NON-Nurses Giving Shots in MD Offices

Nurses General Nursing

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I apologize if this already has been discussed elsewhere, but wanted to point out the following:

I was in my MD's office for a physical and wanted two vaccines before international travel. The NON-nurse "medical assistant"--UNlicensed in NY--came in to administer the vaccines and I told her she was violating the law--she said she does it every day as part of her job! I told the MD I would get my vaccines elsewhere. Apparently this practice is rampant--at least here in NYC. MD Offices don't want to pay for patient safety by having a licensed nurse. ADMINISTRATION of medications is restricted BY LAW to licensed MDs, RNs/LPNs, and some others, but NOT "medical assistants." Have the Nursing Associations thought about cracking down on this? I do NOT think I'm being petty: administrating a medication--particularly, via injection--is serious stuff---in this case, she was going to use incorrect needles (assuming of course that she didn't plan on using the SAME needle for BOTH vaccines), amongst other errors...Upset about this. It's NOT brain surgery, but there are serious risks with all medications, which is why legally only specified licensed personnel may administer them. Your thoughts? Thanks.

Specializes in Med Surg.
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Get over it. Many Medical Assistants have 1-2 years of education, if not an associates degree, something not even required for Nurses. In many states they are licensed and authorized to to give shots among other things. In nursing school I memorized appropriate sites and stabbed a foam pad a few times. Injection administration is something virtually any competent person can be trained to do, including children. Which is why I find it puzzling when nurses denounce other health care professionals doing it, there's even a thread griping about pharmacists giving the flu vaccine. Shrug, better them than me I suppose. *wine

Ever been on the receiving end of home health? Insurance companies and Medicare will insist that a family member be taught to perform "routine" procedures when a competent person is available. I learned to give weekly B12 shots to my grandmother when I was 14 because Medicare said a family member needed to be doing this. Before I became a nurse, I had to flush PICC lines on my wife, do wound care (several times), and apply a wound vac. Since becoming a nurse I have actually been complimented on my wound care skills.

I did draw the line on the day they tried to get me to dc a PICC while talking me though it on the phone. :no: (Yes, it really happened, no I didn't do it)

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Just a thought: Perhaps a better way of dealing with the situation would be to ask the medical assistant questions about needle sizes, the procedure, the vaccine, the proper dose and side effects, etc. instead of getting confrontational and assume she doesn't know what she's doing. :)

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

That's very surprising you would think the CMA had no training in giving injections. I'm under the impression that is exactly one of the tasks she would be trained to do. I've seen the textbooks an MA friend had. Generally, they are taught to give shots, do EKGs, simple X-rays, positioning the patient for specialized exams, etc. depending on the type of practice the doctor has.

My doctor had a new MA a few months ago. I needed an intradermal PPD. She seemed really nervous, but when that little bubble formed I think she wanted to start jumping up and down and say"yippeee"!! :)

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Specializes in ICU, Cardiac Cath/EPS Labs.
Just a thought: Perhaps a better way of dealing with the situation would be to ask the medical assistant questions about needle sizes, the procedure, the vaccine, the proper dose and side effects, etc. instead of getting confrontational and assume she doesn't know what she's doing. :)

As she was about to stick me with an 18-gauge needle, I figured I didn't want to deal with educating her.

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One thing you have to stress that even in the states where MA are permitted to do shots, the doctor is totally responsible for any mistakes they make. That means his license and his money.

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Specializes in ICU, Cardiac Cath/EPS Labs.
Most Vaccinations are in individual single does vials, those that are not...well Certified Medical Assistants are trained, and permitted by the law in most states; and its really not hard to draw up a vaccination even in multiple dose vials...there is no math calculations or anything...but Certified Medical Assistants are trained in that too. Certified Medical Assistants have more training in injections than group-home workers. I find it odd that you rant and rave about Medical Assistants but have no problem with group-home workers giving injections; whom of which have less training...

In a state with a trained/educated/licensed "medical assistant," I would have no problem, but in NYState where ANYONE can be called a "medical assistant," I won't proffer my arm to an 18 gauge needle anytime soon.... Re: group-home workers giving meds in NYState, they DO HAVE training and legal authorization to administer meds--that's why I'm not "ranting + raving" about them...In fact, one of my classmates in my RN program previously worked as such a group-home "pourer" of meds: she taught the rest of us in RN school how to give injections and also got the highest grade in our pharmaceutical class.

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Specializes in ICU, Cardiac Cath/EPS Labs.
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Ever been on the receiving end of home health? Insurance companies and Medicare will insist that a family member be taught to perform "routine" procedures when a competent person is available. I learned to give weekly B12 shots to my grandmother when I was 14 because Medicare said a family member needed to be doing this. Before I became a nurse, I had to flush PICC lines on my wife, do wound care (several times), and apply a wound vac. Since becoming a nurse I have actually been complimented on my wound care skills.

