Medical Assistants in the office

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This is probably going to open a can of worms.............but how do you all feel about replacing nurses in the office setting with Medical Assistants? How (if at all) do you feel it affects patient care?

Do any of the MA's in your offices refer to themselves as "nurses"? Have you had any problems with the knowledge base of the MA's? How are they with patient education?

May be just my situation, but I have run across some significant problems in this area................and not sure how to address it...........or even if I can address it.

We also have to remember that we are chosing to be in the profession that we are in. Once there, we can move around, go back to school, stay where we are at, etc. There should be respect across the professions, and I do have my own very strong feelings on this issue. However, teh bottom line is that there is a big difference between what CMA's and RN's do. Sometimes that line is muddled in a clinic setting, and ultimately, we all have to take responsibility for the tasks we perform....especially if it is out of our scope of practice.

I'm going back to school because it's hard to stay put. I need to learn more and be more, for my own satisfaction. As much as I love what I do, I won't be able to obtain my goals if I don't go back to school. And, yes, some more respect for what I do would be good. I've fought hard for it, but the truth is that it's hard to change percepetions of the CMA profession. That's why you should always work hard, learn as much as you can, stay within your scope and represent yourself as a professional. Be a role model for the profession...it's the only way things may ever change!

My 2 cents!

Lisa

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I just wanted to share my experience. I am a CMA and work at an Urgent Care clinic. I am the only clinical staff on duty. It is me, a doctor, and a receptionist. If someone comes in having a heart attack, bleeding profusely, or fresh from an MVA the doctor and I have to handle it. I do labs, xrays, IV's, straight catheters, triage etc.. I have had excess training and the doctor wants me to do those tasks. My nametag has my name/certified medical assistant. Below it reads clinic nurse/ my hospital. This is how they choose to label me, not how I label myself.

I also wanted to add that 10 years ago when I checked into schooling, I was told that they were phasing out LPN's. They had a 2 year CMA program or 4 year RN, no LPN program offered. They were phasing CMA's into clinics, and leaving the RN's for hospitals, claiming they would have no need for LPN's. Obviously things have changed. I am having great experiences as a CMA, but yes I do feel limited and that is why I have chosen to go further.

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I don't know about other states but in NC it's against the law for someone to identify a person a "a nurse" unless they are a licsensed nurse (LPN or RN). :nono:

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I sat here reading these posts from the beginning (2001 or so) I am an ofice nurse, an RN, and have had this med. assistant versus nurse problem for several years now. I have been in a private, two doctor office for three years now. He just hired a person off the street, actually a friend of his. She had no prior experience. My other two coworkers are a man who is a graduate of a cma program.The office manager has been the primary fake nurse for years, she is medically untrained and OUR BOSS. She is the primary nurse in the practice and is very good at it BUT It irks me every day that an untrained quote nurse can get to be my boss and an untrained person can get a job in an office giving shots without any formal training. The office manager trained her, I was not even asked. The doctor calls everyone nurse and I resent it. We dont wear name tags. Everyone thinks we are all nurses. The public doesnt care and doesnt even think to ask. We put on our white labs coats and we are nurses.Why does the ANA allow this? If youre a hairdresser you need training and a license. If youre a plumber you need training and a license. IF youre an undertaker you need training and a license. If your a medical assitant it should be the law that you have training and a license.Why is the American Nurses Assoc. allowing this kind of NURSES JOBS to be given away to untrained people? THey fought a long battle to see nursing as a profession not an occupation , and that stupid ongoing debate about adn versus bsn, but they have ignored the fact that an office nurse will be a thing of the past. WHat is next?I can only see it getting worse. My partime second job is in assisted living. Those nurses aides give the medicines to the residents,even the narcotics, the nurse doesnt. THis is what is next. Many States allow medical assistants to give meds out. I bet that in the future the nurses aides in hospitals will be doing the medicines and the IV's and all the tasks the nurses do now. I just so angry I wasted four years of school and still have my loan to repay and the uneducated people get 2 dollars less an hour than I do, but get the respect of being THE NURSE.

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Specializes in Oncology/Haemetology/HIV.

And how is the ANA to prevent this? They have no power of law to do so.

Your Board that licenses you is the culprit. You need to be reporting it to them for action.

And why do you work there? If you continue to work in the situation and do nothing to change it, then you are tacitly supporting it.

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I know the ANA isnt involved with laws but I have contacted the Mass BORN and it is allowed in Mass to have unlicensed and untrained people as medical assistants. On the job training under the physician is allthat is required. I still can not believe that the woman who cuts my hair had to have 1000 hours of training and a license and my new coworker is a former church secretary.

Why do I work there? Do you think this is an isolated case? My doctors office is one of thousands that are replacing nurses with untrained people, but these people are still called the nurse. How would you suggest I try to change this?

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I just wanted to reply and state that the public does care who takes care of them. I am a CMA and have been for 8 years now, and there have been many instances in which patients have questioned my credentials...mostly because many people don't know what a CMA is/does. I have even had 2 times that patients have asked for an RN to give their injections, because they were more comfortable with an RN. I can admit that at first, I was offended by this, but now I have a different heart. As I have posted before, CMA's should be trainied by an accredited school, and they should be certified by the AAMA in order to work. I know this isn't the case. I work for a Mayo institution, and we have 3 "CMA's" on staff that are either unofficially trained or not certified, or both. I can tell you that it takes a lot of work to become recertified every 5 years...but it should be required. As well, we are often put into situations in which we are asked to use skills higher than our training permits...like Foley changes and giving some meds above our training ( allergy shots, etc). All of this, and the lack of respect for my profession have really driven home for me, that I need to be an RN. It's an absolute calling for me and I will never be satisfied if I"m not.

