NON-Nurses Giving Shots in MD Offices

nyforlove · Oct 7, 2009

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.

What "bothers" me is that NYState PROHIBITS "medical assistants" from administering meds, yet MDs Offices routinely flout the law and compromise patient safety because they prefer not to hire an RN/LPN. Is it too much to ask that the law be enforced? MDs are the first to oppose any legal expansion of Nurse Practitioners' scope of practice, yet brazenly facilitate "medical assistants" performing NURSE-ONLY functions.

HeartsOpenWide, RN · Oct 7, 2009

What "bothers" me is that NYState PROHIBITS "medical assistants" from administering meds, yet MDs Offices routinely flout the law and compromise patient safety because they prefer not to hire an RN/LPN. Is it too much to ask that the law be enforced? MDs are the first to oppose any legal expansion of Nurse Practitioners' scope of practice, yet brazenly facilitate "medical assistants" performing NURSE-ONLY functions.

Are the group home workers giving injections? Then they too would be performing "NURSE-ONLY" functions. Yes, Hippocrates are infuriating. Why not contact your state medical board if in fact what these medical assistants are doing is out of their scope of practice for your state. If everyone comes on here and complains but does nothing about it all we are going to get is more post like this, because no one is doing anything about it. Let it stop with you.

dream'n, BSN, RN · Oct 7, 2009

As far as I know there are very few states that make MA certification mandatory. Most allow anyone that the Dr. hires, at his/her own discretion, to be an office MA. Whether they completed MA school or receive on-the-job training. Generally an MA can perform any task that the Dr. wishes him/her to do. In some offices they do telephone triage, at others chemotherapy and suturing. They call in refills, take messages and return calls, do patient teaching, refill and administer medications, and on and on. I feel that the national nursing associations have totally ignored the issue and should have fought the use of MAs a long time ago. The associations have let down nurses and patients by ignoring this issue. I have seen offices where there are no nurses, only MAs. They triage the walk-ins, included a couple of times, MIs. As for lab results and messages, who do you think screens them. Very few Drs have the time to look at all the messages and labs every day. They depend on the staff to bring serious abnormalities to their attention. And who is doing the screening, the MA. For example, in one office a patient called c/o loss of vision in one eye. The MA set up an appointment for the following week. The patient had a retinal detachment. I have worked with some very good MAs in the past, BUT the occupation needs a definite scope of practice and limits. That's my :twocents:

allnurses Guide · Oct 7, 2009

It would seem to me that if you trust your doctor, wouldn't you trust him to hire a competent individual and make sure they are properly trained? I've worked in many doctor's offices and clinics, and honestly I've never had an MA make some sort of horrible mistake like is being described here. When I first started working for a Dermatologist years ago, I frankly did not know everything I needed to know about diagnoses and treatment of actinic keratoses, plantar warts, and blue nevi. Not something nursing school discusses much. Whether you are an RN, an LVN or an MA you will need to know YOUR doctor and his/her individual practice. They will train you on what can wait and what can't.

I guess, bottom line, as with nurses, MAs study their Scope of Practice. Sometimes doctors will ask ancillary staff to do things they have no business doing. We had a thread here where about a gastroenterologist asking the MA to cauterize polyps. Well her antenna went up, and rightly so. She refused to do it, even to the point of being let go.

NYforlove, if anyone tried to give me 0.5 to 1.0ml injection with an 18G needle I would be upset, too. The article from Las Vegas brings up a very important issue, that of "medical spas" that are new and grossly in need of regulation if untrained people are using lasers and giving botox injections, often there is no doctor at all. I would put them in a different category than the MD with MA or LPN or RN.

nyforlove · Oct 8, 2009

Are the group home workers giving injections? Then they too would be performing "NURSE-ONLY" functions. Yes, Hippocrates are infuriating. Why not contact your state medical board if in fact what these medical assistants are doing is out of their scope of practice for your state. If everyone comes on here and complains but does nothing about it all we are going to get is more post like this, because no one is doing anything about it. Let it stop with you.

