*rant* "Nurse" at office answering questions.

I guess I stopped short of the "Cannot do's" at that site. Shame on me....

but you all have the link so now you know where to go for the reliable information. Remember, you may not have a license to lose, but it does not mean you can't lose a LOT practicing outside your scope or allowing yourself to be referred to as a nurse, when you are not.

This is what I've seen and believe to be true, from my experiences over the last oh-so-many years.... MA's are typically trained for office work...what they call "back office", w/some of the "front office" duties thrown in. Nursing assistants, nurse "techs", aides, nursing aides, etc are typically working for hospitals, nursing home, some home health "sitter"/aide type jobs. Having worked extensively w/both "sets" of individuals, there really is a difference. The docs in primary care offices typically do not employ licensed personnel, they "train" MA's fresh from these 3 mo courses (although I have seen MA's who have rcvd OJT) and inform them that they are his/her "nurse" and are working under the MD's license. That is true to an extent, however, the MA can be held legally liable for working outside of their practice. And I can assure you, the MD is not gonna take the fall when/if something comes down. They figure...this person doesn't have a license, they have nothing to "lose"(their mentality, not mine), I'm not taking responsibility (in a court of law) for their "illegal" actions. Believe me, I have seen it.
Furthermore, it is obvious why MD's do this....money, the $$$$$$$, cashola. I have had this discussion w/the medical director of a primary care/urgent care center I was working at....we constantly were having problems w/the MA's wanting to start IV's, draw up and give IV drugs, etc, etc. Of course, it is not going to cost as much to hire an MA vs an LPN or RN. So you have lots of MA's in primary care and very little RN's or LPN's. This is the kicker...the MA's, technically were working under our license, we were supervising them, making their assignments, etc, and we constantly got this "I work under the MD's license" line. That is one reason I got out of primary care, much as I enjoyed Urgent Care, and went back to the hospital....roles seem so much more defined....

Amen.

I have experienced it as an RN. I worked for an MD, who put the pt., on our surgery schedule for a procedure that did not require the type of surgical intervention, that was done on him.

The MD tried to blame it on me and told the practice manager that I had put the pt. on the MD's schedule without his authorization. This was a totally false accusation and I was lucky that one of my coworkers had confirmed with the MD that this pt. was to be placed on the schedule.

The MD then tried to put the blame on me by stating that I should have known by the diagnosis the pt. did not have to be scheduled for this type of intervention. I told the MD that since I am not a surgeon, It wouldn't be up to be to decide what type of procedure the pt. needed to have. In addition, The MD, picked up the knife and cut on the pt., even after looking at the pt.'s chart prior to the start of surgery.

I was very fortunate that the Practice Manager believed me and not the MD.

1. Unfortunately, the MA's I have contact with daily do intentionally misrepresent themselves. When I talk with them, I always have to clarify what type of "nurse" they are, so that my actions are appropriate. ie- I can't take any type of orders from them.
2., dr.s do know ,for the most part ,what the legal ramifications of using the term "nurse", when referering to their MA's. The reason they do it for strictly financial reasons, such as paying a MA $10 per hour vs. a Nurse at $20 per hour. The doctors know that the public doesn't know the difference in responsibilities.

I am aware of what may motivate an MD to "pass off" an MA as a "nurse" in his employ; I have already stated that, as have a couple of others.

However, I believe most MA's do not mean to deceive others, either being unaware of what they are doing is wrong, or just unaware of the difference between nursing and medical assisting.

I am not going to inflame others here by presuming dishonesty first. I would hope we can give the MAs among us the benefit of the doubt, and simply attempt to educate them about the risks they take, misusing the title of "nurse" in their capacity.

Further, if you are aware of a doctor's office/medical practice doing this unlawfully, it becomes an obligation on your part, as a professional, to report this to the Provincial or State Board of Medicine and/or Nursing.

I think the thread has come full circle and it's time to close. If anyone has any new facts/information, please, feel free to begin a new thread on the subject.

I hope we all take away from this a clearer understanding of MAs and their roles in healthcare.

Thank you for understanding.