Medical assistants and LPNs

pagandeva2000, LPN · May 24, 2008

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.

That is how it is in my state I currently teach the RMA program and they are certified by the AMT.They can do more than me in the clinical setting since they are directly under the MD's liscense.There is no governing board for my state as to their scope of practice.AMT simply states thet they can do anything they have been trained by the MD to do if that provider is comfortable leting them do under their liscense.

I have a question for you...if a nurse works with a CMA in the setting of the doctor's office, does the CMA, in any way working under your auspice? If she makes an error while you are there as a Registered Nurse, are you liable in any way? This question always plagued me. Thanks...:)

Kidaroo102 · May 25, 2008

There is a common misconception that MA's work under the nurses.....we do not......we work under the practioner....the actions of the CMA are those of the practioner written order so the legality is covered under their liscense when acting on the practioners wishes. Now if an MA does something without the direction of the practioner, then the MA is on their own so to speak. In the event the provider is a nurse practioner, then the sponser of the NP is the liscense in which we fall under....this is in Alaska. I am not sure about other states. There is malpractice insurance available to MA's as well.

justme1972 · May 25, 2008

MA's in my area, cannot find a job.

There may be a National Certification for an MA but it is not a regulated profession in my state. It is not considered a CNA equivalent and I have never seen or heard of an MA doing anything close to an LPN here.

justme1972 · May 25, 2008

found this interesting . it came off the alaska board of nursing site....
http://www.dced.state.ak.us/occ/pub/nursingfaqs_delegation.pdf

well, that solves the mystery of who is responsible....clearly the physician.

it even specifically states that a nurse practitioner cannot supervise a cma, that it must be the physician.

time4meRN · May 28, 2008

HI all,
I have just finished a medical assisting program and im now looking for a job. I have noticed alot of job openings for lpn but nothing for medical assistants. I was wondering first of all what is the difference? I can pretty much do everything an lpn can do. I was wondering if I applied to lpn positions would I be a candidate for lpn positions or would I be wasting my time? Please somebody answer my question I would greatly appreciate the advice.

This is why I feel MA schools need to be investigated and eventually MA's need to be regulated by BON's. NOOOOO ! an MA is not an LPN. I am an RN, I see what both do. An LPN has it over an MA. LPN's are regulated and have a scope of practice. That is why Dr's us MA's , they can do anything a Dr thinks they can do, therefore , it makes their (the dr's) life a little easier. The problem is the pt suffers. I can not believe what MA's can do in an office. When an MA worked in our ER, it was evident what she knew and didn't know. Things she said that made my jaw drop. Like, "yes, I know how to read the EKG" and don't forget the ever popular, as the dr was doing a difficult intubation, the pt's belly blew up like a balloon, it just so happened that at the same time the dr was able to get the tube in, the pt let a big fart. When the MA heard the fart she said, yep he's in for sure, and with a confident node of the head she walked away as if to say, mission accomplished. Good thing we didn't have to listen to breath sounds or check color change etc.. since the MA was there. :bow: :yeah: Now to find out she is going to write questions and review answers on the CMA test in Ohio. I would assume it's because of her amazing ability to understand A and P and her ability to use critical thinking. To be quiet honest an MA has no buisness doing this. It should at the very least be an RN. So, is it a good thing if an MA can work in a Dr's office because they have less restrictions than an LPN. How would you feel if a flight attendat took charge of flying the aircraft because some piolet showed them how to do it. It's the same with MA's. These schools drive me absolutly nuts. :banghead:

shelly304 · May 29, 2008

The hospital I work for has begun hiring CMA's. Being the information junkie that I am, I set out to find out as much as I could about the MA profession since they are now working with me. The MA certification is national. Not state to state. So if she is telling you that she is writing questions and reviewing the exams (?) for the state of Ohio, I believe that would be a FIB! There is no OHIO exam. Only national exams given by several different certifying agencies across the US. If I am wrong, I apologize. My interest has been to find out as much as possible about their "scope of practice" since I am now working with MA's and knew very little until recently! California does require a secondary state certificate. One of our MA's moved from there. Any other info you may have and want to share would be helpful. Also, I am not trying to fuel the fire about the LPN vs MA debate. Simply trying to educate myself. :nurse:

BearyPrivate · May 29, 2008

Kidarroo if you want to be an LPN go to school like the rest of us. I assure u LPN's are a lot more qualified than a certified med tech. How long are u in a class for maybe 6 weeks? No clinicals that put the pts life directly in your hands unless you pass the wrong pill. No they do not qualify you to handle the situation beyond the med error do they? So as to your statement a certified med tech cannot do things a Licensed Practical Nurse can do. So as I said go to school and earn a license, not a certificate.

