MA in charge of clinic?

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I work for a primary care clinic in TN. I am finding that I am having a very difficult time swallowing the fact that my clinical supervisor is a Medical Assistant. When it comes to the administrative side of the house I have zero qualms with receiving correction or guidance. On the other hand, when it comes to clinical practice or assessing my clinical competency I cannot seem to process how I am under the supervision of someone who does not have a license. I have looked up the Nurse Practice Act for our state but cannot find anything that gives a direct answer. If anyone can tell me their experiences or if this is even legal/acceptable or if I am being unreasonable not wanting to take direction clinically from a Medical Assistant it would be greatly appreciated. Thank you in advance!

Specializes in Med/Surg, Ortho, ASC.
Roser13, I accept I could be wrong, I'm still new to healthcare as a career. Please , enlighten me where I may need to rethink my position.

For the private doctor's office, it's definitely a matter of money. (1)The MAs have been trained in all the clinical skills the OP have stated. If the MA is in a supervisory position the MA had to have proven experience and competence. Respectfully, it's the OP's ego that's getting in the way. Having a license doesn't necessarily make you competent. (2) The doctor obviously has confidence in the MA's clinical skills and critical thinking ability - I doubt the MD would jeopardize his practice. Ego is saying, "I worked long and hard to EARN my RN degree, paid $$$$ dollars, stayed up late at night studying for tests, to maintain a 3.8 GPA, sacrificed time with my family, then the time preparing for the NCLEX; and the MA just spent 10 months to get a certificate." It just doesn't seem fair somehow.

I'm one semester from completing an LPN program. I'm 2 months into working as an PCT in a hospital. I know a PCT (CNA) who's worked in CCU for 10 years and can interpret all the common ECG disrhythms, know all the most common drugs relating to the most common cardio and respiratory ailments (knows interactions, contraindications), correctly anticipates RN's interventions and actions. I would trust my health in her hands as much as an RN, and more so than a new grad RN.

I also worked at a nursing home where the night shift supervisor was an ADN RN with less than a year's experience - giving clinical direction, discipline to BSNs with several years experience.

With all due respect, humbly accept any direction and correction from your qualified supervisor.

You're a naive nursing student yet you are offering patronizing advice to a nurse.

(1). Maybe, maybe not. For example, I have yet to see an MA take a blood pressure appropriately. There is a big arrow on that cuff for a reason - it's supposed to point to an artery, not my medial elbow.

(2). If you believe that the majority of MD's pay any attention to the folks who room their patients and run the office, I've got a bridge in Brooklyn to sell you.

(3). Just because you have encountered a couple of stellar employees who are also MA's does not mean that all MA's meet that standard and are capable of supervising an RN's clinical skills.

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I can understand what you're saying and I honestly don't know why a clinic would have an MA over a RN. If anything, I would expect the RN to be over the clinic not the MA. But, I will say this. As a CMA for 13 years I have a vast range of clinical knowledge. I've worked in private practice where the MA was the nurse and had roles I thought should have been licensed nurse roles. In most clinical settings I've worked, the manager over everyone isn't a licensed nurse.What I'm saying is, just because she's an MA doesn't mean she doesn't have the knowledge or skill to be over the clinic. Please don't let the fact that she doesn't have a license discredit her abilities. With my knowledge and experience i would feel completely comfortable being over a clinic with other MAs working under me. I wouldn't, on the the other hand, be comfortable being over a licensed nurse.

Like I said at the beginning, I truly understand where you're coming from though. Even as a certified medical assistant (soon to be nurse!!) I would be wondering the same things as you if I worked with you in that environment. Maybe that's why you're there, to help management see that they need to re-evaluate their system because it seems backwards.

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At Roser13, I was not giving advice, I was giving my opinion, an opinion shared by at least a few other posters - why don't they scare you, are they naive too, why are you picking me out? I seriously doubt that not one MA you have encountered has done a correct blood pressure - do you have a bridge to sell me? And not one of your three points has any validation to cause you fear - you don't know my work ethics or skill level. I did not say ALL MAs are capable of supervising, just like you didn't say ALL doctors don't pay attention to their staff - you did, however, say you have seen NOT 1 MA do a correct blood pressure. But I'm sure you'll agree NOT ALL RNs are capable and clinically competent.

