Published Apr 4, 2008
time4meRN
457 Posts
Just woundering, how many RN's would be willing to write their BON about the need to regulate and give scope of practice for MA's in the medical feild ?
TheCommuter, BSN, RN
102 Articles; 27,612 Posts
No takers?
ohmeowzer RN, RN
2,306 Posts
i wouln't ven know how to approach the BON , they are not licensed or certified.. and they work under a mD's license... so how would you approach it? and why would the bON care, they never regulaled MA's before .. why now?? i do think they need to be regulated and yes i would write to them , but i don't think it would do any good...
HangTen!
21 Posts
The doctor I work pt for calls his MA's "nurses". I am the ONLY nurse in the office. I have told the girls it is illegal for them to identify themselves as such........but, it still goes on. One who is also an emt pt tells patients "I am the same as a nurse. I do EVERYTHING nurses do, I just don't have the license".
Me? I blow them off b/c their ignorance will Not change. It is as the other poster stated, why would the bon even do anything re this?
The doctor I work pt for calls his MA's "nurses". I am the ONLY nurse in the office. I have told the girls it is illegal for them to identify themselves as such........but, it still goes on. One who is also an emt pt tells patients "I am the same as a nurse. I do EVERYTHING nurses do, I just don't have the license". Me? I blow them off b/c their ignorance will Not change. It is as the other poster stated, why would the bon even do anything re this?
my thoughts exactly.... i don't think the BON would do anything.. i wish they would .. but they won't
HeartsOpenWide, RN
1 Article; 2,889 Posts
The BON has no control over what an MA can or can do..what their scope is, ect; they are not nurses or nurses aids so the Board of Nursing have no say in what they do. I belive the medical board however does. IN my state (california) MA's DO have a scope of practice:
http://www.medbd.ca.gov/allied/medical_assistants_questions.html
Define acceptable and appropriate training to practice as a medical assistant.Prior to performing technical supportive services, a medical assistant shall receive training, as necessary, in the judgment of the supervising physician, podiatrist or instructor to assure the medical assistant's competence in performing that service at the appropriate standard of care.Such training shall be administered in either of the following settings: 1) Under a licensed physician or podiatrist, or under a registered nurse, licensed vocational nurse, a physician assistant or a qualified medical assistant, or 2) in a secondary, post secondary, or adult education program in a public school authorized by the Department of Education, in a community college program provided for in the Education Code, or a post secondary institution accredited or approved by the Bureau for Private Postsecondary and Vocational Education in the Department of Consumer Affairs.To administer medications by intramuscular, subcutaneous and intradermal injections, to perform skin tests, or to perform venipuncture or skin puncture for the purposes of withdrawing blood, a medical assistant shall complete the minimum training prescribed in the regulations. Training shall be for the duration required by the medical assistant to demonstrate to the supervising physician, podiatrist, or instructor, as referenced in 16 CCR Section 1366.3 (a)(2), proficiency in the procedures to be performed as authorized by section 2069 or 2070 of the code, where applicable, but shall include no less than:10 clock hours of training in administering injections and performing skin tests, and/or 10 clock hours of training in venipuncture and skin puncture for the purpose of withdrawing blood, and Satisfactory performance by the trainee of at least 10 each of intramuscular, subcutaneous, and intradermal injections and 10 skin tests, and/or at least 10 venipuncture and 10 skin punctures. For those only administering medicine by inhalation, 10 clock hours of training in administering medical by inhalation. Training in (a) through (d) above, shall include instruction and demonstration in: pertinent anatomy and physiology appropriate to the procedures; choice of equipment; proper technique including sterile technique; hazards and complications; patient care following treatment or tests; emergency procedures; and California law and regulations for medical assistants In every instance, prior to administration of medicine by a medical assistant, a licensed physician or podiatrist, or another appropriate licensed person shall verify the correct medication and dosage. The supervising physician or podiatrist must authorize any technical supportive services performed by the medical assistant and that supervising physician or podiatrist must be physically present in the treatment facility when procedures are performed, except as provided in section 2069(a) of the code.Back to Top--------------------------------------------------------------------------------Are medical assistants required to be licensed or certified by the State of California to perform procedures within their "scope of practice"?No. Medical assistants are not licensed, certified, or registered by the State of California. However, the medical assistant's employer and/or supervising physician's or podiatrist's malpractice insurance carrier may require that the medical assistant be certified by a national or private association. A medical assistant