I always thought that I had a decent understanding of the current evolution of certain parts of the healthcare delivery process: specifically the trend toward MD offices no longer hiring licensed nursing personnel and instead choosing to hire and train MA's to carry parts of the role of the licensed nurse. I have somewhat resigned myself to the trend, considering that (a) I have no choice in the matter, and (b) I deal with the fall-out day in and day out in my position as a pre-op RN in an ASC (i.e., dealing with patients who are totally unsuitable for an ambulatory surgery center, but no one who "assessed" them understood that). At the same time, I thought that the assistive personnel who were filling positions previously occupied by nurses understood the scope of their positions.
However, several recent posts have me wondering if I really do understand what's going on. There are MA's that sincerely believe that they are "doing the job" of a licensed nurse. They apparently believe that their MA courses are on a par with accredited nursing program courses. They do not seem to understand the concept or value of a professional license. And then there's the apparent turf war between MA's and CNA's...MA's rank higher than CNA's?
Am I seeing this trend accurately? I am seriously starting to question where healthcare delivery is headed.
Specializes in Emergency Dept. Trauma. Pediatrics.
Thank you for pointing that out. It took me 2 yrs to complete my pre-req's then 10 months to complete the LPN Diploma Program. We were then told that we could sign up for the Bridge Program and obtain our RN in 1 year instead of two. It is very frustrating to have the first 2 yrs of my education discounted.
I'm confused about MAs posting here, particularly about nursing issues. MAs are not nurses. I understand they work in the health care field, but again, they're not nurses. I guess I don't understand why they aren't posting on boards specific to their own practice.
I'm glad someone brought that up - I've wondered about that, myself!
I'm confused about MAs posting here, particularly about nursing issues. MAs are not nurses. I understand they work in the health care field, but again, they're not nurses. I guess I don't understand why they aren't posting on boards specific to their own practice.
I'm glad someone brought that up - I've wondered about that, myself!
mc3:nurse:
I think that's the point of this whole thread.......
We (in the US) obviously have developed a healthcare system based upon cost. Various participants in our current healthcare system have not been taught/do not understand the limitations of their scopes of practice or the danger of their participation beyond their abilities.
Specializes in Oncology; medical specialty website.
I think that's the point of this whole thread.......
We (in the US) obviously have developed a healthcare system based upon cost. Various participants in our current healthcare system have not been taught/do not understand the limitations of their scopes of practice or the danger of their participation beyond their abilities.
WTH will we do with this fact?
I'm afraid the genie is out of the bottle, so to speak. All we can do now is say something when we see non-nurses trying to pose as nurses. We can try to educate patients about the difference between medical assistants and nurses. I'm not terribly optimistic when it comes to solutions; it's a case of "you don't know what you don't know."
Specializes in Peds/outpatient FP,derm,allergy/private duty.
*****?
Sorry, apparently acronyms for expletives are not allowed either.
Nope. I've been asterisked (say that 5 times fast:p) many times for seemingly benign acronyms or partial words. I guess we're not allowed to make it so someone can guess the intended word. Now back to our regularly scheduled thread topic.
Yes, they are, in the surgeon's office (not starting IV's, but all the rest). And so the ASC receives a patient one hour pre-op and sees:
*An H&P filled out by the surgeon's MA that has no detail, only a check in the box: "All systems negative." MD"s stamped signature.
*A list of meds a mile long that includes: Digoxin, nitro, lisinopril, warfarin, prednisone, Metformin, etc., etc. The MA (calling herself Dr. H's nurse) who filled out the "assessment" didn't have enough basic understanding of anything to connect the dots and realize that some relevant physical conditions must be present.
*A patient that is elderly, frail, incoherent and confused. Accompanying elderly spouse cannot contribute much to the assessment either. It appears to be a miracle of some sort that they made it to the ASC at all.
*A patient who has been instructed to "hold all meds" and has not taken their digoxin, metformin or advair for 5 days.
*No after-care arranged.
I could go on and on and it happens every single day. The nurses and anesthesiologists are constantly scrambling to accurately assess the patient in the one hour that we have pre-op. Poor Anesthesia bears the brunt of providing safe care to an inadequately prepared patient.
Do I blame the surgeon? Of course I do, but I'm never going to change the "cut and run" mindset. I'm just finding the whole situation scary. Back in the day () when an RN was assessing the patients in the surgeon's office, these types of patients were vetted and cleared (cardiac, pulmonary,etc.) before setting foot in the ASC.
I thought I commented to you, but apparently I only did in my head I am truly beside myself after reading this. Are you in a position to work somewhere else?
I thought I commented to you, but apparently I only did in my head I am truly beside myself after reading this. Are you in a position to work somewhere else?
What's next? Is housekeeping going to do CABGs?
This scenario is not limited to my place of employment. It is all around me, in other surgery centers and hospitals in my area.
I think that's the point of this whole thread.......
We (in the US) obviously have developed a healthcare system based upon cost. Various participants in our current healthcare system have not been taught/do not understand the limitations of their scopes of practice or the danger of their participation beyond their abilities.
WTH will we do with this fact?
I would be inclined to move up the food chain, until I received a response that was adequate to address this problem.
I don't care if doctors take responsibility for these very uninformed MA's, but would think that the BON, would be intersted in MAs definately practicing out of their scope of practice.
That included, suturing, "teaching residents how to suture?, preparing patients for surgery, "clearing " patients with dangerous co morbities, siging the doctors', nurses, names, for "release to the OR?".
I would also be inclined to make an appointment with the senior partner of the law firm who represents/defends, the hospital in law suits. I believe that he/she would be VERY INTERESTED IN WHAT PHYSCIANS ARE ALLOWING MEDICAL ASSISTANTS TO DO IN THEIR NAME/LICENSE.
Just because doctors allow the MAs to do these things. does not mean that it is kosher.
You are not making enough noise about this, or it would be raising eyebrows with the Risk Management department in your facility. Have they been notified this is going on?
Personally, I would not accept responsibility for allowing a patient to undergo surgery, with an MA, signing off, clearing the patient, and everything they are doing. But that is just me, an in your face, opinionated, NYer voicing my $0.02, again.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
When I was researching the "scope of practice" for MAs in my state, I discovered that though there is no requirement for training or certification, the insurance company who covers the physician for malpractice will often require that the MA meet certain minimum standards and they would be the mostl likely to be interested to know exactly what sort of things the doctor is delegating to a Medical Assistant.
There was an MA herea while back who came on to ask if cauterizing polyps in the large intestine was something she should be doing (obviously not) but that the other MAs in the office felt that made them feel important and flattered by the responsibility. She used her best judgement and got outta there!
) when an RN was assessing the patients in the surgeon's office, these types of patients were vetted and cleared (cardiac, pulmonary,etc.) before setting foot in the ASC.
~Mi Vida Loca~RN, ASN, RN
5,259 Posts
I agree, very frustrating indeed.