Unlisenced assistive personell replacing nurse positions

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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!!!

Specializes in Psych , Peds ,Nicu.

If someone is representing themselves to be a licensed nurse , whoever or whatever their role is , the simple answer would be to see the person responsible for supervising their " nursing " activities ( ie the MD. in the case of a Doctors office ) , inform that person to get this behavior to stop ,and inform them you are going to report this problem to the appropriate state authority .

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Lillymom- i am sincerely sorry if i upset you or if you feel i was trying to put you down. It was not my intention. You are right there are some good mas and i believe you are one of them. Just like there are bad mas there are bad nurses and drs. I really am sorry if i upset you. I was not trying to put you or anyone else down. I wasnt trying to attack your character at all. Please understand that things here are a lot different and it could be very dangerous to pts. Here it is against the law for a non licensed person to administer any type of med or injection and they are doing it anyways. Again i am so sorry if i hurt your feelings. Best of luck in nursing school!!

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Italia - No I wasn't upset at all. You have the right to your opinon and to seek medical care that you find appropriate. I wouldn't want anyone who wasn't trained and educated properly to administer meds to me either. I take no offense whatsoever.

It is good that you stand up for what you believe in and it will make you a great advocate for your patients! I am sure you will be a great nurse as well. Well wishes and good luck!

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Specializes in Critical Care.

From my understanding, MA's are taught how to run the MD's office and how to do some clinical skills. As previous posters have mentioned, MA's do billing and scheduling, etc. That isn't covered in nursing school.

However, I think there should be RNs in the office for patient education. An MA can't do that, and the MD isn't going to (sometimes I wonder if they even know what to teach the patient). My previous MD didn't have a nurse, so there wasn't any patient education beyond "take this 3 times a day." I now go to an MD that has an MA, LPN, and RN.

And from my understanding, specialty offices use more nurses for that patient education.

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Specializes in Hemodialysis.

Yes, she's being sarcastic. I believe. At least I took it that way and laughed quite hard when I read that.

A medical diagnosis done by a physician is totally different than a nursing diagnosis formulated by a nurse. It's just another animal entirely.

Doctors don't pick up on a lot of assessment issues because they're too busy reading the nurses' assessment while looking at their watch and wondering if they're going to hit their tee time. The amount of time a nurse spends gathering a history, assessing a patient, and addressing patient teaching needs is about triple the amount of time a Dr. actually spends with a patient, so it's just common sense that the nurse can pick up on more subtle issues that could become a much larger problem. Has nothing to do with how "good" the Dr. is.

There are huge differences between MA's and nurses. One may not have MORE education than another, even as an RN. It's just a DIFFERENT education. An MA can go to school for 2 years and an RN can go to school for 2 years. But it's an entirely different job and the two should not be meshed together. That's the same as saying that a PhD is qualified to do surgery because he's a "doctor" too, right?

I'm not a nurse...yet. I've got just under 5 months until I graduate my RN program, but I have seen a lot of things done on the clinical level and I'm good about picking up dynamics. Dr.'s used to scare the crap out of me. I'd see them, back up, keep my mouth shut and stand quivering in a corner. (Not really but it felt that way) Some of the best Dr.'s that I've seen with patients recovering faster and have less complications in the hospital ask the nurses what their opinion is, and make a lot of decisions relying heavily on the nurse and her assessment data. It's as pertinent as labs. The Dr. doesn't go run his own labs. He depends on the lab to do that and depends on the results they report. I've seen nurses flat out tell the Dr. no, they shouldn't do it that way. Guess what? They don't.

Today during grand rounds, the attending and a bunch of residents rounded on my patient. When they were done, he looked over at me, realized that I'd been with the patient for 2 days now and asked me what I thought. The lowly student nurse. The bottom of the food chain. Guess what? He listened to me, and then he agreed with me. I actually felt competent.

And I didn't quiver in the corner.

MA's may very well be outnumbering nurses in Dr's offices these days, but they can't REPLACE them. The MA is doing most of the administrative work and some basic skills, but the Dr. if he's worth a grain of salt is now responsible for his job plus doing his own assessments and critical thinking, so I guess you get what you pay for.

I head it all off at the pass and just go directly to the NP at my Dr.'s office. I don't even know if they have MA's because the NP gets me from the waiting room and handles everything from start to finish. I never see the Dr., and don't need to. The NP has been able to handle anything I've brought to her, and the Dr. doesn't have to worry about missing his tee time.