must be certified by one of the approved certifying organizations in order to train other medical assistants. (Title 16 CCR 1366.3)Back to Top--------------------------------------------------------------------------------How may medical assistants legally "administer medications"?The phrase intends to mean the direct application of medication in several ways including simple injections, ingestion and inhalation or pre-measured medications. For our purposes, the phrase "administer medications" when used regarding medical assistants, means to inject, handle, or provide medications to a patient after verification by a physician, podiatrist or another appropriate licensed person.Back to Top--------------------------------------------------------------------------------Are medical assistants allowed to administer injections of scheduled drugs?If after receiving the appropriate training as indicated in Item 1, medical assistants are allowed to administer injections of scheduled drugs only if the dosage is verified and the injection is intramuscular, intradermal or subcutaneous. The supervising physician or podiatrist must be on the premises as required in section 2069 of the Business and Professions Code, except as provided in subdivision (a) of that section. However, this does not include the administration of any anesthetic agent.Back to Top--------------------------------------------------------------------------------Are medical assistants allowed to start or disconnect IV's or administer injections or medication into IV's?No. Medical assistants may not place the needle or start and disconnect the infusion tube of an IV. These procedures are considered invasive, and therefore, not within the medical assistant's scope of practice. Medical assistants are not allowed to administer medications or injections into the IV line. (Title 16 CCR 1366(b)(1))Back to Top--------------------------------------------------------------------------------Are medical assistants allowed to perform nasal smears?Yes. Only if the procedure is limited to the opening of the nasal cavity.Back to Top--------------------------------------------------------------------------------Are medical assistants permitted to perform "finger sticks"?Yes. Medical assistants are trained and allowed to draw blood as long as they have received the proper training. The procedure of finger stick is the pricking of the finger in order to collect a sample of blood. This procedure is within the "scope of practice" of a medical assistant.Back to Top--------------------------------------------------------------------------------Are medical assistants allowed to swab the throat in order to preserve the specimen in a throat culture?Yes. Medical assistants are allowed to swab throats as long as the medical assistant has received the proper training and a physician or podiatrist is on the premises.Back to Top--------------------------------------------------------------------------------Are medical assistants allowed to take a patient's blood pressure?Yes. Medical assistants are allowed to take the necessary information to prepare a patient for the physician's or podiatrist's visit. This information may include taking the patient's height, weight, temperature, blood pressure and noting the information on the patient's chart.Back to Top--------------------------------------------------------------------------------Are medical assistants allowed to give narcotic injections?Yes. At this time there are no restrictions as to what type of medications a medical assistant may inject, EXCEPT anesthetic agents, as long as the medication has been pre-verified and the injection is either intradermal, intramuscular, or subcutaneous. (16 CCR 1366 (b)(1)). Both 1366 and Business and Professions Code section 2069 provide that they shall not be construed as authorizing the administration of any anesthetic agent by a medical assistant."Back to Top--------------------------------------------------------------------------------Are medical assistants allowed to have access to the keys of the narcotic medication cabinet?This question should be directed to the supervising physician or podiatrist as it is an "in-house" procedure and the decision must be made by the supervising physician or podiatrist.Back to Top--------------------------------------------------------------------------------Are medical assistants allowed to chart pupillary responses?No. The charting of pupillary responses is considered an assessment, which is a form of interpretation. Medical assistants are not allowed to read, interpret or diagnose symptoms or test results.Back to Top--------------------------------------------------------------------------------Are medical assistants allowed to insert urine catheters?No. Insertion of a urine catheter is considered an invasive procedure and therefore, not within the medical assistant's scope of practice.Back to Top--------------------------------------------------------------------------------Are medical assistants allowed to perform telephone triage?No. Medical assistants are not allowed to independently perform telephone triage as they are not legally authorized to interpret data or diagnose symptoms.Back to Top--------------------------------------------------------------------------------Are medical assistants allowed to inject collagen?No. The injection of collagen does not fall within the medical assistant's scope of practice. 