Medical assistants and LPNs

asoonernurse · May 15, 2008

I do see your POV, Kidaroo, however, to play Devil's Devil's Advocate Susan is quite correct in that would YOU have killed a patient administering narcotics (medical administration mistakes happen ALL the time), the opposing attorney would most certainly have you over a barrel, no matter what your opinion of the differing roles of the LVN/MA.

While hospitals in your neck of the woods may be forced by circumstances to "bend the rules" to get things done, I can assure you that you will become radioactive should a lawsuit be brought against you.

Simply having a physician's order for a medication will not save you in a court of law. You simply do not have the "LICENSE." I believe that is the point everyone is trying to make.

Saying an MA can "do" everything an LVN can is the same as me saying an LVN can "do" everything an RN can (we can't... :no: ) Although I understand and have "relatively" the same training, an RN can do far more than I because she is licensed to do so. Simple.

Good Luck. :nuke:

Michael

I don't know what the big pinch is in the nursing community about CMA's. In Alaska there is ONE nursing program for RN's one 2 yr and one 4 yr at the university. With the lack of nursing instructors they allow 30 students each program twice a year. This has created a greater need for medical professionals. MA's are filling the gap for the RN shortfall.
I am not saying that one is better than the other I am simply stating that CMA's with a physician that trains them can do MORE than and LPN in some states, specifically Alaska. I have administered narcotics IV, per a doctors order and according to the state nursing board here a LPN can't do that. And we can administer medications as well as dispense them under the physicians order in Alaska. It does vary from state to state, but here we are allowed to by law.

asoonernurse · May 15, 2008

I have been in the medical profession for the last 7 years, 5 as a military medic doing more than an RN civilian would ever do...

This is so stupid for LPN's to think they are so much better than CMA's

So the truth of the matter here is sour grapes???

I'm disappointed in you Kidaroo, I thought this was to be a discourse in the different classifications (real and imagined) of CMA's and LVNs.

I didn't expect this to be another "my level of expertise is better than yours" school yard fight. :stone

asoonernurse · May 15, 2008

author: the state of alaska: (thanks, txspadequeen921)

can nurses delegate injections to unlicensed assistive personnel (uaps)?

no. 12 aac 44.970 (13) states that the administration of injectable medications cannot be delegatedto uaps.

can a nurse delegate insulin injections to a uap?

no. injections cannot be delegated.

i’m a cma in a physician’s office. the nurse gave me a pill to take to the patient. can i do that?

no. this practice does not fall under home or community based settings (aac 44.965 (b)(1)&(2))

the physician employs a cma and wants the nurse to supervise the cma starting an iv and giving iv push medications. is this a proper role for the nurse?

no. this nursing duty is not delegatable by the nurse to a uap. the nurse cannot be involved in supervising this activity. the delegation and supervision has to be by the physician. this includes anps; they can not delegate this task or supervise the cma.

but the physician ordered it.

it does not matter. the delegation including supervision of the cma performing this iv start and iv push by the rn or anp violates the nurse practice act.

this from your own state's regs, kidaroo. this is what we mean when we speak of licensed versus unlicensed personnel. like pagandeva2000 says, no one here is is saying that medical assistants are not valuable members of the medical community. they are, however, different; they are not interchangeable.

good luck :nuke:

michael

jjjoy, LPN · May 15, 2008

What I understand from the above posting is that NURSES aren't allowed to delegate such activities to CMAs or to supervise them in such activities... but it sounds like some of those activities CAN be delegated to CMAs by PHYSICIANS if "supervised" by physician... and I can imagine some MDs being very liberal in their definition of "supervise."

No wonder it's so confusing!

irish6363 · May 16, 2008

Stirring the pot here but in California alot of the schools for MA's do not require a HS diploma....????? just a thought.

pagandeva2000, LPN · May 16, 2008

What I understand from the above posting is that NURSES aren't allowed to delegate such activities to CMAs or to supervise them in such activities... but it sounds like some of those activities CAN be delegated to CMAs by PHYSICIANS if "supervised" by physician... and I can imagine some MDs being very liberal in their definition of "supervise."
No wonder it's so confusing!

