How do Nurses feel about CMAs?

Neon8 · Dec 15, 2002

I 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 of medical terminology and 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.

RN2B2005 · Dec 16, 2002

It'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.

Brownms46 · Dec 16, 2002

Originally posted by Susy K
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!

I totally agree! Didn't say I liked hearing those who are MAs or CNAs or tech calling themselves a "nurse"....just know that they're those who do it. But the word "nurse" is even used in Church organizations.

Brownms46 · Dec 16, 2002

Originally posted by RN2B2005
It'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.
Since I have worked with MAs in Seattle, I know they do not have to be licensed by the BON. They come under the BON only if they're allowed to give injecitons or draw blood. When I did a contract at Group Health, their MAs weren't allowed to do either.
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.
From what I have read you're totally right in your assumption that hospital based MAs would come under the medical Director of a hospital.
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.

I ran into a situation similar in a clinic where an MD was allowing a totally untrained "assistant" to give injections/meds, and she had NO idea of what she was doing! I and others had to stop her from doing some stupid stuff, and giving bad info out. We were very worried about this "assistant", so we called the BON, and was informed this person worked under the MD's license and he was the one responsible for her actions. We still watched her to protect unsuspecting pts., from her ignorance!

Brownms46 · Dec 16, 2002

Originally posted by mattsmom81
Hospitals 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....

You're right mattsmom, they don't have a clue. Their too busy trying to get in a quick fix, and get the pressure off them no matter who it affects.

I think the reason there is in some places a trend toward bringing in licensed staff as opposed to MAs is so these folks will have someone to blame the crap on! The docs are dealing with higher malpractice insurance, and I believe this is one way some are using to get some of the load off on them and onto nurses. So if they screw up, they can have someone to blame. I think it's all about the numbers game now. I know it's not for the benefit of better pt. care!

CMAMW · Dec 16, 2002

Thanks again for replying to my original post. There is a lot of good responses. As a CMA in training I understand that it is not a stepping stone to Nursing. Medical Assisting is a completely separate profession with different training. I do not agree with uneducated people working as MAs. I also live in Washington state, like RN2B2005, and we have more strict laws concerning MAs. The clinics in my area do not hire MAs unless they are certified or are in the process of certification. I do not agree with CMAs calling themselves nursing and neither does the professional community of CMAs, such as the AAMA. CMAs are not trained to work in hospitals, LPNs and RNs are. We are trained to work in ambulatory care settings. A licensed physician MUST be present in the building in order for CMAs to provide the care that has been delegated. It is important for those who enter the profession or that has been in the MA profession that clinics are where we are trained to work, not hospitals. It is the phsyician's duty as the delegator of the CMA to supervise and weed out the unqualified MAs. CMAs also are recommended to carry malpratice insurance and can be sued. But usually the physician and clinic are the ones people go after because they have more insurance and more money. In my humble opinion, CMAs are valuable to the healthcare team of MDs, NP, PAs, RNs, LPNs and other staff. We need to all work together to provide the best possible care to the patient.

Also CMA is the stepping stone to becoming a PA.

I've said my peace, thank you again.

Brownms46 · Dec 16, 2002

In my humble opinion, CMAs are valuable to the healthcare team of MDs, NP, PAs, RNs, LPNs and other staff. We need to all work together to provide the best possible care to the patient.

.

Totally agree! I have worked with and currently with excellent MAs and CMAs. I worked with MAs in Seattle who weren't CMAs, but they were still excellent never the less. The CMA where I am currrently has been an excellent resource, and is an excellent person to work with. I enjoy everyday I have the pleasure of working with her. I pray each day she doesn't leave before my contract is up, as she is the only one except for two PT RNs who knows what is what around there! :cool: We would many times be lost without her expertise, as she has been with the hospital for over 20yrs now.

CMERN · Dec 16, 2002

As pertaining to MA NOT being a stepping stone to R.N....well you CAN make it any thing you want... As far as that goes.