16 CCR section 1366.4 states that medical assistants may inject "medications".Back to Top--------------------------------------------------------------------------------Are medical assistants allowed to use lasers to remove hair, wrinkles, scars, moles or other blemishes?No. Medical assistants are not legally authorized to use lasers to remove hair, wrinkles, scars, moles, or other blemishes.Back to Top--------------------------------------------------------------------------------Are medical assistants allowed to administer chemotherapy and/or monitor patients?No. Medical assistants are not legally authorized to administer chemotherapy or make an assessment of the patient as the procedure does not fall within the medical assistant's scope of practice.Back to Top--------------------------------------------------------------------------------Are medical assistants allowed to apply orthopedic splints in emergency situations, such as splints in a physician's office?No. Medical assistants are legally authorized only to remove casts, splints and other external devices. Placement of these devices does not fall within the medical assistant's scope of practice. Please reference CCR Section 1366(b)(3).Back to Top--------------------------------------------------------------------------------Are medical assistants allowed to interpret the results of skin tests?No. Medical assistants may measure and describe the test reaction and make a record in the patient's chart. For every questionable test result, the result should be immediately brought to the physician's attention. In addition, all results need to be reported to the appropriate provider. Please reference 16 CCR 1366(b)(2).Back to Top--------------------------------------------------------------------------------Can medical assistants be supervised by a nurse practitioner, nurse midwife, or physicians assistant in the absence of a physician and surgeon?Per Business and Professions Code section 2069 (a)(1), a supervising physician and surgeon at a "community clinic" licensed under Health and Safety Code section 1204(a) may, at his or her discretion, in consultation with the nurse practitioner, nurse midwife, or physician assistant provide written instructions to be followed by a medical assistant in the performance of tasks or supportive services. The written instructions may provide that the supervisory function for the medical assistant in performing these tasks or supportive services may be delegated to the nurse practitioner, nurse midwife, or physician assistant and that those tasks may be performed when the supervising physician and surgeon is not on site.Back to Top--------------------------------------------------------------------------------Can medical assistants call in refills to a pharmacy?Yes. Under the direct supervision of the physician or podiatrist, a medical assistant may call in routine refills that are exact and have no changes in the dosage levels. The refill must be documented in the patient's chart as a standing order, patient specific. Medical assistants may not call in new prescriptions or any prescriptions that have changes. The physician should view carefully his or her decision to allow medical assistants to perform this task, as the authority to prescribe or refill prescriptions is only granted to licensed physicians and surgeons, podiatrists, or those individuals authorized by law to do so.Back to Top--------------------------------------------------------------------------------Can medical assistants perform hearing tests?Yes. Medical assistants may perform hearing tests under the direct supervision of a licensed physician and surgeon or podiatrist. This procedure is within the scope of practice of a medical assistant. Per Business and Professions Code section 2530.5(a), "Nothing in this chapter shall be construed as restricting hearing testing conducted by licensed physicians and surgeons or by persons conducting hearing tests under the direct supervision of a physician and surgeon."Back to Top--------------------------------------------------------------------------------Are medical assistants allowed to administer flu shots?Yes. After receiving the appropriate training as indicated in the first question, medical assistants are allowed to administer influenza vaccinations in a clinic or physician's office settings. The dosage must be verified and the supervising practitioner must be on the premises as required in section 2069 of the Business and Professions Code, except as provided in subdivision (a) of that section.However, if the shot is being provided at a local governmental or private, nonprofit agency the vaccine shall be administered only by a physician, a registered nurse, or a licensed vocational nurse acting within the scope of their professional practice acts. The physician under whose direction the registered nurse or a licensed vocational nurse is acting shall require the nurse to satisfactorily demonstrate familiarity with (1) contraindication for the administration of such immunizing agents, (2) treatment of possible anaphylactic reactions, and (3) the administration of treatment, and reactions to such immunizing agents. (Health & Safety section 104900(e))
Prior to performing technical supportive services, a medical assistant shall receive training, as necessary, in the judgment of the supervising physician, podiatrist or instructor to assure the medical assistant's competence in performing that service at the appropriate standard of care.
