I know a CNA who's name badge says nurse!

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Okay, my relative by marraige is a CNA II. She works for a Dr's office that is owned by a larger hospital coorporation. Since she has worked for this office she has called herself a "nurse" and she does get to administer IM injections and do lab draws, EKG'S, immunizations, and she says she even does patient teaching. Her husband told all the parents on our ball team that if any emergency arose not to worry because his wife is a nurse. This truely irritaes me to no end because I worked my butt off to get through nursing school and sacrificed so much to get my RN. I hate the fact that she has no idea what nursing is all about. Well, the other day she got off work and I saw that her badge said nurse, not LPN or RN just nurse. Not only am I offended that she uses this title but I feel like it is very misleading to patients who see Dr's at this practice. I know there are some good unlicensed health care workers but they still do not have the background, education or right to call themselves nurses. I have not confronted her about calling herself a nurse but I see this happening in the future. Makes me wonder if the "nurses" in the office that I go to are really nurses. I think from now on I will ask, "Where did you go to nursing school," just to be safe.

Specializes in Community Health, Med-Surg, Home Health.
CMA's work under direct supervison from the physician. They physician is responsible for the CMA actions.. have no worries

Sorry, in all due respect, I have to hear that from my own governing body. I know that it sounds to you that some nurses are making a big deal over nothing, but that is really not so. And, it is not anyone condemning all or any CMAs. Nursing is a different breed. It is not better or superior, it is different. And, you have to be a nurse to really see how things can go sour for a nurse really quickly, many times, out of her/his control.

Equate it to this; if a person commits a crime, they are wrong, sure. But, if it is the parent that gets in trouble, that is one thing. But, what if there is a witness? In a court of law, the witness may be questioned as to why they didn't report what they saw or intervene.

Or imagine this scenerio; you take your child to a doctor's office, and an employee does something that may be harmful and you choose to sue. Your attorney gathers all of the information on who else works there, their status, and if they were aware of a practice or practitioner that is not performing properly. You find out that one of them is a nurse-maybe even an RN. Your attorney would be within his rights to say that that 'licensed person' knew better, should have interceded for your child and done such and such. The doctor is liable for the delegation, the nurse may be because she is 'supposed to know better' based on training. Wouldn't you go for the gusto if it was your child, mother or husband? The doctor may say "I thought she could do it, I had my nurse train her" or "she looked like she knew what to do". But, does that make a difference to you if someone you cared for was wrong?

Whether you believe it or not, this is nothing for you to be defensive about. This is not a personal attack on your person or what you do on a living, or good, caring CMAs in general. But, nurses have certainly seen, early in school, and early in their careers that this is not a friendly situation where 'everyone understands'.

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Specializes in Med-Surg Nursing.
Binkie,

Mostly we were told if JACHO or the state comes in they may ask us to see it... Something for them to ding you for if nothing else is wrong, kinda like a cop! :bugeyes:

Doesn't HR have a copy of every RN/LPN's licenses on file? I know in my state (PA) my employer has the main copy of my nursing license. I've never been asked by JCHAO to see my license. The human resource dept has it!

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Doesn't HR have a copy of every RN/LPN's licenses on file? I know in my state (PA) my employer has the main copy of my nursing license. I've never been asked by JCHAO to see my license. The human resource dept has it!

In CA you are supposed to be able to produce it if asked... HR has a copy, but it is like your drivers license, even though the DMV (like HR) has a copy you still need to be able to show it... Maybe your state is different...

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My question is this...If CMA's are considered such a high risk in clinical settings, why has this clinical assistant profession existed for the last 50 years? (aside from the financial aspects for MD's) I have no concrete opinion here either way. Just trying to understand and educate myself:clown: Thanks!

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Specializes in Community Health, Med-Surg, Home Health.

That is unusual. I haven't heard of Joint Commission asking for licenses directly from nurses, either. But, nothing is impossible with those vultures. I do have a license that is the size of a drivers ID with my picture and license number, though. I carry it around like another piece of ID, and I use it primarily for other agency jobs that have not given me an ID card, or in case I see an opportunity to apply somewhere, since I don't carry the actual paper license.

