RN refusing MA assignment

Nurses Safety

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I am a nurse practitioner/back office manager in an OB/GYN office. A few weeks ago, we had to let go my medical assistant so we are work short handed until a replacement is found. She was also the "float" in the office. One of the other MA's this past week was off on vacation as she was getting married. THEN, another was out because her son was admitted emergently to the hospital. That left us with 2 for 4 physician's. The good thing is that usually there is one physician off per day and I can handle my own patients. SO-We had asked our triage RN to fill in and help be an MA for the day. She refused, initially, stating that it was against her licensure to be an MA (and go downward?) The position includes getting weights, blood pressures, stand by assist if needed. Clean the rooms. I have even filled in when the situation has arisen. I don't ask anyone to do anything that I, myself, am not willing to do. This particular day, I was to do my job, my MA's job, and by the phone triage person as well. She was angry because she also stated that such duties were not in her job description, however, the "clause" is performs other duties as necessary, especially in effort to assist, learn from and take direction from managers. Also included in the job description is clinical duties which are not performed by this nurse which now she states she is unable to perform because she has "now not been a clinical nurse for 35 years." "I was hired to be a triage nurse and a triage nurse only." She called in sick on Friday. This woman will be asked to fill in only one day this next week, as the MA that got married will be returning and the one with the ill child will still be out for another week. Any thoughts? Am I out of line in my expectations?

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Specializes in Pain mgmt, PCU.

Out of line for what? Asking for help, reasonable help, to keep an office running smoothly for a couple of weeks? and "The position includes getting weights, blood pressures, stand by assist if needed. Clean the rooms." Is like riding a horse. If she needs a refresher on how use a BP cuff that should be fairly quick. Standby assist may be a problem, but a workable one.

I don't know what the policy where you are is, but if she calls in again definite action needs to be taken. A third time requires a Dr. note to return to work. This all will put you even shorter w/o a triage nurse, but she needs to know that she's acting silly. :bugeyes: I never could understand that "I can't do it" people. At least TRY!

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You have my sympathy, however without knowing your state laws, if you are union or the other side of this coin I would hesitate to comment. I do wish you luck in your endevors.

TuTonka

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Specializes in ER.

Hi-

I just want to play devil's advocate. You hired a triage nurse and you got one. (Agree that she probably is making excuses about the weights and vitals. She should just be upfront.)

I personally can see where this is heading. You ask your triage nurse to do MA duties only to discover she can "juggle" both tasks and let go of the MAs and ask her to do more work for what, a buck more an hour? I have been caught in this cycle, more and more responsibilities, poorer and poorer work being done and less and less respect. The clause you refer to refers to things within her scope of responsibility, not anything and everything you want. Would you expect her to clean toilets because you asked her to?

YOU should find a temp agency. SHE is losing points for not being a TEAM PLAYER. It goes both ways and its good and bad for both of you.

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LOL Good point you devil you RN2tobeatlanta:)

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Specializes in Pain mgmt, PCU.
Hi-

I just want to play devil's advocate. You hired a triage nurse and you got one. (Agree that she probably is making excuses about the weights and vitals. She should just be upfront.)

I personally can see where this is heading. You ask your triage nurse to do MA duties only to discover she can "juggle" both tasks and let go of the MAs and ask her to do more work for what, a buck more an hour? I have been caught in this cycle, more and more responsibilities, poorer and poorer work being done and less and less respect. The clause you refer to refers to things within her scope of responsibility, not anything and everything you want. Would you expect her to clean toilets because you asked her to?

YOU should find a temp agency. SHE is losing points for not being a TEAM PLAYER. It goes both ways and its good and bad for both of you.

You have a point. However, it sound like the nurse is over reacting. I guess I did skip the part about her still having the triage to do. One day does not a MA make. I think at one time or another many of us have unwittingly been caught in this cycle - been there - and I would agree it can lead to exhaustion and decreased performance, if it were for more than one day.

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Specializes in EMS, ER, GI, PCU/Telemetry.

i don't think you were out of line at all. she's a member of the staff and should help out when things aren't running smoothly if she's able to. after all, you guys sign her paycheck.

you did not ask her to perform any duties outside of her scope of practice. she legally can perform the duties you asked to her do (taking weight and vitals, etc).

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LOL excellent point RN2beatlanta!

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LOL excellent point RN2beatlanta!

That is a good point.

However, when I worked in a doc's office we all pitched in. Cleaned a room, took vitals, etc. It didn't change the job description for anything more than a temporary time.

My neurologist takes his own vitals - it seemed odd to have a doc take my bp but he said why pay a lot of money for an RN since he doesn't do any office procedures (shots, etc.) that a nurse would be helpful for and he can take a bp as well as anyone.

steph

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Specializes in ICU, Home Health Care, End of Life, LTC.

If she claims to be unable to perform functions within the scope of a Registered Nurse:down: because she "has not been a clinical nurse for 35 years" it sounds like she has failed to meet her responsibilities as a registered nurse:cry:. The scope of nursing practice is well spelled out by the board of registered nursing in my state as well as the responsibility of nurses to remain COMPETENT. You might want to point this out to her during her exit interview:banghead:. In my state if you are aware of a nurse who is not able to practice according to the scope of nursing you are required by the terms of your license to report that nurse to the board:nono:. Sorry to be so grumpy but its been one of those weekends:madface:.

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There are plenty of doctor's offices without MA's also however I see the other side..if she can do both, why hire another? Perhaps a definite time can be discussed for help? This would allow team help but also asure her it won't be permanent?

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Your problem nurse sounds like somebody I would not like to work with for several reasons. She needs a reality check and attitude adjustment. Does your practice somehow reward for productivity (e.g. income?)-- I think profit sharing would help keep people motivated to pitch in for one another as team members.

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