Nursing Assistant drawing up and giving injections?

[OBNurseWannabe]

First of all I am new to this site. I am currently a nursing student in a RN ASN program! I will graduate next may and I'm so excited about that! Now the reason for my post is I'm concerned. I live in TN. I took my son to see his doctor today for a checkup and vaccinations. They used to have a wonderful LPN that did the shots, but now it seems they've gone the cheaper way and replaced all the nurses. The first girl that came in to give the injections said "oh well "V" drew these up but she did not sign off on this so I will be right back." Her name tag said Medical Office Assistant. Ok well the only problem there is you are giving an injection someone else drew up. Well then here comes "V" she's going to give the injections since she drew up the med. Her nametag clearly says "NURSING ASSISTANT" !!! I know she is not supposed to be drawing up or administering any medications. My question here is should I report this? And to who, the BON or the Department of Health also has where you can file a complaint on a practitioner. I am going to be switching pediatricians. I don't feel comfortable having a nursing assistant drawing up and giving meds to my child.

[Jolie, BSN]

The scope of practice of employees in a doctor's office may vary tremendously from the scope of practice of the same category of employee in a hospital or licensed health care agency or facility.

In an office, the employees are essentially working as agents of the physician, practicing under his/her license and can do virtually any task assigned, because they are acting as the hands of the physician. Many physician offices employ medical assistants, some with formal training and certification, and some hired off the street and trained in house.

I share your concern that someone with so little training is drawing up and administering medications/vaccines, however, it is unlikely that anything illegal has happened. I suggest speaking to the doctor and letting him/her know that this is unacceptable to you. You can insist on care from a licensed nurse in the future (if he employs one) or change offices, if needed.

[onetiredmomma]

Altho this differs states to state I would guess this falls under delegation guidlines. Having never worked in a dr office I am not sure what they can train and subsequently delegate to unlicensed staff. Start with BON to find out how this works in your states.

[LovebugLPN]

Did your child not get the injections then? Did you say anything to anyone?

[southern rn]

If the assistant gave the injection, how well did they do? Anyone can be taught to give a shot, many people give them to themselves or family members at home. It does not require a nursing license to learn to do this.

[roser13, ASN, RN]

"I am going to be switching pediatricians."

I doubt that you will likely find circumstances very different in another pediatrician's office. In my experience, MD offices are very regional. By that I mean that word seems to travel between MD's and so what one practice has initiated (MA's substituted for licensed nursing personnel, for example), other practices in the area will soon follow. Especiallly when it involves potential cost-savings to the practice.

[NurseLoveJoy88, ASN, RN]

When I was a cna in school health I gave injections to a diabetic student daily. I was a med tech and thoroughly trained by the Rn to do so. It depends on the facility and BON.I would never give a med I didnt draw up though, that is not safe.

[cheltoe]

I live in TN too. I have been told that anyone can give injections in a Dr.'s Office. The liability falls to the Doc. He can let anyone he chooses to give injections.

[wannabecnl]

This was also the case in our previous pediatrician's office (which is in NH). The medical assistant gave all the vaccinations; I do not know who drew them up, though. She was really, really good at it (very careful with sharps around the kids) and ended up going back to get her nursing degree. Go figure.

[P_RN, ADN, RN]

I worked for a general practitioner for 7 years as a Medical Assistant. I had 2 1/2 years in the BSN program when I got married and moved away. I gave at least 40 shots a week sometimes 40 a day in flu clinics. I was totally proficient as would anyone who is properly trained and my boss trusted me and I knew enough not to do things I hadn't been taught.

My internist actually has an RN in his office and she is great, but the medical assistants he has had in the past were equally good. The RN can do more things such as ABGs and checking my pacer that the MA wouldn't do. The onus is on the doctor in this state to hire appropriately, but I doubt many physicians have full RN staff. Most will have Medical Assistants.

[koi310]

You should contact your local DOH and BON if you're concerned about the legalities. I've never heard of it, but I don't live in your area.