I did draw the line on the day they tried to get me to dc a PICC while talking me though it on the phone. :no: (Yes, it really happened, no I didn't do it)

Thanks for the post, yes, you're right: people can give meds in such situations because there is no charge for services and thus those instances fall outside the State Nurse (and MD) Practice Acts; but where an MD is making $ but doesn't want to pay an RN/LPN, the law is violated in NYState.

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Specializes in ICU, Cardiac Cath/EPS Labs.

Nevada STOPS "Medical Assistants" from Giving Injections

http://74.125.95.132/search?q=cache:PHc20-qRHeYJ:www.lvrj.com/news/breaking_news/Judge-approves-62656457.html+nurses+injections+doctor%27s+offices&cd=16&hl=en&ct=clnk&gl=us&client=safari

Sep. 29, 2009

Copyright © Las Vegas Review-Journal

Injunction blocks ruling for medical assistants giving injections

LAS VEGAS REVIEW-JOURNAL

They should have let her speak. That was the message Tracy Hurst had for the Nevada State Board of Medical Examiners on Tuesday after a judge approved her lawyer’s request for an injunction that prevents emergency regulations allowing medical assistants to give flu shots.

District Judge Kathleen Delaney ruled the board violated the state’s open meeting law during a Sept. 18 hearing to pass the regulations, which would have permitted medical assistants to give flu shots and other vaccines, but also prohibit them from administering injections of cosmetic drugs such as Botox.

At that hearing, some doctors on the board said they had to leave for luncheon engagements and, in danger of losing its quorum, the board voted unanimously to pass the regulations.

Three people had yet to testify, including Hurst, owner of the Medical Spa at Summerlin, and on Tuesday, Delaney ruled the board had violated the open meeting law by voting before all public comment was taken.,,,

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Specializes in Ante-Intra-Postpartum, Post Gyne.
...In fact, one of my classmates in my RN program previously worked as such a group-home "pourer" of meds: she taught the rest of us in RN school how to give injections and also got the highest grade in our pharmaceutical class.

Really? Good for her! As a past Certified Medical Assistant I also helped other students learn out to give injections and got an A in my pharm class. Med "pourer"? they have training for that? I highly doubt the training she got as a med "pourer" is why she did so well in nursing school, it probably just her. My program for medical assisting was a year long, it was not just some afternoon spend on learning how to "pour" meds. I too find it frustrating that anyone can call themselves a medical assistant; I got trained and earned my title (even though I have moved on to nursing) If it bothers you maybe you should try to get a legislation that states medical assistants must be certified to practice.

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Specializes in ICU, Cardiac Cath/EPS Labs.
Really? Good for her! As a past Certified Medical Assistant I also helped other students learn out to give injections and got an A in my pharm class. Med "pourer"? they have training for that? I highly doubt the training she got as a med "pourer" is why she did so well in nursing school, it probably just her. My program for medical assisting was a year long, it was not just some afternoon spend on learning how to "pour" meds. I too find it frustrating that anyone can call themselves a medical assistant; I got trained and earned my title (even though I have moved on to nursing) If it bothers you maybe you should try to get a legislation that states medical assistants must be certified to practice.

In what state(s) were you a certified "medical assistant"? Were you authorized to provide injections?

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Specializes in Ante-Intra-Postpartum, Post Gyne.
In what state(s) were you a certified "medical assistant"? Were you authorized to provide injections?

I am in California. I was authorized to provide injections and draw blood.

How may medical assistants legally "administer medications"?

The phrase intends to mean the direct application of medication in several ways including simple injections, ingestion and inhalation or pre-measured medications. For our purposes, the phrase "administer medications" when used regarding medical assistants, means to inject, handle, or provide medications to a patient after verification by a physician, podiatrist or another appropriate licensed person.

Are medical assistants allowed to administer injections of scheduled drugs?

If after receiving the appropriate training as indicated in Item 1, medical assistants are allowed to administer injections of scheduled drugs only if the dosage is verified and the injection is intramuscular, intradermal or subcutaneous. The supervising physician or podiatrist must be on the premises as required in section 2069 of the Business and Professions Code, except as provided in subdivision (a) of that section. However, this does not include the administration of any anesthetic agent.

Are medical assistants allowed to start or disconnect IV's or administer injections or medication into IV's?

No. Medical assistants may not place the needle or start and disconnect the infusion tube of an IV. These procedures are considered invasive, and therefore, not within the medical assistant's scope of practice. Medical assistants are not allowed to administer medications or injections into the IV line. (Title 16 CCR 1366(b)(1))

more "cans" and "cants": http://www.medbd.ca.gov/allied/medical_assistants_questions.html#3

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Specializes in ICU, Cardiac Cath/EPS Labs.
I am in California. I was authorized to provide injections and draw blood.

more "cans" and "cants": http://www.medbd.ca.gov/allied/medical_assistants_questions.html#3

Thanks for the references.

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