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Oh my gosh. As a former MA, who has now been an RN for over 5 years, please let me explain a few things. As an RN, you learn under other RNs, whom have learned from other RNs, etc. etc. They learn bad habits because there are always preceptors and trainers who actually (whoa!) kind of suck at nursing. Where as an MA works side by side a PHYSICIAN all day long. One whom performs the same procedures over and over and over again. MAs learn things in the most effective way because the physician they work with NEVER changes his habits, especially if he is a Specialist. It used to crack me up when licensed RNs, who trained me when I was a licensed RN, would tell me how to talk to a doctor and they would try and intimidate me and tell me that doctors can be mean and I need to respect them. Ha!!! I had better relations with Physicians I worked with and they were much more fun, easygoing, and HUMAN than so many licensed RNs are. I can say this because I am one. Anyway, just because you have a license doesn't mean you know the field you are working in. These MAs who are in charge have worked their asses off to get to where they are, have likely been there for years, and guess what?!!! They do work under a license --- the PHYSICIAN'S license. Do you think he/she would let someone run his clinic if it could result in lawsuits?!!! I am sick of everyone always trying to be better than everyone else. Everyone needs to get the eff over themselves and do what is best for patients. I miss being an MA and assisting the KIND and nice physicians with cytoscopies, bladder biopsies, stent removals, prostate biopsies, urodynamic studies, MOHS surgery, holter monitoring, IV starts (they really aren't that difficult, licensed RN), stress tests, injections, venipuncture.... etc. All that is done in a physicians office is under their license, and when I worked with RNs for a critical care doctor, specializing in pulmonary hypertension, they would ask us (the MAs) how to do things all of the time and they were OK with asking us because they didn't let their egos get (boo hoo) hurt. It is because of people like you that has made nursing start to suck. You're getting paid much more money than them, so who cares? Do you like the doctors? The patients? I'm sure the MAs are doing a great job of running it, otherwise, there would be NO PATIENTS there. These patients can actually choose where they want to go unlike a hospital. You are the type of RN I hate to work with. Let us all just go to work, do our crap, take care of patients and go home. Instead of focusing on who is in charge focus on the care of your patients. It is bothersome how much this is bothering you. Sad you are focusing so much on this while you're at work rather than just helping the patients.

Signed,

An RN who holds a BSN who really, really misses being an MA and working with real humans...

Ugh!!! You are likely there because they need an RN there because of her license. Meanwhile, the doctor probably dreads signing your much higher paycheck because now you are causing problems when, before, he likely had none. I would take that job, in a heartbeat, to get away from ego driven Licensed RNs in hospitals.

Get over yourself

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Oh my gosh. As a former MA, who has now been an RN for over 5 years, please let me explain a few things. As an RN, you learn under other RNs, whom have learned from other RNs, etc. etc. They learn bad habits because there are always preceptors and trainers who actually (whoa!) kind of suck at nursing. Where as an MA works side by side a PHYSICIAN all day long. One whom performs the same procedures over and over and over again. MAs learn things in the most effective way because the physician they work with NEVER changes his habits, especially if he is a Specialist. It used to crack me up when licensed RNs, who trained me when I was a licensed RN, would tell me how to talk to a doctor and they would try and intimidate me and tell me that doctors can be mean and I need to respect them. Ha!!! I had better relations with Physicians I worked with and they were much more fun, easygoing, and HUMAN than so many licensed RNs are. I can say this because I am one. Anyway, just because you have a license doesn't mean you know the field you are working in. These MAs who are in charge have worked their asses off to get to where they are, have likely been there for years, and guess what?!!! They do work under a license --- the PHYSICIAN'S license. Do you think he/she would let someone run his clinic if it could result in lawsuits?!!! I am sick of everyone always trying to be better than everyone else. Everyone needs to get the eff over themselves and do what is best for patients. I miss being an MA and assisting the KIND and nice physicians with cytoscopies, bladder biopsies, stent removals, prostate biopsies, urodynamic studies, MOHS surgery, holter monitoring, IV starts (they really aren't that difficult, licensed RN), stress tests, injections, venipuncture.... etc. All that is done in a physicians office is under their license, and when I worked with RNs for a critical care doctor, specializing in pulmonary hypertension, they would ask us (the MAs) how to do things all of the time and they were OK with asking us because they didn't let their egos get (boo hoo) hurt. It is because of people like you that has made nursing start to suck. You're getting paid much more money than them, so who cares? Do you like the doctors? The patients? I'm sure the MAs are doing a great job of running it, otherwise, there would be NO PATIENTS there. These patients can actually choose where they want to go unlike a hospital. You are the type of RN I hate to work with. Let us all just go to work, do our crap, take care of patients and go home. Instead of focusing on who is in charge focus on the care of your patients. It is bothersome how much this is bothering you. Sad you are focusing so much on this while you're at work rather than just helping the patients.

Signed,

An RN who holds a BSN who really, really misses being an MA and working with real humans...

Ugh!!! You are likely there because they need an RN there because of her license. Meanwhile, the doctor probably dreads signing your much higher paycheck because now you are causing problems when, before, he likely had none. I would take that job, in a heartbeat, to get away from ego driven Licensed RNs in hospitals.

Get over yourself

Lol, I was literally just thinking the same thing about your post. "Settle down, Captain Happy."