This is how vague explainations can cause a great deal of trouble. As you said, it does appear that the physician delegate such a task to a CMA. Now, if the nurse is aware of such a practice, knows that the CMA is probably not trained or should perform such a act, BUT THE NURSE DID NOT DELEGATE THIS TASK, just how LIABLE is that NURSE if there is a negative outcome?? How does that nurse explain to the BON that she did not delegate or supervise the skill, but, KNEW this was happening??

And, I can see the MD saying that he had the licensed nurse train and supervise this person in court, to complicate things (because he wants to cover his bum) even further.

irish6363 · May 16, 2008

Do MA's need to be certified to work as an MA ? Or is that up to the individual employer ? Also do they need to have a Department of Justice check as well as an FBI check done before they can work with any patients or have access to any type of prescription medications for patients ? Here in California I think they are not required. You can take your classes and receive your diploma and start working once you find an employer, I guess the certification is not required by any laws in this state. Not sure though.

pagandeva2000, LPN · May 16, 2008

Do MA's need to be certified to work as an MA ? Or is that up to the individual employer ? Also do they need to have a Department of Justice check as well as an FBI check done before they can work with any patients or have access to any type of prescription medications for patients ? Here in California I think they are not required. You can take your classes and receive your diploma and start working once you find an employer, I guess the certification is not required by any laws in this state. Not sure though.

The thing that is confusing is that certification for MAs is not regulated. Some programs are three months, 6-12 months and others are associate degree programs; and the education is varying, due to the lengths of the programs. Some states seem to say that only Registered or Certified Medical Assistants can be hired, others are more lax. Because of this, it may be harder to check on their history as it would be for licensed or certified personnel.

asoonernurse · May 16, 2008

Sounds like the MA's are more screwed up than we are! :lol2: Are the RN's the only group out there that seem to have everything well in hand or am I missing something here??

The thing that is confusing is that certification for MAs is not regulated. Some programs are three months, 6-12 months and others are associate degree programs; and the education is varying, due to the lengths of the programs. Some states seem to say that only Registered or Certified Medical Assistants can be hired, others are more lax. Because of this, it may be harder to check on their history as it would be for licensed or certified personnel.

pagandeva2000, LPN · May 18, 2008

Sounds like the MA's are more screwed up than we are! Are the RN's the only group out there that seem to have everything well in hand or am I missing something here??

http://en.wikipedia.org/wiki/Medical_assistant

Reading this will certainly make you wonder, simply because it showed to me that being certified or registered as a Medical Assistant is voluntary. It may be that some areas are requiring it, but it is not nationally mandatory.

asoonernurse · May 18, 2008

Gee, I wonder if the MA students at my school realize that they really DIDN'T have to pay $20,000 to have Unitek give them a certificate??

:yeah:

http://en.wikipedia.org/wiki/Medical_assistant
Reading this will certainly make you wonder, simply because it showed to me that being certified or registered as a Medical Assistant is voluntary. It may be that some areas are requiring it, but it is not nationally mandatory.

pagandeva2000, LPN · May 18, 2008

Gee, I wonder if the MA students at my school realize that they really DIDN'T have to pay $20,000 to have Unitek give them a certificate??

I took an MA course 15 years ago for $300, a three month course. Took phlebotomy for the same price. CNA was about $500. I was able to work at an agency for medical assistants and did not have to worry about the high tuition these students had to pay. I was not certified or registered as a Medical Assistant, but certified as a Phlebotomist and Nursing Assistant. Got plenty of jobs because of my clinical experiences as both.

The cheapest program I saw in a community college for Medical Assisting was $2500. It is a 4 month course that also included mandatory clinical time for about a month in a doctor's office. I would suggested interested people to do that, but not for more...and that is because it was held at a community college that has a decent reputation. I also think they would be sure to at least have licensed instructors teaching them.