Medical Assistants in the office - page 5

This is probably going to open a can of worms.............but how do you all feel about replacing nurses in the office setting with Medical Assistants? How (if at all) do you feel it affects patient... Read More

  1. by   ImaEMT
    I just wanted to reply and state that the public does care who takes care of them. I am a CMA and have been for 8 years now, and there have been many instances in which patients have questioned my credentials...mostly because many people don't know what a CMA is/does. I have even had 2 times that patients have asked for an RN to give their injections, because they were more comfortable with an RN. I can admit that at first, I was offended by this, but now I have a different heart. As I have posted before, CMA's should be trainied by an accredited school, and they should be certified by the AAMA in order to work. I know this isn't the case. I work for a Mayo institution, and we have 3 "CMA's" on staff that are either unofficially trained or not certified, or both. I can tell you that it takes a lot of work to become recertified every 5 years...but it should be required. As well, we are often put into situations in which we are asked to use skills higher than our training Foley changes and giving some meds above our training ( allergy shots, etc). All of this, and the lack of respect for my profession have really driven home for me, that I need to be an RN. It's an absolute calling for me and I will never be satisfied if I"m not.

    Here is what you do to take action against misrepresentation or misutilization of CMA's in your office: contact the AAMA. They can assist in problems with certified individuals. Like already posted, there really is nothing to be done about the uncertified people. Take issue with your employer if nothing else. I am now on a counsel at the clinic where I work to help seperate the duties of the staff CMA's and RN's. I feel there needs to be a very clear line.

    Take care
  2. by   tjn97
    We currently have 2 MA's at our family practice office. It was a difficult transition for the first one hired, as all the other nursing staff consisted of RN's and LPN's. She met a lot of resistance from our head nurse, who didn't like the idea of hiring MA's. Now, with 2 hired, the staff has more flexibility and has become very cohesive.

    Frankly, if the person is trained properly and given adequate supervision, I feel they can be as competent as a RN or LPN.
  3. by   JeanthePHN
    Thank you for the reply about the AAMA organization. That is a helpful reply. I was so upset about this I went to the local hospital and applied for a job so I could work with real nurses and real LPN and CMA. I was totally shocked when the nurse recruiter at xx hospital told me that since I have been an office nurse for 10 years I am unemployable at the hospital. I got so angry and depressed I took a ativan I had at home for my tooth extraction I had last year!! SO this woman walked in my office with no medical training and she gets a job, my supervisor is the former secretary turned nurse and this registered nurse isnt even offered the chance to work at a hospital!
  4. by   Sekar
    Quote from JeanthePHN
    I sat here reading these posts from the beginning (2001 or so) I am an ofice nurse, an RN, and have had this med. assistant versus nurse problem for several years now. I have been in a private, two doctor office for three years now. He just hired a person off the street, actually a friend of his. She had no prior experience. My other two coworkers are a man who is a graduate of a cma program.The office manager has been the primary fake nurse for years, she is medically untrained and OUR BOSS. She is the primary nurse in the practice and is very good at it BUT It irks me every day that an untrained quote nurse can get to be my boss and an untrained person can get a job in an office giving shots without any formal training. The office manager trained her, I was not even asked. The doctor calls everyone nurse and I resent it. We dont wear name tags. Everyone thinks we are all nurses. The public doesnt care and doesnt even think to ask. We put on our white labs coats and we are nurses.Why does the ANA allow this? If youre a hairdresser you need training and a license. If youre a plumber you need training and a license. IF youre an undertaker you need training and a license. If your a medical assitant it should be the law that you have training and a license.Why is the American Nurses Assoc. allowing this kind of NURSES JOBS to be given away to untrained people? THey fought a long battle to see nursing as a profession not an occupation , and that stupid ongoing debate about adn versus bsn, but they have ignored the fact that an office nurse will be a thing of the past. WHat is next?I can only see it getting worse. My partime second job is in assisted living. Those nurses aides give the medicines to the residents,even the narcotics, the nurse doesnt. THis is what is next. Many States allow medical assistants to give meds out. I bet that in the future the nurses aides in hospitals will be doing the medicines and the IV's and all the tasks the nurses do now. I just so angry I wasted four years of school and still have my loan to repay and the uneducated people get 2 dollars less an hour than I do, but get the respect of being THE NURSE.

