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How can I found out which states allow medical assitants to give IV medications?
A medical assistant has from what I understand, a six months course, not taught by anyone in the medical field , but by a college instructor. Their training is more about "office"/reception training. I as a LPN, had 12 full months of training , lived in a dorm next to the hospital. We had 12 instructors and rotated through every service, we were trained in IM, sub-q and the giving of oral meds, including the Z-track method. We had to be checked off 3 times for every procedure we would have to do once working, as a LPN. We back then, even mixed eg. ms tab, with sterile h2o and had to know and figure out the proper dosage to give, once mixed. I've had IV training and Telemetry training along with the R.N.'s in same classroom. LPN's and R.N.'s are now trained in a community college, 2 semmesters and your LPN, 2 more and your R.N. Most of them spend 4 hrs 3 days a week working in a hospital. We had one work on our Respiratory care unit, who spelled Gall Bladder..Gull bladder......we found out 3 months after boards and after she had worked as a R.N. on a Sub-Acute Respiratory unit , that she didn't pass her boards....she was dismissed......we also had a doctor working there who had never went to med school and was practicing as a surgeon???????? Once he was found out , he was dismissed, And now , in our state they HAVE to not just take a doctors word for his schooling,but must unlike what they were doing , check on his credentials , verfying their reality. Anyway, I've also worked in docors office where M.A.'s were employed , they made $7.00/hr.(cheap doctors), I made $14.00. she was doing call- backs for the doctor that day and I could't believe the inaccurate knowledge she was giving that patient and that she was allowed to prescribe what she thought the doctor would order for that patient..........the patients thought she was a nurse, which is why we should go back to wearing our uniforms and caps........in order to differienate us from CNA's, MA's, and orderly, and doctors.........patients have no idea who is who these days......and everyone including the CNA's think they are nurses. Doctors hire them because they are cheap and M.A.'s are nationally certified........they have no license to loose........such as we do.......therefore they are less liability for the doctor........but maybe that is why there are more lawsuits against doctors also......because they are ultimately liablle........but then if no one knows what the hell was done or told or if they don't know an error when they see one....who the heck knows what harm was done by misinformation given or anyway the whole mess is dangerous if you ask me..........and the M.A.'s have taken the LPN's job away from her in the doctors offices and R.N.'s and CNA's ( doing telemetry checks, accuchecks) in the hospitals has taken the LPN's job away from us, and the CNA's in the ASSisted Living facilities doing all the medications has taken the LPN"s job away from us........so consequently over 500,000 LPN"s are out of work!!!!!!!!! I've seen some major errors happen in a assisted living facility done by CNA"s.......they asked me to supervise them and be repsonsible for their med passes.......they were so cocky........thought they were somethin....they had a ex-truck driver giving meds and if he didn'twant to give it , he didn't....a EMT gave 30mg Oxycontin , normally given to 230# F, to a 90# F, who was suppose to get 10mg......well, I quit , no way were they going to use my license for those kids who were too cocky to teach anything to.......I mean, where is the list of M.A.'s and CNA.'s who have lost their licenses.........I'll bet there is no way for them to jeopardize their credentials......that's why the system uses them.......but don't blame the nurse for poor nursing care.....or for a nursing shortage, because us well trained LPN's would love to work again.......
Not trying to flame here, BUT most facilites have a dress code/color of scrub for the level of care being provided. I don't want to ever crawl in another nursing uniform with a cap!
I have heard nightmares about nursing homes. I wouldn't work at all if it came down to having to work in that environment. I have talked with friends that have. They said the CNAs were horrible to work with. They had smart mouths and would actually refuse to follow orders.
