So I called my FP's office to schedule an appointment for a lump I found in my breast. No big deal, probably a milk duct since I'm a lactating mom, but I wanted it checked out all the same. So I call the office for an appointment. The woman I spoke to was nice enough, and offered an appointment a week from the time I was calling. I questioned if I should be seen sooner or if it was ok to go a week out. So she starts asking questions, kind of assessing the situation. Well, I'm dumb but not stupid, so I ask, "Are you a nurse?" And she says, "Yes, I am, I'm Dr. S's nurse." And then I say, "Are you an RN or an LVN?" And she says,
"I'm neither. I'm a Medical Assistant."
AAAGGGHHH. I replied, "Then you are not a nurse and you shouldn't be trying to assess over the phone." I wasn't trying to be a rude b*tch, but when a MA, who has very limited medical training, is trying to assess a breast lump over the phone, she should not pass herself off as a nurse. I spoke to one of the docs in the clinic, who is a friend, and I told her she needed to speak to this "nurse", because that MA was opening the clinic up to major medical liability if she screwed up and assessed something or someone she wasn't supposed to.
Am I off here? Or am I just being a cranky new mom? I guess I'm just protective of the title "nurse", since that implies a certain skill and knowledge set.
Have you talked to your cousin about the possible legal ramifications concerning this?
It makes me wonder about what these instructors in these MA courses are telling their students. Has anyone seen the advertisments for Georgia Medical Institute? Without using the word "nurse" at all in their advertisment, they certainly leave the impression that anyone can beome a nurse "in a few short months."
One of our local vocational training schools, doesn't use the term Medical Assistant, when advertising it's school. It shows a picture of a young women in scrubs with the caption "medical professional", under her picture.
I get uncomfortable, as a nursing assistant, when people refer to me as a nurse. I don't want that kind of liability when I don't have that level of expertise. I've even had a patient call me Doctor. Uh, just because I can take vital signs doesn't make me a doctor!
My sister refers to her MIL as a nurse even though she's an MA. There does seem to be a widespread confusion in the public arena about what the difference is between the two. Last night one of my coworkers (who is an MA at her other job) lectured me about how important it is for me as a NURSE to take accurate vital signs. Uh, I'm NOT A NURSE! I'm tempted to correct these people, but they would probably get irritated and say "Whatever".
Here's an update. I complained to my doctor and stressed the liability part of it. Who knows if anything will change.
While I was there, I asked for Miriam to be weighed, since she's 6 weeks old and I was curious. (She's almost 14 lbs and was 8 lb 9 oz at birth, so I'm thrilled.)
When they went to weigh her, they pulled out a piece of paper to line the scale with, and what did it have written all over it??!?!?!?!?!?!?!?
ENFAMIL. It was a freakin' advertisement for a formula company!!!
Those of you who know me from my posts know that I had a total cow. I complained to the doc (boy, was SHE happy to see me! :) ) and to the clinic manager. The doc had a great response (she was very unthrilled to hear about the scale liners), but the clinic manager had some real gems.
She justified the decision for a couple of reasons:
1. It was free, so they HAVE to use it. *ahem* If you had free stuff from Phillip Morris, would you HAVE to use that, too?
2. Even though some women nurse, and the clinics supports breastfeeding, some women just CAN'T nurse. Well, no duh, lady, but that doesn't mean you should give free formula advertising when the research says that doing so lowers breastfeeding rates.
Really, her comment is about guilt. They don't want to make women feel guilty for not breastfeeding. Fine, don't. But don't sabotage the healthier choice, either. As a health care clinic, make your stand strong and unambiguous. Just because some moms can't or don't want to doesn't mean you remain "neutral". Have lactation consultants that you can call, have a mother-to-mother nursing group that meets at the clinic, have the #'s of LLL leaders women can call. And then maybe (*gasp*) you'll see your BFing rates rise.
Oh, and you know what burns my hide, too? They put out the stupid formula papers, but had NO breastfeeding/nursing promotion posters up. Nada. (That was justified on the basis that the clinic is "new". Oh puh-leeze. It's been open since 2003.) In fact, the doc I met with said she and another doc tried to put out some BF pamphlets, and they mysteriously disappeared.
I'm writing a letter to the head of the clinic (the pediatrician who is not really so BF friendly), and CCing it to the Dean of the medical school. I'm also going to offer to give a class on breastfeeding promotion, and will offer free posters as well. Anything to help change the attitudes floating around the clinic. My husband, who's a med school student, is going to contact the OB-GYN and Pediatric clubs on campus and enlist their help.
