MA's being used as "nurses"

Specialties Ambulatory

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Hello all! I work in a private practice office in which I am the only RN. There are several MA's and one LPN. My concern is that the MA's are referred to as "nurses". The patients often do not know that their "nurse" really isn't one. We all have the same job descriptions and duties, and I was told shortly after starting work (by a non-nurse office manager) that they consider MA's, LPN's and RN's to be the same (it is interesting, though, that I am paid an RN wage). We all are responsible for phone triage one day a week. The team leader for the "nursing staff" is also an MA!! Has anyone else run into this type of situation??

Specializes in ED, Cardiac Medicine, Retail Health.

As an MA one should be upset about "being able to do what a nurse can do" and getting paid a hell of a lot less to do it. I feel MA's are a talented members of the health care team that are used by doctors as cheap labor. In my area a new nurse is paid twice as much as a seasoned MA. Maybe the MD's are allowing the MA's great latitude of practice without having to pay them very much.

Gerry

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Specializes in ER/SICU/Med-Surg/Ortho/Trauma/Flight.

Yeah, well I know I get paid alot more then an MA, but Ive been a nurse for a long time now, and she had no right what so ever calling us nurses nitwits, I was an aide, then an LPN, now an RN and a nursing supervisor and yes I did report her to the doc, and I can almost garuntee that one of us is going to pull that line and put in a large line, we are a level 1 trauma center, and I can also garuntee the trauma doc would have a cow if he had seen that 24 gauge, thats why I changed it I mean his crit was 12, he required fluid resuscitation, and lots of blood, he also was in hypovalemic shock this mans BP was 70/palp. pulse was 160, by the time the medics got here with him he was practically coding, no BP, SVT, he required immediate intubation, gastric lavage, we ended up putting in a central line and a PICC, yours truly got to put in the picc, which we almost didnt get either in, hes veins were shot where the office MA's and nurses had poked the Cr@p out of him, we had to do a femoral stick just for labs, the medics couldnt get a line in at all not even an EJ, so the 24 was left in so we could get some fluids in, we finally got the large lines in and sent him to OR, now hes in my SICU, he may not make it, the surgeons left his abdomen open and packed, covered with plastic. Its touch and go, the office doc should have acted faster, they had made him wait for 2 hours in the office waiting room according to his wife, hed probabley be ok if they acted faster, now hes in multiple organ failure.

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Specializes in Medical Office and Long term care.

I am a LPN and have worked with some MA's in the past in a clinic. I think it just depends on the state. Because in Illinois, they allowed the MA's to take phone messages and such but did not allow them to give injections and such...

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Specializes in IM/Critical Care/Cardiology.

Sounds like the problem started with the 2 hour wait in the waiting room.

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Specializes in OB, M/S, HH, Medical Imaging RN.
As an MA one should be upset about "being able to do what a nurse can do" and getting paid a hell of a lot less to do it. I feel MA's are a talented members of the health care team that are used by doctors as cheap labor.

Yes, MA's are used by doctors as cheap labor and it's because they can get away with it. Why pay for a nurse when you "think" you can get the same job done for half the money.

MA's are not entitled to be paid at the same level as a nurse. Nurses have a license. MA's do not. MA's may feel they can do anything a nurse can do but they cannot. Not legally. If they made the same amount as a nurse you can be sure the doctors would not be hiring any MA's, for the same money they'd take a nurse anyday. ;)

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Specializes in OB, M/S, HH, Medical Imaging RN.
I am a LPN and have worked with some MA's in the past in a clinic. I think it just depends on the state. Because in Illinois, they allowed the MA's to take phone messages and such but did not allow them to give injections and such...

Maybe I should move to Illinois!

WELCOME TO ALLNURSES!!

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Specializes in OB, M/S, HH, Medical Imaging RN.
I did report her to the doc, and I can almost garuntee that one of us is going to pull that line and put in a large line, we are a level 1 trauma center, and I can also garuntee the trauma doc would have a cow if he had seen that 24 gauge,
Of course you changed it! I've had patients come over with 24g IV's as well and yep we pulled it pronto. My point was, as a professional nurse, why bring yourself down to her level? She called you a nurse nitwit and that shows her character, respond in a professional way, "this conversation is about a patient not about us, thank you for your report" I'm glad you reported her, did you get a reply?

Its touch and go, the office doc should have acted faster, they had made him wait for 2 hours in the office waiting room according to his wife, hed probabley be ok if they acted faster, now hes in multiple organ failure.

I feel bad for the patient and hope things work out for him, sounds like they probably won't. How often have critically ill patients had to sit in a docs waiting room for hours? The receptionists are not capable of assessing how sick a patient is and it's not their fault. The patient should be pro-active about their health and insist to be assessed by a nurse (if the doctor even employes one), by the doctor or should leave and go to the ER. I believe the patient holds some responsibility.

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Specializes in ER/SICU/Med-Surg/Ortho/Trauma/Flight.

Thats the thing this office didnt have an LPN or RN, just one MA, 1 receptionist, and 1 doc, this doc is notorious for acting like this hes cheap, he also sends pts over for shots of any narc, and he gives them any meds they want, the other day I had a guy bring his wife in, I was triage, well she had this same doc, and she had overdosed because of poly pharmacy, he had her on Roxanol, Valium, Xanax, meperidine, and hydrocodone, we had to pump her and give her narcan and romazicon out the wazoo, and tube her its rediculous he does this all the time. And about my critical patient his wife asked the receptionist to get the nurse (MA) or doc, and she told her that the nurse had already triaged him accordingly and he would be fine, well I cant say anymore about this but if I were them Id sue the pants off that doc. And yes I got a reply from the doc over his MA, hes not going to do anything to her, not even a warning because she has been there for along time and none of us ER nurses know what were talking about, thats exactley what he told me, although it was good the ER chief chewed his butt good about not acting quicker with that patient and being nasty to his nurses and that he is definately going to see he gets his privelages at this hospital revoked!