I have actually had a previous nightmare with a CMA at my son's Pediatrician. My son already had a URI. The MD put him on Augmentin oral susp. He was still having a runny nose etc.. He is 2 y/o. I was going to try a little Benadryl Allergy for Peds. I had left my nursing drug handbook at home. I called the office and the CMA answered the phone. I told her I needed to talk with the MD on dosing since the bottle stated to consult a physician for children 6 y/o and under. I gave her my cell number. She called back with the dose. She said 3-4 tsp q4-6. I just didn't think that was right. When I got home I checked against my drug book. My heart sank! That would have been 50mgs! Every 4-6 hours! I called back. This time the receptionist answered the phone. I probably took off her ear, LOL, but I said I wanted to talk to the MD right now! He came to the phone. I bereated him over his careless call on the dosing and he said had no knowledge of the call. I told him I had talked to his CMA and left word with her to give him the message. He said he didn't recieve it. He gave me the proper dose and I asked to talk to the CMA. I told her to never do that again. I let her know that the dose she was giving "ordering" could have killed my son. She said it was right there in HER nursing drug handbook. She started with a story that she had been a EMT at one time and is certified as a CMA.
I asked to speak with the Administrator of the practice. I told her of the incident. She said she would address this immediately. The next time I went in she had been replaced with a LPN. That made me feel more comfortable. I knew working with LPNs that they would follow orders and remember they had a license on the line. Not knocking all CMAs, but most want to play "Nurse Betty" and not think of the seriousness. Scrubs do not make you a nurse, a license does...
I am presently not working as a LPN, because all I am able to work in presently, it seems is in nursing homes, and I"ve had enough nightmares in those places. CNA's are horrible to get along with, they are all insubordinate most of the time.......and have gotten my butt in trouble more times than not, They also think they know more than a nurse. I think I know why they are protected so much.......by administration. I checked out the National Board of Nursing out of Chicago one day and their idea of who is most important in giving care in a nursing home is the CNA's and the Social Workers.......!!!!!!!!!!! I had a Social Worker for a head nurse once! That's illegal for us to take delegated orders from someone outside of our profession! Everytime I would consult with her about a issue , she would say, I don't know I'm not a nurse! Then the gave the position to a R.N./Chiropractor.....who had no experience with nursing , but at least yah could communicate with her ......then she became the head of Human Rsources and they hired a CNA/with a some corrspondance course /degree in Administration and she became the head nurse!!!!!!!!!! I left, she discounted the nurses and stuck up for the CNA's all the time.........I left........another place I worked everyone in social work and administration brought their dogs to work.....and the social worker carried her two dogs everywhere she went....I never once had her discuss a careplan with us or see her talking to a patient.......the CNA's were allowed to sleep on their lunch hours......and then allowed them to put the patients to bed right after supper, (illegal without an acitivity)....the maintence dept, was always playing darts in their office and grilling their diners in their office on a outdoor grill.....they were allowed to shut the lights off, per timer, at 7:40pm......when us nurses were still passing meds til 9:00pm!And this place was suppose to be citation free last year! I spoke with all my bosses about this but they did nothing about it...there is much more....but anyway I quit. Half the people yah work with have very little experience, like I have.......I swear their brain dead.....and hell bent on making a profit and to hell with patient care...rules or regs. No body cares in those places if they do things right.....because they don't have the most experienced nurses running the place.......its like working in a human factory,,,I swear their all non-thinking , non compassionate people who are just doing a job they know nothing about!!!!!!!Its a crime if you ask me.....and there they have no air conditioning and the CNA's told me its 110 degrees in there in the summer.! Can you imagine......I wish the state would let me be an inspector.........instead of a an R.N. who knows nothing about what to look for in those places or when.....