Thanks for letting me vent, everyone. The situation is making me nuts. Still, there's possibility for change, and that warms the cockles of my heart. (Even though it may take guerilla tactics to do so. )
Oh, and if they choose to not change anything at the clinic, I will let them know that any chance I get, I'll make sure that every nursing mother I know should NOT take their children to that clinic. Sometimes appealing to the financial side is the only route you have.
Hopefully this will not be the case. I want to see the clinic succeed. But it needs to follow the osteopathic model of promoting health and preventing disease, not just treating illness. (Though as a clinic, they certainly stand to make more money from formula fed babies, since they generally suffer from more illness and have a higher # of doctor visits, according to the research.)
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
AHHHH You are right to be peeved, but in the huge scheme of things, you may be "tilting at windmills", here, so to speak. MANY dr offices and hospitals get and use Formula-provided tools and freebies like these and it's hard to get them to stop. One thing, as nurse, I do NOT eat the meals the formula companies provide us when they have their "classes" for us. These classes are to tell us the latest about their formula, e.g. Lipil, AHA etc and promotional deals for our patients. I will listen, and politely, because some of my patients choose to use formula and they should know what is in there. I however, am not willing to be "bought" by eating their dinners and I try not to use their pens, etc. I do have a name badge holder w/Similac on it. I need to replace it w/something more appropriate, now that I think of it.
I feel I also am fighting a losing battle, e.g. "tilting at windmills" myself, but it's my own personal code.
I just do not want to be "bought" by formula companies as a health care professional.
I hate handing out diaper bags, for the same reason. I don't like the inference "Breast is best, but JUST IN CASE, here is the formula!". One place I worked, the Pediatrician had a standing order, "remove all formula and ads from the diaper bags prior to issue for breastfeeding moms". Pretty gutsy move on his part, but no one argued w/him on it. I thought it was great and did this w/pleasure.
I hate handing out diaper bags, for the same reason. I don't like the inference "Breast is best, but JUST IN CASE, here is the formula!". One place I worked, the Pediatrician had a standing order, "remove all formula and ads from the diaper bags prior to issue for breastfeeding moms". Pretty gutsy move on his part, but no one argued w/him on it. I thought it was great and did this w/pleasure.
deb
A very gutsy move, if you consider health promotion and standing up for babies to be "gutsy". How sad that it is. There is such clear research about what those formula gift packs do to sabotage breastfeeding that any hospital handing them out to nursing moms should be ashamed of itself. There aer so many other products you could put in there. When I was discharged from the hospital with my ds, the nurse there actually tried pushing me into accepting the formula. ("But what if there's an emergency??")
Well, as we've seen from the Gulf Coast, emergencies do happen, and I'll take breastmilk over contaminated water in my formula bottle, thanks. *shudder* This should be a call to action for hospitals and heath care professionals. My heart goes out to the bottle feeding moms down there who were probably panicked over not having clean water for their babies. Such a scary situation. But our society could help prevent some of those deaths if it wasn't so busy shoving formula at women at the dr's office, at the hospital, in major maazines and through direct advertising to the consumer.
On another message board I frequent, many of the mothers said they would have accepted the emergency formula, drank it themselves to stay hydrated, then continued to nurse their babies and toddlers.
Deb, I admire the fact that you do not partake in the meals and use formula products. (But heck, I admire you, period!) It is not always easy to take a stand on such things. But popularity is not my first goal, healthy moms and babies are. When I become a nurse (*please God!*), I will always try and put my patients/clients before profits.
If a woman wants to bottle feed, I also believe that more education needs to be done regarding how to bottle feed. I'm sick to death of seeing propped bottles and babies not being held or forced to hold their own bottles prematurely. Bottle feeding can be done with so much love, and I think health care educators can stress that as well. Just a thought.
I hate handing out diaper bags, for the same reason. I don't like the inference "Breast is best, but JUST IN CASE, here is the formula!". One place I worked, the Pediatrician had a standing order, "remove all formula and ads from the diaper bags prior to issue for breastfeeding moms". Pretty gutsy move on his part, but no one argued w/him on it. I thought it was great and did this w/pleasure.
deb
*****
Deb - we used to do the same thing, formula, coupons and all related formula stuff. Until one new mom who was breastfeeding found out from a friend of hers who was also a new mom and NOT breastfeeding, that the bags had formula in them. BFing mom came in and made a complaint that her formula was removed. Needless to say, we had to stop doing that.
Specializes in Case Mgmt; Mat/Child, Critical Care.
Sorry, but I haven't seen any negative attitudes here. The bottom line is....MA's/Techs, NA's....unlicensed assistive personnel can not, under any circumstances, assess and then "triage" a pt.. It is against the nurse practice act. Assessment is something that only RN's are licensed to do. And yes, most nurses are protective with the term "nurse", rightly so.
