How do Nurses feel about CMAs? - page 2
I just wanted to get a some information on how Nurses feel about Ceritifed Medical Assistants because I am currently in a CMA program. Since my ultimate goal is to become a NP, I plan on going into... Read More
Dec 14, '02Occupation: Patient Education Specialty: 7 year(s) of experience in LDRP; Education ; Joined: Mar '01; Posts: 7,470; Likes: 56I'm a skeptic. I never would have thought that we would have been eliminated in favor of MAs (in a clinic) but we were. Who knows what's next?
Dec 14, '02Occupation: RN Joined: Nov '99; Posts: 2,950; Likes: 619Many moons ago when the MD who delivered me (I remember him making house calls) first started out in practice he could not affored a nuse. He had his wife assist him (not a nurse). I think by the time I was born he actually had a nurse and wife was home being a home maker and mom.
I don't think they do that anymore today (like the way of house calls). But as far as I know there is nothing stopping MDs from still training their own assistants like this. It is just they now can get them already trained which is better for them in many ways. Since the way they have to watch the $$$ and time now days makes it too costly for them to train someone themselves from scratch.
Dec 14, '02Occupation: Enterprise Application Systems Analyst Specialty: 27 year(s) of experience in Everything except surgery ; Joined: Mar '01; Posts: 5,601; Likes: 174CMA do not work under an RN, as they do not come under the nurse practice act of any state I know. They work under an MD, and can call themselves nurses, but can't use the initials RN or LP/VN. The word nurse is not protected under any law I know of. I work with a CMA and she is probably more knowledgeable in many clinical areas than all of the RNs and LPNs working with her, and that includes me ! Here is a link about MAs:
http://stats.bls.gov/oco/ocos164.htmLast edit by Brownms46 on Dec 14, '02
Dec 14, '02Occupation: Proud and Educated Licensed Vocation Nurse Joined: Jun '02; Posts: 1,286; Likes: 27Originally posted by sr moore
Our group belongs to an HMO and we usually get7 -10$ per month per patient as capitation. No matter if we see the patient 1 time or 12 times that month.
Other procedures and necessary treatments that fall under other reimbursement codes would be paid based on Physician Relative Values, M&R, InterQual, or another higher capitation rate, I presume.
Dec 14, '02Occupation: Student, future CMA, then RN, then NP...Geez thats a lot of school Joined: Dec '02; Posts: 14; Likes: 1I just want to thank everyone for responding to my post. I understand that some of you have positive and negative views about CMAs. In the area of Washington State in which I reside, CMAs definately do not replace RNs. The hospital here does not hire CMAs or LPNs, just RNs. I decided to go into medical assisting because my personal situations do not allow me to attend Nursing school at this time. I did not choose to attend the LPN program here because the only jobs that LPNs in this area receive are in LTC (not a field I am really interested in). Also, the market here is overflowing with LPNs. My ultimate goal is to work in an ambulatory care setting as an NP or possibly a PA. Since CMAs only work in these settings (suppose to anyway) I chose this profession over LPN. The RNs here are considered highly educated and are trained to handle complex cases, specifically in the hospital setting. The physicians do hire RNs to handle more the complex cases. The CMA assists the phsyician/NP and can perform all delegated tasks within their (CMA's) scope of practice. My instructor at school constantly reminds us NOT to call ourselves nurses, because we are not. It is our duty as (future)CMAs to educate patients, physicians, nurses, etc. that we are Medical Assistants and we are a completely different profession from nursing. LPNs, at least in this area, are trained for bedside care, not to work in a physician's office. CMAs are trained to do many more things like, EKGs, suture removel, assisting with minor office surgery, seting up sterile surgical tray, knowledge of all surgical instruments used in the office setting and many other things. We are not licensed because we assist the physician, practicing delegated tasks, under his/her license. One last point I would like to include, the CMA creditials can not be used by anyone except those MAs who have been certified by the American Association of Medical Assistants. In order to become certified one has to attend an accredited program, take the certification exam and participate in CEs (Continuting Education) credits to continute their certification. All the offices that are hiring medical assistants in this area require that they either be certified or are going to become certified very soon. If not you will not get hired. Sorry so long. Thanks again for respondingLast edit by CMAMW on Dec 14, '02
