To the point and factual. No nasties, just plain old run of the mill, boring everyday facts. People need to get over themselves, their egos. Keep up the good work and the good attitude. People, stop getting your panties in a bunch! I know a person who dropped out of nursing school in one state, moved to another, and worked as a nurse for years in a private practice. When I called her out on it, she said no one ever checked her credentials; they just took her word for it. So, this nurse is only taking issue with those medical professionals who claim to be something they are not.
I understand your frustration and respect the California laws. But not all states have the same laws either. I think your attitude is misguided. Many MA refer themselves as nurses because colloquially people call anyone that is not a doctor, a nurse. If they try to explain their positions, it often creates confusion or even trouble when a patient declines protocol until they see who they want.
Some patients come from other countries even in english speaking countries, the terms change where the position may not exist.
MAs are not out there planning on stealing your jobs. You have your hard earned degree and experience that they simply cannot compete with. Not everyone is afforded with your opportunities. My mother is a MA who has worked under the supervision of several doctors for 40 plus years. She has a lot of wisdom and experience that she shares with new doctors and knows how to make her medical organization successful and profitable. Many M. As I mentioned, she was not afforded with the opportunity to go to a more advanced nursing school.
But as a single mother, she was successful to afford me with the opportunity to pursue my two master degrees, one being in organizational behavior. Punish people to call you and only you a nurse and punish those who call themselves a nurse. Seem a bit drastic? Well, it certainly is not how you build a healthy community either.
So perhaps, voice your frustration a bit differently. Why would you want to create more? There are more important things to deal with than repeating the cycle of condescending behaviors. If a MA introduces himself as a nurse to a patient, go ahead and correct, but do it in a way that is not condescending.
If it happens several times, document it. But I assure you, if you correct with respect, they will respect you back. Wow ,this is why medical assistants think its OK to call themselves nurses. Most medical assistant programs are not two years many are months. Some have just on the job training. The problem are the city school and tech schools that want to sell their program.
They make it a two year degree and it give the perception that you are similar to a nurse. These programs take these students money and tell them they will be like nurses and when they get out and graduate they are struck with a 15, dollar bill and are making only a few dollars more an hour they would have made without the MA education. I have seen several MA graduates work for 1 year and go back to work where they worked before going through the MA classes.
If you want to be a nurse go back to school and go through a legitimate RN program. Next will be the CNA two year degree program,I am sure someone offers this somewhere!!! Any one can offer a MA program and unfortunately many people think it is an easy backdoor entry to the nursing field and when they start working they realize they have been duped!!! This whole debate is ridiculous!
It is obvious that each have their roles and all are important to patient care. What matters most is how the law and government define each title and each scope of practice. So lets stop being prideful and taking offense when truth is spoken. I am an MA and im proud of it. I would not call myself an RN because that is not my job. However, we do have a pretty demanding job. Ive worked for an endocrinologist for almost 4 years.
I instruct patients many of our patients are nurses on how to properly give insulin injections, testosterone injections, how to use a glucometer, insulin pump training, putting on and downloading CGMS, phlebotomy, running US machine, etc.
I do not claim to be anything other than an MA. I am damn proud of it. So one would think that nurses in the hospital would have some respect for the MA in the office. These are 2 completely different jobs. I have been an RN for over 40 years, so I have seen many changes over the years. I have a relative who is a surgical tech-she knows the name and the look of surgical instruments and knows which instrument to pass to the physician in what order.
For years she has been calling herself a nurse for many years. Her rationale is that she takes care of patiients. She just does not understand that just because she is in the room while a patient is having surgery, she is caring for the patient.
An MA works a whole lot cheaper than an RN. Either the MAs I have run into never took a pharmacology class or they have forgotten what they learned. It is a little scary when I, as the patient, have to spell the name of my meds and explain what they are for.
I certainly was surprised to find no jobs available because MDs would prefer to hire a young lady cause they usually are who has 6 months of school, being taught technical skills, some of which are online classes or for profit schools.
They are taught the how but not the why, what to watch for as far as adverse effects. I am a school nurse and am frequently asked by students if I help the nurse. What do you think of a clinic aide calling them self a nurse?
It makes me mad, and principal and teachers do it too! I think not. Can you insert foleys? Can you push meds like fentnyl, dilaudid, epi, sodium bicarbonate, or any other ACLS medications? Can you suction traches or do nasopharyngeal suctioning?
Can you insert NG tubes? Can you start cardizem drips, insulin drips, heparin drips, or nitro drips? I am not saying you are not educated, but to say that you can do any and all things an RN or LPN can is just wrong. As a former PCA patient care assistant I have the highest respect for all people involved in giving care to patients. We should work in coordination with each other but we should NEVER claim to be able to do things that are out of our scope of practice.
We all perform some sort of nursing care to patients. There are MANY aspects of nursing and not just RNs are involved in providing that care, but there has to be clarification for patients that do not understand the difference in our education and areas of expertise. No one should lead patients to believe their knowledge and ability in practice is greater than it is. At the end of the day we are responsible for ourselves and our licenses…we need to be sure we use our appropriate titles regardless of what type of nursing care we provide.