Thanks HeartsOpenWide,

Oh, YES, I DO PLAN ON COMPLAINING to the state, but first doing research here and finding out more about the practice: its prevalence, illegality, dangerous consequences...I want to make sure I have my information prepared before making a complaint and ALLNURSES.com is a wonderful forum whereby nurses can help each other and the profession--an invaluable resource, which is why I have been a Premium Member for years. Thanks again for your post.

nyforlove · Oct 10, 2009

See related News Item and further discussion here:

https://allnurses.com/nursing-news/nevada-stops-medical-429303.html

nyforlove · Oct 13, 2009

i am a nursing student, who will graduating soon as an rn but i have been a medical assistant for 10 years.... obliviously there are incompetent people everywhere (yes-there are even nurses and doctors that do things that are wrong) and that is s separate issue. if the particular medical assistant was doing something that was unsafe or incorrect, it should be handled & reported just as it would be if any other licensed practitioner were doing it. the issue that you have mentioned that it is illegal and not within the scope of practice for medical assistants to administer vaccines is incorrect (at least in the state of oh.)
http://aamantl.org/employers/laws.aspx provides links to various state codes, ny is not specifically mentioned, but there is a link to send an inquiry to the aama executive director and staff legal counsel donald a. balasa, jd, mba, & he will respond to your query.

thanks for the reference!

flightnurse2b, LPN · Oct 13, 2009

not to add fuel to any fire.. but not all doctors actually hire certified/registered medical assistants... and very few states require it. alot of practices get away with paying these people very low wages to do the work of a clinic CMA/RMA and train them on the job.

i used to work in an outpatient endoscopy clinic where the doctors all had MA's assisting them in their offices. only one of them had actually been through MA training in a school, the others had learned on the job and were just given the title of "MA". i remember two of the procedure schedulers that had been there answering phones were offered the job of "MA" with no formal training, and both came back and asked our staff (which was required to be licensed) how to give IM and SQ injections and if they could practice on us... whatever, if the docs want them working under their license is fine, but i would rather have someone who atleast has a basic knowledge of A&P (which i know is taught in MA programs) if they are going near my backside with a needle.

no disrespect meant at all.

michigancma · Oct 19, 2009

Thank you, HeartsOpenWide! I truly appreciate you going to bat for the Medical Assistants who are responsible, skilled and capable of performing well at their jobs. You know, I too get tired of the rivalry. Granted there are some incompetent Medical Assistants out there, but the same holds true for some nurses. I've met a few incompetent nurses during my 14 year stint in this field.

Example: I was being administered a TB skin test by a RN. She went through all of the motions; and while drawing up the PPD solution the phone rang. She withdrew the syringe from the vial, sat the (uncapped) syringe down on the table, and answered the phone. Once she was finished with the phone call she came back over, picked up the syringe off of the table and proceeded to administer the test (i.e. trying to stick me with that syringe!) She also didn't bother to wash her hands again, nor use hand sanitizer. And yes, she was a registered nurse. Did I mention that she didn't bother to wear gloves either?

Do I think ALL RN's are incompetent just because of that one incident? Nope. I try not generalize and/or assume things about people.

And, for those that are interested in knowing. No, I didn't allow her to administer the test using that (contaminated) syringe.

Good day everyone!

michigancma · Oct 19, 2009

You're right, FlightNurse2b. But while some employers hire non-grads of an accredited Medical Assistant program, more and more employers are beginning to require formal education. Most employers (in Michigan, anyhow) actually prefer those who have graduated from an accredited program; be it ABHES or CAAHEP. Although currently it is optional for the M.A. graduate to become registered through the AMT (or) certified through the AAMA, soon it will be mandatory for all M.A. graduates to become nationally certified/registered. M.A.'s without a formal education are eligible to sit for either exam after 5 years of continued experience.

For me personally, after graduating from an ABHES accredited M.A. program I became certified through the American Association of Medical Assistants.

diane227, LPN, RN · Oct 20, 2009

When someone works in a physician office they work under a doctors license (unless they are an RN or an LPN). They can have the janitor give injections if they are willing to accept the responsibility.

Tinksrn · Oct 27, 2010

I know this is an old post... however I had to go get my tdap for pre-employment as a travel nurse. I have never been to a doctor's office where I have been given an IM injection by lab tech. So, yesterday was a first for me. I was very surprised. I can't say that I feel that it's a bad thing with the proper training- however, having said that- without having some basic knowledge about pharmacology and medication side effects is it really a good idea? I don't feel that it is. I read a post here that said that some lab techs are giving narcotics IM. I find this ridiculous. I would also like to mention that the IM injection I received was not in the correct area to give an injection. It was a bit late once the needle was in my arm to protest. She administered the IM injection in the very top of my deltiod muscle (level with the very top of my joint). I was completely speechless. I didn't think to ask prior to the injection if she was a nurse or not. She didn't have on any sort of identification- only scrubs. Once I had a copy of the paperwork I realized that she was listed as a lab tech. It may not be illegal but, at the VERY LEAST these individuals need to be properly educated about how to administer IM injection if they are going to administer them. I still really think it is a HUGE liability. :eek: