Only LPN in an Office of MAs who want to act like nurses

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This is more of a vent, but I need a way to figure out how to handle this situation. I've been an LPN for 14 years. I worked in MedSurg & LTC until 2 years ago when I found a great office job. Its close to home I have holidays and weekends off. I'm able to drive my kids to school in the mornings, and I'm able to be at all their activities. I make less money, but it was worth the trade off. It's a small Family Practice office, and my docs are fantasic, as are all the girls I work with, personality wise. Great, right?

My job there is to call the abnormal test results, among about a million other things. This can get complicated if other people that don't have the experience to explain whats going on with the labs get a hold of them. Or the experience to know what can wait and what can't. For example, last Friday the lab called with a critical K+ level of 2.9 on a pt. while I was at lunch. The doc took the call, but since I wasn't around he asked the MA to find out what the BUN/CRT was. She tried to look it up in the computer, and when she couldn't find it, she let it sit. All weekend. I got the final lab report on Tuesday and nearly fell over. Luckily this particular pt. had home health that had been notified of the result, and they called her to see what we had told her, and when she said nothing, they encouraged her to go to the ED, and she refused and went to the local pharm and bought some OTC K+. Not the greatest solution, but better than doing nothing. I called her as soon as I saw what happened and got her a stat BMP, but sheesh, it was Tuesday! This is not the only example, but probably the most extreme. Both MAs in our office have graduated in the last year.

The other problem is that every staff member in the office is referred to as a nurse. I feel thats misleading to pts. They think the women answering the phone is a nurse, they think the MAs are nurses, and I'm really trying hard to not let it bother me, but the more these MAs are trying to assert that they can do my job the more annoyed I'm getting. I really feel these MAs are trying to assert themselves, and I understand they make less money, and they're on their feet all day, but they aren't nurses. They've never been on a floor. There's a difference between asking to learn how to do something and just taking it over and doing it wrong out of pride. Any ideas?

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Post your state's nurse practice act on the staff toilet wall.

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Specializes in Ambulatory (Urgent care) & Home Health.

Amen sista !:yeah: I've been a MA for 10 yrs and i've had alot of office jobs, time and time again you'll hear the front desk refer to the back office as "nurses" :banghead:. I would always let them know NOT to call me a nurse , i knew better but most of the MA's ive worked with rather enjoyed that title. Now that im in nursing school i'm really offended by that after i finish i want to be apart of whatever group there is to crack down on this type of behavior . When pts come to an office they assume the person in scrubs putting a needle in there arm is a nurse:confused: , most of time we didn't wear name tags and when asked " are you a nurse" I over heard the girls say yes:down:. I told them thats fraud impersonating a nurse but they just laughed:chuckle it off, the problem is alot of MA's say and i quote " We do the same things has the nurse" . I think its terrible , they might do the same job (in an office setting):( BUT 1 major difference is that they dont know why their doing it. You should talk with your office manager or Doc about this let them know that its illegal for those girls to call themselves nurses, that could cost the Doc a pretty penny if he's sued. Thats my:twocents::twocents: I'm soooo glad someone brought this up.

P.S... I love M.A's the ones that stay in their scope of practice are fabulous. They are an important part of the medical office setting . But to become an MA at least in my state(CA) you dont even need a high school diploma and the course is 3-6 months so anyone can become an MA i personally think it needs to be restructured and the pts should know. The lady that triaged your phone call, interpreted your labs and sticks a needle in you DOSEN'T have a high school diploma. There are some good MA programs but not enough.

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The MA's in California can't give shots without the MD present. I know that most MD's are in the facility, but if they're out the MA's can't give the shots. A nurse doesn't need the MD there, they practice under their own license. Also, they don't know the medications like a nurse does. They might know the basics of that they're giving, but they don't know the side effects, contraindications etc. See if the MA would have known labs, they would have known that K of 2.9 is critical and I'm blown away that they just sat on it all weekend long. Don't get me wrong, I've had some very good MA's, but they are medical assistants, not nurses and should be corrected.

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The MA's in California can't give shots without the MD present. I know that most MD's are in the facility, but if they're out the MA's can't give the shots. A nurse doesn't need the MD there, they practice under their own license. Also, they don't know the medications like a nurse does. They might know the basics of that they're giving, but they don't know the side effects, contraindications etc. See if the MA would have known labs, they would have known that K of 2.9 is critical and I'm blown away that they just sat on it all weekend long. Don't get me wrong, I've had some very good MA's, but they are medical assistants, not nurses and should be corrected.

wow. I didn't realize this. I just took my daughter last week to have her preschool physical. She needed 3 shots. The 'nurse' came in with the needles, was a very mature and lovely woman...and when I asked her if she was a 'nurse' (only to 'talk shop' since I am starting ns in 2 weeks) she immediately took the defensive. She told me she was not a nurse, but an MA, and continued on .....and i quote; "been one for over 30 years and I CAN RUN CIRCLES AROUND ANY NURSE with MY experience".

I almost fell over when that came out of her mouth....was a bit shocked at her reaction to being asked if she was a nurse. I was just trying to make conversation and distract my daughter and myself from the needles and impending 'doom' :). So, If i had known this "MA" was not allowed to give shots to my daughter, I am not quite sure how I would have reacted. Now, looking back, I may have said something. I wish I had known this. I don't think I will be taking my daughter back to this particular doc...I don't know. After learning this info, don't know how to feel. I am a little irritated by her poopy attitude, but now I am peeved at the doc who is allowing this?

What was the MD thinking? Isn't this taking a risk? do they get a slap on the hand for this or does anyone know? just curious.

