MA for a boss?

[guest464345]

I am a school nurse - I worked previously in emergency departments and in public health, no outpatient clinic experience. I'm wondering if this situation seems strange to others:

I just had a job interview in a private, physician-owned practice that has never had a nurse on staff before. There are two medical assistants (not required to be certified in my state, not sure of their status), both of whom have been with this doctor for 10+ years.

The clinic does some outpatient procedures that require monitored anesthesia care; an anesthesiologist comes in for these, and they want an RN with ACLS partly to handle pre- and post-procedure care (which the MAs have been doing until now, along with patient education and many other things in an RN scope of practice).

So I asked about how the RN would be trained and supervised - and it turns out that one of the MAs is supposed to be the supervisor.

I'm not planning to take this job, but I'm curious to know whether this is a common arrangement? It seems like a terrible idea to me, no matter how well-trained or competent the MA may be.

[caliotter3]

Does not seem to be a terrible idea as far as the practice is concerned, but like you, I certainly would not become part of this.

I'm curious to know why are they only now thinking a RN is better suited for this job? Wondering if they got dinged for something? I would def not be comfortable with someone with less medical training train me and supervise me clinically. I have had supervisors who are non clinical in past jobs but where my actual clinical skills were concerned I always had someone medically equal or higher supervise that aspect.

[guest464345]

7 hours ago, MHDNURSE said:

I'm curious to know why are they only now thinking a RN is better suited for this job? Wondering if they got dinged for something?

I asked that exact question in the interview (well, I didn't ask if they got dinged), and I did not get a clear answer. She said something very vague and clearly was not going to elaborate, which raised a red flag and made me realize this probably wasn't going to be a good fit. So I didn't pursue the question aggressively. I sort of wondered if they'd had a near-miss or some kind of bad outcome.

[JRT1, MSN, RN]

yeah.... that sounds like a disaster waiting to happen. Its not uncommon for non-RNs to be supervisors in a outpatient setting. In fact more often than not they are not RNs. However, these MAs have been working outside their scope of practice most likely even with an anesthesia present and an MA cannot "supervise" an RN in the sense of competency. This is one of the reasons most practices partner with a hospital or bigger health care organization. The private practice offices do not always have access to what they should be doing from a compliance standpoint.

[lpn164]

One of the bigger problems in privately owned practices are just this. The doctors can mold and train anyone to do anything if they are willing to do it. A lot of times the person does not know that they even have a scope of practice or that they might be overstepping it. I don't doubt that the MA is not very knowledgeable she probably is with her experience. I agree that there was a potential near miss and this is likely why they are looking for a an RN however she cannot sign off on any of your skills or competencies that requires equal or higher role. She may be able to supervise the office in other ways but not clinical in your situation.

[T-Bird78]

I’m an LPN but my initial clinical supervisor was a surgical tech. When HR realized she’d let her certification lapse and had no plans to renew it or get her nursing degree like she’d said, they pulled her out of a clinical position completely and moved her to a front desk position. Our new clinical supervisor is an RN; she oversees 3 locations with 2 LPNs and 6 MAs, yet she lets the MA that is going to school for healthcare leadership make decisions. Oh, well, I just work here.

[bugya90, ASN, BSN, LVN, RN]

I am a RN. I am the Charge Nurse in my clinic with 6 LVNs and 3 CMAs. However on paper our clinic manager (who is not a nurse) is the direct supervisor for all of us. Everyone "reports" to the Clinic Manager. I handle any in house clinical issues, daily staffing needs, etc. The clinic manager handles any HR or payroll issues. We also have a Nurse Manager off-site who handles clinical competencies and any charge nurse issues for the 8 clinics in our group but she does not have any direct report employees.

I agree with you that I would not be comfortable reporting clinically to someone with less training or licensure than me. She could be your supervisor for HR but clinically the MD would need to be the supervisor.