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.

[nctamelanurse]

Who can you report it to since Ohio does nt require registration?

[carrie_c]

I worked as an MA for many years, and it wasn't until I went to nursing school that I realized I shouldn't have been doing some of the things I had been required to do. Medical assistants should be much better trained. It really is all about greed.

[ktliz]

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.

True, although jail seems unlikely. She could DEFINITELY be sued though. I doubt an MA pushing IV drugs is covered by the physician's malpractice insurance!

[carrie_c]

I read a story a while back about an MA being charged because a patient had died due to a medication error. I don't remember where I read it. The school I went to for MA recommended that MA's have their own malpractice insurance, but most don't bother getting it.

[bdsmom]

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.

LPN's aren't even allowed to push IV medication and they are trained and licensed. I'm not understanding why someone with very little knowledge base would want to take that type of responsibility anyway.. Yeah, she's being compensated but is it worth endangering lives? I say you need to report this, do you want a possible deadly mistake on your shoulders?

[DogWmn]

As an LPN I worked in Family Practice and Pediatric clinics and loved it BTW.

I'd also like to point out that the LPN scope of practice regarding IV's varies greatly from state to state. Here in GA there are no restrictions.

I'll refer you to this link outlining by state what the scope is:

http://nursing.advanceweb.com/article/lpns-and-iv-administration.aspx

You'll notice in many states there is no restriction or very little in regards to IV's and then in other's it's very restrictive.

[Catedi]

Just to be clear, she is not my friend. She is an acquaintance I met through my sister, who used to do her nails and is now her friend. We were visiting my sister on the same afternoon when we had our conversation. She truly believes the patients are in no danger, stating she feels the doctors trained her very well. I do not want this on my conscience, and will report it as soon as I know who I can report it to. I was hoping a more experienced medical professional could direct me to where I needed to go with this. It's so crazy, I can hardly believe it!

[Catedi]

Also, @ Dogwmn, LPNs can start an IV in Ohio if they've received a certificate to do so. They can be delegated to give medications through an IV, under the licensed RN.

[GilaRRT]

Just to be clear, she is not my friend. She is an acquaintance I met through my sister, who used to do her nails and is now her friend. We were visiting my sister on the same afternoon when we had our conversation. She truly believes the patients are in no danger, stating she feels the doctors trained her very well. I do not want this on my conscience, and will report it as soon as I know who I can report it to. I was hoping a more experienced medical professional could direct me to where I needed to go with this. It's so crazy, I can hardly believe it!

You, in fact may not have a case. People have provided you with accurate information. We don't know where you live, so you will have to do some leg work and find out what laws or regulations exist regarding medical assistants in your area. As already stated, medical assistants in many areas have an essentially "open" scope of practice that is determined by their physician. It is legal and you may have absolutely no recourse. Again, the onus is on you to find out what regulations exist in your area.

[ImThatGuy, BSN, RN]

Medical assistants aren't regulated here so there's no scope of practice to violate. Conceivably, a medical assistant could do whatever he/she was trained to do although the reasonableness of the situation would dictate lawfullness. You're not going to have one doing a craniotomy, for example. Anyone could be called that and use that title in the work place.

[CaregiverGrace]

Just to be clear, she is not my friend. She is an acquaintance I met through my sister, who used to do her nails and is now her friend. We were visiting my sister on the same afternoon when we had our conversation. She truly believes the patients are in no danger, stating she feels the doctors trained her very well. I do not want this on my conscience, and will report it as soon as I know who I can report it to. I was hoping a more experienced medical professional could direct me to where I needed to go with this. It's so crazy, I can hardly believe it!

As the earlier poster said, this is wrong that an MA is performing these skilled procedures, but it may not technically be illegal. At the least, you should inform this person of how much risk she is putting herself in, but reporting her to authorities/BON may not get you anywhere. Actually, the BON might give the doc a phone call to ruffle his feathers a bit, but beyond that, I doubt there's anything legally you can do about it.

[SummitRN, BSN, RN]

So then may an RN perform any skill an MD wants, not as an RN, but as an assistant MA under the MDs license?