Dec 14, '02Joined: Jul '00; Posts: 11,351; Likes: 387Originally posted by Brownms46
CMA do not work under an RN, as they do not come under the nurse practice act of any state I know. They work under an MD, and can call themselves nurses, but can't use the initials RN or LP/VN. The word nurse is not protected under any law I know of. I work with a CMA and she is probably more knowledgeable in many clinical areas than all of the RNs and LPNs working with her, and that includes me ! Here is a link about MAs:
Dec 15, '02Occupation: Enterprise Application Systems Analyst Specialty: 27 year(s) of experience in Everything except surgery ; Joined: Mar '01; Posts: 5,601; Likes: 174It isn't illegal here, and since this is the country I live in, this is the one I was referring to. Also I didn't state that CMAs are nurses, I said they can call themselves, and that as it isn't illegal to do so here, as long as they don't seek employment stating they are a practical, registered or licensed nurse. After reading many different Nurse Practice Acts in the US this is the usual wording I have found:
Represent or use any title, abbreviation, letters, figures, sign, card or device to indicate that the person or any other person is a registered, graduate or professional nurse.
Represent or use any title, abbreviation, letters, sign, card or device to indicate that the person or any other person is a licensed practical nurse or a certified nursing assistant.
If someone can show me where in this country, it says only a RN or an LP/VN can use the word "nurse", I would be interested in seeing it. Hey there just might be some I missed.
Dec 15, '02Occupation: Nursing student Joined: Nov '02; Posts: 389; Likes: 10In my experience, I've never met a CERTIFIED medical assistant who called themselves a nurse. I have, however, seen physicians and uneducated staff refer to MA's as "nurses"--some patients think every female non-physician in a clinic is a nurse (I've been referred to as a "nurse" while working as a medical secretary) and unfortunately that perception is rarely corrected except by the MA herself. Uncertified MA's seem less likely to correct the mistaken impression of being a nurse, and also seem less proud of their work. The clinic I formerly worked at, an 85-physician multispecialty clinic in downtown Seattle, employed primarily MA's, some well-trained and certified, some not. Some of the MA's actually worked as surgical assistants. Employing MA's in lieu of RN's or even LPN's was a cost-saving measure, since the physicians had decided in the mid-1990's to accept capitated plan patients. They allowed the RN staff to shrink via attrition, and hired MA's to fill what were formerly RN positions.
In Washington state, almost anyone can work as a medical assistant, provided that a physician is willing to sponsor them--they work under the physician's licence. There are different licencing levels, called Health Care Assistant classes A-F. I know that Class A is pretty much being a warm body, and then the levels progress in responsibility and duties. I decided NOT to enroll in an MA programme primarily because of the lack of career mobility (each state has different rules for MA's) and because the programme that would allow me to become certified through the national registry was one year long, the same length as an LPN programme.
As a patient, I've had primarily good experiences with clinics staffed with MA's, except in two specific instances. The first was when I went to see my physician in the middle of the day, suffering from an acute asthma flare-up complicated by pneumonia. I needed to receive IV Solu-Medrol and Ceftin, but although the clinic was fully staffed, there were no non-physician staff members who could start or monitor an IV (the only RN's employed at the clinic were in the same-day surgery area). So, instead of saving my insurance plan money by avoiding the emergency room, I ended up being transferred by ambulance TO the emergency room just to receive the IV.
The second instance was just recently, when a Td vaccine administered to me by an uncertified (but licenced) MA resulted in a skin infection and abscess. Turned out the variety of staph cultured from the skin matched that cultured from under the MA's artificial nails.
All in all, though, I have a great deal of respect for MA's who take the time to go to school and keep up on current theory. It's not a career for me, but we all know that physicians will find ways to cut corners, and I'd rather have them employing well-trained MA's than some idiot off the street or worse, no one at all.
Good luck in your programme!