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Specializes in Medical Surgical Orthopedic.
2 orange tree-

listen, i clearly stated that i was not trying to be mean. how am i "patting myself on the back 2 hard"? i am not sitting here claiming that i know everything there is 2 know about nursing or saying that anyone is better than anyone. if you actually looked into my issue with ma's taking nursing positions you would understand. it would be a totally different story if i was trying to slander someone or making statements as if nurses were better than ma's, which i am not. do you really want an unlisenced person treating your child or loved one? sorry, but i don't and won't put up with it. if that makes me a terrible person then so be it! unlisenced personell should not be doing triage or administering any type of medication. period. end of story. and i do have an aas in medical assisting. so really sorry 2 burst your bubble but i know what is being taught, what is part of the aama cur. and what is not being taught. and @ no point in any ma program be it aas or a vocational program do they teach how to assess patients. it is not their scope of practice. and again i am not trying to be rude. but mistakes can be fatal. how are you supposed to understand if you were never taught and it is not in your sop? in the pharm course in ma school not one time did they discuss the difference b/w heparin and hep-flush. the bottle are almost identical. do you think it is really appropriate to have people who don't understand the pharmokinetics and the importance of the medication, dosage range, route, interactions or usual side effects associated with the medication administering them???? sorry - strongly disagree. no way. peoples lives are at stake!!!!

no, i wouldn't have a problem with a competent ma administering medication to me. the fact that they might have been trained by the physician they work for instead of a nurse in nursing school doesn't make them incapable. and yes, heparin can be a very dangerous drug. there have been many high-profile cases where nurses (with all of their schooling) administered incorrect doses. in some instances, the result was death.

any schooling prepares an individual for entry into their field. it does not provide them with everything they need to know, in fact, it doesn't even come close. what you're saying is that you would like the entry level training to work in a doctor's office to be higher.

fair enough, but are you aware that some people would like to get rid of all lvns because they think they're not qualified enough to be nurses? these people think that only rns have their "eyes open" wide enough to know what they're doing and would throw you under the bus if they could. actually, there are people who think rns with diplomas or associate's degrees should be thrown under the bus too. they believe that only rns with bachelor's degrees are qualified to administer medication to their families.

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Specializes in Ante-Intra-Postpartum, Post Gyne.

Because MAs are cheaper and in the office setting they are sufficient. I worked as an MA for a few years before getting my RN-BSN and although I have a new perspective on nursing I still think that MAs are more than efficient in the medical office setting. I supose an LVN or RN would be needed in some more specialized offices such as internal medicine, out patient surgical, ect; but in your basic family practice medical office the MA is just fine. Yes I some times roll my eyes when the MA is not looking because she really does not know as much as I do as a nurse, but I am not there to see her; I am there to see the doctor and I have no problem with the MA getting my history and vitals. I do not even have a problem with the MA drawing blood or giving me an injection (which they are allowed to do in my state) I am sure I will get flamed, but these skills do not require critical thinking or a nursing license. (and yes, they are limited to what they can inject)

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Specializes in ICU, PICC Nurse, Nursing Supervisor.

it surprises me that you would say this:eek:....every medication that you inject requires critical thinking....

i do not even have a problem with the ma drawing blood or giving me an injection (which they are allowed to do in my state) i am sure i will get flamed, but these skills do not require critical thinking or a nursing license. (and yes, they are limited to what they can inject)
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Specializes in Ante-Intra-Postpartum, Post Gyne.

Ok, some critical thinking, but not the level of critical thinking a nurse needs to perform at at least.

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Specializes in Hemodialysis.
Because MAs are cheaper and in the office setting they are sufficient. I worked as an MA for a few years before getting my RN-BSN and although I have a new perspective on nursing I still think that MAs are more than efficient in the medical office setting. I supose an LVN or RN would be needed in some more specialized offices such as internal medicine, out patient surgical, ect; but in your basic family practice medical office the MA is just fine. Yes I some times roll my eyes when the MA is not looking because she really does not know as much as I do as a nurse, but I am not there to see her; I am there to see the doctor and I have no problem with the MA getting my history and vitals. I do not even have a problem with the MA drawing blood or giving me an injection (which they are allowed to do in my state) I am sure I will get flamed, but these skills do not require critical thinking or a nursing license. (and yes, they are limited to what they can inject)

I'm glad that you brought that up, it was interesting to see heparin used as an example earlier because we need to have 2 RN's sign off on heparin, and insulin, and morphine, just to name a few. On the pediatric circuit there are literally so many meds that need verified by 2 RNs that I have to refer to a list because there's no way I'd remember them all. I do know of MAs who work in the surgery center, I happen to go to school with one or two of them, although I don't know what all they do.

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2 orange tree-

i don't think you understand what i am saying. we will use my state for the example. anyways here in nys it is illegal for anyone without a license to administer any medication by any route. it is to protect the patient. so how do you think that it is okay to staff them in a nurses position. i have attached a link so you can take a look at it. after you read it you can give me your take on an ma taking a nurses position. maybe you will be able to understand where i am coming from after reading it. thank you for responding!

http://www.op.nysed.gov/prof/nurse/nurse-medical-assistants.htm

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Specializes in Hemodialysis.

At least NY has addressed these issues and clarified them quite clearly. It sounds as if the MA is very limited in their practice in NY and it also sounds from the wording of that letter that there have been a number of inquiries regarding their scope.

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