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Specializes in Med-Surg Nursing.
If you feel like you do not want to work along side of an MA then I suggest you not go to work in an office setting... My office has 8 physicans, 4 LPNS and 7 CMA's... if that tells you anything...

Seems like you have something against CMA's??? I hope I have that wrong, but I have worked just as hard as the next person.. .2 years of school and hard classes and clinicals and I deserve to be in the office helping patients just as much as the next CMA, LPN or RN... I am trained in administering medications, assisting in minor office surgerys, vital signs, venipuncture, handling medical records, and the list could go on. Its a shame that you do not feel "safe and secure" with a CMA being in the office... we are trained also.. and in my office... I do everything the LPN does... I had a LPN train me the first week I was there.... Please do not act like we are not properly trained to handle patient care, because we are

Most MA's have malpractice and liability insurance... but if not, then the physican will be liable, usually.... however, I know the nurse will not be liable.....

And again, if i mis-interrpreted your post, then I'm sorry, but that is the vibe you threw out there...

What it tells me when a Dr's office has a lot of MA's is that the Dr is TOO CHEAP to pay for a nurse!!!

So, school for a CMA is TWO YEARS???

Gee, if you're gonna invest two years of your time, why not go to school for an RN degree? Or, in 15 months be an LPN?

Sorry honey, but UNTIL you pass a NATIONAL LICENSING EXAM (NCLEX-RN, NCLEX-LPN) YOU ARE NOT AS GOOD AS A NURSE....and that is because YOU AREN'T ONE!!!! Understand???

I'm sorry because it REALLY bothers me that MA's and Nurse aides, act like they are as good as a nurse when they aren't. Nothing against them as they can be VERY helpful to me as an ICU with tasks that I DELEGATE to them but to think that you are as good as a nurse is really funny......you are not a nurse!

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My question is this...If CMA's are considered such a high risk in clinical settings, why has this clinical assistant profession existed for the last 50 years? (aside from the financial aspects for MD's) I have no concrete opinion here either way. Just trying to understand and educate myself:clown: Thanks!

Certified or noncertified Medical Assistants exist because that designation is the creation of doctors in order to cheapen the wages of those that assist them in their private practice. Why pay an RN $35 an hour when you can pay a CMA $12 an hour, if you even pay the CMA that much? My daughter worked in an office where the CMAs were being paid $9 and $10 an hour. I wonder how they were paying off the loans for their education at that rate of pay. Another example of cheap labor that adds to the weight pulling down the wages of licensed nurses.

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Sorry, in all due respect, I have to hear that from my own governing body. I know that it sounds to you that some nurses are making a big deal over nothing, but that is really not so. And, it is not anyone condemning all or any CMAs. Nursing is a different breed. It is not better or superior, it is different. And, you have to be a nurse to really see how things can go sour for a nurse really quickly, many times, out of her/his control.

Equate it to this; if a person commits a crime, they are wrong, sure. But, if it is the parent that gets in trouble, that is one thing. But, what if there is a witness? In a court of law, the witness may be questioned as to why they didn't report what they saw or intervene.

Or imagine this scenerio; you take your child to a doctor's office, and an employee does something that may be harmful and you choose to sue. Your attorney gathers all of the information on who else works there, their status, and if they were aware of a practice or practitioner that is not performing properly. You find out that one of them is a nurse-maybe even an RN. Your attorney would be within his rights to say that that 'licensed person' knew better, should have interceded for your child and done such and such. The doctor is liable for the delegation, the nurse may be because she is 'supposed to know better' based on training. Wouldn't you go for the gusto if it was your child, mother or husband? The doctor may say "I thought she could do it, I had my nurse train her" or "she looked like she knew what to do". But, does that make a difference to you if someone you cared for was wrong?

Whether you believe it or not, this is nothing for you to be defensive about. This is not a personal attack on your person or what you do on a living, or good, caring CMAs in general. But, nurses have certainly seen, early in school, and early in their careers that this is not a friendly situation where 'everyone understands'.

