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| No. 30 |
Oct 10, 2009, 12:05 PM
Re: Nevada Stops "Medical Assistants" from Giving Injections
Folks,
YES, this is about protecting our turf (scope of practice), and not just about patient safety. There is nothing wrong about wanting to protect our jobs. The PTB, continue to chip away at our professional scope of practice, and would like nothing more than to eliminate nurses entirely, and replace us with unlicensed, assistive, personnel. Why do nurses act as enablers, and allow them to do this? What else are we going to give away?
We now have HS dropouts giving medications in nursing homes and assisted living facilities. I never, in my wildest dream, thought that I would ever see that come to pass. Isn't medication administration a professional responsibility? We have allowed them to make it just, "they are just handing them a pill, like a family member would". Only family members do not have 25 or 30, relatives to give medications to. We are allowing them to destroy our profession.
This is a professional scope of practice issue, not just an issue about a task. JMHO and my NY $0.02.
Lindarn, RN, BSN, CCRN
Spokane, Washington
| | Advertisement Sponsored Links | | | | No. 31 |
Oct 10, 2009, 02:13 PM
Re: Nevada Stops "Medical Assistants" from Giving Injections Originally Posted by madnurse2b My butt you can tell the difference! I am in nursing school and I had to do more injections on each other for my cert for my MA certification than I have had to do for my ADN - and I am in a highly regarded program locally. An IM is an IM - if you are trained and you know what you are doing technique is technique. As far as what needs to be monitored afterward, I was a VERY well trained MA and I always monitored for reactions to new medications. I have had an RN tell me that an IV was not infiltrated when it was, I have had an RN tell me that ranitidine was for my family member's allergies not his GERD problems (and yes I know it can be given, but at least I knew what he ACTUALLY took it for)...the list goes on and on. There are great MA's and great Nurses - and if you think that we would be able to get RN's and LPN's for every doctors office in this state (Nevada) let alone every one in the country you are sorely mistaken! We don't have enough for all of the critical needs RN positions for goshsakes. Let people have their jobs, RN is different from LPN is different from a CNA is different from an MA and all have their value.
Have the MA curriculum change to include giving IMs, Sub-Qs injections??
I'm sorry but MA is not certified to administered Flu shots, give medications in any kind of way. If you are giving those things with just order of the doctor without having any kind of certification under your state laws, you are out of your scope of practice, and this is a national thing. NO way in a MA curriculum is administering flu shots and medication was included, if you are/was a Certified/Registered Medical Assistant, you should've known what your scope of practice is. for instance, in the state of Maryland there is a Certified Medication Assistant program where a GNA (Geriatric Nursing Assistant) with atleast 1 year full time experience the facility that he/she works at and with the recommendation of his/her facility nursing supervisor can go get the training for certification to administered medications mostly oral and topical, but they will be practicing under the RA supervisor that is in charge for the entire unit. If anything goes wrong that CMA also be held accountable, along with everyone else, because he/she has a certification for the State Board of Nursing. They also, have a Medication Assistant program that apply to Assisted living facilities(only valid assisted living facilities) but that does not require recommendation. either way, you receive training and get certified and will be working under that RN.
The only sticking with needles a MA should be doing in a Doctor's office is drawing blood and they only should be drawing blood if they have their RMA with the phlebotomy certification. But I can tell you that doctors are letting them doing this without having their certification. How, I know? because I went to a doctor's office and was having my blood drawn and a new(I having seen her there before) MA was making me uncomfortable and I told her to let the other MA draw it and her response to me was, "I am more certified to do this than her, because she is not a RMA." This person that is uncertified drawn my blood a couple times before. To even working on their own they need that RMA from the national association that governs their practice. But, many of them are taking a chance when finishing school and then working without getting RMA. This girl been working for more than 2 years for that doctor before this new MA told me this information. so what I got from that information is that, she haven't pass the exam to be a RMA. These doctors cry about the price for malpractice insurance, but they put themselves out there.
One last thing, when a MA are giving these flu shots, IM etc. are they working under the doctor's medical license?
| | No. 32 |
Oct 10, 2009, 02:32 PM
Re: Nevada Stops "Medical Assistants" from Giving Injections Originally Posted by wannab06 Have the MA curriculum change to include giving IMs, Sub-Qs injections??