MA are allowed to ask questions over the phone. How was she assessing? I though she was asking questions. I work as a Certified Medical Assistant as I am going to school. When patients call and asked to talk to a nurse the receptionist says, "We do not have nurses, we have medical assistants, would you like to talk to one?"
MAs are allowed to triage, which involves asking questions so they can tell the doctor what is going on. But not make major decisions.
They can however give basic medical advise, like "Your U/A came back and indicates that you have a UTI. The doctor is having me call in an Rx for you. It is a good idea to drink a lot of orange juice. Avoid bubble baths and make sure you urinate frequently and not hold it too long." Then when they ask questions about the test result they can say, "Normal range for urine pH is 5.0 to 7.0. Above 7.0 is considered alkaline, and below 5.0 is acid. If a urine specimen is above a pH of 7.0, more than likely it contains a large amount of bacteria, which is why the urine is alkaline. Urinary casts that are formed in the kidneys are destroyed, and urinary casts are important in the diagnosis of a patient' condition. Adjustments can be made to help the body balance out pH levels. A patient with a condition like the above, maybe instructed by their doctor to drink large amounts of orange juice, not only to help flush the bacteria out of the urinary system, but to help balance their pH levels with the orange juice's citric acid.
When homeostasis is out of balance, all cells of the body suffer. Moderate dysfunctions, like bacteria in the urine that causes a pH level rise, can cause illness, like a painful burn upon urination (UTI). Severe dysfunction can lead to death."
Yes, MA's should not refer to themselves as Nurses. I however hope that when I become a nurse I do not gain such a negative attitude about some one that has a lower status than me. I know when I become a nurse I do not want a doctor to say "Oh, what advise can she give? She is only a nurse"
As a MA we are told over and over again-all the way through school not to do what this woman has done to you, I would say something so this problem can be corrected. But we are advised to ask questions so we can better help the patient get what they need-ie: appt to see the Dr. and how soon the appt should be ect...
It is against the law in Texas to represent yourself as a licensed nurse when you are not one. Is that not so in your state? The District Atty. in Texas prosecutes people who pass themselves off as nurses (even LVN';s who say they are RN's).
Ditto NC.
But it is a problem. The CNA's in home health or even the personal care aides, which in some companies are simply OFF THE STREET help , just LOVE to call themselves nurses.
I'm not even really too polite, I just say, "you mean Nurse's aide?".
This is one subject that really really makes me angry. We have this problem at the hospital with medical assistants calling Dr's orders to the floor. They say they are the Dr's nurse. Are you an LPN or RN? No I'm a REGISTERED MEDICAL ASSISTANT . This one particular chick has pulled this on me at leat 5 times in the past year and each time I've told her "IT IS AGAINST THE LAW TO SAY THAT YOU ARE A NURSE IF YOU ARE NOT", she continues to call "I'm Dr L's nurse. OMG Makes my blood boil !!! I reported her to the CNO, to Administration, to Dr. L himself and nothing was done about it. By some miracle last week these fliers went up all over the station and all over the dictation room that states "It's against the law for the floor nurses to accept a doctors order over the phone from anyone other than a licensed health professional which excludes MEDICAL ASSISTANTS! I just dare her, I just double dare her to try to identify herself as a nurse again. I believe the flier says it's Federal law but not 100% sure. Will check Wednesday when I work again and will let you all know. I think I'll send Dr L's Medical Assistant a copy in the mail for prosperity. OMG Makes my blood boil !!!!:angryfire :angryfire :angryfire
I posted earlier about my cousin the MA, and I took one poster's advice about telling her about the ramifications of calling herself a nurse. However in our conversation I was enlightened. It seems MAs go to school, just like nurses, but then their education continues under the direction of a physician. I know nurses do CEs, but this sounds like it is a little different. Their CE is more like an apprenticeship, and they have no definitive scope of practice. So if their physician teaches them to hang IVs, supposedly (and I'm only taking this from what she told me!) they are legally allowed to do so. And so on and so on. She said that they aren't taught to call themselves nurses in school, but after being taken under the wing of a MD and learning "nursing" skills, a lot of the MDs start to refer to them as "my nurse". She said that after gaining the MD's respect and mastering certain skills they do feel justified to call themselves "Dr. Z's nurse." She said she would never refer to herself as "A nurse", but only as his/her nurse specifically. She related it to a sickly husband calling his wife, the caregiver, "my nurse".
It is definitely not right, and I SO DO NOT AGREE, but I felt I would share from her POV, just so as an example of how one MA felt about the nurse title.
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hipab4hands
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