Dec 15, '02Occupation: Enterprise Application Systems Analyst Specialty: 27 year(s) of experience in Everything except surgery ; Joined: Mar '01; Posts: 5,601; Likes: 174I have heard MA calling and or allowing themselves to be called nurses. But I can't say whether or not they were CMAs or MAs. I work with a CMA and she does correct pts, and others who refer to her as a nurse. But she has a great amount of experience and knowledge, and so I know she doesn't feel inferior to the nurses in any way at all. In fact if anyone wants to know about how to do anything, they ask her.
Where I am now, they have fired all but the one CMA and are looking to replace them with RN and LPNs. In fact they got rid of 3 of them in one fell swoop. While at a going away party for one of the nurses, the remaining CMA stated she knew why she was still there. She stated she was there to train us! She has been applying for just about every job that comes along. Funny thing is that she is turned down without ever getting an interview.
At one time this hospsital allowed CMAs to give injecitons, and triage, but now she can do neither.
Now this clinic/hospital is in bad shape, as far as getting nurses to stay here, as they don't pay their staff very well. And up until they decided to get rid of their CMAs they had a very good work environment. So now they have only PT RNs, and travelers. Kind of makes you go hmmmmmm.
Dec 15, '02Joined: Jan '02; Posts: 5,673; Likes: 159Hospitals and their infinite wisdom (not), eh Brownie?
Some run off LVN's, CNA's, ...what have you. Some run off the RN's for cheaper help. Some (like yours) bring the CMA's in...and now they're running THEM off. It's like they don't have a clue....
I believe my BON states only a person who has graduated from an accredited school of NURSING can legally call themselves a nurse...I'll try and hunt it down to be sure.
Personally I don't know how hospitals can legally allow CMA's to practice within their walls...who is accountable/liable for them? The chief of staff? Have they sweet talked some RN/DON into it? Not a slam on MA's...but hospitals want someone licensed to blame when something goes wrong....
Dec 15, '02Occupation: Patient Education Specialty: 7 year(s) of experience in LDRP; Education ; Joined: Mar '01; Posts: 7,470; Likes: 56I was fairly certain 'nurse' was a protected title; at least in some states. And even if it isn't, calling oneself a nurse knowing full well the public assumes this means a licensed nurse, whether RN or LPN, is intentionally misleading and/or lying to a patient which is unethical!
Dec 15, '02Joined: Jul '02; Posts: 100; Likes: 1I worked as a medical assistant for 10 years. Now I am a registered nurse. Being a medical assistant first was, in no way, a stepping stone to becoming a nurse. None of the classes were transferrable, as the Medical Assisting classes were taken at a vocational school, and the nursing classes were taken at a community college and a state university. The only benifits I could see from being a medical assistant first was already having a knowledge ofand abbreviations, knowing already how to take BPs and how to give injections. The out patient clinic is totally different from the inpatient environment. Being a CNA or an LVN first, rather than a medical assistant, would have been more helpful to me.
Dec 15, '02Occupation: Nursing student Joined: Nov '02; Posts: 389; Likes: 10It's funny, the clinic I formerly worked at is doing the same thing now....laying off most of their uncertified MA's and replacing them with LPN's and a few RN's. It makes me wonder if the Board of Health didn't issue some new rules or something.
In this state, medical assistants are LICENSED through the BOH with the sponsorship of a physician--that physician's name actually appears on the license. The MA does not, however, have to work directly with the sponsoring physician--for instance, the MA against whom I filed a BOH complaint following the staph infection worked as a clinic float, and her sponsoring physician didn't even work in the same building. I'm not sure whether this is entirely legal or not, but that's how this clinic operates. The Board of Nursing has nothing to do with, and no responsibility for, MA's. CERTIFIED MA's are certified through the American Association of Medical Assistants. I would imagine that hospital-based MA's are on the license of the medical director of the hospital in which they're employed.
It would still make me nervous, as an RN, if an MA was working with me in hospital setting. When the s**t hits the proverbial fan and some patient sues the hospital, I'd bet that the nurse gets the blame somehow for inadequate supervision of the MA. It's a legal grey area--up until 15 or 20 years ago, most support staff in a hospital or even an outpatient setting were licenced RN's.