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At Roser13, I was not giving advice, I was giving my opinion, an opinion shared by at least a few other posters - why don't they scare you, are they naive too, why are you picking me out? I seriously doubt that not one MA you have encountered has done a correct blood pressure - do you have a bridge to sell me? And not one of your three points has any validation to cause you fear - you don't know my work ethics or skill level. I did not say ALL MAs are capable of supervising, just like you didn't say ALL doctors don't pay attention to their staff - you did, however, say you have seen NOT 1 MA do a correct blood pressure. But I'm sure you'll agree NOT ALL RNs are capable and clinically competent.

I've seen 2 MAs that have the good stuff. I've been a nurse for over 20 years. 2. TWO.

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Denise.RNformerMA, must be nice up there on your high horse in the land of delusion.

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"Instead of focusing on who is in charge focus on the care of your patients. It is bothersome how much this is bothering you. Sad you are focusing so much on this while you're at work rather than just helping the patients...Meanwhile, the doctor probably dreads signing your much higher paycheck because now you are causing problems when, before, he likely had none. I would take that job, in a heartbeat, to get away from ego driven Licensed RNs in hospitals."

There are so many assumptions made in these two statements that it sickens me. Apparently this conversation has struck a cord with you to have this type of reaction. If you took 2 secs to think outside your pseudo reality and your own personal bias you would recognize that I was addressing an issue out of concern for my patients and protecting my license. Also, if it was an issue of "ego" getting in the way why would anyone work in an office that they are fully aware is being clinically managed by MA's? If you work in the medical field and don't go in everyday acknowledging that you give and get respect with everyone no matter their status, AND that you can learn something from everyone you work with then you are doing yourself a great disservice. Obviously you haven't learned this yet.

Sidenote, of all the skills that you listed above that you performed as an MA and stated they "aren't hard" such as starting an IV, do you believe that negates the need to learn about disease processes and proper technique before doing so? Would you like one of your family members being treated by someone that lacks that knowledge and just performing tasks that "aren't hard" because they were told to? I think not.

Maybe you should stop with the judgment and self reflect that if being an MA in this AMAZING office that you report it was that great then why did you want to become a nurse?

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Specializes in Oncology; medical specialty website.
Roser13, I accept I could be wrong, I'm still new to healthcare as a career. Please , enlighten me where I may need to rethink my position.

Passing NCLEX means that a nurse has shown that s/he has the minimum level of competence to practice as a nurse. Nurses are licensed by their respective state BON and answer to them. Nursing education is highly regulated.

An MA's education does not have the same rigor. MAs are not licensed, except in certain states, and even then that licensure does not carry the same weight as a nurse's license. Nurses are held accountable for their actions under their license; an MA, even one with a license, works under the auspices of his/her supervising physician.

Someone may be able to know which squiggly lines require what medications, but that's a far cry from understanding the whats, the whys, and the wherefores of said treatment. Someone can't begin to understand how much you don't know until s/he actually goes to nursing school and starts learning about body systems, disease processes, and how they're managed.

It's more likely that you're seeing lesser qualified individuals in supervisory positions because someone wants to save a buck or two.

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Specializes in Nsg. Ed, Infusion, Pediatrics, LTC.

To illustrate the difference between a licensed nurse and a MA, I offer several anecdotes. All of these have happened at my local provider's office over the last several years.

1. Weighed me with several textbooks in my hand and my bag. Had to ask to be re- weighed and had to explain why.

2. Auscultating my heart sounds on the incorrect side.

3. Called with test results and insisted that the doctor had to lower my dosage of Synthroid. Didn't understand why I have to be kept hyperthyroid (s/p thyroid ca with mets)

4. No hand hygiene

And so on. Please note these are my experiences and certainly not representative of all MAs, but from what I have experienced- there is a wide disparity in knowledge base and critical thinking between the MA and the licensed nurse. I don't see how the MA could be effective in a clinical oversight role over the LPN/RN.

Just my 0.2

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Specializes in Palliative, Onc, Med-Surg, Home Hospice.
Roser13, I accept I could be wrong, I'm still new to healthcare as a career. Please , enlighten me where I may need to rethink my position.

I have a problem with your idea that a CNA, even with all her years of experience, is as knowledgable as an RN with regards to meds and RN interventions. All the monitor techs I have worked with have been CNA's so I won't dispute that, but in NO way is the CNA 'safer' than an RN, even a new grad. Mainly because as a new grad I knew that I didn't know everything. The CNA's who were like what you described had NO idea what they didn't know. And I'm sorry, as you haven't yet passed boards, you don't know what you don't know. And you illustrated it with your post.

I'll be honest, I find it rather frightening that you would trust your health to a non-licensed person, who thinks she knows all this. Believe, she doesn't.

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