irish6363 · May 29, 2008

Well according to a close friend who is an MA here in CA. to work as an MA here, your certification/certificate is a bonus not a requirement for employment, therefore you can still work as an MA with just your MA school diploma, and certification just being an additional plus for you to be better qualified and hired by some more respectable medical establishments. Which they would more than likely want any MA to have before they consider you for work. In other words it is not the law so therefore no regulation or minimum standards are established by the state to uphold to or be accountable for. That is up to the specific employer to decide. Now that sounds at least to me very unsafe. There are standards that must be met no matter what when it comes to any and all patient care. Any person wishing to hide federal arrests, criminal arrests, drug convictions etc, can successfully evade the process and work just fine at a clinic or private practice with an employer not verifying this because it is not law here. In comparison to nursing where you cannot hide these factors for the state you work in WILL investigate and these things come up during your licensing and thereafter. So how anyone can say that we are the same based on that alone is sufficient for me to want a nurse to be at my beside rather than an MA. Just based on that alone, never mind the educational aspect of it...that is another story. I mean no offense to any MA's by no means it is just that each has it's place and they do not come even remotely close.

egglady, LPN · May 29, 2008

Well, I know one thing for sure- a MA can NOT call herself or himself a nurse. They just arent. no matter how much they think they do "the same things as a LPN" they dont. LPN's are nurses, MA's are NOT.

shelly304 · May 30, 2008

Hospitals and physician offices all do background checks on their employees. (At least in my state) Whether you hold a license, certification, do medical coding, or scheduling a background check is a given. If you have EVER been finger printed this is on record with the FBI and will be discovered on a BC so you can't hide an arrest by simply lying on a application. We now have CMAs working in my hospital, but they must be certified. I do see ads in the classifieds that read "certification not necessary". You can work without the cert. and some Dr. offices will even train their staff as MA's. Doesn't seem like the profession will ever move forward if this continues. I am still trying to figure out their scope of practice.

AnnemRN · May 30, 2008

The following is from the California medical board website:

Is Your Medical Assistant Practicing Beyond His or Her Scope of Training?

The Medical Board receives numerous inquiries concerning the use of medical assistants in a physician's office. (By law, a medical assistant may not be employed for inpatient care in a licensed general acute care hospital.)

Medical assistants are unlicensed, and may only perform basic administrative, clerical and technical supportive services as permitted by law. An unlicensed person may not diagnose or treat or perform any task that is invasive or requires assessment. The responsibility for the appropriate use of unlicensed persons in healthcare delivery rests with the physician.

The classification of medical assistant is defined under the provisions of the Medical Practice Act (Business and Professions Code sections 2069-2071) as a person who may be unlicensed who performs basic administrative, clerical, and technical supportive services under the supervision of a licensed physician or podiatrist.

Under the law, "technical supportive services" are simple, routine medical tasks and procedures that may be safely performed by a medical assistant who has limited training and who functions under the supervision of a licensed physician or podiatrist. "Supervision" is defined to require the licensed physician or podiatrist to be physically present in the treatment facility during the performance of those procedures. The only exception is contained in Business and Professions Code section 2069(a) and relates to clinics licensed under Health and Safety Code section 1204.

Prior to performing technical supportive services, a medical assistant shall receive training by either (1) a licensed physician and surgeon or podiatrist or (2) an instructor in an approved school program to assure the medical assistant's competence in performing a service at the appropriate standard of care.

A medical assistant who has completed the minimum training prescribed by regulation may administer medication by intradermal, subcutaneous, or intramuscular injections, perform skin tests, and other technical supportive services upon the specific authorization and supervision of a licensed physician and surgeon or podiatrist.

"Specific authorization" means a specific written order prepared by the supervising physician or podiatrist authorizing the procedures to be performed on a patient, which shall be placed in the patient's medical record; or a standing order prepared by the supervising physician or podiatrist authorizing the procedures to be performed, the duration of which shall be consistent with accepted medical practice. A notation of the standing order shall be placed in the patient's medical record.

Other technical supportive services which a medical assistant may perform have been established by regulation and include: applying and removing bandages and dressings, removing sutures, performing ear lavage, preparing patients for examinations, and shaving and disinfecting treatment sites. The regulations governing medical assistants can be found in Title 16 California Code of Regulations sections 1366-1366.4. Medical assistants who have completed the minimum training prescribed by regulation may draw blood.

Medical assistants are not allowed to perform such invasive procedures as:

placing the needle or starting and disconnecting the infusion tube of an IV.
administering medications or injections into the IV line.
charting the pupillary responses.
inserting a urine catheter.
independently performing telephone triage.
injecting collagen.
using lasers to remove hair, wrinkles, scars, moles or other blemishes.
administering chemotherapy.

Medical assistants may not interpret the results of skin tests, although they may measure and describe the test reaction and make a record in the patient's chart.

In summary, medical assistants are not licensed, and it is not legal to use them to replace highly trained, licensed professionals. The medical assistant is present to assist and perform basic supportive services in the physician's office.

Those duties must be appropriate with the medical assistant's required training.

pagandeva2000, LPN · May 30, 2008

Hospitals and physician offices all do background checks on their employees. (At least in my state) Whether you hold a license, certification, do medical coding, or scheduling a background check is a given. If you have EVER been finger printed this is on record with the FBI and will be discovered on a BC so you can't hide an arrest by simply lying on a application. We now have CMAs working in my hospital, but they must be certified. I do see ads in the classifieds that read "certification not necessary". You can work without the cert. and some Dr. offices will even train their staff as MA's. Doesn't seem like the profession will ever move forward if this continues. I am still trying to figure out their scope of practice.

I am curious, does the hospital require that the medical assistant be certified as a CMA or as a nursing assistant? I think that their scope of practice is 'whatever way the wind blows'.