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.

terrifying?

just because someone is licensed does not mean that they know what they are doing. i worked at a hospital for a very long time. i had nurses call me and ask me how to draw from a picc line. i had nurses calling me asking me what the difference between a cbc and a cmp was. i actually had an rn ask me to calculate the dosage because she was never any good at math. how does that make you feel??

i worked very hard to get to where i am. i am trained to do so. i am a medical assistant. and just some information for some people who don't know... the only thing a medical assistant cant do that a licensed practical nurse can do, is start and stop an iv, without a doctor present.

i graduated from a accredited program, and have a degree in allied health. so, yes. i know what i am doing.

according to the original poster, this is not a true statement in ny. she has provided links attesting to such. it sounds to me like individual states have individual laws and policies regarding what ma's are allowed to do. similarly, the nurse practice acts of various states are not identical.

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Specializes in ICU, Cardiac Cath/EPS Labs.
Medical Assistants today are being trained to daw blood and give injections. It is now part of their certification.

It depends on your state--very few permit this--and when the state does, there are certain restrictions, e.g., the MD must be on the premises.

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A lot of states allow Medical Assistants to give certain kinds of injections and to draw blood. A Medical Assistant with an Associates Degree have two years of training which is plenty for their scope of practice. Anything additional is up to the doctor to perform, and at that point they are working under the license of the Physician. Granted I would probably not allow a MA to start an IV in my arm, but I don't see why they can't take blood or give vaccinations. It's not like it is rocket science, especially with two years of training, and a national test that must be taken in order to gain accreditation as either a Certified Medical Assistant or a Registered Medical Assistant, anyone who is not certified can't use the CMA or RMA title, legally.

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Specializes in Emergency Dept. Trauma. Pediatrics.

An old thread that was bumped but I wanted to say that the MA's I know got a heck of a lot more training and practice when it came to injections and blood draws then we got in our school and then what I know many other fellow nurses got. They focused on IV stuff in school and did only a little on injection and blood draws with like 5 mins practice on the fake man arm.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
A lot of states allow Medical Assistants to give certain kinds of injections and to draw blood. A Medical Assistant with an Associates Degree have two years of training which is plenty for their scope of practice. Anything additional is up to the doctor to perform, and at that point they are working under the license of the Physician. Granted I would probably not allow a MA to start an IV in my arm, but I don't see why they can't take blood or give vaccinations. It's not like it is rocket science, especially with two years of training, and a national test that must be taken in order to gain accreditation as either a Certified Medical Assistant or a Registered Medical Assistant, anyone who is not certified can't use the CMA or RMA title, legally.

In a lot of states, including mine, there is no educational requirement to be an MA or to be "certified". The doctor trains the MA. A program can be 6 months long.

They can give injections if it is checked by an MD or nurse prior to administration, draw blood, but not start IVs or give meds via IV.

Once again the best place to find out what is legal in your state is to check with the Medical Board of that state. There are no rules and regulations that cover every state.

I wouldn't worry about an MA drawing blood or giving an IM injection. Some vaccinations and things like allergy immunotherapy shots require extra training.

Last time I had the PPD for TB I think it was the first time this MA had done an intradermal injection and I just about decided to hold her hand still for her it was shaking so bad and held my arm out till it hurt so as to help her. So I am not a big nurse meanie.

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In a lot of states, including mine, there is no educational requirement to be an MA or to be "certified". The doctor trains the MA. A program can be 6 months long.

They can give injections if it is checked by an MD or nurse prior to administration, draw blood, but not start IVs or give meds via IV.

Once again the best place to find out what is legal in your state is to check with the Medical Board of that state. There are no rules and regulations that cover every state.

I wouldn't worry about an MA drawing blood or giving an IM injection. Some vaccinations and things like allergy immunotherapy shots require extra training.

Last time I had the PPD for TB I think it was the first time this MA had done an intradermal injection and I just about decided to hold her hand still for her it was shaking so bad and held my arm out till it hurt so as to help her. So I am not a big nurse meanie.

