Today I was at a patient's home and had to call the doctor. The answering service said "If you would like to speak to a nurse press 3" So I pressed three.
A girl came on, "This is Tina" and I said "Hi Tina I'm a nurse with so & so and your machine prompt says press three for a nurse. Are you a nurse"
Tina says "Yes. Well, an MA, same thing, go ahead"
Hmmm. What to do what to do?
May I also point out that the reason I am seeing this woman is for a major abdominal post op infection? When she came home from the hospital she developed a fever of 101 with redness and pus at the wound site. She called the service and the "nurse" told her to take an advil and come in for her scheduled appointment in a week.
This was the MA who I had spoken to. The doctor flipped when he saw the wound and she was immediately readmitted for iv abx and debridement. What is going on and who do I report her to?
In my state, it is not premissable to misrepresent yourself as well. But what I am curious about is how aggressively is this pursued? Since they are not under the auspice of the BON, how can a person be penalized?
The title of nurse is legally protected in Australia - not only could: the MA be fined but so could the employer: the OP was instructed to press 3 for a nurse but the call was answered by another provider, who did not disclose that she was not a nurse. Unless her employer could demonstrate that this was an unsanctioned aberration s/he would also be liable, and for a greater fine.
Not that it would happen here - Australia at present does not have MAs (or respiratory therapists, not that that is relevant here), Victoria does not have NAs or PAs is acute care, and we only have two kinds of registered nurse: division 1 or division 2 (known as enrolled in some states), so the situation is less confusing all around.
as someone pointed out, the term "nurse" does not mean just lvn or rn.
whoa now.. yes it does!! a cna is not a nurse, cna's are "certifies nurses aides". they aide the nurse by doing certain aspects of patient care that is within their scope of training and license, and this patient care helps the rn or lpn so that he/she may provide advanced levels of patient are.
a nurse is a nurse, it is a protected title. rn, lpn, bsn, msn, dnp, np.. they are nurses.
ma are medical assistants, not nurses. they are not trained in even remotely the same way nurses are, and they are not 'licensed', only certified/registered.
i don't think it would bother me if an ma said they were a "nurse" to a patient, as long as what the patient wanted was withing their scope of practice.
it would bother me. i do not want an ma being called a nurse, they are not nurses.
correct me if im wrong, but mas can not give medical advice. you have no education on which to base it. you only carry a certification, no?
yes, you can if it is pre- approved by the physician. why, because the physician has already approved the medical advice. if the patients symptoms or illness does not fit within the protocol or their illness/symptoms are serious then the physician is give the call asap. if the patient's symptoms do fit within a protocol then you give the advice...gather the information taken from the patient and the advice given to patient...then the doctor reviews and signs off or adds more details...example:
mom calls about her 5 y/o child c/o cough x2 days. in the protocol book you would go to cough.....then ask the series of questions given. the parent's responses then direct the ma to what advice to give, to have them seen immediately, or to direct the information to the physician. if the patient does not fall within a protocol then the call is referred to the physician.
now when i give advice i tell the patient that i will call them back if there is additional information the physician would like to add after he/she reviews the call.
some might say this process is faulty. well the book that we use is used by pediatric on call services throughout the dallas/ft. worth area and the rn's utilize the book the same way i do. please don't take the above statement wrong...i'm not comparing myself to a rn. i am saying that it doesn't take a genius to follow protocols and i have be trained very well by the physicians i work for...and i would never give out the protocol advice if the patient is in immediate danger.
that again brings me back to my initial statement. physicians hiring ma must train them!!!!!! if you have well trained ma's then your patients get appropriate care .
Specializes in Community Health, Med-Surg, Home Health.
yes, you can if it is pre- approved by the physician. why, because the physician has already approved the medical advice. if the patients symptoms or illness does not fit within the protocol or their illness/symptoms are serious then the physician is give the call asap. if the patient's symptoms do fit within a protocol then you give the advice...gather the information taken from the patient and the advice given to patient...then the doctor reviews and signs off or adds more details...example:
mom calls about her 5 y/o child c/o cough x2 days. in the protocol book you would go to cough.....then ask the series of questions given. the parent's responses then direct the ma to what advice to give, to have them seen immediately, or to direct the information to the physician. if the patient does not fall within a protocol then the call is referred to the physician.
now when i give advice i tell the patient that i will call them back if there is additional information the physician would like to add after he/she reviews the call.
some might say this process is faulty. well the book that we use is used by pediatric on call services throughout the dallas/ft. worth area and the rn's utilize the book the same way i do. please don't take the above statement wrong...i'm not comparing myself to a rn. i am saying that it doesn't take a genius to follow protocols and i have be trained very well by the physicians i work for...and i would never give out the protocol advice if the patient is in immediate danger.
that again brings me back to my initial statement. physicians hiring ma must train them!!!!!! if you have well trained ma's then your patients get appropriate care .
i can understand your point. when a licensed person assigns a task to a uap, they must be specific. doing so can lead to a better outcome than depending on this person, who was not trained to triage a call effectively. if the physician does not train, he can suffer for this, later.
I can understand your point. When a licensed person assigns a task to a UAP, they must be specific. Doing so can lead to a better outcome than depending on this person, who was not trained to triage a call effectively. If the physician does not train, he can suffer for this, later.
Exactly!
