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?
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.
I've worked in an office and just like you. I've NEVER seen the doctors sign anything off as to an MA's advice. What kind of advice can an MA provide? I only learned medical office procedures in my training. Based on what knowledge do they provide medical advice? I really want to know, so I can go back to my 6K MA training and ask them to teach me how to give medical advice.
There's a difference between being weak and being stupid.
I see a bunch of moderate, well thought out replies, like sinking stones.
Our profession has not even stepped out of the primordial ether long enough to look around and all we do is place limits and competencies on every piece of practice and form of caring we see. We microcontrol our behaviours possibly to make up for our lack of control of our own destiny.
And I don't blame anyone more than the Medical Associations worldwide, first it was the principles of Galen now its unwavering belief in scientific process, but its always something stupid. They hoard financial and political power and wield it with self interest at heart. We on the otherhand do look after the weak/sick/poor/stupid day in day out, only somewhat begrudgingly. We are in hospitals 24hrs/7days and are often totally dismissed, our concerns, well they are ''little problems''. There are mutliple exceptions to this rule, but I intend to generalise.
One of my biggest bug bears is the way we treat assisting staff. We value our qualification as though some some higher power has bestowed us the power to do what the medical profession does to nurses, in general. Tell them they arent good enough, not quite there yet and know your place. Are we helping to raise peoples view of our profession? You may competantly argue yes, but I would say you are retarding us from our best.
ne of my biggest bug bears is the way we treat assisting staff. we value our qualification as though some some higher power has bestowed us the power to do what the medical profession does to nurses, in general. tell them they arent good enough, not quite there yet and know your place.
what is so 'bad' about knowing your place? you choose to become an ma, not an rn, it is not my actions that prevent you from being called "nurse", it is your own lack of education and license.
i will never say that ma's are not good people capable of good practice as an ma, but they are not nurses, and not capable to practice as good nurses. there are huge educational differences between an ma and a nurse, as well as differing scopes of practice, and those are facts.
we are not trying to put anyone down, but everyone within health care should know their 'place' on the hierarchy. i was a cna for 9 years before begining nursing school, i certainly knew my place, and i respected my place on the hospital food chain.
want to be a nurse? go to nursing school, do not become an ma.
"And I don't blame anyone more than the Medical Associations worldwide, first it was the principles of Galen now its unwavering belief in scientific process, but its always something stupid. They hoard financial and political power and wield it with self interest at heart"
footsoldier - I find your posts impenetrable and quite odd. If you hope to post so that the majority can understand your views and positions, could you try to be a little less obscure? For instance, what does this even mean?
"I see a bunch of moderate, well thought out replies, like sinking stones.
Our profession has not even stepped out of the primordial ether long enough to look around and all we do is place limits and competencies on every piece of practice and form of caring we see"
Specializes in Peds/outpatient FP,derm,allergy/private duty.
"And I don't blame anyone more than the Medical Associations worldwide, first it was the principles of Galen now its unwavering belief in scientific process, but its always something stupid. They hoard financial and political power and wield it with self interest at heart"
footsoldier - I find your posts impenetrable and quite odd. If you hope to post so that the majority can understand your views and positions, could you try to be a little less obscure? For instance, what does this even mean?
"I see a bunch of moderate, well thought out replies, like sinking stones.
Our profession has not even stepped out of the primordial ether long enough to look around and all we do is place limits and competencies on every piece of practice and form of caring we see"
Care to define primordial ether?
Some kind of quasi-medical Marxist poetry, maybe??
it's easy to become drunk with power when you feel like you are your md's right hand person...
you could get even drunker if the doc actually paid for all you do.
ma's are used as "cheap" replacements for nurses by far too many clinics/docs.
my cna friend has happily been a cna for 20 years in a ped clinic. now she and the other cna's she works with are being told they must become ma's.
my friend does not want to but is being forced. she does not want to give injections.
she will get no raise for the additional training... training of the manual process of injections, not the education behind it.
the clinic has let go several nurses. they are replacing them with these new ma's.
and newly hired ma's... get paid less than my cna friend. hmmmm, not that ain't right now is it, folks?? not when you consider the amount of school both positions require.
but, i digress... all ma's aren't bad title-thievin', power-hungry creeps. some are excellent at what they do.
but i agree that some are just dangerous and it's up to us to make sure we protect ourselves and make sure we're dealing with who we are told we are dealing with.
