MA working beyond scope of practice

[Catedi]

I'm not sure what to do here. Someone I know told me this week that her employers allow her to work beyond her scope of practice. I always thought she was a Surgical Tech, although, she never went into details about what she did, other than assist in surgery. I just found out she went to a school for medical assisting. Her program was 6 months long and she graduated with a certificate. She's not even registered, as in Ohio, registration is not required. Essentially, she is an unlicensed medical assistant. She stated to me that her employers, a private dermatology and cosmetic surgery practice, have her assist in surgery, such as starting IVs, injecting medications into the IVs, monitor patients under anesthesia and do post surgical care. I was floored when she told me this. I calmly questioned her on why they don't have an RN doing these things and she stated, they only have one nurse on board because the 'practice' feels it's too expensive to pay RNs, when the physicians at her practice can just train MAs to do what she's doing. I'm a newly licensed RN, so I'm not sure what to do or say about this situation. Nor, do I know who to turn to to report this. I just know this is beyond her scope and this is endangering patient' safety. This person understands what she is doing is beyond her scope, but doesn't care, since she is compensated beyond what an MA would ever make with a certificate. She also feels the risk of getting caught is minimal, as she asked, "How could anyone possibly find out?". I'm wondering, does a patient death have to occur for this to stop? Any advice would be welcome.

[carrie_c]

This actually does not surprise me at all. Before I went to nursing school, I worked for 4 years as an MA. Most doctors now are hiring medical assistants because they don't have to pay them nearly as much as they would an RN. It's all about money, and patient care is suffering because of this. However, medical assistants are NOT supposed to be giving IV medications. Your friend may think it is no big deal, but she needs to realize that if something happens, she is just as much responsible as the doctor. She might think she is just following orders, but if someone dies, she could very well be charged and go to jail. I am not really sure how or where you could report this, maybe the health department?

[KayRN910]

Oh, LORD, this post made me shiver! When I was in my first round of clinicals, my clinical instructor told me wise words of widsom. She said,"You cant reverse IV meds. Once they are pushed, they're pushed. Its like trying to put toothpaste back in the tube. And if its a mistake, you're chasing your tail trying to fix it, assuming the patient doesn't die." It put a healthy dose of fear in me.

Sounds like your friend needs a healthy dose of fear in her.

[carrie_c]

I don't understand these states that don't regulate medical assistants. My state is the same way (TN). A doctor can hire someone off the street with no medical experience at all to care for patients. It's really scary.

[morte, LPN, LVN]

hmm my understanding of MAs was they could do anything the doctors let them because it was on the doc's license...

[Flo., BSN, RN]

Scary! This needs to be reported.

[carrie_c]

No, they are not supposed to do anything the doctor lets them do. They are not supposed to give IV meds. And they can be charged along with the doctor if anything happens.

[Mrs. SnowStormRN, RN]

You would think doctors wouldn't want to risk their licenses like this, but I guess they do:eek:. This may sound harsh, but you get what you pay for (as the saying goes) and these doctors don't want to pay a nurse so they pay a MA, next thing you know another news story, lawsuit, and a poor patient that suffered from it. Really sad and scary. I know there are good MAs, but some things should be done by a licensed person. MAs are great at running doctor offices (billing, scheduling and things of this nature) but IVs meds are extreme! :smackingf

[carrie_c]

When I was in school for medical assistanting, I was told that we could start an IV line, but IV medication was strictly off limits.

[ktliz]

If there's no licensing, there's no scope. It's the responsibility of the physician to supervise and the MA is practicing under the physician's license. Ohio law dictates what a physician can delegate to a MA, and also says that patient harm does NOT have to occur for it to be considered a violation.

http://codes.ohio.gov/oac/4731-23

HTH.

[carrie_c]

She could still be charged though if something were to happen. She may not have a license to lose, but she could still get into trouble and go to jail.

[CaregiverGrace]

MA's are essentially glorified secretaries. Every time I hear a story about an MA performing a treatment or procedure, I wince. IVs are out of the scope of LPNs in some states.. and an MA is certainly below an LPN. It all comes down to greed, with of course the patient at the most risk.