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 some states MAs most certainly can do advice following established protocols. I've worked with them and have read the BoN's opinion letter on it myself (the WA BoN doesn't have a problem with it).
There are many pathways that we use as a guide as nurses. but that is what they are...a guide. If i call my doctor's office for advice on my personal care, then i want my doctor's advice. if i wanted the advice of an uneducated medical personel, i could just ask the CNAs at work what they think i should do. same difference.
no, sorry, but i will NOT be taking any advice from a MA for any reason under any circumstance.
just because you can give a shot, take some vitals, ask me what i'm there for that day and draw my blood...that gives you no right to give medical advice. and if your BON has no problem with uneducated medical personel giving medical advice then i'm really glad i live in tennessee where my BON not only wants to protect my patients from uneducated advice but also wants to protect MY title of nurse and will go after any MA that calls herself a nurse.
"no, sorry, but i will NOT be taking any advice from a MA for any reason under any circumstance."
That's all well and good, but as has been mentioned, sometimes you cannot get a straight answer when you try to determine who you're talking to. Some MA's flat out say yes when asked if they are Dr. So&So's nurse. They are the gatekeepers to the MD and can really stymy attempts to get to the doctor. Short of making an appointment to to see the doctor and advise him/her of how their office is being run, you are sometimes SOL if you hope to get a decent message conveyed.
And even if you do tell the doctor that you don't appreciate being triaged by (or receive medical advice from) an MA, you run the risk of alienating your doctor who may be fully aware of how the office is being administered.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
And even if you do tell the doctor that you don't appreciate being triaged by (or receive medical advice from) an MA, you run the risk of alienating your doctor who may be fully aware of how the office is being administered.
This is so true.
One of my classmates is an LPN who attends an RN completer program at a local school with me. She complained vigorously about the MAs performing tasks to her OB/GYN. After one too many complaints, the OB/GYN sent my classmate a letter communicating that he no longer wanted to see her as a patient due to "philosophical differences."
She voiced her complaints about the MAs employed at her doctor's office, and was quickly shown the door. I suspect that many other doctors across the country don't care about patient complaints regarding MAs, as long as they are saving a few dollars on the salaries and overhead they must pay out.
I'm currently a CNA working on my VN program--I'll be done at the end of the year. I can't count how many times I've stopped my patients and told them I'm the nursing ASSISTANT, not the nurse. And then explained the difference. Still, they will insist on calling me and the other aids as well by "nurse".
It gets to a point where there's not much I can do about it. I explain it multipile times a shift to the same patients over and over. I have to admit that after awhile I do tend to ignore it and just let them have their way, once it's clear nothing I say will change it.
Then the next day I start it all over again with the new patients.
Prior to becoming an aspiring nursing student, I worked as a Dental Assistant. Many patients would even refer to me as "nurse". Sometimes people just see scrubs and assume the title Nurse. Obviously in the Dental Field, there is no such thing as a Nurse, just Doctors or Assistants. However, any doctor I've ever worked for as a DA would always refer to me as his Assistant.
MA's are used as "cheap" replacements for nurses by far too many clinics/docs.
MA's are hired over nurses in clinics because nurses are not needed in the clinical setting. The work of an MA in the office setting does not require the critical thinking of an RN/LVN. The skills of the MA do include some nursing skills but they are all basic; like taking vitals, drawing blood, giving shots, doing U/As, taking a short history such as "what is your chief compliant?". It would be economically ignorant to hire a nurse over an MA in a medical office...why pay a nurse $20 something an hour for something a MA could do for $10 or less? Its not a skilled position, therefore it does not require a licensed personal. The MA is not taking a nurses job. And I say this as a past CMA now RN.
MA's are hired over nurses in clinics because nurses are not needed in the clinical setting. The work of an MA in the office setting does not require the critical thinking of an RN/LVN. The skills of the MA do include some nursing skills but they are all basic; like taking vitals, drawing blood, giving shots, doing U/As, taking a short history such as "what is your chief compliant?". It would be economically ignorant to hire a nurse over an MA in a medical office...why pay a nurse $20 something an hour for something a MA could do for $10 or less? Its not a skilled position, therefore it does not require a licensed personal. The MA is not taking a nurses job. And I say this as a past CMA now RN.
I will reiterate my question from before (Please be patient as I am a student): Do you not need to perform an assessment before administering vaccines? (ie Does the patient have allergies? Has the patient had a fever?) How can that not be the job of a nurse?
when i saw the title i thought MA like masters but then I realized. lol yeah this happens a lot, but I just try to take everything in stride and not let little things like that get to me. correct them if you can.