The patients appreciated the care and advice that I gave them and understood my scope of practice. They trusted that I would give them the correct advice and if the was any doubt I would never hesitate to ask the physician.
The physician I worked for had a 5 room office, one ma, one lvn, and a receptionist. We gave a full 30 minutes for well exams and a full 15 for sick. Every patient received personal care and we knew everything about every single one of our patients. When patients would walk in for their appointments they were the only ones in the waiting room and called back immediately. When patients where seriously ill and in the hospital we would visit them and pray for them (if they allowed). The day the practice closed (so the doctor could do missionary work) our patients cried and begged for us to stay open. The only way the doctor was able to provide such personal care was to hire cheaper back office staff. There is no way she could have paid a RN. This is true with many private practices and that is why MA's are so vital. Now I'm not saying that we are should replace RN's, I'm saying we are needed. I would also like to point out that RN's, MD's, LVN's, and other health care personals make the same mistakes as the person in the initial post
The patients appreciated the care and advice that I gave them and understood my scope of practice. They trusted that I would give them the correct advice and if the was any doubt I would never hesitate to ask the physician.
The physician I worked for had a 5 room office, one ma, one lvn, and a receptionist. We gave a full 30 minutes for well exams and a full 15 for sick. Every patient received personal care and we knew everything about every single one of our patients. When patients would walk in for their appointments they were the only ones in the waiting room and called back immediately. When patients where seriously ill and in the hospital we would visit them and pray for them (if they allowed). The day the practice closed (so the doctor could do missionary work) our patients cried and begged for us to stay open. The only way the doctor was able to provide such personal care was to hire cheaper back office staff. There is no way she could have paid a RN. This is true with many private practices and that is why MA's are so vital. Now I'm not saying that we are should replace RN's, I'm saying we are needed. I would also like to point out that RN's, MD's, LVN's, and other health care personals make the same mistakes as the person in the initial post
I am the person from the original post. As a nurse I have made mistakes. I have never ignored obvious signs of infection. I doubt there are many nurses who would do so. Fever, redness, pus at op site warrants a look see by a doctor. I was not her nurse at the time, she didn't have one. Now she does.
i think that most patients and families do not know better and just associate medical staff with nurses. its not like we wear our scope of practice under our name tag.
i dont mind if a patient does not know better; i will politely correct them. however, if the actual cna or ma refers to themselves as a nurse - that is where the line gets crossed.
we should broaden our naming categories- for associate rns, bachelor rns, lpns, and so forth instead of just grouping them with the name nurse. it seems like the word nurse is used under an umbrella meaning that most people have their own definitions of. which is not fair to the rns that spent the grueling hours learning their practice. nor is it fair to the patients that want a degreed nurse's opinion and expertise. just my
why would you need to separate adn's from bsn's? same boards, same license, same scope of practice. that is not the same as distinguishing between rn's, lpn's, and cna's.
Why would you need to separate ADN's from BSN's? Same boards, same license, same scope of practice. That is NOT the same as distinguishing between RN's, LPN's, and CNA's.
I agree. A RN is a RN. You take the exact same boards and have the exact same license regardless of whether you have a ADN or BSN. A RN is a RN, a LPN is a LPN, a CNA is a CNA, and a MA is a MA. If everyone was honest about what they truly were and not passing themselves off as something they weren't this topic wouldn't even need to exist. And the fact that people are so dishonest with patients is despicable.
I have worked in an office and have NEVER seen the doctors sign anything off as to a MA's advice. In NC, I don't know what the rules are on this, but I have listened to the MAs talk or advise while waiting in the waiting room and some of their interpretations leave much to be desired.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I remember the words that a wise RN said to me recently: "Nurses are not paid for what we do. We're paid for what we know."
The fund of knowledge is the bottom line. RNs, LPNs, and MAs are doing "the same tasks" in doctors offices, clinics, and medical groups across the country. While they might outwardly appear to be doing "the same thing," the office employees with a nursing education (RNs and LPNs) are incorporating their fund of knowledge, problem-solving techniques, and other multifaceted approaches into the tasks they complete.
We all know how to complete dressing changes, but we might approach the duty in varied ways. The MA changes the dressing with the focus of getting the task completed in a cleanly and efficient manner. The LPN changes the dressing with the focus of assessing the wound's progress and gathering information (slightly odorous, serous drainage, pink wound bed, no tunneling noted, measures 3x4cm). The RN changes the dressing with the focus of managing the entire care of this patient's wound and, if necessary, updating the plan of care.
We might be doing the "same things," but certain care providers are being paid more money for fund of knowledge that goes into doing these things.
By the way, I have had a taste of all levels. I completed a MA program in 2000, an LPN/LVN program in 2005, and I'm presently attending an RN program.
talaxandra
3,037 Posts
The title of nurse is legally protected in Australia - not only could: the MA be fined but so could the employer: the OP was instructed to press 3 for a nurse but the call was answered by another provider, who did not disclose that she was not a nurse. Unless her employer could demonstrate that this was an unsanctioned aberration s/he would also be liable, and for a greater fine.
Not that it would happen here - Australia at present does not have MAs (or respiratory therapists, not that that is relevant here), Victoria does not have NAs or PAs is acute care, and we only have two kinds of registered nurse: division 1 or division 2 (known as enrolled in some states), so the situation is less confusing all around.