    The ANA is an essentially powerless lobby. Don't waste your time or money on them. Go straight to the source and work through your board of nursing. In North Carolina, as previously stated, it is against the law for anyone to refer to themselves as a nurse unless they are a RN or LPN. It is also a requirement of law for all health care providers to wear name tags with their title. The law states that the patient has the right to know who is working on them and what their qualifications are before they are touched by the health care provider. Violations are punishible by a $250 fine, at least that's what a former CMA got charged for calling herself a Nurse.
    The law got changed in this state by nurses who were fed up with physicians and their tricks to make us powerless. We elected a board of nursing with teeth, replaced the dinosaurs, and got some reasonable laws enacted. You should do the same, or maybe move to North Carolina. We need more nurses.
  5. by   Sekar
    Quote from WA-Educator
    Medical Assisting Programs don't include any nursing courses because there is no reason for CMAs to know basic nursing skills. Don't confuse medical assistants with nurse assistants. Certified Medical Assistants (CMAs) do need to learn basic medical assisting skills though. Any acredited medical assisting program includes pathology, psychology, patient education, symptom analysis, therapeutic relations, law and ethics, and all the technical skills such as minor surgery assisting, urinalysis, venipuncture, ECG, blood tests, etc. None of those technical skills are included in nursing and that is a major difference between the two professions. I have seen so many nurses botch ECGs and blood draws and lab test because they simply don't know how to do them. Those are the technical skills needed for the doctors offices which is why CMAs do them and nurses don't. As far as the assessment skills, RNs do learn a much higher level of patient assessment than the CMA or the LPN. This is because in the hospital setting the RN needs to be able to assess the patients and alert the physician if needed or making nursing decisions as indicated. It all make perfect sense if you think about the basic of the curriculum linked to the jobs performed. Great conversation!!

    Nurses don't learn technical skills? LPNs aren't doing high levels of assessments? Gee when I went to LPN school we leaned all those "technical" skills only then they were called "essential nursing skills" as were the assessment skills we were trained in. These days, in NC, LPNs still use these essential nursing skills (to include venipuncture, EKG, routine waived lab tests, IVs, patient assessment etc) on a daily basis. In fact RNs do so as well, what with those being essential nursing skills. While it is true that many RN programs are getting away from essential nursing skills and teaching more esoteric stuff such as the "theory of nursing", any program worth attending still teaches the "technical skills"
  6. by   Roozeyk
    We have MA's throughout the clinics I work at. Some of them think quite a bit of themselves, I guess that's all fine and good as long as their performance can live up to their attitude. However, I'm a little concerned over the fact that they are allowed to give Injections...especially narcotic injections....I came from an area that MA's were not allowed to give injections of any kind......have the MA's that are allowed to give them, been specially trained to do so? I would just be a little afraid of how that would hold up in court?.....hhmmm.
  7. by   Vailgang
    I have only had limited contact with CMA and the ones that I have had contact with I am not impressed with them or their attitude. A student who was doing her intership at our clinic tried to tell me how to do my job when I had worked there for over 3 years. Needless to say I don't have much respect for her. Another one who was training in our office tried to tell me that I was going to file!! I am the nurse and I work the back office and I don't file. The other students that have been in our office were always late or didn't show or had to be gone. The were scared of the back office and only wanted to do paper work. Sorry to stereotype them but to me I am not impressed and hope that Dr's realize one of the reasons for increased malpractice insurance. Also do these CMA's know that they may think it is cool to play nurse but along with that is being sued if you don't know your job and trying to do a job you are not qualified for?
  8. by   tiroka03
    On my unit we have an n/ar who is studying to be a MA. She has been studying for the past 15 years for this position. Stil haven't passed it. But, the attitude she has about her education and skills is amazing. She has made the statement that LPN's and RN's are trained monkeys. Are they learning this in their schools? She states she has more education then us and therefore is better equipped to make decisions. Following are some of her decisions:

    When choosing who to treat in an emergency, she picks constipation over severe sob and chest pain.

    How many inches in a foot? she asks, you tell her 12. Oh! But, then how do you know how many inches a 41 inch person is? Inches? How about feet dear? Oh. How do you know that? Divide it by 12 you say. Why she asks. You say then you know how many feet. Oh, she says how many inches in a foot? gritting your teeth you say 12 . Oh, she says are you sure, maybe you should look it up to be sure.