I'm sorry but MA is not certified to administered Flu shots, give medications in any kind of way. If you are giving those things with just order of the doctor without having any kind of certification under your state laws, you are out of your scope of practice, and this is a national thing. NO way in a MA curriculum is administering flu shots and medication was included, if you are/was a Certified/Registered Medical Assistant, you should've known what your scope of practice is. for instance, in the state of Maryland there is a Certified Medication Assistant program where a GNA (Geriatric Nursing Assistant) with atleast 1 year full time experience the facility that he/she works at and with the recommendation of his/her facility nursing supervisor can go get the training for certification to administered medications mostly oral and topical, but they will be practicing under the RA supervisor that is in charge for the entire unit. If anything goes wrong that CMA also be held accountable, along with everyone else, because he/she has a certification for the State Board of Nursing. They also, have a Medication Assistant program that apply to Assisted living facilities(only valid assisted living facilities) but that does not require recommendation. either way, you receive training and get certified and will be working under that RN
Thanks for the info. re: Maryland's regulations: was not aware that such a scheme existed to allow partial med administration by a subset of specially-trained MAs who have been at the subject facility for at least a year.
| | No. 33 |
Oct 10, 2009, 03:42 PM
Re: Nevada Stops "Medical Assistants" from Giving Injections
In Texas I've never even seen or heard of an MA in any doctor's office I've been to. We have CNAs working in hospitals and long term care. There is also a Certified Medication Aide. That position has been around forever. My wife was one back in the seventies. They work in LTC and pass PO meds and do some topical applications but they can't give shots. As for scope of practice, they don't have one because they are under the jurisdiction of the State Dept. of Health, not the BON.
As far as getting or giving shots goes, there are two LVNs working for my doctor. One has been a nurse for about 2 years, the other for about 30 years. I'll let the 2 year nurse give me a shot any day of the week. If I see the 30 year nurse holding a needle I hunt for a hole to crawl into.
Just an observation but it seems that nyforlove is worrying a lot about what other states are doing when her problem is in NY. Do you think that the states that allow MAs to do shots are endangering their citizens in some way? Perhaps we are seeing the start of a nationwide crusade here.
| | No. 34 |
Oct 10, 2009, 04:02 PM
Re: Nevada Stops "Medical Assistants" from Giving Injections Originally Posted by nyforlove Thanks Cherybaby,
Further to your statement, don't you find it important for nurses to "protect" their turf, just like MDs do? As you see from some comments here, patients are frequently misled as to who actually is a "nurse" (if anyone is) in their MDs Office...Several years back, the New York State Nurses Association ran a TV campaign highlighting the issue with the motto, "Ask for a REAL Nurse---a REGISTERED Nurse." Since then, however, we have succeeded in restricting use of the term "nurse" in NYState to Rns/LPNs. Progress sometimes comes in small steps, but it's worth continuing to pursue. Thanks again for your input.
I do recall that ad campaign...and I recall that it sent LPN's up in arms. They felt that they were looked over as "not real nurses" because the commercial did not state "licensed and registered nurses". I think, in my experience, that a lot of MD's are loosening up a bit and allowing Nurse Practitioners and Physician Assistants to lighten their load. This is the same way I look at Certified Medical Assistants. They are there to afford me the luxury of getting my meds passed, treatments done, paperwork and charting completed, phone calls out of the way, etc. I truthfully love having CMA's at my disposal and feel they are a VERY vital part of the nursing team. I don't feel edged out or threatened by their existance in the least, so long as they have the proper training and credentials.
Good luck to you as you continue through nursing school.
| | No. 35 |
Oct 10, 2009, 04:03 PM
Re: Nevada Stops "Medical Assistants" from Giving Injections Originally Posted by wannab06 Have the MA curriculum change to include giving IMs, Sub-Qs injections??
I'm sorry but MA is not certified to administered Flu shots, give medications in any kind of way. If you are giving those things with just order of the doctor without having any kind of certification under your state laws, you are out of your scope of practice, and this is a national thing. NO way in a MA curriculum is administering flu shots and medication was included, if you are/was a Certified/Registered Medical Assistant, you should've known what your scope of practice is.
It does matter what state you are in. The Certified Medical Assistants in California ARE certified to give injections and one of their certification requirements is to gradate from a school that has injection training in the curriculum. http://www.medbd.ca.gov/allied/medic...questions.html (The more of these post I read the more I think California is the only one on the ball)
I agree that Medical Assistants should be certified (and it should be required for them to post their certification document where patients can easily see it) and that the certification should be on a national level so that the curriculum is consistent.
I also believe the place for the medical assistant is in the physicians office. I can not imagine the need for a medical assistant in a hospital, aside from the fact that their scope of practice would be too limited in a place like that. Therefore I do not believe the medical assistant is a threat to the nurse; a nurse really is not needed in the basic family physicians office. I worked as a CMA in a physicians office before becoming a nurse and now as I nurse I still do not see the need for the nurse in the family physicians office. Medical assistants in specialty offices? Depends. Medical assistants in the hospital? of course not.
| | No. 36 |
Oct 10, 2009, 04:47 PM
Updated
Oct 10, 2009 at 05:04 PM by nyforlove
Re: Nevada Stops "Medical Assistants" from Giving Injections Originally Posted by belgarion Just an observation but it seems that nyforlove is worrying a lot about what other states are doing when her "problem" is in NY. Do you think that the states that allow MAs to do shots are endangering their citizens in some way? Perhaps we are seeing the start of a nationwide crusade here.
