Medical Assistants the new RNs???

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Is it me or are more and more doctor's offices replacing RNs with MAs? Some places go as far as letting them do histories, injections, and give results. As a nurse I have worked as a patient care tech/cna but I also know the level of critical thinking it takes to be an RN so it does bother me that MAs seem to be given a lot of RN responsibilities. As fellow nurses I wanted to know your thoughts?

Specializes in Nephrology, Cardiology, ER, ICU.

As several have said, this isn't a new phenomenon. I work in a large nephrology practice and in our offices we have MAs and RNs, both clearly identified with name tags. I do know that cost containment is and will always rule what we do as providers.

I too always ask what the staff's credentials are when I come into contact with new people.

Specializes in Nephrology, Cardiology, ER, ICU.

Okay - this is getting off topic. This is not an MA vs RN thread. This is an observational thread discussing office practices that use MAs.

Let's keep on topic please.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

In California I was really surprised to see that there is no educational requirement (such as a certification) to work as a Medical Assistant.

I've worked lots of doctor's office/outpatient clinic. In 1983, a gigantic multi-specialty clinic with probably 50 (if you count part-time) docs only had two RNs working. The rest were LVN/LPNs. They did not hire MAs. Now they probably would.

Back then they still placed a value on critical thinking skills, assessments, and the ability to "telephone triage". Thoise are two things specifically excluded from the MA scope here.

I can't say that I really blame the physicians for trying to hire less expensive office staff because they too feel the pinch of rising costs and slower and lower reimbursements. I'm almost certain that within the confines of the individual practice, the docs are allowing people to do things that would make our hair stand on end, though. It seems that lately docs are far more willing to take shortcuts to save money than they were before.

I recall one MA here telling us that she could do telephone triage or assessments because her boss had given her a booklet of basically a script of what to say for whatever the person on the other end was reporting to her. I think that is pretty dangerous myself, and the state of CA agrees.

Another MA here told us her boss was insisting that she cauterize polyps - she quit the job rather than do it. It's not so much a pecking order as a difference.

This is all the more reason that nurses need to increase their educational level, RNs to a BSN, and LPN/LVNs to an Associates Degree. Physical Therapy ASSISTANTS have an Associates Degree as Entry into practice!! Individuals have a Bachelors Degree to get a degree, in of all things, "RECREATIONAL THERAPY" !!.

Our low levels of education make our professional practice seem to be indistinguishable from MA's and any other "flavor", of unlicensed assistive personel. This allows the PTB to continue to chip away at our Professional Scope of Practice, with little or now complaints from the public, or anyone else for that matter.

This is not a slam on anyones education, but lets get real folks. We ARE being replaced slowly but surely by not much more than HS dropouts with a fancy title and a stethescope around their neck.

Think out side the box, and what is the best for the nursing profession. What is good for the nursing profession is good for our patients. JMHO and my NY $0.02.

Lindarn, RN, BSN,CCRN

Somewhere in the PACNW

Specializes in m/s.

sometimes it's not about the license but about the brains. i've worked with some RN's that made me cringe and wonder- what were they thinking????? and then i've been care for MA's that couldn't help me for squat.... so- live & let live and try to share the knowledge to better our colleagues, for we're all in this healthcareboat together, right?

Specializes in HH, Peds, Rehab, Clinical.
Is it me or are more and more doctor's offices replacing RNs with MAs? Some places go as far as letting them do histories, injections, and give results. As a nurse I have worked as a patient care tech/cna but I also know the level of critical thinking it takes to be an RN so it does bother me that MAs seem to be given a lot of RN responsibilities. As fellow nurses I wanted to know your thoughts?

Yup, that's the way it is around here!! The clinic where I am a patient hires a very few RN's for things like phone triage, IV starts, etc--but they would have to pay RN rate that they pay at the "home' base, a MUCH larger city.

I have a friend who just finished MA school, she got a job in a cardio office--she's doing EKG's and next week starts ACLS certification. *****! I haven't asked much about it because I don't want her to think I'm not supportive and encouraging, but *****!:eek:

Specializes in HH, Peds, Rehab, Clinical.
I haven't seen an RN in an MD office in forever. I always ask, too. They dress up the MAs in scrubs with a fancy name tag with no credentials. I also report the facility to the nursing board if I catch the MAs calling themselves nurses. Because I'm a cranky old broad!

Oh yeah, they don't do anything to let you know they are NOT a nurse. If you call and ask for "Dr Smith's nurse", "Carrie" will get on the line and I KNOW she's an MA! If you ask for clarification you get "oh, I'm Dr. SMITH'S nurse". Um, no, you're not.:uhoh3:

Specializes in Peds/outpatient FP,derm,allergy/private duty.

To answer the original question in my state there is nothing illegal about an MA "taking a history" that involves the type of questions normally asked on a clipboard form, giving an injection, doing an EKG, or giving out lab results that are normal and require no follow up or special instructions.

We have these discussions here often. Our profession is in a state of flux - but it isn't personal. We had a real blow-out thread recently about vets calling their helpers "pet nurses" :uhoh21: . yeeeeahhh . . . that one got pretty heated, too.

Patient Education followed the RN right out the door. The impact of that is far reaching and one of the greatest losses.

When I trained as a MA I was required to have a HS diploma. Our grading system is the same as the LPN/ RN program @ the same school (80%=C). The program was also an AS degree. Critical thinking is a requirement so the MA is aware of a situation that requires the Dr. Most clinics in my area are staffed exclusively by MAs. Certification and completing an accredited training program are required. As in all programs theory only takes you so far and skill development occurs in the field.

MA+C.N.A.=PCT

Specializes in Surgical Acute Unit (Bariatrics & Ortho).

I worked at a clinic as an MA through the registry after I got my license because there were no RN jobs for New Grads at the time. The clinic had one nurse for patient education, but the rest of the staff was comprised of MAs.

The MAs were fantastic and taught me everything about working at a clinic, something I didn't know squat about. And in actuality, I would have eventually gotten bored with vitals, rooming patients, and giving injections. I think a well trained, compassionate MA can do all those things.

The part that was difficult, is that patients had to make an appointment to see the RN for education. Much of the education that occurs between patient & nurse requires a relationship be developed over time. Th MAs all had better relationships with the patients than the nurse did because they saw them at every appointment.

I think that MAs have a great place in the office, but I also think that there needs to be more than just one RN in an office. There needs to be someone who floats in and around, who actually provides direct supervision, and who drops in on patients to talk to them about their health.

JMHO.

Specializes in Oncology/Haemetology/HIV.

Oncology clinics that give chemo utilize RNs, because in most places, LPNs/MAs cannot hang chemo.

Beyond that, for about the last 30 years, it is mostly MAs in offices.

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