Medical Assistants the new RNs???

[ayorenee]

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?

[LV08]

I NEVER EVER ONCE said I was a nurse and always corrected patients if they said that I was. I was not a high school drop out. I graduated with a diploma. I have seen a lot of ads here in NJ stating you need a HS diploma to work with offices as an MA. That to me is outrageous! You need schooling to become an MA. You need to know what you are doing!!!!

I was MA for about 3 years in a pediatric office. I enjoyed it to the best that I could. Working there was a nightmare. But I got a lot of experience with the kids and that is what I wanted.

Since I want more, I am continuing my education for LPN. There is only so much an MA can do. We can not ever replace what an RN can do.

These small practices hire MA's for the wrong reasons a lot of times. The doctors are expecting the MA's to perform as an RN. That is where it goes all wrong. We do not have all the same knowledge. We know basic things. Then when a patient asks a question, you can't give it to them. The doctor expects you to know and if they don't have an RN on hand you can't help the patient. That is the big mistake.

I have been to many offices. Some MA's are good, and some have no idea what they are doing! But this goes along with LPN'S and RN's as well.

Putting someone down for being an MA is wrong. Putting someone in their place, well that is not so wrong.

It mostly is the doctor's fault for hiring people that are not well prepared for the position really is the big problem.

[dream'n, BSN, RN]

I have been to many offices. Some MA's are good, and some have no idea what they are doing! But this goes along with LPN'S and RN's as well.

Yes, I agree that every individual's skill/knowledge set is different. BUT a big difference is that LPNs and RNs take a national licensure exam to determine that they have a minimum level of competency. This does give some assurance that they have a good knowledge base. Whereas most states do not require that MAs be certified. And just because it is common practice for physicians to minimize costs by using MAs in their offices, it doesn't mean that I have to agree that it is a safe practice at this time. For the MA profession to gain credibility in my eyes, it must first standardize training, set up clear scope guidelines, and have a system to determine competency for ALL MAs to practice.

[tishluvnc]

Since you all are nurses and I'm a cna trying to make a career decision, maybe some of you can give me advise. Well I'm contemplating going back to school for LPN or RN, however my delima is that I need a job while I'm doing it, at least while I do my pre-reques. I will be graduating with a Ba in sociology in December and I'm doing an internship at a mental health agency (so boaring).

I'm on the track going into social work, but health care is my dream. I love being a CNA, but I'm only a CNA 1 and I've never worked in a facility. I love my patients been with them for years but for my own life I have to progress. I was contemplating finishing up a 2 semesters associate degree in medical office administration or becoming a MA for the time being, or returning back to school to redo my cna and begin to work in a LTC.

All I'm sure about is wanting to get back into health care my dream is to work either in a clinic, rehabilitation center, or public health agency. What is the best entry level job in your opinion.I's not about the money,but more about experience and being able to find a job and work part time. Thanks!

[FLmomof5]

Not all MAs are "equal". My DD is an MA at an urgent care clinic. She was eagerly hired by the Manager there when he saw that her experience was as a Combat Medic with 2 Iraq tours. The experience one gets as a combat medic cannot compare with schooled MAs and the Medic course for the Army is quite lengthy.

The urgent care clinic does not hire RNs either. However, the MAs there do not hold themselves out to be nurses. My DD is in the process of getting her RN/BSN.

I can see the logic used by clinics. For the most part, in an MD office and general clinics, the "nurse" gathered history, current complaint and vitals. At the end, the discharge instructions and prescription. Seems to me, an MA could do the same for far less cost.

[roser13, ASN, RN]

"I can see the logic used by clinics. For the most part, in an MD office and general clinics, the "nurse" gathered history, current complaint and vitals. At the end, the discharge instructions and prescription. Seems to me, an MA could do the same for far less cost. "

Yes, we all can see the business logic. But as has been noted previously in this thread, the patients are on the losing end. It is a hidden loss for the majority of patients and I'm not certain if the MD's even notice or care. But when the RN's/LPN's disappear from the medical practice, patient education disappears as well. Discharge instructions from the MA? What could those be, other than a printed form to be distributed? As long as we're at it, why not dispense standard discharge instructions from a machine? That would certainly be more cost-effective than employing an actual person.

Who will take the time to explain the implications of taking the new script? And what to do if X, Y, or Z happens? And what to expect down the road in terms of improvement of the illness/condition? The doctor? Not likely, especially since the push is on to see more and more patients per day in order to bump up the revenue.

Most importantly, who will take the time to listen to the patient's fears about their new diagnosis/medication/treatment plan? The doctor? Maybe. Maybe not. Traditionally, the nurse has been viewed (rightly or wrongly) as the more approachable, more patient-oriented figure in the clinic - the medical professional who builds a relationship with the patient and with whom the patient feels comfortable sharing concerns. It is of grave concern to me that patients continue to seek the advice and counsel of that "nurse" figure in the Dr's office, yet are completely unaware that the employee is not in any way, shape or form a nurse. Nor is the nurse figure remotely qualified to or capable of dispensing medical advice. Whether or not the MA covertly or overtly conveys the "nurse" title to patients, patients believe that the person next to the Dr who is handing out scripts and giving advice and instructions is the nurse. This thread is the perfect example of how uninformed some of us really are with regard to the current state of healthcare delivery - OP is an RN who had no idea that nurses have virtually disappeared from the office practice.

[nursel56]

FLMomof5 -I dont think anyone would disagree that your daughter is exceptional! You must be incrediblly proud of her. I am grateful to all the men and women who help make sure the things we value here will continue to be so long into the future.

I make the argument here all the time that it is not just the amount classroom time that makes a good nurse, but also the life experiences the person brings to the table. Your daughter is a very clear example of that. :)

[FLmomof5]

Thanks! And, yes, I am very proud of her.

[luvazsun, RN]

The Family Practice office I go to allows their MA to inject Botox. Apparently, if the doctor allows it, their MA can do anything. What next - starting IV's. AND - if you want a flu shot, etc you have to ask to schedule a "nurse visit" - that is false advertising IMO!

I think the point to consider is what are the "tasks" that once only an RN could do are now perfectly fine for a MA to do? For family members to do? Are they taught just "how to do the procedure" or are they taught why they are doing it? What are signs of a complication? How to problem solve? Seems rather scary to me, but it's the MD's license at risk.

[OCNRN63, RN]

Botox? I'd be getting a different doc.

At one of my doc visits the MA proceeded to talk to me in a condescending manner while doing "pt teaching." Not that it wasn't anything I hadn't learned a long time ago, ...What bothered me was her manner in teaching. I just let her go on with her spiel.

[MN-Nurse, ASN, RN]

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?

Yes. It sucks.

I had my peds clinical in a clinic where each unit was staffed by one RN and the rest were MAs. The MAs did all the cares. The RN would do "education" which consisted of handing the pt's family a pamphlet after the MA did her thing.

That was a USELESS clinical. The RN really couldn't work with me because they were doing administrative work and the MAs were insufferable jerks who thought they were RNs and called themselves, "nurses." The preceptor was nice enough to warn me, "The Medical Assistants all think they are RNs now and since you will be a "real" RN soon they will not work with you at all."

The supervisor noted, "They are doing all these cares undery MY license. My bosses said they would 'take care of me' if anything happened, but who knows what they will do?"

[MN-Nurse, ASN, RN]

Seems rather scary to me, but it's the MD's license at risk.

Nah, they just stick one RN on the property and hang his or her license out to dry.

[roser13, ASN, RN]

Nah, they just stick one RN on the property and hang his or her license out to dry.

MA's operate under the MD license, not the RN license.