Here is what you do to take action against misrepresentation or misutilization of CMA's in your office: contact the AAMA. http://www.aama.org They can assist in problems with certified individuals. Like already posted, there really is nothing to be done about the uncertified people. Take issue with your employer if nothing else. I am now on a counsel at the clinic where I work to help seperate the duties of the staff CMA's and RN's. I feel there needs to be a very clear line.

Take care

Lisa

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We currently have 2 MA's at our family practice office. It was a difficult transition for the first one hired, as all the other nursing staff consisted of RN's and LPN's. She met a lot of resistance from our head nurse, who didn't like the idea of hiring MA's. Now, with 2 hired, the staff has more flexibility and has become very cohesive.

Frankly, if the person is trained properly and given adequate supervision, I feel they can be as competent as a RN or LPN.

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Thank you for the reply about the AAMA organization. That is a helpful reply. I was so upset about this I went to the local hospital and applied for a job so I could work with real nurses and real LPN and CMA. I was totally shocked when the nurse recruiter at xx hospital told me that since I have been an office nurse for 10 years I am unemployable at the hospital. I got so angry and depressed I took a ativan I had at home for my tooth extraction I had last year!! SO this woman walked in my office with no medical training and she gets a job, my supervisor is the former secretary turned nurse and this registered nurse isnt even offered the chance to work at a hospital!

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I sat here reading these posts from the beginning (2001 or so) I am an ofice nurse, an RN, and have had this med. assistant versus nurse problem for several years now. I have been in a private, two doctor office for three years now. He just hired a person off the street, actually a friend of his. She had no prior experience. My other two coworkers are a man who is a graduate of a cma program.The office manager has been the primary fake nurse for years, she is medically untrained and OUR BOSS. She is the primary nurse in the practice and is very good at it BUT It irks me every day that an untrained quote nurse can get to be my boss and an untrained person can get a job in an office giving shots without any formal training. The office manager trained her, I was not even asked. The doctor calls everyone nurse and I resent it. We dont wear name tags. Everyone thinks we are all nurses. The public doesnt care and doesnt even think to ask. We put on our white labs coats and we are nurses.Why does the ANA allow this? If youre a hairdresser you need training and a license. If youre a plumber you need training and a license. IF youre an undertaker you need training and a license. If your a medical assitant it should be the law that you have training and a license.Why is the American Nurses Assoc. allowing this kind of NURSES JOBS to be given away to untrained people? THey fought a long battle to see nursing as a profession not an occupation , and that stupid ongoing debate about adn versus bsn, but they have ignored the fact that an office nurse will be a thing of the past. WHat is next?I can only see it getting worse. My partime second job is in assisted living. Those nurses aides give the medicines to the residents,even the narcotics, the nurse doesnt. THis is what is next. Many States allow medical assistants to give meds out. I bet that in the future the nurses aides in hospitals will be doing the medicines and the IV's and all the tasks the nurses do now. I just so angry I wasted four years of school and still have my loan to repay and the uneducated people get 2 dollars less an hour than I do, but get the respect of being THE NURSE.

The ANA is an essentially powerless lobby. Don't waste your time or money on them. Go straight to the source and work through your board of nursing. In North Carolina, as previously stated, it is against the law for anyone to refer to themselves as a nurse unless they are a RN or LPN. It is also a requirement of law for all health care providers to wear name tags with their title. The law states that the patient has the right to know who is working on them and what their qualifications are before they are touched by the health care provider. Violations are punishible by a $250 fine, at least that's what a former CMA got charged for calling herself a Nurse.

The law got changed in this state by nurses who were fed up with physicians and their tricks to make us powerless. We elected a board of nursing with teeth, replaced the dinosaurs, and got some reasonable laws enacted. You should do the same, or maybe move to North Carolina. We need more nurses.

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Medical Assisting Programs don't include any nursing courses because there is no reason for CMAs to know basic nursing skills. Don't confuse medical assistants with nurse assistants. Certified Medical Assistants (CMAs) do need to learn basic medical assisting skills though. Any acredited medical assisting program includes pathology, psychology, patient education, symptom analysis, therapeutic relations, law and ethics, and all the technical skills such as minor surgery assisting, urinalysis, venipuncture, ECG, blood tests, etc. None of those technical skills are included in nursing and that is a major difference between the two professions. I have seen so many nurses botch ECGs and blood draws and lab test because they simply don't know how to do them. Those are the technical skills needed for the doctors offices which is why CMAs do them and nurses don't. As far as the assessment skills, RNs do learn a much higher level of patient assessment than the CMA or the LPN. This is because in the hospital setting the RN needs to be able to assess the patients and alert the physician if needed or making nursing decisions as indicated. It all make perfect sense if you think about the basic of the curriculum linked to the jobs performed. Great conversation!!

Nurses don't learn technical skills? LPNs aren't doing high levels of assessments? Gee when I went to LPN school we leaned all those "technical" skills only then they were called "essential nursing skills" as were the assessment skills we were trained in. These days, in NC, LPNs still use these essential nursing skills (to include venipuncture, EKG, routine waived lab tests, IVs, patient assessment etc) on a daily basis. In fact RNs do so as well, what with those being essential nursing skills. While it is true that many RN programs are getting away from essential nursing skills and teaching more esoteric stuff such as the "theory of nursing", any program worth attending still teaches the "technical skills"

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Specializes in ER, OB/GYN, Womens Health.

We have MA's throughout the clinics I work at. Some of them think quite a bit of themselves, I guess that's all fine and good as long as their performance can live up to their attitude. However, I'm a little concerned over the fact that they are allowed to give Injections...especially narcotic injections....I came from an area that MA's were not allowed to give injections of any kind......have the MA's that are allowed to give them, been specially trained to do so? I would just be a little afraid of how that would hold up in court?.....hhmmm.

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