Hired as LVN and doing medical assistant job

Nurses LPN/LVN

Published

Hello I am new to this forum ,I'm a new grad LVN ,I have worked as a CNA for the past 3 years . I got a job as a LVN in an outpatient clinic but there are only medical assistants there ,I'm the only LVN on this site ,and my leader is a medical assistant and all my coworkers are medical assistants , I have being trained for medical assistants . When I was hired ,I was told by the health manager that my duties as a LVN were working in the pharmacy clinic checking the meds and hand them to the patients or to the doctor ,check the immunizations,doing telephone triage and supervise the medical assistants . This is my third week of training and I have being trained only by medical assistants and doing what they do ,and they sent me to another clinic in one city 30 minutes away from my clinic site to be trained by a LV. And when I got there i have just be trained by medical assistants and this same LVN told me that I'm going work on the floor doing the same job as the medical assistants . I don't have anything against medical assistants ,most of them are very helpful ,but some are keeping telling me why I don't know some task if I'm the LVN ,is a competition all the time . Please give me some advise ,thanks

No I didn't see ,when I said that I did t see she started to tell me that I was refusing to do a job task

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Specializes in Med/Surg, LTACH, LTC, Home Health.

Just me, but I would leave. If not, tell the MA that I plan to prepare my own medications if I am to give it. If she doesn't like it, too bad. But I see that you are considered an outsider and the hostile environment was already created when the news of your arrival was announced. You can't afford to not work, true. But, given their hostility or aggression, there is a possibility that they may set you up even at the expense of harming a patient. If that happens, there (possibly) goes your career because you are taught not to give a medication that another nurse or person prepared. If the doctor won't set any boundaries between your actual scope and theirs and inform them of it (because they're not going to accept it coming from you), I would make the office door my boundary between me and them....forever....if I were you.

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In my humble opinion, you need to find other work.

It sounds like the MA's in that location have banded together to force you out. And they are successfully intimidating and creating a hostile environment for you to work in. As you are a new grad without experience in your duties, this is rather easy to accomplish. Remember, you have a license (and all the responsibilities that come with it), and they do not.

Please tell me you did not give a medication to a patient prepared by an unlicensed personnel that you didn't witness? I shuddered when I read that. I believe you are being set up to fail. Yes, you need to work I totally get that. But there are definitely other options out there. Please consider taking a position as a new grad where you will be taught/enriched/oriented/precepted to your specific duties. Right now you are in a situation where you are more or less alone. The position you describe in your OP refers to one where even an experienced nurse would have some hurdles to clear. Being a new grad with no experience makes you teachable, yes - but it also makes you expendable, able to be manipulated easily into practicing outside your scope, and a great fall guy for someone's error should a situation occur.

Have you asked yourself why the Physician hired you, a new grad, over a more experienced nurse? If you haven't, you really should. It seems to me that your hire there looks good on paper, but is bad in practice. You haven't yet had opportunity to develop your leadership skills or really know your scope of practice. And you've been thrown to the wolves.

Please, look for other work. You are in a situation where you are endangering your license. And there isn't anyone to defend, educate, and support you. It's bad all the way around by your description.

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Thanks everyone ,I talked with the my health manager and she said that she doesn't have any specific duties for LVNs and that I was going to be doing the same as medical assistants and being trained and supervised by them. She said that I was taking personally that they were attacking me ,that I should not bother when they say soemthing with sarcasm for me ,several times some of them had said that if I'm a LVN I should know more than they and I should go and complete the job task without help . As I mentioned before in the training I had a discussion with one of the MAs because she was almost forcing me to give injections that she prepared ,I didn't gave the injection and because of that they started to gossiping between them. I prepared another injection with one of them monitoring and when I went to give to the patient one of them according to the rules had to go with me to see how I was doing,so by this time all of them ignored me ,even when I stated that I needed someone to go with me so I decided to go on my own when the patient was waiting for more than 10 minutes ,when I came out from the room all of the MAs where waiting outside and the leader said that I could not give the injection by myself,than she documented saying that I gave the injection,put my first and last name and my tittle. They are trying everything to put me in a dangerous situation ,and I need to protect my license .I will look for another job ,

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Be very careful about that. Sounds like a very poor work environment.

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I know ,I already quit and got a new job ;)

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Specializes in Transitional Nursing.

Just to play devils advocate, I did the MA program once upon a time and it was the same length as the LPN program. IMO, that program absolutley prepared us to work in a doc office setting.

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I totally respect the medical assistants ,I know they are very prepared to work in a clinic setting . I had to quit because I was doing things that could cost my license ,and like I said I already got a new job,I'm very much happier now .

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I used to work at a private practice before my current job and have realized that MAs are an integral part to running the practice. Thus, I as well respect them for what they do. One noted difference is that they are task oriented where as LVNs/RNs know the reasons/background behind each task (ex. When to use z-track for IM injections, etc.). I feel that MAs have the tendency to intimidate nurses in the clinic setting because of how much we make or the level of education we have. In their eyes, they are performing the same role as the nurse in the clinic setting and in other cases many of them aspire to become nurses and cannot due to whatever personal reason. Just my 2 cents.

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Medical Assistant = Task oriented. Efficient, but little to- in some cases- no background knowledge regarding disease process/intervention/prevention/critical thinking. Medical assistants from what I've seen over the years do not receive adequate training/education to:

1. Triage, interpret data, or diagnose symptoms.

2. Independently treat patients.

3. Start, flush, or discontinue intravenous lines (there are some state exceptions)

4. Advise patients regarding their treatment regimen.

5. Make assessments or perform any kind of medical care decision making.

6. Perform invasive procedures or tests except for skin tests and drawing blood(as permitted by state law).

7. Interpret the results of blood or skin tests. Including routine labs.

8. Provide medical treatment, analyze, or interpret test results.

9. Administer any anesthetic agent (except topical numbing agents such as EMLA cream). In some states, even this is questionable.

Those are just a few things I can think of on the fly. Some of these items listed as examples the MA can become certified through the AAMA and be legally able to approach, dependent on state laws. Their duties in many cases overlap with the LPN or RN. However due to their level of training they are ideally suited in an ancillary capacity. Then there is, of course, the fact that the MA can indeed become certified, but never independently licensed. They work under the license of a physician or nurse.

In the OP's example; the MA's she was (thankfully) working with were performing duties under her license and/or scope of practice. Unless the physician was present and overseeing them him/herself. This is dangerous to her license in a number of ways. More importantly however, there definitely did not appear to be an understanding of this in either the MA's or the Nurses interactions as detailed in the OP. It is not, nor has it been, that the MA (ancillary) give orders or instructions to licensed staff. This was being accomplished though fear tactics and intimidation. Were if anything, (and I sincerely mean anything), were to go wrong you bet your buttocks that the licensed nurse will take the fall without consideration of the work environment or the physician being held responsible under their individual license for the situation.

When I was an EMT/Tech it was much the same. I could perform many duties that overlapped those of my nurses. Yet it was up to the license to make decisions regarding what tasks I would be performing and why. The fact that I could perform those tasks in a faster and more efficient manner overall was not relevant. It did make me a highly valued and requested person to have around:yes:

Sorry if that offends anyone. That's not my intention, but that is what I've seen.

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A person subordinate in job title and function put an alarm on you and another stated that you failed to do a job task when you refused to take the risk of administering something that she had prepared? I would have been gone the minute the boss said the alarm was acceptable office practice! How insulting and hazardous to boot. Glad you are gone.

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