Such training shall be administered in either of the following settings: 1) Under a licensed physician or podiatrist, or under a registered nurse, licensed vocational nurse, a physician assistant or a qualified medical assistant, or 2) in a secondary, post secondary, or adult education program in a public school authorized by the Department of Education, in a community college program provided for in the Education Code, or a post secondary institution accredited or approved by the Bureau for Private Postsecondary and Vocational Education in the Department of Consumer Affairs.
To administer medications by intramuscular, subcutaneous and intradermal injections, to perform skin tests, or to perform venipuncture or skin puncture for the purposes of withdrawing blood, a medical assistant shall complete the minimum training prescribed in the regulations. Training shall be for the duration required by the medical assistant to demonstrate to the supervising physician, podiatrist, or instructor, as referenced in 16 CCR Section 1366.3 (a)(2), proficiency in the procedures to be performed as authorized by section 2069 or 2070 of the code, where applicable, but shall include no less than:
10 clock hours of training in administering injections and performing skin tests, and/or
10 clock hours of training in venipuncture and skin puncture for the purpose of withdrawing blood, and
Satisfactory performance by the trainee of at least 10 each of intramuscular, subcutaneous, and intradermal injections and 10 skin tests, and/or at least 10 venipuncture and 10 skin punctures.
For those only administering medicine by inhalation, 10 clock hours of training in administering medical by inhalation.
Training in (a) through (d) above, shall include instruction and demonstration in:
pertinent anatomy and physiology appropriate to the procedures;
choice of equipment;
proper technique including sterile technique;
hazards and complications;
patient care following treatment or tests;
emergency procedures; and
California law and regulations for medical assistants
In every instance, prior to administration of medicine by a medical assistant, a licensed physician or podiatrist, or another appropriate licensed person shall verify the correct medication and dosage. The supervising physician or podiatrist must authorize any technical supportive services performed by the medical assistant and that supervising physician or podiatrist must be physically present in the treatment facility when procedures are performed, except as provided in section 2069(a) of the code.
Back to Top
--------------------------------------------------------------------------------
Are medical assistants required to be licensed or certified by the State of California to perform procedures within their "scope of practice"?
No. Medical assistants are not licensed, certified, or registered by the State of California. However, the medical assistant's employer and/or supervising physician's or podiatrist's malpractice insurance carrier may require that the medical assistant be certified by a national or private association. A medical assistant must be certified by one of the approved certifying organizations in order to train other medical assistants. (Title 16 CCR 1366.3)
How may medical assistants legally "administer medications"?
The phrase intends to mean the direct application of medication in several ways including simple injections, ingestion and inhalation or pre-measured medications. For our purposes, the phrase "administer medications" when used regarding medical assistants, means to inject, handle, or provide medications to a patient after verification by a physician, podiatrist or another appropriate licensed person.
Are medical assistants allowed to administer injections of scheduled drugs?
If after receiving the appropriate training as indicated in Item 1, medical assistants are allowed to administer injections of scheduled drugs only if the dosage is verified and the injection is intramuscular, intradermal or subcutaneous. The supervising physician or podiatrist must be on the premises as required in section 2069 of the Business and Professions Code, except as provided in subdivision (a) of that section. However, this does not include the administration of any anesthetic agent.