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Specializes in Ambulatory (Urgent care) & Home Health.

Medical assistants ARE allowed to give shots and trained to do so, however i've worked with plenty of "MA's" that graduate from these quickie schools that have no idea what they are doing. I personally will only let a licensed person put needles in me or my child . My doc has an LVN on staff most of them dont because they can get off cheaper with an MA.

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No, I said that MA's can give injections, but the MD has to be present. I was told by one of my former nursing instructors who was a MA instructor before. I remember someone asking what's the difference between a LVN and a MA. That's where she broke it down basically that the LVN functions under her own license under the MD, MAs can give injections but with a MD present (in facility or in room, unclear), MA's have limited pharmacology compared to the LVN. I'm not sure, but I believe they can only give certain medications. I hope a MA can elaborate on this further.

For the person who had to deal with the MA who has 30 years experience and stated they can run circles against any nurse I can't believe that comment. Maybe in a doctors office against a new nurse. But over all, I don't believe that since the scope of practice is very limited with the MA and a nurse. There are LVN's that I've worked with that can run circles around any RN in the place that I work with, but again only compared to the level of skill. When it goes beyond the LVN's scope of practice, that's where the RN takes over.

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Medical assistants ARE allowed to give shots and trained to do so, however i've worked with plenty of "MA's" that graduate from these quickie schools that have no idea what they are doing. I personally will only let a licensed person put needles in me or my child . My doc has an LVN on staff most of them dont because they can get off cheaper with an MA.

Blowingbubbles (Love the screen name BTW), I just saw that you are a MA and have been for 10 years, can you elaborate more on the dispensing medications for me. I'm totally unclear since I was told almost 2 years ago the difference between a MA and a LVN/LPN. What are you allowed to do, and what aren't you allowed to do as a MA. Thanks

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Thanks for all the great comments every one. My understanding is the MA can give injestions with the Doc in the facility, call in RXs to pharmacies, and room pts. They have CPR training, but I'm not sure what if anything they are taught about lab values, which is the basis of my irritation. Again, I'm willing to explain anything to anyone, if I know they have a question. But I guess they have to know the question to ask in the first place!

As far as everyone in my office being a "nurse" it is starting to hurt my feelings a little. But it's my job, not a love fest...

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Specializes in LTC.

By MA ....does that mean they are just "medical assistants" or are they CNA 2s? When I had to go for my physical for nursing school....I went to my doc's office and had to get a tetorifice shot...I made the mistake of assuming that the ones that worked there were nurses...so I let this "nurse" give me my shot...ok....well this same "nurse" had worked w/ my labs before...they mail out the results and she signed her name "jane doe RN" on my labs...so for a whole freakin year I thought she was a nurse....til my clinical day at my own doc's office! I go with this one girl who tells me shes just a cna 2! Then she showed me their assignment board and OMG...there was that "Nurse" who signed my labs off as an RN and gave me the tetorifice shot!...she was a CNA!!!!!!!!!!!!!!!!! I let a CNA stick a needle in MY ARM!!!!!!!!!!! I was dumbfounded for sure. Turns out they work under the license of the doctors there. Still...it finally made sense as to why she didnt even ask me if I was allergic to anything..esp eggs which is NOT good if you're about to get a tetorifice shot. However...I do agree with the prior post...put up your nurse practice act in the bathroom....someone is sure to read it there eventually. Maybe you can find an article on the net about THE DIFFERENCE BETWEEN A MEDICAL ASSISTANT AND A LICENSED NURSE....and post it as well. The hint should be taken.

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What's a CNA 2? As far as I know CNA's can't give shots, and you've had a shot given to you by a CNA? This is crazy, doesn't the scope of a CNA have its limits? CNA's aren't trained to know what to do regarding injections.

For the CNA who signed her name as Jane Doe RN, I would report her especially if you still lab report. I don't know about other states but in California they post your name on the BRN if you're caught practicing as a RN with out a license. To me, that's practicing as a RN with out a license, hey the name was signed.

I don't understand why everyone doesn't wear a name tag in the office, the patients have a right to know who's a nurse and who's a medical assistant, and who's the doctor!

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Specializes in Community Health, Med-Surg, Home Health.
By MA ....does that mean they are just "medical assistants" or are they CNA 2s? When I had to go for my physical for nursing school....I went to my doc's office and had to get a tetorifice shot...I made the mistake of assuming that the ones that worked there were nurses...so I let this "nurse" give me my shot...ok....well this same "nurse" had worked w/ my labs before...they mail out the results and she signed her name "jane doe RN" on my labs...so for a whole freakin year I thought she was a nurse....til my clinical day at my own doc's office! I go with this one girl who tells me shes just a cna 2! Then she showed me their assignment board and OMG...there was that "Nurse" who signed my labs off as an RN and gave me the tetorifice shot!...she was a CNA!!!!!!!!!!!!!!!!! I let a CNA stick a needle in MY ARM!!!!!!!!!!! I was dumbfounded for sure. Turns out they work under the license of the doctors there. Still...it finally made sense as to why she didnt even ask me if I was allergic to anything..esp eggs which is NOT good if you're about to get a tetorifice shot. However...I do agree with the prior post...put up your nurse practice act in the bathroom....someone is sure to read it there eventually. Maybe you can find an article on the net about THE DIFFERENCE BETWEEN A MEDICAL ASSISTANT AND A LICENSED NURSE....and post it as well. The hint should be taken.

Just need to ask in case I overlooked something...tetorifice-allergy to eggs? I thought it was flu where we have to check for egg allergies. I double checked my drug book and immunize.org and didn't see where egg allergies was contraindicated.

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