I would sue the person that delegated that responsiblity to the CMA.. which is the physician.. the physician delegates not the nurse.. CMAs work under physician.. call your governing body tomorrow and ask them.. if me and you were working together and I messed up, you would not be liable... the physician would.. not you..

things can go sour for anyone in the health care profession.... quicky and out of his/her control.. I have seen it many times in my profession.. We are a different breed, and, we all have important roles in the health care profession.

Its not a factor if I belive it or not... I know the nurse is not liable... nurses do not delegate to CMA's.... we work under the physician.... the only thing I can tell you is for you to contact your governing body and ask them about this.

And to respond to your child scenerio, anyone in the office, licensed, certified, or registered should intervene if someone is doing something wrong that can harm the patient, its not just the licensed nurses' responsiblity to do so, but for everyone that has direct access to patient care. If the LPN or RN sees a CMA doing something wrong that could harm a patient, and does nothing, then yes.. they could be in trouble.. and the same goes for a CMA watching a LPN or RN doing something wrong... Lets say there were other CMA's or RMA's in the office, they are certified and registared with approved medical associations and should know better also.

And to respond to committing a crime. If anyone in a health care setting; licensed, certified, or registered sees someone commit something unethical its our job to report it. If I see a LPN doing something unethical, its my job to do something about it. If I do not, I could be called upon for not reporting it, and vise versa.

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Specializes in Community Health, Med-Surg, Home Health.
My question is this...If CMA's are considered such a high risk in clinical settings, why has this clinical assistant profession existed for the last 50 years? (aside from the financial aspects for MD's) I have no concrete opinion here either way. Just trying to understand and educate myself:clown: Thanks!

What the debate is about is not that CMAs per se are high risk, but who is responsible for them if a nurse is present/aware of a daily practice and something goes wrong. In nursing school, part of training is to intervene if someone is doing something unsafe, may it be medication administration, patient teaching or tasks. If harm comes to the patient, who is ultimately responsible? The CMA works under the auspice of the physician, yes. And the physician can delegate someone to do a task for him, sure. But, if there is a negative outcome and the nurse is aware of the practice, where is her liability if the physician is responsible for the CMA and yet, she is supposed to know and intervene/act? This may mean, if the physician is responsible for this person that she cannot counsel the person, and she cannot write this person up, or report them to a governing body if it is, say, a sentinel event.

Something as simple as handing a prescription to a patient can cause problems. Say a doctor prescribed a new patient penicillin, and the patient has a history of Steven-Johnson Syndrome r/t a reaction to penicillin, the medical assistant sends the patient home (nurse does not know patient came to office for that moment) and patient takes the medication and starts developing blisters, gets admitted to hospital and almost dies. Patient decides to sue, because he reported the history, nurse was aware of history, on the premises, but went to the bathroom. Who, then, is dealing with the outcome? Now, if ALL CMAs everywhere were certified, registered or regulated, with the same education, then, maybe they can be held to task, because then, they would ALL be taught pharmacology. Nurses are taught to question or clarify with the doctor and then chart the response and intervention. A good lawyer would say that the nurse was aware of the patient's history and should have jumped in and spoke to the doctor, paged him, or whatever. But, if the nurse knows that the doctor normally lets this person do teaching or to administer penicillin shots, or whatever and didn't question, then, WHO is liable? It has nothing to do with insulting their education or competence...just who is responsible?

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Specializes in Community Health, Med-Surg, Home Health.
I would sue the person that delegated that responsiblity to the CMA.. which is the physician.. the physician delegates not the nurse.. CMAs work under physician.. call your governing body tomorrow and ask them.. if me and you were working together and I messed up, you would not be liable... the physician would.. not you..

things can go sour for anyone in the health care profession.... quicky and out of his/her control.. I have seen it many times in my profession.. We are a different breed, and, we all have important roles in the health care profession.

Its not a factor if I belive it or not... I know the nurse is not liable... nurses do not delegate to CMA's.... we work under the physician.... the only thing I can tell you is for you to contact your governing body and ask them about this.

And to respond to your child scenerio, anyone in the office, licensed, certified, or registered should intervene if someone is doing something wrong that can harm the patient, its not just the licensed nurses' responsiblity to do so, but for everyone that has direct access to patient care. If the LPN or RN sees a CMA doing something wrong that could harm a patient, and does nothing, then yes.. they could be in trouble.. and the same goes for a CMA watching a LPN or RN doing something wrong... Lets say there were other CMA's or RMA's in the office, they are certified and registared with approved medical associations and should know better also.