I am probably guilty of flying off the handle on this issue, with some quasi medical Marxist poetry too, I quite like that one.
In fact I am probably in the wrong thread, given I don't exact;y know about the US situation, or exactly what an MA is/does, so forgive me for that.
Mabye I'll go and start a new thread, some where in the primordial ether.
I wish to clarify a couple of points, when I mentioned assistants I guess I am talking about more those that work directly with nurses. If everything we do is ideally patient based, then I would on some levels and in some workplaces like to proclaim assistants as possessing powerful amounts of practical knowledge. Yet we dismiss this just as readily as we ourselves are dismissed.
Much of our real work is done with people who for age or comorbid/disese state reasons are simply not on a happy tradjectory. Put simply, I thought you might like that!, a kind word is worth more than a prescription. Come with me this is not rocket science, just a delicious form of nursing science. As we know these unseen, unrecorded interventions are nursings bread and butter. They provide us with small but vital amounts of gratification, if and when we reflect on benefits that can be established through genuine healing.
The real world road block is how do we emerge through all the crap to keep on giving when the outcomes are so grim and the families so annoying. It is my belief we still have so far to go, and those who are more about secularising and professionalising, thats ok. My focus however is the point of caring, both in the bedside and philosophically. I think there is a distinct role for technology which does not just tick all managments boxes, but distills nursing knowledge. I am not talking about NANDA either, I meant programs that can increase fairness and point of contact caring. Anyways....happy postings.
I work in a HUGE pediatric practice with MAs that I really like and they do a great job. The thing that gets me is that every time an RN quits they are replaced by one or two MAs. We are definitely being phased out of the practice. Our manager lets the MAs do just about everything including giving medications and injections. When the RNs have taken our concerns to management we are told to train the MAs to do the best job they can because that is the way it is going to be. It really gets to me.
Start praying that the manager is removed from your life.
Prisoners in Buchenwald and/or other concentration camps were harnessed like horses to pull heavy wagons. They were lashed during this grueling, excruciating work. They were also forced to sing while doing it. (from the book, "The Theory and Practice of Hell" by Eugen Kogen) GEt my point? Not only are you to expect to lose your job but you are ordered to train your replacements. Selah. (Think on that.) You might want to be pretty silent in your rebellion, of course.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
Glad you liked my poetry phrase, footsoldier----- and don't worry, I don't often know what the situation is here in the US, and I live here! :) I'm going to take my computer to work and see if I can decipher your post-- just kidding!
Comparing conditions anyone in the Western world works under to Buchenwald (or any concentration camp) is not only a massive over-statement but insulting to the memories of those who suffered. Some perspective, please.
I now return you to the originally scheduled thread...
You are describing exactly what happened to me the last time I was in the doctor's office. The front office staff referred to the MA as a "nurse" and when I asked the woman what kind of nurse she was, she actually told me she wasn't one.
I felt sorry for her. She clearly was caught in the middle. The manager told the front office to call them nurses and when she is asked, she has no choice but to confess that she isn't.
In terms of this idea that doctors "need" to do it to save money, give me a break! They *want* to do it to save money. Please let's keep some perspective on this thing.
Further, I will note that the white paper on this so-called impending nursing shortage includes a large number of positions that are going to be vacated in doctor's offices.
:lol2:
roser13, ASN, RN
6,504 Posts
"We are all nursin' in point of fact,
cut these assistants some slack.
I am a nurse/murse and your pusher person,
but we are pawns in a bigger powerpolitik,
so why are we persicuting the weak?
This is my point in fact, we are more client managers
and they more nurse! "
Huh?