Unlisenced assistive personell replacing nurse positions

caliotter3 · Mar 8, 2011

Since the medical profession is responsible for creating the role of the medical assistant, your question is best posed to members of the medical community, physicians. This topic is discussed quite frequently. The medical assistant job classification was brought about to avoid paying the salaries of licensed nurses. Hype about shortage of personnel to perform the functions is just that, hype. My daughter worked in an office in such a role. She was hired at $10 an hour, only to be paid $9 an hour. To do the filing in a multi-person set up. She ended up being cross trained into every function there, front office, back office, office manager, receptionist, you get the picture. All for fast food wages. She did not stay long enough for a nursing license to become a problem. Doctor's offices used to be quite a good source of employment for nurses, but not any more. Even for those willing to work for $9 an hour, most medical offices will not hire nurses for those positions. So, again, ask the doctors why. They have the answers.

merlee · Mar 8, 2011

It comes down to money, money, money. Also, the MA works under the Doc's license, and the Doc - not another employee - must provide the training.

Also. the MA is NOT allowed to introduce herself as a nurse of any kind. No, No, NO!

BabyLady, BSN, RN · Mar 8, 2011

hello all! i am currently an lpn/lvn student. i went to college for my associates degree in medical assisting. here is the problem, while in school for my ma we were told time after time that ma's are the equivalent of an lpn/lvn. i quickly learned while i worked my first job that this just wasn't true and i didn't understand why i wasn't treated like the "nurses" (lpn/rn). after starting the lpn program my eyes were opened to the world of nursing. and i see everything that it entails. i have learned more in the time i have been at my lpn program and at clinicals than i have learned the whole time i went to school to be an ma and including my work exp. the problem i am seeing is that so many doctors offices are hiring ma's instead of nurses. now i am not saying that there are not good ma's out there. i am sure there are some great ones! but ma's don't have a clue about the nursing process as it is not in their scope of practice. i took a whole pharm course at my ma school and let me tell you it doesn't even compare to the pharm at nursing school. so i don't understand why doctors are allowed to hire ma's instead of nurses???? esp. in my state which is ny. here ma's can't administer medications, draw up injections or administer injections. no triage. no positioning. basically just vitals and phlebotomy. but i feel as tho it is not right to hire them for a nurses role. if my child were to be ill i would want to know that the person on the other end of the phone was a nurse and knew exactly how to assess the situation. ma's are not allowed to do triage of any kind and yet they do it all the time. i am not saying there isn't a place for ma's, because they certainly can do phlebotomy, office work, vitals and a few other basic tasks that don't require critical thinking. so why are doctors opting to hire them instead of nurses??? i just don't understand. at my doctors office the ma introduces herself as a nurse all the time and i even went as far as to ask her where she attended. her response was actually i am an ma. i am sorry but i don't want someone who doesn't have a lisence giving me my family or my child advice when it comes to healthcare. does anyone else agree?? ma's have a certificate. not a lisence. the certificate just means that they have passed an exam. it is not a lisence so why are they being hired to work in a nurses place?? someone please shed some light on this! maybe i am wrong. and i appologize if this sounds offensive as it is not my intention. thank you!!!

the big difference between the two is that a physician is not legally responsible for the lpn or rn's actions as they function under their own license.

an ma is under the license of the physician...can you imagine how hard this would be to find a job if you ever lost it? another physician would have to bank on another's training. many are not willing to do that.

the term "nurse" is a legal one and if an ma introduces themselves as a nurse, that is deliberately misleading the public into thinking the ma has credentials that they do not have and can be a prosecutable offense.

Anne36, LPN · Mar 8, 2011

What you described is exactly what has happened at my childrens Dr office. They do not have any Nurses on staff, its all medical assistants now.