    When asking her during a flu outbreak on the unit, how many people had emesis and how many had loose stools, she says, well someone else took care of the pt in rom 102. You say fine. Two minutes later she says. OH MY GOODNESS are you charting without asking the other person. Of course not. Then she feels the need to ask again "I wouldnt chart that without asking the other person you are wrong you know. Again of course I am not charting this, I am working on medicare, if she cared to look. She now feels the need to be my supervisor.

    When asked what the UOP is she states 361 cc - your kidding right?

    When this genius checks and changes a person, she states I think they are having a heart attack. when you check the person said, what? I told her I had a big mac attack.

    When the urine is very slightly concentrated, she states they are in renal failure, she know the color and smell of renal failure by heart.

    Need I go on.

    She says one of the major hospitals in town will be soon replacing ALL it's nurses with people like her. Because people like her are so much more educated then people like us.

    How many inches are in a foot?

    No she is not a MA and I have never worked with one, but if she is any indication of what the attitudes are - I'm frightened. These are all real examples in the past month. She is due to graduate in one month.

    Oh, and not too long ago, this gem. When doing a c-diff and finding it positive, we decieded not to repeat this test as a positive is what we were looking for. She stated I would always do three stool test on everything no matter what. Oh, I say I quesse I was wrong. You see we were doing the c diff test to check for e-coli in the stool. Had we found there was e-coli in the stool the person would be in certian trouble. Yes, she says, I've heard of the test looking for e-coli in the stool, it's a very important one. Too bad you aren't more aware of the tests you are doing and their importance. Just think of that person, she might have had e-coli in her stool and you would have to give her antibotics to kill it. And if you didn't test three times - well that could be a disaster. Good thing I am persistant isn't it?

    Good thing she is so well trained, and oh by the way, she is already calling herself nurse.
  9. by   newgrad04
    I was a MA for 17 years and I ran into many other MA's referring to themselves as "nurses". By now, I finished school and finally got my RN license. The last job I took prior to graduating from nursing school was in a GI outpatient office that never had a licensed nurse before. They've always worked with MA's. Very difficult, I can tell you. The last MA that left here before I started left a big mess behind, i guess, because she did not really have the skills required to do the job. With no licensed personell available, telephone triage, assessment, injections, prescriptions, patient teaching, .... everything was done by MA's. I don't think that's such a good and safe idea. I don't think I could have done the job the way it was supposed to be done without having the knowledge that I gained by going through school while working there. Now that I graduated and got licensed - I still work in the same office. I love my job, my co-workers (all non-medical) are very nice, and I really enjoy working for my doctors. And they are sooo proud to finally have a nurse.
  10. by   txspadequeenRN
    You shouldnt feel offended if someone ask to see the vials of meds you drew up. Let me give you a perfect example to shed somelight on this. What if you took your baby into a pedi office for upper resp infection or whatever. And the Physicain ordered a hefty dose of Rhocephin . Wouldnt you want to make sure the med was mixed right. This little senerio should change your mind. I bring the vials with me to the room and always have. I have no problem showing my patients what they are getting it is their body. I was a MA prior to being a nurse so I have seen both sides. I by no means are questioning your ability in your profession but CMA's do not get the pharmacology background they need to be giving injections or med's period. So feeling betrayed distrusted whatever that's a hang up you need to deal with , everyone has a right to know what they are receiving.

    Quote from EMTMom
    This comes about ALL the time. So, I'll say me peice on it as I usually have to do to clarify my career to others in the medical profession. I am CMA. I do injections, phlebotomy, EKG's, limited X-rays, some triage, RX refills and many other things. I DO NOT, assess a patient, formulate patient care plans or diagnoses, handle IV therapy or meds, triage to a RN ability. I am not a nurse, and I don't portray myself as one. However, the nurses and MD's here all know I am a CMA ( we are a 14 person practice), and they still refer to me as Dr. M's NURSE. I'm thrown in with the general "nursing staff". I am very confident in my ability to treat patients AS DIRECTED by my supervising physician. I do have critical thinking skills and the deisre to always learn, that enable me to know the differences between meds that I handle and call in, know what is urgent and what is not, and when to ask the nurse for help. I would feel very offended if a nurse asked me to show her the vials of medicine I was giving before I gave her the injections. As would you if another nurse asked the same. If this is truely the case, the lack of trust and understanding, or complete apparent lack of education on part of the MA, in your community, you should be bringing it up to the mdical board of that facility. As should anyone who obsereves a medical professional acting unsafely.