Re: And I continue my rant of MAs pretending to be nurses..
Originally Posted by Hygiene Queen
"MA's are hired over nurses in clinics because nurses are not needed in the clinical setting"
This statement reflects the view from someone who has drunk the current kool-aid.
Medical practices are set up to best utilize the time/energy of the MD. In an effectively-run practice, the initial encounter with the patient in any given office visit is used to perform an assessment. That assessment allows the MD to quickly perform his/her own assessment and come to a diagnosis/treatment plan.
When the initial assessment is performed by licensed personnel, the MD has a basis for building his/her treatment plan. When that "assessment" is performed by an MA or other ancillary personnel, the MD only receives a listing of meds and ailments as given by the (notoriously unreliable) patient. There can be no clinical evaluation by the MA because he/she is not qualified to assess - simply to list.
Nurses are indeed needed in the clinical setting - but only by those who value their patients.
"It would be economically ignorant to hire a nurse over an MA in a medical office...why pay a nurse $20 something an hour for something a MA could do for $10 or less?"
Again, a currently popular yet short-sighted viewpoint. It is not what the RN/LPN does, it is what he/she knows. Of course an MA can take a blood pressure or a temp, but can she follow up on the findings and anticipate the next steps that the MD may require for further evaluation?
The MA can perform the basic steps of a UA, but can they analyze the results and effectively prepare for the MD's care plan?
"no, sorry, but i will NOT be taking any advice from a MA for any reason under any circumstance."
That's all well and good, but as has been mentioned, sometimes you cannot get a straight answer when you try to determine who you're talking to. Some MA's flat out say yes when asked if they are Dr. So&So's nurse. They are the gatekeepers to the MD and can really stymy attempts to get to the doctor. Short of making an appointment to to see the doctor and advise him/her of how their office is being run, you are sometimes SOL if you hope to get a decent message conveyed.
And even if you do tell the doctor that you don't appreciate being triaged by (or receive medical advice from) an MA, you run the risk of alienating your doctor who may be fully aware of how the office is being administered.
I actually get along great with my doc's MA. She doesn't call herself a nurse and she doesnt give out uneducated advice she is not supposed to. if i call her to tell the doc i'm sick or need something, she's on it in a second. she's really fantastic at her job. i dont mind a bit when i go in and she takes my vitals, triages me, etc.
i liken a good office MA or office nurse as a type of administrative assistant. i was my dad's secretary for 15 years. when you work closely with someone like that, you get to know each other and how each other works. my doc and her MA are a great team.
the thread is about MA's that call themselves nurses and do things beyond their scope of practice. THAT is my rant.
i wouldnt worry about alienating myself if my doctor was offended when i complained the MA was calling herself a nurse. you are supposed to have a trusting, professional relationship with your doc. they are , afterall, in charge of your healthcare. you, the doc and her nurse or MA are a team. but if a part of the team is dishonest, then there is no team.
so if my doc's MA was calling herself a nurse and i asked her not to do that in front of me and complained to the doc and they got upset...i'd just find a new doc. i wont trust someone with my life that i cant trust. period.
so i would NOT allow myself to be bullied into just 'accepting' an MA professing to be a nurse. that is illegal in my state and i would report it.
i dont mind MA's at all. i just dont want them to be telling people they are a nurse when they are not.
I will reiterate my question from before (Please be patient as I am a student): Do you not need to perform an assessment before administering vaccines? (ie Does the patient have allergies? Has the patient had a fever?) How can that not be the job of a nurse?
Asking some one if they have allergies and taking their temp is not a nursing assessment and therefore does not require a nursing degree. In my state, CA, certified medical assistants are trained in venipuncture and injections. They are limited on what they can inject, some narcs, vaccinations/immunizations, ABX, TB; all IM/SubQ,Sub-Dermal of course.
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Re: And I continue my rant of MAs pretending to be nurses..
southernbeegirl, BSN, RN
903 Posts
There are many pathways that we use as a guide as nurses. but that is what they are...a guide. If i call my doctor's office for advice on my personal care, then i want my doctor's advice. if i wanted the advice of an uneducated medical personel, i could just ask the CNAs at work what they think i should do. same difference.
no, sorry, but i will NOT be taking any advice from a MA for any reason under any circumstance.
just because you can give a shot, take some vitals, ask me what i'm there for that day and draw my blood...that gives you no right to give medical advice. and if your BON has no problem with uneducated medical personel giving medical advice then i'm really glad i live in tennessee where my BON not only wants to protect my patients from uneducated advice but also wants to protect MY title of nurse and will go after any MA that calls herself a nurse.