Italia23 · Mar 8, 2011

i mean i really don't want to sound rude you know? but there are so many ma's out there claiming their "nurses" and unfortunately i don't think that a lot of doctors even know what they can and can not do. it is unfortunate that i went to an ma school before nursing school because it was almost like they brainwash you into believing an ma is equal to a nurse. i'm not talking about like "ranking" or "who is better than who" what i am talking about is job role and responsibility. it is going to be sad but sooner or later the lack of traning and education is going to seriously injure a pt. again, i am not saying that ma's are a waste because i don't feel that. but they should really be taught that no they are not nurses. if there was an emergency they wouldn't even know how to respond. they aren't allowed to do assessments/data collection. when you go to the doctors office you deserve to have a nurse taking care of you. i just think that esp in my state which is ny they should make all ma's front office or phlebotomy only. they can't assess. they can't administer medication, they can't give medical advice and yet some are. and they are calling themselves nurses. it just isn't right. people's lives are at stake here. it isn't about titles and pay grade. it's about taking care of people. nurses operate on their own lisence. ma's operate on the doctors lisence. i am actually suprised at how many doctors are willing to risk their credentials to save a few bucks. how does everyone else feel????? :mad:

mentalhealthRN · Mar 8, 2011

I am in NY myself. I have not seen these MA's in any offices I have been in. All of the nurses have been RNs or LPNs. But I do agree that other then being the front office folks they are not trained to take the place of the nurses. And maybe a letter to the NYS Office of professions letting them know of how often you are seeing MAs illegally refer to themselves as nurses would be good. As far as the RNs and LPNs practicing on their own license--I was under the impression based on the scope detailed on the Office of Professions website that LPNs practice under RNs, MDs, and mid-levels--not independantly. Correct me if I am wrong but I thought that was the case. But as far as why these docs are doing this--who knows. Maybe if the public was aware of the different roles they would demand a nurse. I myself was in a WorkFit center the other day getting a PPD--a place where they do workplace health-- and the guy at the reception desk was on his cell phone and says to the person on the phone-- "oh I'm here and the nurse is calling to get my surgery set up". I heard the girl behind the desk correct the man telling him--"oh I'm actually a Medical Assistant not a nurse" and he says, "Whatever, same thing. It's easier for me to remember nurse".........she clearly did the right thing and let him know she was not a nurse and he clearly had no idea that a MA is NOT a nurse and it is NOT the "same thing"....that was scary to see!! The public needs to be educated. I'd love to see some public awareness comercials letting the public know that they need to know who is providing their care and what the roles and qualifications are of each of these roles......so maybe if we all take the time to write a letter to our state to inform them of this concern we can make a difference.

lillymom · Mar 8, 2011

i mean i really don't want to sound rude you know? but there are so many ma's out there claiming their "nurses" and unfortunately i don't think that a lot of doctors even know what they can and can not do. it is unfortunate that i went to an ma school before nursing school because it was almost like they brainwash you into believing an ma is equal to a nurse. i'm not talking about like "ranking" or "who is better than who" what i am talking about is job role and responsibility. it is going to be sad but sooner or later the lack of traning and education is going to seriously injure a pt. again, i am not saying that ma's are a waste because i don't feel that. but they should really be taught that no they are not nurses. if there was an emergency they wouldn't even know how to respond. they aren't allowed to do assessments/data collection. when you go to the doctors office you deserve to have a nurse taking care of you. i just think that esp in my state which is ny they should make all ma's front office or phlebotomy only. they can't assess. they can't administer medication, they can't give medical advice and yet some are. and they are calling themselves nurses. it just isn't right. people's lives are at stake here. it isn't about titles and pay grade. it's about taking care of people. nurses operate on their own lisence. ma's operate on the doctors lisence. i am actually suprised at how many doctors are willing to risk their credentials to save a few bucks. how does everyone else feel?????

i am a cma in nc. i do agree that a cma should never call themselves a nurse but most people call me that anyway and i do correct them but they don't care. i also have an associate's degree, not a diploma. i have two year's worth of education from everything to symptomatology, lab procedures, administration, and managerial skills to name a few. i can do anything, in nc, that a md will allow me to do since we practice under their liscense but it is my ethical responsibility, as should be yours, that if you are not trained or compentent that you should not do what is being asked of you. i give injections constantly in my office, in fact i give them more than the lpn's here and it is legal. this varies greatly by state and we are not governed or associated in any way with the state bon.