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Specializes in OB, M/S, HH, Medical Imaging RN.
it was good the ER chief chewed his butt good about not acting quicker with that patient and being nasty to his nurses and that he is definately going to see he gets his privelages at this hospital revoked!

:w00t::w00t::w00t:

We have a couple of docs like that and it really burns my a** and that's a big job!

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Specializes in IM/Critical Care/Cardiology.
Thats the thing this office didnt have an LPN or RN, just one MA, 1 receptionist, and 1 doc, this doc is notorious for acting like this hes cheap, he also sends pts over for shots of any narc, and he gives them any meds they want, the other day I had a guy bring his wife in, I was triage, well she had this same doc, and she had overdosed because of poly pharmacy, he had her on Roxanol, Valium, Xanax, meperidine, and hydrocodone, we had to pump her and give her narcan and romazicon out the wazoo, and tube her its rediculous he does this all the time. And about my critical patient his wife asked the receptionist to get the nurse (MA) or doc, and she told her that the nurse had already triaged him accordingly and he would be fine, well I cant say anymore about this but if I were them Id sue the pants off that doc. And yes I got a reply from the doc over his MA, hes not going to do anything to her, not even a warning because she has been there for along time and none of us ER nurses know what were talking about, thats exactley what he told me, although it was good the ER chief chewed his butt good about not acting quicker with that patient and being nasty to his nurses and that he is definately going to see he gets his privelages at this hospital revoked!

That's when you get the medical board involved. Sounds like this doc doesn't get it. I'm wondering if the doc searched the body for a decent vein, most office crash carts don't have much, maybe an 18ga, another point is that there is a defeninitive line behind medical receptionists and persons hired off the street to fill this position.

If the wife asked (again) for the "nurse", the "nurse" should have been there. It's pretty obvious to me that she didn't get it either. But i won't go there.

I started as a medical receptionist (with schooling for this), CMA, LPN, and currently working on my RN. I hear ya. It makes me feel terrible for this patient as you said he was pretty bad when you got him.

As an LPN I had a HHC nurse call me about a CHF'r and told her to call 911 and get him to the hospital. At 7pm as I was leaving there he was sitting in our waiting room. I wheeled him into the ER myself per W/C. Called the agency the next am and reported the pt had expired. I was fit to be tied. Then I went to management, for liabilities sake, and to ensure this didn't happen again.

The CMA has a board, but who knows if this person is certified. I'd still call. I think revoking hospital priveleges is the best last resort in helping save future lives of patients.

I live in MN and no way- no how could we start IV's. Period. Don't Know where this all took place but during codes MD's got to work, but with one doc and one nurse who knows with intubation and a line. Sad, sad situation. There's always one bad apple that takes the cake for stuff like this. Thank you for saving this man's life.

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Specializes in ICU, Telemetry, neuro,research.

jeanbean,

you are right. i work at a huge university based medical center and one of the areas i have tried, to round out my resume, was the outpatient center. there was no dilineation of job descriptions or skills needed or anything. and even though there were some ladies there that were very nice people and moderately good workers, it eventually got to me that they were being referred to as "nurses" when they were not. there were 5 nurses, including me,3 college grads and one diploma nurse who graduated from a program who does not exist anymore.

i worked hard to get my bsn and i do not have a problem with all the different levels of entry there are to the career but i should have gotten more responsibility and more money, (they go together). unfortunately, the organization did not see it that way, experience was the ruler that we are all measured by.

i am in research now and i am happy. but eventually, there has to be a bottom line. i understand that the state of florida has been trying to make one entry level requirement, bsn. but so far, no luck. well, i suppose the bottom line is the profession has to grow and change and adapt. that is the only constant in a nurses career, change.

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Specializes in Neurovascular, Ortho, Community Health.
Now these posts are old but here is my 2 cents....I foolishly went in nursing in 1980 because, at 20 years old, I did not have much career choices. Girls who grew up in the 60's and 70's did not become rocket scientists. The hospital school of nursing closed in 1976. The local voke-tech LPN school was closing--it never did though. All girls who wanted to be nurses had to go to the 4 yr college. There was no 2 year community college nursing degree at the community college then. I did not want to work as a hospital nurse. Even naive as I was, I knew that hospital work was a pink collar ghetto and I always hoped to work in an office. Today, 20 years later, this RN with a BSN is applying for jobs as a medical assistant because RN's are not being hired in doctor's offices/clinics here in Massachusetts. Nursing school did not support ambulatory out-patient nursing. Now a days, some nurising schools are putting community health students in schools for a taste of school nursing, but have you ever seen a college put a nursing student in a doctors office or clinic? As a public health nurse I did have students because I pushed for it at work, but generally across America nursing school ignores that field. So, why would someone spend 12 months in a medical assistant school instead of going toRN or LPN school? Medical assistant are replacing LPN/RN because they are cheaper but they are the only trained health care worker that specializes in out-patient/ambulatory care.The salaries, at least here in Mass are not that much different if you compared a office nurse to an office MA. I wish I could of had the chance to go to MA school. I would of been happier because I would have had a career that did not cost 4 years, a 15 plus year school loan to repay, and more job opportunities.

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If all you want to do is lead them to their rooms & take their blood pressure before the doc comes in, then yea, maybe you should've been an MA. Clinics DO hire RNs, usually BSNs, as pt educators, case managers, triage nurses, etc. It's all about what exactly you are trying to do though. If you're a blood draw kind of gal, then by all means....

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