I would like to know if any of you are seeing this trend where physicians are hiring registered nurses to function in the capacity of an Advanced practice nurse. I know of several situations where a registered nurse is hired by a provider to round on patients and write orders as if they were advanced practice clinicians when in reality they are not.
Please respond with input or personal experience with this problem
Specializes in Nurse Leader specializing in Labor & Delivery.
That is very different than what is being described...... And it's concerning to me that you are unable to differentiate
Oh please. This is what was described:
I have personally visited some outpatient clinics and observed the administration of meds by medical assistants and I question if they are even checking the vials carefully.
How is that "very different"? Where in that statement does it say that the MAs are running amok in a clinic devoid of any kind of licensed provider?
We did a phone RN UTI clinic as part of a major HMO a few years back - person would call in, the RN would run through the protocol, if the patient qualified you checked the box for an antibiotic and faxed the slip to the pharmacy. All on protocols. I assume the doc had to see them at some point.. :)
My comment refers to observation during a personal visit, that I observed an MA get a vaccine for administration. I don't believe there were any RN's hired by this physician. Hopefully, the MD was monitoring his staff and they were appropriately trained.
As far as algorithms and protocols in the clinic environment, the physician is responsible for reviewing and signing before they are enacted by nursing staff for each individual patient.
I felt the MA hesitated when looking for vials, asking another MA what color the vial was. You need to really look at medications, spelling, dose, expiration date. I don't have a problem with a trained MA giving a vaccine. I feel there should be some RN supervision in the clinic because physicians are often doing consultations.
However, I work in an outpatient dialysis clinic. I do not work with medical assistants or medicine technicians. Rn's administer medications. We have algorithms for administrations of anemia meds, iron dosing, antibiotics based on lab results, cultures, signs and symptoms of infection. And Yes, we call the physician if the algorithm advises for specific situations or we have a question. There are , medications and situations that we cannot refer to an algorithm. When I started in 1989 we had nephrologist make rounds almost every shift, but this happens much less often. Dialysis is highly regulated and we get inspected by ESRD networks and to my knowledge, algorithms are seldom a concern to the regulating network. Personally, I would love the availability of an APRN or the nephrologist on the premises all the time. It's just not the reality of my work place.
klone, MSN, RN
14,857 Posts
Oh please. This is what was described:
How is that "very different"? Where in that statement does it say that the MAs are running amok in a clinic devoid of any kind of licensed provider?