MA's do not have the anatomy and Pathology training that R.N.s have. Ma's arent trained with patient care as a primary focus. Mybest medical terminology teaching was obtained through M.A. program TO each his own..

mattsmom81 · Dec 16, 2002

MA's and PA's and docs are trained using the medical model. They must work under a sponsoring physician.

CNA's, nurses and NP's are trained using the nursing model. CNA's work under a nurse and NP's are independent practitioners.

I believe docs invented MA's and PA's because nurses moved into their own profession and away from them. They wanted ownership, control and all that. And of course docs delegate most of their shytwork to their PA's....and MA's are much cheaper than nurses....so this is all to benefit docs IMO.

Sekar · Jan 9, 2003

Brownms46 wrote: "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." Brownms46 you did miss it. Here is an excerpt from the NC State Law GS 90-171.3 states that "No Cap, Pin, Uniform, Insignia, or Title shall be used to represent to the public that an unlicensed person is a Registered Nurse or Licensed Practical Nurse". So by law, in the state of North Carolina, a MA cannot refer to themselves as a Nurse.

Anytime I catch the MAs in my clinic being referred to as Nurses by the Doctors, Staff, Patients, or by themselves I immediately correct them. I worked hard to earn the title Nurse and I'm not going to stand idly by and allow someone who is not a licensed nurse to be refered "Nurse".

It is not arrogance at work here. I think it is a good law, it protects the public from receiving care from a unlicensed person who is misrepresenting themselves as a licensed person. The public has the right to know who is working on them and what level of certification / licensure that person possesses. I hope more states will adopt such laws in the near future.

WA-Educator · Mar 14, 2003

Originally posted by RN2B2005
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.

Actually, in Washington State CMAs who are performing invasive procedures such as venipuncture and injections must registered under the Health Care Assistant Law (Chapter 18.135 RCW) In order to register under the HCA Law, they must prove college level education in A & P, Pathology, microbiology, asepsis, math & dosage calculations, pharmacology, administration of medications, and more. But, they are not licensed. They are then Certified Medical Assistants who are Registered with the Dept of Health under the HCA Law. I know its confusing, but what bureaucratic process isn't? They accept delegation only from their physician employers and their physician delegators must be in the building when injections are given. Remember, CMAs assist physicians, NAC/CNAs assist nurses.

:)

CMAMW is absolutely right, CMAs are very much encouraged to carry personal Liability Insurance. They are subject to the Uniform Disciplinary Act of Washington State - Regulations of Health Professions (Chapter 19-130 RCW)

It sounds like some of you are running into generic medical type workers who are calling themselves "medical assistants" (or nurses) but who are neither. They actually are giving professional CMAs a tainted image.

BTW, "nurse" is a title in Washington State that is protected by law. (I don't have the exact RCW, but its in the Nursing Law). The only people who may refer to themselves as nurses or allow others to believe they are nurses are those people who actually hold a license as an LPN, RN, or (interestingly enough) the Christian Science Nurse.

Great discussion forum!!!

:)

MrsK1223 · Mar 14, 2003

I started out as a CMA, went thru a year long intensive program and did some very good clinicals, some were 5 days a week 8 hrs a day. When graduating school, I ran the front business office for a dermatology office. Occasionally I would give an injection or assist in a procedure. I went on and got an Associate degree in nursing and it is a whole new world. I think medical assistants are a good thing but I think they are being utilized in some things where there should really be nurses. I loved office nursing but I could not find a job in an office or clinic because they have replaced us with MA's, and has alot to do with $$$$$...they don't want to pay nurses. Medical assistants can go either towards administrative duties or patient care...that gave me an advantage cause I knew a lot about insurance, could do transcription and a multitude of other things and I can still use those skills if I ever want to get out of nursing/patient care.

But I will tell you this....I was recently at an interview for a nursing position and found out afterwards that the two women that interviewed me were medical assistants....I about fell over...what the hell do they know about nursing in order to make an informed decision, needless to say they looked like hoochies from sunset blvd and I knew before the interview was over that I was not taking the job...not because they were MA's but how they presented themselves and it just added insult to find out MA's were making a decision about an RN position. Makes no sense.