Come'on Belgarion,
Everything's supposed to be bigger in Texas so why are you thinking so small? Yes, I live in NY, but attend school in NJ, have family and loved ones in several of our united States and recognize how many health care changes began as an isolated effort in one jurisdiction, e.g., Massachusetts' ongoing--and so-far pretty successful--version of mandated-insurance coverage. And at one point, Colorado was the ONLY state to authorize Nurse Practitioners. Always helpful to examine the experiences of patients and providers in different states where laws/practices/etc. differ. You gotta a "problem" with that ;-) P.S. Thanks for your info. re: TX provisions.
| | No. 37 |
Oct 10, 2009, 04:56 PM
Re: Nevada Stops "Medical Assistants" from Giving Injections Originally Posted by nyforlove Come'on Belgarion,
Everything's supposed to be bigger in Texas so why are you thinking so small? Yes, I live in NY, but attend school in NJ, have family and loved ones in several of our united States and recognize how many health care changes began as an isolated effort in one jurisdiction, e.g., Massachusetts' ongoing--and so-far pretty successful--version of mandated-insurance coverage. And at one point, Colorado was the ONLY state to authorize Nurse Practitioners. Always helpful to examine the experiences of patients and providers in different states where laws/practices/etc. differ. You gotta a "problem" with that ;-) P.S. Thanks for your info. re: TX provisions.
I don't (have a problem with that), if nurses were not regulated then you would see posts like these but about nurses written by doctors. If medical assistants were regulated across the board (as in across the country) like nurses are there would not be a need for post like these.
| | No. 38 |
Oct 11, 2009, 07:46 AM
Re: Nevada Stops "Medical Assistants" from Giving Injections Originally Posted by nyforlove Come'on Belgarion, Originally Posted by nyforlove Everything's supposed to be bigger in Texas so why are you thinking so small? Yes, I live in NY, but attend school in NJ, have family and loved ones in several of our united States and recognize how many health care changes began as an isolated effort in one jurisdiction, e.g., Massachusetts' ongoing--and so-far pretty successful--version of mandated-insurance coverage. And at one point, Colorado was the ONLY state to authorize Nurse Practitioners. Always helpful to examine the experiences of patients and providers in different states where laws/practices/etc. differ. You gotta a "problem" with that ;-) P.S. Thanks for your info. re: TX provisions.
No, actually I don't have a problem, I'm just curious as to where you are going with all this. You started out with a very legitimate complaint that doctors in NY are not following state laws. It seems to have morphed into a nationwide crusade. As I stated, I have never even met an MA so I really don't care one way or the other. If you are going to file a complaint in NY, then file it already. I doubt that anyone there will care about what other states do. If indeed you are planning a nationwide campaign to define what MAs can or can't do, let us know. I want to get my popcorn ready.
| | No. 39 |
Oct 11, 2009, 01:23 PM
Re: Nevada Stops "Medical Assistants" from Giving Injections
My mom went to MA school 14 years ago in WA state, she went full time for one year (actually I believe it was a 14 month program) and then had I think it was 6 weeks externship or internship I can't ever remember the difference between the two. She has drawn my blood, given me flu shots and she does an exceptional job. I am a very hard stick but she has always done great. She had to take some test at the end of her program so she is considered a Certified medical assistant. She is very good at what she does. In my nursing program we get very LITTLE training on phlebotomy and IV's and Injections. Less training then my mom got. They say it's because their are specialized teams for all this now. It still seems to me that we should get good training on it regardless in case one of the team members aren't around.
I have been a patient tons of times and have nurses and MA's do my injections and blood draws and IV's and people in all fields have done great and some have sucked. Just last weekend I went to get my meningitis vaccine and the nurse that did it did a terrible job and I have never had a shot be so painful. My arm was dripping alcohol when he did it and it burned so bad from that, not to mention I think more of the vaccine was oozing OUT of the injection site then in. (heh maybe he was a new grad from my school and only practiced once on the giant man arm we have). Then again, 2 months ago I had my tetanus shot at the health clinic and I did not feel a thing, just the soreness 2 days later. The lady was awesome at her injections.
I am not a nurse yet nor am I a MA so I can't speak on my opinions on who should be allowed to do what. But I can say, being a MA does not mean you do a crappy job with needles. I was very grateful that man that did my vaccine last weekend (a nurse) was on the adult side and not the kids line or those kids would probably be traumatized. I have had IV's less painful then that shot!
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