as far as emergencies there is a doctor in the office at all times so i just go get a doctor. i have also had cpr and first aid so i do know how to handle an emergency. if i know our office can't help them then i tell the pt. to go to urgent care or the er(specialty office we only treat certain conditions).

doctors created the ma role because they wanted to hire people that could work the entire office if need be. i was taught billing, scheduling, coding, transcription, navigating emr all that stuff as well as pharmacology, phlebotomy, clia waived testing and more. we were not however taught anything about care plans and i really have no idea what they are but from what i can tell they are nursing diagnoses which, from my understanding we don't need to do, because that is what the doctor will do since we are in an office setting. we can, but generally do not, work in hosptials or nursing homes.

we are meant to be able to walk in the office on the first day and be able to do everything with very minimal training and some of us can. we mainly have to learn the doctor's preference with procedures and such. with all that being said i am going for my rn (if i get accepted this year) because i am bored to death in an office setting. cma's and lpn's make about the same pay here they may get fifty cents more per hour. just thought i would shed a little light. :)

Italia23 · Mar 8, 2011

2 lillymom-

thank you for your response. i am glad i didn't offend you because it really was not my intention to put ma's down. to clarify- lpn's work on their own lisence under the direction of an rn or md. rn's work on their own lisence and under the direction of an md. md's answer to themselves so to speak. i also have an aas in medical assisting degree. when i was working as an ma i didn't understand why ma's were not treated like the rest of the nurses because in school we were told on a daily basis that ma's were replacing lpn's. (untrue) and it wasn't until i became a nursing student that i realized what the difference is/was. nurses are expected to do assessments. for rn's it's called nursing assessments and for lpn's it's data collection. nurses need to know that if someone is having a cardiac issue then you need to do a cardiac assessment and assess for things such as pedal pulses. an ma is not allowed to do that no matter what the dr says. it isn't in their scope of practice. when you get into nursing school you will see the medical field with a whole new set of eyes! (nursing eyes lol) a nursing diagnosis is not the same as an md's medical diagnosis. you have to have the understanding of the theory behind things. for example, if a pt has pneumothorax an appropriate diagnosis may be impaired gas exchange r/t pneumothorax. a nurse is supposed to know if they suspect a pulmonary embolism they need to get the pt positioned in trendelenburg stat. these are things that they just don't teach you in ma school or that ma's are even allowed to do. you get a microscopic taste of the clinical setting. but i am not trying to put being an ma down at all. i am just sharing the facts and why it bothers me that some ma's pretend to be nurses. please don't get me wrong. i know some ma's that are really nice and don't pretend that they are a nurse and know everything. it's a matter of pt safety here you know? so i appologize if i offended you in any way shape or form. you are going to make a great nurse!!!! good luck!!!!!!!!!!!!!!!!

tewdles, RN · Mar 8, 2011

Trust me, if there is no nurse in the doctor's office there will be no nursing diagnosis on the chart and the doctor will not "do it".

BabyLady, BSN, RN · Mar 8, 2011

What you described is exactly what has happened at my childrens Dr office. They do not have any Nurses on staff, its all medical assistants now.

...and if that was the case, I would change physicians and send a letter to the physician explaining why you are changing.

No way, would an MA be explaining drugs or giving injections to my children...seriously..think about everything you know that needs to be considered and the fact that most Mom's are not nurses.

Orange Tree · Mar 8, 2011

At the risk of sounding rude, you seem to be patting yourself on the back a little bit too hard. You may not "mean" to put down MAs, but you certainly seem condescending toward them....amazing, since you were one not too long ago. You think your eyes are being "opened" now, but your eyes are going to be opened even more when you finish school, hit the ground running, and realize how much you still don't know.

I have to wonder how you'll feel about LVNs if you ever decide to go to RN school. Hopefully you'll have your ego under control by then. :twocents: