I tend to keep my finger on the pulse of new(er) trends.
This subject is something I've alluded to before, yet now I am even more convinced it may become reality.
My state--a west coast state--recently (last year) redefined the scope of practice for MA's to include much of what RN's are responsible for, based on a new tiered level of education and certifications. Colleges have jumped on the bandwagon to develop intense MA programs to fill the need.
At one time, MA's were relegated mostly to Dr.'s offices (which used to be the domain of RN's). That may not be the case much longer, if the trending continues.
I was just speaking with a fellow student from a math class, who is pursuing her MA. One of our college's nursing program professors is apparently steering potential nursing candidates (friends of hers) away from the nursing program on the QT. She stated, "Now that the scope of practice for MA's has been legally expanded, the hospital is looking to integrate MA's to fill the floors, instead of the more costly RN's."
Just sayin'. Research on your own, and draw your own conclusions.
when I said fluff such as ethics and legal and safety I'm talking a out the questions on exams I get where the right answer is to label a defective bp machine and take itnto an engineer rather than take vitals. Knowing the difference between slander libel and defamation. Stuff like that. I understand a good nurse is there to recognize bad orders, but do you work in a setting where the doctors make so many orders that its imperative nurses are there to catch them all, lest the whole hospital go up in flames ?[/quote']
Legality in healthcare is more than what you are talking about; those issues are imperative; just because to you you believe these issues are minute, again, it is a while other ball game. As far as catching orders, I do work in a setting where it is imperative to catch orders and question them; I do this everyday for my residents in LTC as a nursing supervisor; and I have done this in a hospital setting however I do MUCH MORE than that, as vera4130 has said much more eloquently.
It's not just catching bad orders. It's also being able to recognize when a patient starts to decompensate before it becomes an emergency or recognizing that your septic patient hasn't gotten enough fluid (and subsequently getting orders for it), or changing out the dressings for a patient's 18 tunneling wounds. Nursing is much more than tasks. You know who really wouldn't put up with the MA business? The doctors. Most of our doctors know the value of a good nurse. I can only imagine the kind of hell they would raise to find out it would be MAs calling them at 3 AM.[/quote']
Here's the thing. When an MA can sit for their own license and I don't need to be delegating to UAP's whom I am responsible for, then have at it. Otherwise, I would prefer to do my own thing, as ultimately, I am responsible.
I know several RNs who prefer to do their own thing when working with LPNs. Even if an MA were to obtain a license for more expanded work, they would be treated just like a repressed member of the healthcare team- less respected, and making less for advanced skill and learned knowledge/experience.
... MAs can do all the same stuff?
I'm an ICU nurse and I have had patients on as many as 9 gtts while also getting blood products, completely unstable and on CRRT. I frequently call the doctors and ask for orders, sometimes they just ask me what I want. I also need to be able to recognize bad orders.....
....saying MAs can be trained to do everything is an overstatement. I don't know what kind of program you're in but mine was hard...
While I'm only familiar with a handful of nursing schools in the midwest, I feel confident in saying, no new grad was ever prepared to care for a pt like the one you just described, vera4130. Generally, people work their way up to managing complex care like that single handedly. Those were not all things taught in school.
With regards to refusing a medication order, was that because of something learned in school or something you became familiar with through experience?
I, too, work in acute care and find myself always able to look up meds that I'm unfamiliar with. I do this with surprising regularity. However, I know nurses in LTC who give meds regularly not knowing their mechanism of action or specific side effects due to time constraints r/t poor staffing. Its time to get'er done!
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I read another post regarding the types of people who become MAs. There were comments to the effect of, thank goodness they were never going to get into nursing school. Obviously, this is a generalization. During an interview for an MA primary caregiver role, an MA should be well screened for his/her ability to learn and desire to learn. An MA could be judged on enthusiasm and energy. An MA could be judged on past accomplishments inside and outside the medical field. I suppose, I'm saying a new hire is to be judged on their character and that character is what will make the MA equivalent to a nurse in present day role/duty.
It's not just catching bad orders. It's also being able to recognize when a patient starts to decompensate before it becomes an emergency, or recognizing that your septic patient hasn't gotten enough fluid (and subsequently getting orders for it), or changing out the dressings for a patient's 18 tunneling wounds. Nursing is much more than tasks.
You know who really wouldn't put up with the MA business? The doctors. Most of our doctors know the value of a good nurse. I can only imagine the kind of hell they would raise to find out it would be MAs calling them at 3 AM.
I was educated how to recognize a downward trend in patients I cared for through experience. I had amazing preceptors I would ask their opinions and respect, learn, and put into practice what they said. In school, there were only a handful of times I was able see and attempt to learn to recognize s/s of someone CTD. I am adamantly convinced it is experience through work in a field that prepares you for a job, not formalized education. An MA with the right mindset could go so far with proper practice changes. Safe, effective care could be given.
edit: oh ps! I know soooo many nurses that were reemed for calling a doctor with seemingly silly requests that got the provider's briches in a bunch at 3 AM. I see no difference between an MA, LPN, or RN calling for new orders.
. An MA with the right mindset could go so far with proper practice changes. Safe effective care could be given.[/quote']
...then they can become nurses...
There will not be practice changes to MAs that will eliminate the need for nurses. The political, monetary, publicity AND legalities when it hits the fan will be too much. It wouldn't happen in my neck of the woods, especially in acute care. My state LOVES the no cap on malpractice; jurors will eat a hospital ALIVE if a MA is the primary caregiver of a brittle sick patient, even in Med-Surg. It just isn't going to happen...there seems to be an underestimation of the empowerment of nurses, even in the legal, political, and theoretical areas in this thread.
Again, love the history of nursing, my EBP...if you want to be a nurse, I suggest anyone who thinks that a MA can replace a nurse is hogwash; sorry tasks won't overcome knowledge of the nursing model; if MAs have the capability, then they need to sign up and join the nursing ranks; that's the only way.
Too much is emphasized in tasks instead of the knowledge that it TAKES to be a COMPETENT nurse...it comes by experience, but it is the knowledge when you have this patient that allows the competent to occur.
Specializes in Oncology; medical specialty website.
You aren't sure of all the functions of a nurse but think MAs can do all the same stuff?
I'm an ICU nurse and I have had patients on as many as 9 gtts while also getting blood products, completely unstable and on CRRT. I frequently call the doctors and ask for orders, sometimes they just ask me what I want. I also need to be able to recognize bad orders. I've refused orders before because they were inappropriate.
There are bad nurses, just like there are bad CNAs, EMTs, and MDs. But saying MAs can be trained to do everything is an overstatement. I don't know what kind of program you're in but mine was hard - and I had a prior science degree. We learned a lot, and were expected to know a ton of patho and pharm.
Oh, come on vera. You know what you do in ICU is nothing but monkey skills, right?
Specializes in Oncology; medical specialty website.
But you all forget, the reason for the move to MAs is just that. They don't want thinkers. They just want "staff" to complete the list of tasks given.
I see movement to off floor management centers full of telemetry and live feed images from each patient room. Generalists probably NP/PA hospitalists will be responsible for managing the day to day. MAs will complete tasks given and talk to the camera on the wall as THEY perform assessments and med passes (No thinking, just doing, charting and reporting findings).
NP/PAs will supervise and will report back to a MD in a glassed-in central area within the management center (He's eating cheetos and watching SportsCenter and plotting fantasy football). He's there in case he's needed... better not bug him...
I don't see RNs in this mix, once it's all established.
That's a pretty dystopian view of nursing's, and health care's future. Is your last name Orwell?
Specializes in Oncology; medical specialty website.
If MAs want to work as faux-nurses, let them take a licensing exam and practice under it, rather than running to hide under Mommy's skirt (the RN/MD) when they screw up. Let them assume responsibility for their actions rather than turfing it to someone else.
What is the body of knowledge that the field of medical assisting has? How is it unique medical assisting rather than nursing or medicine? Is there independent research out there done by medical assistants?
Yup, because clearly the education brought on by 2 years of nursing school prepared a new grad to run and stabilize 9 drips on a single patient whereas the ma would have crashed and burned getting tangled in the tubing.
Yup because clearly the education brought on by 2 years of nursing school prepared a new grad to run and stabilize 9 drips on a single patient whereas the ma would have crashed and burned getting tangled in the tubing.[/quote']
To clarify...it's 4 YEARS with relevant pre requisites compared to 10 months minimum for some MA programs. Yes, nurses are prepared; again nursing model, theory and knowledge.
To clarify...it's 4 YEARS with relevant pre requisites compared to 10 months minimum for some MA programs. Yes, nurses are prepared; again nursing model, theory and knowledge.
You're actually saying a fresh new grad can handle a busy icu ? And I was referring to an ADN not BSN
You're actually saying a fresh new grad can handle a busy icu ? And I was referring to an ADN not BSN
Yes. The best nurses I know started in ICU, titration of drips, etc. That's due to the education guided by seasoned nurses, and the knowledge of the new grad RN; senior rotation is done in Stepdown and shadow rotation to ICU and/or ER; so it's not impossible for new grads to handle a busy ICU; again, I think you underestimate new nurses being competent enough to be put into those situations and can excel in them; it has been occurring for years and enough of a success rate for new grad programs Critical Care programs to continue. I've been a new grad ICU nurse; titrating drips is not a "feat"; the knowledge, care and the stabilization that goes song with it isn't either; it's "new" because if the transition of the role of student to novice nurse; but having that knowledge and putting it together as a new nurse is probable and possible.
FYI, ADN is the same amount of time as a BSN...there are two years of pre requisites PRIOR to getting into an ADN program. Even in diploma programs, there are pre-requisites; there is no nurse that I know of that has done two years without any pre-requisites to build on; they are doing pre-req's to build on the nursing base, so if there are nurses that did ALL of those pre-req's combined with nursing classes; but most mere mortals have completed at least 1-2 years of pre-requisites.
I also suggest you research more thoroughly into nursing education, and nursing ENTIRELY instead of making assumptions about what nursing is...a nursing degree is a total different animal, than most associates or bachelors degrees.
I'm tired of being called a two year RN. It took me four years to get my ADN. I know some people who took three but NO ONE can do it in two. The program it'self is two years yes, but in order to START those two years you need A&P, Microbiology, Chemistry, intro to psych, Human Development, Ethics, Nutrition, Dosage and Calculations, Comp 1
The political, monetary, publicity AND legalities when it hits the fan will be too much. It wouldn't happen in my neck of the woods, especially in acute care. 
LadyFree28, BSN, LPN, RN
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