As far as the M.A.s........I took care of a elderly man in a homecare case....he was on Coumadin 5mg, Lasix 80mg BID, and can't think of the other meds...but 1 for HTN, 2 others for CHF, all of which slow your heart rate down....when I stated taking care of him, his pulse was running 36-48/min......he was fatiqued, diarrhea, pale, I called the doctor's office and we got him in to see the cardiologist.......his HGB. 10.2 (low for a male), and instead of changing his meds, the doc, put hiim on iron and increased his med doses...and then wanted him to get a pacemaker.......he was also throwing some PVC's.......he refused it......didn't want it.....so his pulse continued to be low....and irregular........I called and spoke with the MA,who I also had to ask her credentials, she calls back and said she had spoke with the doctor to increase his med doses again!!!!!!!!!! I couldn't believe it....I went over to the pharmacy to pick them up and talked with the pharmacist who also after hearing about the case, agreed with me to wait on getting the meds and call the doctors office the next day and ask to speak with him......I did and for some reason, I talked with the R.N., who worked PT there.I told her the scenerio and she also, couldn't believe what the MA had called into the pharmacy.......for this patient......she got a hold of the doctor and reduced his med doses had me take him in for more blood work and once we got him straightened around , he had more energy, less insomnia, less falling (which could have been from episodes of V-Tach).......and he generally felt better......but if I had done what that MA said to do, and what she claimed the doctor said to do.....that man would have died from the side effects of those
drugs. Why would a cardiologist have a MA working for him anyway? But yah know , I have worked with R.N.'s who are afraid to communicate with the doctors, what's with that anyway?
That's the only way , we the adminstrators of the medications they order , can help the doctor know what those drugs are doing over time........they expect us to be looking for those problems and to let them know......It really bugs me that a doctor would hire a MA to do anymore than medical billing and reception duties......Those doctors need to go back to hiring nurses......don't yah think.???? Its there fault in the first place!
CALIFORNIA BUSINESS AND PROFESSIONS CODE
MEDICAL PRACTICE ACT
Section 2069
(1) (A) Notwithstanding any other provision of law, a medical assistant may administer medication only by intradermal, subcutaneous, or intramuscular injections and perform skin tests and additional technical supportive service upon the specific authorization and supervision of a licensed physician and surgeon or a licensed podiatrist.
Medical Assistants are not allowed to give IV medications in California. The required training for the giving of injections is clearly spelled out in the Business and Professions Code. A doctor or licensed nurse must check and initial all injections prior to administration by the MA. Most clinics do not allow MAs to administer controlled substances, insulin, or allergy shots.
The MA functions under the doctor's license, therefore the doctor is liable for everything that the MA does. The doctor usually delegates the training and supervision of the MA to a licensed nurse. California Law forbids the Medical Assistant from identifying themselves as "nurses" to patients.
RE to your reply.
I am a LPN, not a medical assistent, and in your comments, it looks like California is refering to medical assistents, not LPN's or LVN's. I did not know there was any rules and regs for a medical assistent , M.A. . Is California getting us confused? Because the M.A.s, tend not know their scope of practice. M.A.'s have a national certifivation , not a license. LPN's./LVN's, take state boards, after graduating from an accredited school. There is some confusion around a M.A.'s scope of training and performance. Who defines it for them? Can you claify, whom your refering to when the law reads -------medical assistents........cause that could mean anyone off the street, unless the law refers to a licensed LPN/LVN or R.N...........does a M.A. take a state board? How do they obtain their M.A. and who oversees their performance?
Please respond. thank-you.
Originally posted by TCJanI am presently not working as a LPN, because all I am able to work in presently, it seems is in nursing homes, and I"ve had enough nightmares in those places. CNA's are horrible to get along with, they are all insubordinate most of the time.......and have gotten my butt in trouble more times than not, They also think they know more than a nurse. I think I know why they are protected so much.......by administration. I checked out the National Board of Nursing out of Chicago one day and their idea of who is most important in giving care in a nursing home is the CNA's and the Social Workers.......!!!!!!!!!!! I had a Social Worker for a head nurse once! That's illegal for us to take delegated orders from someone outside of our profession! Everytime I would consult with her about a issue , she would say, I don't know I'm not a nurse! Then the gave the position to a R.N./Chiropractor.....who had no experience with nursing , but at least yah could communicate with her ......then she became the head of Human Rsources and they hired a CNA/with a some corrspondance course /degree in Administration and she became the head nurse!!!!!!!!!! I left, she discounted the nurses and stuck up for the CNA's all the time.........I left........another place I worked everyone in social work and administration brought their dogs to work.....and the social worker carried her two dogs everywhere she went....I never once had her discuss a careplan with us or see her talking to a patient.......the CNA's were allowed to sleep on their lunch hours......and then allowed them to put the patients to bed right after supper, (illegal without an acitivity)....the maintence dept, was always playing darts in their office and grilling their diners in their office on a outdoor grill.....they were allowed to shut the lights off, per timer, at 7:40pm......when us nurses were still passing meds til 9:00pm!And this place was suppose to be citation free last year! I spoke with all my bosses about this but they did nothing about it...there is much more....but anyway I quit. Half the people yah work with have very little experience, like I have.......I swear their brain dead.....and hell bent on making a profit and to hell with patient care...rules or regs. No body cares in those places if they do things right.....because they don't have the most experienced nurses running the place.......its like working in a human factory,,,I swear their all non-thinking , non compassionate people who are just doing a job they know nothing about!!!!!!!Its a crime if you ask me.....and there they have no air conditioning and the CNA's told me its 110 degrees in there in the summer.! Can you imagine......I wish the state would let me be an inspector.........instead of a an R.N. who knows nothing about what to look for in those places or when.....