And to respond to committing a crime. If anyone in a health care setting; licensed, certified, or registered sees someone commit something unethical its our job to report it. If I see a LPN doing something unethical, its my job to do something about it. If I do not, I could be called upon for not reporting it, and vise versa.

Basically, we can agree to disagree on this. We are answering to two different bodies of people. Not all Medical Assistants are certified, nor is all of the education uniform. You may be able to attest for who certifies you, but you can't state how it would affect who licenses mine. What I am saying is that unless it is written and illustrated by mine and it has not really been in my neck of the woods, I can't leave it to the physician or the MA to ensure it for me.

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What it tells me when a Dr's office has a lot of MA's is that the Dr is TOO CHEAP to pay for a nurse!!!

So, school for a CMA is TWO YEARS???

Gee, if you're gonna invest two years of your time, why not go to school for an RN degree? Or, in 15 months be an LPN?

Sorry honey, but UNTIL you pass a NATIONAL LICENSING EXAM (NCLEX-RN, NCLEX-LPN) YOU ARE NOT AS GOOD AS A NURSE....and that is because YOU AREN'T ONE!!!! Understand???

I'm sorry because it REALLY bothers me that MA's and Nurse aides, act like they are as good as a nurse when they aren't. Nothing against them as they can be VERY helpful to me as an ICU with tasks that I DELEGATE to them but to think that you are as good as a nurse is really funny......you are not a nurse!

You delegate tasks to CMA's?????? tsk tsk tsk... thats really NOT ALLOWED.... :nono:

yes 2 years ... I did it b/c I wanted to do so... I love what I do... I have an associates degree in health science...

Your attitude really stinks by the way, I would HATE to be one of your patients or work anywhere around you.... health care professionals should come together to help and assist patients, and everyone should respect each other... something that you lack

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What the debate is about is not that CMAs per se are high risk, but who is responsible for them if a nurse is present/aware of a daily practice and something goes wrong. In nursing school, part of training is to intervene if someone is doing something unsafe, may it be medication administration, patient teaching or tasks. If harm comes to the patient, who is ultimately responsible? The CMA works under the auspice of the physician, yes. And the physician can delegate someone to do a task for him, sure. But, if there is a negative outcome and the nurse is aware of the practice, where is her liability if the physician is responsible for the CMA and yet, she is supposed to know and intervene/act? This may mean, if the physician is responsible for this person that she cannot counsel the person, and she cannot write this person up, or report them to a governing body if it is, say, a sentinel event.

Something as simple as handing a prescription to a patient can cause problems. Say a doctor prescribed a new patient penicillin, and the patient has a history of Steven-Johnson Syndrome r/t a reaction to penicillin, the medical assistant sends the patient home (nurse does not know patient came to office for that moment) and patient takes the medication and starts developing blisters, gets admitted to hospital and almost dies. Patient decides to sue, because he reported the history, nurse was aware of history, on the premises, but went to the bathroom. Who, then, is dealing with the outcome? Now, if ALL CMAs everywhere were certified, registered or regulated, with the same education, then, maybe they can be held to task, because then, they would ALL be taught pharmacology. Nurses are taught to question or clarify with the doctor and then chart the response and intervention. A good lawyer would say that the nurse was aware of the patient's history and should have jumped in and spoke to the doctor, paged him, or whatever. But, if the nurse knows that the doctor normally lets this person do teaching or to administer penicillin shots, or whatever and didn't question, then, WHO is liable? It has nothing to do with insulting their education or competence...just who is responsible?

I understand what you are saying, but I still say the physician is responsible. But you are right, we can agree to disagree, that works for me.

The LPN's I work with are WONDERFUL and I love working with them. We all respect each other, and as I said earlier a LPN trained me at my office. I do not look at it as whos better than who. We all help each other out in my office and look out for one another. This whole CMA/LPN issue has never been brought up in my office. I think we all are there to do a job and to help patients and we all love the medical field. And that should be enough :up:

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