that a Physician isn't authorized to delegate that task out...

    It's a good idea to know what YOUR scope of practice is and what's allowable for other personnel in your work environment. Once you know that, you'll be able to spot violations and be able to report them to the appropriate authority.

    Being that MA's work under the direct supervision of a Physician, I would expect that the same licensing body for Physicians and Surgeons in each state is where you'd report problems with a MA...

    And I just gotta say it again: EACH STATE IS DIFFERENT!!!!
    lillymom likes this.
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    (F) Except as provided in divisions (D)(4) to (D)(8) of section 4731.053 of the Revised Code, a physician shall not delegate to an unlicensed person the administration of anesthesia, controlled substances, or drugs administered intravenously.

    This is from the Ohio State Medical Board website. It is located under the heading of "Delegation by a Physician".
    KayRN910 likes this.


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