As far as the M.A.s........I took care of a elderly man in a homecare case....he was on Coumadin 5mg, Lasix 80mg BID, and can't think of the other meds...but 1 for HTN, 2 others for CHF, all of which slow your heart rate down....when I stated taking care of him, his pulse was running 36-48/min......he was fatiqued, diarrhea, pale, I called the doctor's office and we got him in to see the cardiologist.......his HGB. 10.2 (low for a male), and instead of changing his meds, the doc, put hiim on iron and increased his med doses...and then wanted him to get a pacemaker.......he was also throwing some PVC's.......he refused it......didn't want it.....so his pulse continued to be low....and irregular........I called and spoke with the MA,who I also had to ask her credentials, she calls back and said she had spoke with the doctor to increase his med doses again!!!!!!!!!! I couldn't believe it....I went over to the pharmacy to pick them up and talked with the pharmacist who also after hearing about the case, agreed with me to wait on getting the meds and call the doctors office the next day and ask to speak with him......I did and for some reason, I talked with the R.N., who worked PT there.I told her the scenerio and she also, couldn't believe what the MA had called into the pharmacy.......for this patient......she got a hold of the doctor and reduced his med doses had me take him in for more blood work and once we got him straightened around , he had more energy, less insomnia, less falling (which could have been from episodes of V-Tach).......and he generally felt better......but if I had done what that MA said to do, and what she claimed the doctor said to do.....that man would have died from the side effects of those
drugs. Why would a cardiologist have a MA working for him anyway? But yah know , I have worked with R.N.'s who are afraid to communicate with the doctors, what's with that anyway?
That's the only way , we the adminstrators of the medications they order , can help the doctor know what those drugs are doing over time........they expect us to be looking for those problems and to let them know......It really bugs me that a doctor would hire a MA to do anymore than medical billing and reception duties......Those doctors need to go back to hiring nurses......don't yah think.???? Its there fault in the first place!
What a nightmare!
Off topic, but you and I would agree that administrators should only be a medical professional/provider. Long ago I was terminated on the spot for asking an "administrator" where she got her medical license. It was all about "dispensing" meds without a license. She was calling in people's meds, giving them samples and didn't even know the "unwritten rule" about checking the last time the pt. was seen in the office, if the MD stopped the med for a reason and so on. She had been doing so years. You have to be a MD or a pharmacist in my state to dispense. I, like many RNs (and LPNs) can do so with an order. Many pt.'s will like a med restarted because the liked the effects better. They don't take into account that the MD stopped it because of other reasons. The office was shut down temporarily after my complaint to the medical board in my state.
My current administrator is a FNP, at the same office. I would never work for an office again that has an administrator that is not a medical professonal/provider.
One of the docs I went to refused to hire RN's because the RN's cost too much -- they only hired agency nurses when they needed the help. Instead, they trained the CMA's to draw blood and instruct on meds/procedures. They also employed a PA to do minor office procedures (this is an infertility practice) so the docs could be out there raking in the major $$$$ with surgery.