In order to be certified as a Medical Assistant one must complete a CAHHEP approved program, and only then are they even allowed to take the national test for certification that is offered by the AAMA or AMT which are the governing body that approves CMA's and RMA's, respectively. Employer's do not typically hire a MA that isn't certified through the AAMA or AMT. Another thing is that employer's will not hire the graduates of these short programs unless they have one year of experience, and even then, where I live all CMA's are hired through Caromont Health which requires that all CMA's pass a written and skills exam in addition to being certified (by AAMA or AMT) in order to be hired. Most offices that are not linked with Caromont Health also have a similar system. In essence, it is VERY difficult for a CMA to gain employment right out of graduation without an Associates Degree. I do agree that there are MA's out there that have received very little training and should not be practising. However, I am lucky enough to live in an area where all the MA's are certified, and practically all of them have completed respectable programs, I know of the program that all of the CMA's at my Doctor's office graduated from. All this being said, there is a VERY STRONG push within the CMA/RMA community to require licensing in order to practice. I am one of them even though my main focus is becoming a RN.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
In order to be certified as a Medical Assistant one must complete a CAHHEP approved program, and only then are they even allowed to take the national test for certification that is offered by the AAMA or AMT which are the governing body that approves CMA's and RMA's, respectively. Employer's do not typically hire a MA that isn't certified through the AAMA or AMT. Another thing is that employer's will not hire the graduates of these short programs unless they have one year of experience, and even then, where I live all CMA's are hired through Caromont Health which requires that all CMA's pass a written and skills exam in addition to being certified (by AAMA or AMT) in order to be hired. Most offices that are not linked with Caromont Health also have a similar system. In essence, it is VERY difficult for a CMA to gain employment right out of graduation without an Associates Degree. I do agree that there are MA's out there that have received very little training and should not be practising. However, I am lucky enough to live in an area where all the MA's are certified, and practically all of them have completed respectable programs, I know of the program that all of the CMA's at my Doctor's office graduated from. All this being said, there is a VERY STRONG push within the CMA/RMA community to require licensing in order to practice. I am one of them even though my main focus is becoming a RN.

That's very interesting. I've worked in doctor's offices and clinics for a total of over 10 years in my state, and I find most doctors are only concerned with their balance sheets, a full set of appointments, getting them out on time and running interference between them and people they desire to avoid. Most prefer to train them in the specifics of their particular practice. Every doctor is going to practice in a way that suits his or her training, his ambition, and innumerable other peculiarities they posess. A few lovely souls still hire nurses, bless their hearts.

Giving an injection certainly isn't rocket science as you said, but neither is making an appointment, drawing blood, taking vital signs, asking what the chief complaint is, and doing an EKG. Everything I learned working in ambulatory care I learned on the job in a few weeks. A few examples: phlebotomy, how to spin blood/basic lab tests, pill counting (like a pharmacy tech), skin caliper testing, allergy testing, pulmonary function tests, glaucoma testing, ear lavage(barf), and lots of others.

I don't see the point in going to medical assistant school for two years when you can at least start your nursing education and maybe have your LPN or ADN in the same amount of time. That opens all sorts of doors that an MA doesn't have, and opens the door so you can do telephone triage and assessments.

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Specializes in ICU.

Terrifying? Nahhh, I don't think so. May they not be licenced, they are trained.

Take fertility treatments for example. Progesterone IM needs to be given in the buttocks. Who's going to do it in most cases? The spouse. So the spouse and the patient is trained and they administer it.

I was lucky enough I was nurse and my coworkers game me my shots. On then nights I wasn't working, my exH gave them. No problems there. he was very comfortable with it.

So, of course you don't want illegal practice, but it's not illegal in most states I believe.

Yes, a skill nurses learn is injections. We also learn how to wipe a good butt, make a good bed, how to draw blood. Which other unlicensed professional can to also, and sometimes better!

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Well the reason I am getting my CMA first is because I can't start the ADN program until Fall of 2013. Everything just lines up perfectly that way because I will be graduating the CMA in the Spring of 2013.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
Well the reason I am getting my CMA first is because I can't start the ADN program until Fall of 2013. Everything just lines up perfectly that way because I will be graduating the CMA in the Spring of 2013.

Best of luck to you! Just as an aside, I've been on my (24 yr old) son's case to at least give the CNA thing a try, and no go so far. Thanks for being a trailblazer. :)

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Best of luck to you! Just as an aside, I've been on my (24 yr old) son's case to at least give the CNA thing a try, and no go so far. Thanks for being a trailblazer. :)

Haha, thanks, I'm sure he will bloom sooner or later. I could start an ADN program in the Fall of 2012, but I don't feel like paying 20k for tuition (private school) :0, or being that much in debt.

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