Are medical assistants allowed to start or disconnect IV's or administer injections or medication into IV's?
No. Medical assistants may not place the needle or start and disconnect the infusion tube of an IV. These procedures are considered invasive, and therefore, not within the medical assistant's scope of practice. Medical assistants are not allowed to administer medications or injections into the IV line. (Title 16 CCR 1366(b)(1))
Are medical assistants allowed to perform nasal smears?
Yes. Only if the procedure is limited to the opening of the nasal cavity.
Are medical assistants permitted to perform "finger sticks"?
Yes. Medical assistants are trained and allowed to draw blood as long as they have received the proper training. The procedure of finger stick is the pricking of the finger in order to collect a sample of blood. This procedure is within the "scope of practice" of a medical assistant.
Are medical assistants allowed to swab the throat in order to preserve the specimen in a throat culture?
Yes. Medical assistants are allowed to swab throats as long as the medical assistant has received the proper training and a physician or podiatrist is on the premises.
Are medical assistants allowed to take a patient's blood pressure?
Yes. Medical assistants are allowed to take the necessary information to prepare a patient for the physician's or podiatrist's visit. This information may include taking the patient's height, weight, temperature, blood pressure and noting the information on the patient's chart.
Are medical assistants allowed to give narcotic injections?
Yes. At this time there are no restrictions as to what type of medications a medical assistant may inject, EXCEPT anesthetic agents, as long as the medication has been pre-verified and the injection is either intradermal, intramuscular, or subcutaneous. (16 CCR 1366 (b)(1)). Both 1366 and Business and Professions Code section 2069 provide that they shall not be construed as authorizing the administration of any anesthetic agent by a medical assistant."
Are medical assistants allowed to have access to the keys of the narcotic medication cabinet?
This question should be directed to the supervising physician or podiatrist as it is an "in-house" procedure and the decision must be made by the supervising physician or podiatrist.
Are medical assistants allowed to chart pupillary responses?
No. The charting of pupillary responses is considered an assessment, which is a form of interpretation. Medical assistants are not allowed to read, interpret or diagnose symptoms or test results.
Are medical assistants allowed to insert urine catheters?
No. Insertion of a urine catheter is considered an invasive procedure and therefore, not within the medical assistant's scope of practice.
Are medical assistants allowed to perform telephone triage?
No. Medical assistants are not allowed to independently perform telephone triage as they are not legally authorized to interpret data or diagnose symptoms.
Are medical assistants allowed to inject collagen?
No. The injection of collagen does not fall within the medical assistant's scope of practice. 16 CCR section 1366.4 states that medical assistants may inject "medications".
Are medical assistants allowed to use lasers to remove hair, wrinkles, scars, moles or other blemishes?
No. Medical assistants are not legally authorized to use lasers to remove hair, wrinkles, scars, moles, or other blemishes.
Are medical assistants allowed to administer chemotherapy and/or monitor patients?
No. Medical assistants are not legally authorized to administer chemotherapy or make an assessment of the patient as the procedure does not fall within the medical assistant's scope of practice.
Are medical assistants allowed to apply orthopedic splints in emergency situations, such as splints in a physician's office?
No. Medical assistants are legally authorized only to remove casts, splints and other external devices. Placement of these devices does not fall within the medical assistant's scope of practice. Please reference CCR Section 1366(b)(3).
Are medical assistants allowed to interpret the results of skin tests?
No. Medical assistants may measure and describe the test reaction and make a record in the patient's chart. For every questionable test result, the result should be immediately brought to the physician's attention. In addition, all results need to be reported to the appropriate provider. Please reference 16 CCR 1366(b)(2).
Can medical assistants be supervised by a nurse practitioner, nurse midwife, or physicians assistant in the absence of a physician and surgeon?
Per Business and Professions Code section 2069 (a)(1), a supervising physician and surgeon at a "community clinic" licensed under Health and Safety Code section 1204(a) may, at his or her discretion, in consultation with the nurse practitioner, nurse midwife, or physician assistant provide written instructions to be followed by a medical assistant in the performance of tasks or supportive services. The written instructions may provide that the supervisory function for the medical assistant in performing these tasks or supportive services may be delegated to the nurse practitioner, nurse midwife, or physician assistant and that those tasks may be performed when the supervising physician and surgeon is not on site.
Can medical assistants call in refills to a pharmacy?
Yes. Under the direct supervision of the physician or podiatrist, a medical assistant may call in routine refills that are exact and have no changes in the dosage levels. The refill must be documented in the patient's chart as a standing order, patient specific. Medical assistants may not call in new prescriptions or any prescriptions that have changes. The physician should view carefully his or her decision to allow medical assistants to perform this task, as the authority to prescribe or refill prescriptions is only granted to licensed physicians and surgeons, podiatrists, or those individuals authorized by law to do so.
Can medical assistants perform hearing tests?
Yes. Medical assistants may perform hearing tests under the direct supervision of a licensed physician and surgeon or podiatrist. This procedure is within the scope of practice of a medical assistant. Per Business and Professions Code section 2530.5(a), "Nothing in this chapter shall be construed as restricting hearing testing conducted by licensed physicians and surgeons or by persons conducting hearing tests under the direct supervision of a physician and surgeon."
Are medical assistants allowed to administer flu shots?
Yes. After receiving the appropriate training as indicated in the first question, medical assistants are allowed to administer influenza vaccinations in a clinic or physician's office settings. The dosage must be verified and the supervising practitioner must be on the premises as required in section 2069 of the Business and Professions Code, except as provided in subdivision (a) of that section.
However, if the shot is being provided at a local governmental or private, nonprofit agency the vaccine shall be administered only by a physician, a registered nurse, or a licensed vocational nurse acting within the scope of their professional practice acts. The physician under whose direction the registered nurse or a licensed vocational nurse is acting shall require the nurse to satisfactorily demonstrate familiarity with (1) contraindication for the administration of such immunizing agents, (2) treatment of possible anaphylactic reactions, and (3) the administration of treatment, and reactions to such immunizing agents. (Health & Safety section 104900(e))
mscsrjhm
646 Posts
Have you shown the Doctor and the MAs your state statute regarding the term "nurses"? (Some states do not have laws regarding the term).
Does the Office Manager have any pull?
DutchgirlRN, ASN, RN
3,932 Posts
have you shown the doctor and the mas your state statute regarding the term "nurses"? (some states do not have laws regarding the term).
doctors who call their ma's nurses know very well that they are not nurses but unfortuneately the money in their pocket speaks louder than the brain in their head. there is absolutely nothing wrong with being an ma. the problem comes only when they refer to themselves as nurses. a person who calls themself a nurse is an imposter no matter which state they live in. sorry that doesn't hold any water.
pagandeva2000, LPN
7,984 Posts
If the BON will not define their scope of practice, then, some governing body should. My personal opinion is that they do perform many nursing duties, therefore, should fall under the BON. Each of the skills they perform somehow ties to patient safety and better outcomes, may it be vital signs, specimen collection, scheduling, basic teaching, filing billing claims and such. If the BON took over, then, it would be easier to define their role in allied health.
RN1989
1,348 Posts
I will if there are enough people to stand with me. I just don't have the time or energy to try to take this situation on by myself because as one person, I would never get anywhere on this particular issue.
BinkieRN, BSN, RN
486 Posts
I don't know that I would go the the BON about anything. If a person is a fake nurse they will end up putting the noose around their own neck, sooner or later.
nursemedic78
17 Posts
MA's don't fall under the jurisdiction of the board of nursing in any state I've lived in...