The bad part about all of this...the MA didn't have a clue where to put subq injections. She was having more fun writing prescriptions and wearing the doc's grey coat because "she was cold". These MA's were also taking CALL for the docs. Since these patients were more anxious than anything, going thru infertility cycles, the docs apparently felt ok with this, because "it's not like you can kill anybody with infertility meds".
That's why my husband and I are still child-free. . .
My point is, if a CMA wants to be a nurse, go to school and do it. Don't rely on the doc to give you job responsibilities because I would bet the doc would be the first one to hang you out to dry if a major issue came up. IMO, if you want the responsibility, you have to earn the right to sign your name "RN" or "LPN". That means passing the darned test, no matter how big a pain in the butt it is.
It's a privilege to be called nurse. You're not a nurse just because you work with a doc. Nurses practice independently of physicians and make their own decisions independently of physicians within the scope of the physician's orders -- that's the difference between an MA and an RN. That, and the clerical duties that MA's perform in the office setting.
I wonder what the AMA would do if nurses(RN or LPN) started writting scripts on their own and making diagnosis. You can bet it would never happen. We (nurses) already walk on dangerous ground giving meds with a license let alone giving meds without one. Everyone has a scope of practice that tells them what they can and can't do. Stick with that and don't let anyone convince you otherwise. I can say with 99% accuracy (nothing is 100% except death) that if something bad happens, you will be hung out to dry. Good Luck
I have read all the posts on how Medical Assistants are what appears by popular opion untrained, unreliable and basically unrespected by most. In defense of us Medical Assistants, I have to disagree, with out us CMAS that are very well trained in many areas you "nurses" would have to work alot harder. I have a great deal of respect for nurses and do correct those who classify me as a nurse because until I am done with school I am not a nurse. I am able to do many things from ekg phlebotomy emergency care injections medications and xray.( I am also an EMT-I which helps) I do however have to agree there are some schools that do not put the amount of time into training that my particular school did and there are alot of not so great CMAs out there but I have come across alot of not so great nurses also. It is said that "nurses" may be afraid that CMAs may be replacing alot of nurses because of our versatility and broad training, could that be the issue here with some? I can do IVs run major traumas administer medications all very well without worrying about doing the wrong thing I can read just as well as the RN, I am currently finishing my RN training and I learned more about patient care in MA and EMT school. Sorry if this post makes people mad but I didnt think it was fair that all CMAs are lumped together some of us know what we are doing and have actually saved some lives.
Erin RN
396 Posts
I see this is a pretty old thread and somewhat heated but I actually had an incident that happened TODAY that is relevant.
My mother in law has been having some BP problems and angina over the last year (she had a MI during minor surgical procedure about a yr ago)about 4 weeks ago her PCP put her on Norvasc. After taking it for about 2 weeks she didn't feel good. light headed, palpitations, flushing and extremely tired. My father in law informed me of this today and said that she had passed out in the bathroom. He said I called the PCP and asked his nurse if it could be the Norvasc..his nurse "Susy Q" told me "Norvasc wouldn't do that to her.".WTH???? As an RN I know that Norvasc is a great great drug in those that can tolerate it and many can not. I called the PCPs office and asked for the nurse.."susy Q" said I am Dr XX nurse what can I do for you? I told her the problem and said I thought perhaps it was the Norvasc..she said "Norvasc wouldn't cause that" I then said ummmm are you a nurse..I mean a licensed nurse? Susy Q says "well I am Dr XX medical assistant. I then asked to speak to either a licensed nurse or the MD..I spoke to him, he stopped the Norvasc and sounded totally peeved at the MA. Now I know this is one instance but I was furious!! If MAs are so proud of their certifications and qualifications why do they misrepresent themselves that way? I mean I don't answer the phone and say, "Hello this is Dr Erin"..I have worked with great CMAs so I don;t mean to offend but presenting yourself as the nurse is fradulant and it sets you up for questions that you are not prepared to answer and legally should not be answering...Erin