    I think all MA's should have a minimum 2 years of training. I have an associates degree in medical assisting. I also think all MA's should have some kind of EMT or patient assessment, emergency training to bump up their skills.

    I strongly believe that MA's should not cross the boundaries seperating them and the nurses they work with. Granted, many of our responsibilities are the same, and sometimes there are no lines between the roles, but there are skills and critical thinking that MA's just aren't taught.

    i am considering LPN school to bump up my skills and finally have the title of nurse. I'm tired of having to explain to everyone what I do, and no, I'm not a nurse, even though I work in the clinic and do "nursing" things. I have several friends who are CMA's and I would never distrust them. My Doctor's assistant is wonderful and competent and caring.

  11. by   Nanceenurse
    I have been an RN for almost 26 years and also have my masters degree. I am currently working in a supervisory position for a large practice connected with a major teaching hospital. We employ RN's and CMA's. This rivalry between nurses and MA's has been going on for years. I have to be honest here. I've employed quite a number of highly skilled MA's, some with their BS in science as their undergrad basis. I and others in a supervisory capacity have had MA's that were more astute in their position then some of the RN's. We RN's tend to have a "holier than thou" attitude and a complacency when it comes to even physicians we work, let alone MA's. We are still the only profession
    that you can obtain RN licensure through a 2 year or 3 year diploma program and or a bachelors degree program. The war among nursing is far from being over either. Until the nursing profession makes permanent changes to elevate the standards of their education system things will never change. One can't teach school, or be a chemical engineer with a diploma program vs a college degree so why does nursing belittle itself in this way? The point is there are different schools of accreditation with Medical Assisting as well. We only hire those that are highly specialized in clinical training and theory. Many of these schools are taught by highly skilled RN's. The bottom line is there is a place for both of these positions in an office or clinic setting. I have found often that nurses overstep their boundaries as well with regard to giving out pt information. Unless you are a Nursepractioner, nurses are not in the position qualification wise or licensed wise to diagnose or to prescribe medication yet many do. I think all of us in nursing have worked with wonderfully trained and caring staff in our lives but have also encountered many RN's that lack skills pertaining to assessment or even decent clinical treatment. How many times have RN's been called on the carpet for poor people skills that make you wonder why did this person go into this profession in the first place? There is a severe nursing shortage in this country for a good reason. If nurses can't command respect, they usually don't give respect to each other or others who work in varying medical capacities.
  12. by   cmtbarb
    after reading all the complaining about cma's vs rn/lpn i have to wonder what i will be thought of when i enter the working force as a cma, i am a former nursing student who was capped but due to illness of hubby had to quit....i have studied what lpn's study and the classes are not that different in critical one in their right mind would over step their certification skills/with fear of losing that certification, no more than an rn/lpn would act as the doctor.
  13. by   ImAnMa
    Hello I am new to this Board, In Fact this is my first post!!! I read this topic from the first post to the last and really was amazed at some of what I read, I am a Medical Assistant I do not present myself as a Nurse I do not call myself a Nurse and I have corrected Patients in the past when they have called me a nurse, I do work with some great and I mean really great nurses who have loved teaching me, leading me, showing me and instructing me and helped in perfecting my skills, they have never shown any resentment towards my desire to help them and to care for people/patients.

    And Because as nurses they have shown the greatest of care in teaching me I have excelled in my job and enjoy a great relationship with the Patient's the Dr and the friendship and respect I have for MY NURSES is endless.

    I work in a clinic/office and yes i can do the front office but I dont the Dr and the Nurses prefer to utilize my skills in the clinical setting, My Dr calls me his nurse from time to time however he knows I am a medical assistant and thus he fully understands my limitations and my need for guidance at times, the patients i work with understand I perform many nursing duties and i provide much to them in the way of teaching, learning and nursing advise however when their needs exceed my knowledge they know i will step aside and get the nurse or Dr to assist me in learning how to meet that need for them.

    In closing i think that its all about the medical team working together to give the best medical tx to each and every patient
    Team Work works, I am a medical assistant part of a medical team of health care providers am I am very happy with my tital as Medical Assistant I play an important part in each pateints health care and I make a difference in many peoples life and that after all is what really matters not how long i went to school