*rant* "Nurse" at office answering questions.

Published

Hi all.

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.

Alison

Specializes in OB, M/S, HH, Medical Imaging RN.

:angryfire You're right her POV is WRONG. A nurse goes to nursing school and graduates as a "nurse", earns a college degree, and holds a nursing license. Why can't they be Dr's L's assistant? They are not nurses! I worked very hard to get my degree and am insulted by their arrogance. In Tennesse they are not allowed to deal with IV's no matter who teaches what and I personally don't know any Doctors who know how to handle and IV themselves. They always push the call light. Come make this thing be quiet!!! Can you tell this is a sore subject with me? :angryfire

I . It seems MAs go to school, just like nurses, but then their education continues under the direction of a physician. 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. ls 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.[/quote

Your cousin is setting herself up for serious trouble .

1. MA's do not have to go to school. A dr. can pull anyone off the street and given them the title of MA. However the dr. is responsible of all actions of that person.

2. MA school is a misnomer. In some "schools," you can take a 90 day course and get a certificate. I've worked with MA's, who've come out of these "schools", not knowing how to assemble a syringe and needle.

3. MA's are not allowed to hang IV's or manage them, even if the dr. told them to do it.

4. MA's definately have a scope of practice- they have to work under the direct supervision of a dr./ they can not do invasive procedures, they can not give narcotics, etc.

5. Your cousin is not "justified" in calling herself a nurse. This is the equivalent of me calling myself a Dr., just because I do some of the same tasks as they do

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.

I don't understand doctors like this. Is it just that some are SOOOOOO arrogant that they think it's OK for them to blatently disregard laws governing the use of the title nurse. :angryfire :angryfire

I may feel justified in referring to myself as "Supreme Commander of the Universe," however just because I feel justified in referring to myself as such doesn't make it true. :angryfire :angryfire

Being respectful towards people you work with should be a norm, however because your respected does not make you a nurse.

A sickly husband calling his wife, the caregiver, "my nurse" in that situation it is probably a term of endearment, I doubt said sickly husband would volunteer his wife's "nursing" services at the scene of multivehicle accident, or believe it's OK for her administer immunizations at an Immunization Fair.

I would definately check state laws concerning medication practice/administration especially with unlicensed personal. I would also definately check with the SBON. I don't think administering IVs would fall into what would be considered a standard procedure for MAs to perform, irregardless of who taught them. She may be assuming that when a doctor teaches her to perform a skill that it is legal for her to do it. BTW ignorance of the law is not a valid excuse for breaking it. I doubt your SIL EVER looked at any state laws governing health care practice especially in regards to what can legally be delegated to an MA. :angryfire :angryfire

I know your don't agree with you cousin, it's just that attitude about feeling justified in referring to herself as a nurse burns my Canadian Back Bacon. :angryfire :angryfire

I don't care what school MAs go to, it's not just like nurses.

I sympathize with you Kiyasmom, I imagine talking to your cousin is like :banghead: :banghead: :banghead: :banghead: :banghead: , It's only going to give you a headache.

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"

OMG...I wouldn't even tell a pt. all that and I'm a nurse! That sounds straight out of a text book and you would loose a patient after two sentences with that line!

I've run into this in nursing school. I met a lady the other day that just started nursing school who is a MA. I asked why she decided to go to nursing school. She said "Well, I've been working as a nurse and doing everything a nurse does for 15 years, so I thought I should get paid for it. " Apparently, she has worked for the same MD for 15 years and says she does everything, give all of the shots, answers patients questions who call and ask for the nurse. :uhoh3: She started asking me questions about nursing school (I'm a senior) and I told her what she would be doing first semester when they go to the nursing home. You know, bed baths, cleaning incontenent patients, feedings, bathroom assists. She turned up her nose and says "Ewwww, But I dont do that! I DON"T take care of sick people, I take care of well people." :smackingf HeHe, I think she is in for a rude awakening concerning what a NURSE does.

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.

These MA's that say they "correct the MD" when they call them nurses are SO FULL OF IT! The MA's get a kick out of being called a nurse, it's an ego boost, and I guarantee VERY few of them would correct the dr.

omg...i wouldn't even tell a pt. all that and i'm a nurse! that sounds straight out of a text book and you would loose a patient after two sentences with that line!

you wouldn't do this because that would be prescribing treatment for a patient. that definately falls under the doctors scope of practice, and as a nurse you understand that.

also any health teaching provided to a patient, is worded in a manner that they can understand and is not worded above their heads. btw health teaching is a collaborative measure between the doctor and a nurse. a nurse can also recognize when a patient actually doesn't understand what is being said, despite the fact they're nodding their head in agreement. that's called assessment and evaluation.

originally posted by heartsopenwide

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.

asking questions is part of the assessment process. what do you think triage is? it is assessing the acuity of a patient and prioritizing the care of that patient. you don't think that's a major decision :banghead:

there is a big difference between relaying pertinent information in a matter of fact manner without bias or judgment to a doctor so that the doctor can prioritize the patient's care and triaging patients for the doctor.

originally posted by heartsopenwide: 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"

do you realize that any "advice" a nurse (rn/lpn) provides, means that they can be held accountable for it?

if my neighbour calls for medical advice, and i provide advice based on what she has told me over the phone, and that advice is wrong, i can be held legally accountable. i can be disciplined by the sbon. i can be held criminally negligent. i can be sued for malpractice. i can lose my license to practice as a nurse.

It is against the law in my state to present your self as a nurse without appropriate licensure (LPN, RN). There is a fine involved. Check with your state board of nursing and report her.

I don't think thats fair to say about all MA's. I am sure it is true for some but as for myself, I never allow a patient to assume I am an RN or LPN. I originally went to nursing school and I did not finish the program. So after some time I went back to school and recieved my Associate Degree in Medical Assisting. I learned alot of the same things in MA school as I did in nurisng school and many RN's only have a two year degree also. Therefore, I wouldn't call MA school a "misnomer." MA's can actually do the same thing as LPN's in our state. We can get IV therapy certified through CE courses and even pass out meds. We also must take a certification exam that is very similar to the N-CLEX. Don't get me wrong, nursing school is difficult and very time consuming but becoming a good MA isn't just a walk in the park either. Unfortunatly, there are MA's out there that give the rest of us a bad name but I have also met my fair share of RN"s that really give the title "nurse" a bad taste. We have all had to work our way up so don't forget that. I still think that if we all work together, no matter what our title may be, then we can provide better patient care. Besides, isn't that why we are all here anyway?

Specializes in Pediatrics.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

ok i am going to say it:

i really do not want this to be an" ma versus nurse" thing. no one "always does this" or "never does that".... by that i mean: try not to lump all ma's in w/the few doing the wrong things...or all paint all nurses with the broad brush of being "arrogant". it helps no one to generalize.

clearly, it violates ethics and in some states/provinces, law, to refer to an ma as a "nurse" , or to allow ma's to triage and/or dispense advice to patients at all.

further, it behooves us all to know the laws pertaining to this situation in our own state/province and take correct actions when violations occur. reporting violators is appropriate and is in the best interest of the public safety.

please, refrain from an ma versus nurse debate here. thanks for understanding.

Hi all.

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.

Alison

That is ILLEGAL in Calif. I would highly reccommend calling , or emailing the Board of Registered Nursing , in Sacramento. I did just this, & there was no retailition, but that m.a. never did it again. Thanks for standing in the gap for our PROFESSION.

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