I appreciate all the differences in our scopes of practice. I love being a CMA as most of my patients are ambulatory and I love working in clinics where you can see multi generations of families and build relationships with your patients. When I was in school I was strongly encouraged to never misrepresent myself as we need to educate others of all the different roles in patient care. I get it we all had schooling and are different that is what makes health care so exciting, it is forever changing and growing.
I am an RN with 31 years of experience. I work in psych. LPTs are in their own distinct category and extremely important but have little if any training or education in the medical department. Management allows them to do all the same duties as the RN; interpreting labs, educating patients about health issues,and even has them doing admission assessments and care plans.
Completely wrong by the way…. They may not perform assessments in my state or develop the care plan by making nursing diagnoses and giving interventions. This company will drown when survey time comes around in a couple of months. No use fighting a losing battle here….
So newbie here. I have a goal to be a phlebotomist…then medical assistant…to back me up in my psychology field. Im about to finish my masters in pychology in 2 months. I chose that in the future i will be a medical assistant so i would be well rounded in my knowledge.
If something ever happened to ppl i work with in the future, my psychology knowledge and medical knowledge could save someones life. This post was very informational on how the world is. My mom was a CNA for years so i know the struggle.
However, patients and clients are the most important reason for joining the healthcare field. Alert patients in the nicest way what you are there to help them with, what your title is, and be proud to work with a team of your colleagues working together to achieve the goal of helping others.
I am new to Florida. Imagine how surprised you are as a Registered Nurse of 20 years, to get seen by a Medical Assistant.
While speaking with the Nursing supervisor, I find out that this person is actually a Medical Assistant! That is not just a slap in the face, it is misleading, and misrepresentative of care. I read a response from someone else that this article is disrespectful to Medical Assistants! Wow, no Miss, it is disrespectful to represent yourself as a Nurse when you are not a Nurse. It does not matter how good your education was as a Medical Assistant.
You did not go through nursing school, and you are not licensed as a nurse. You did not earn the title of nurse unless you did, and to say you are a nurse when you are not in fact licensed as such is a misrepresentation of your skillset, and education, and IS disrespectful to Nurses everywhere around the world.
It should also be illegal, but I am discovering unfortunately that it has become standard practice in the state of Florida.
This tells me that licensed Nurses are not respected as a profession in this state. Your medical providers might need a gentle reminder to be more honest, or to be informed about the law, regarding the roles they assign their staff.
We all have our duties, we all have our titles. Just do the best job you can being mindful of your legal scope of practice , so you can be proud of any title you possess. CNAs, while providing a necessary service, are not nurses. If you want to be a nurse and to call yourself a nurse, then go to school for nursing. Calling yourself a nurse when you are not opens the door for lawsuits.
It IS a crime to professionally pose as something you are not. Bottom line… There is a huge difference between a Medical Assistant and an RN, from knowledge base to responsibility. There are bigger differences between all than there are similarities. I should also mention there is more to being a Registered nurse than tasks, which is basically what Medical Assistants do. The training is completely different. Maybe she should start harping on those in her own field of nursing about this instead of trying to call out medical assistants.
We recently hired a girl who is still in college completing her RN. She has not taken her boards yet, or graduated from the RN program, she is telling patients and using the RN title on some patient paperwork. What are my options to address this? I know this is illegal. She has also used the RN title when calling insurance companies to get authorization for patients procedures.
I work for an office that has around employees that they directly call nurses in front of the patients….. This would not be a problem if not for the fact that only one of them is a certified Nurse. What do you recommend I do? How do I approach the Doctor and the Manager? I love my job. But I do not wish to miss-represent those who have studied further than my Associates.
Medical Assistants in my experience of 14 years, do every amount of work a Nurse does and sometimes more. You could of tried to see from their point of view. Though their are close-minded people in every profession. I am a medical assistant and I think the problem is that we are skilled in pt care but we are just assistants.
I think that medical assistants should be called medical nursing assistants. I think that this would be a welcome change.
We do work hard and we are cross trained in a lot of different things. I the practice i was in i did front office as well as clinical duties.
Plus i performed fibo scans and worked in recovery along with LPNs. Bit anyway my point is that we are trained in a lot of different areas and I believe we deserve to be called Medical Nursing Assistants. Personally, I take issue with the CNA, MA, and PCT, which I have encountered, referencing themselves as a nurse because they lack the experience to critically think allowing for life saving decisions.
There is a big difference when the nurse inserts an indwelling catheter as oppose to supportive staff who still refers to as a foley insertion. The nurse is assessing that skill as it relates to all other systems…..
I am not down playing what they do as a whole but the fact of the matter is the Registered Nurse is a highly skilled professional…. MA work really hard just as hard as nurses. You go into a health care profession to help people and care for them not for a title and def not to put others down for their title. If you are not one of these, you are something else. Use your correct title. Nurses are not Physicians. If you have not obtained a license in a particular field of study, you are not legally qualified to practice as such nor purport yourself as such.
They need you to perform YOUR role in their care in the best way possible. At least this is how I take it. You must be logged in to post a comment. Search Medical Assistant Programs.
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She has also made it known that she will have more of an advanced degree than me I have an ADN. Some people are just ignorant. Learn to let it roll off you, sometimes that is hard to do. Has 10 years experience.
I know what you mean. I had a patient's daughter tell me yesterday that she "went to LPN school, but had to drop out so now she's a Home Health Nurse". I ask: so you got your nursing licence after all? I couldn't open my mouth for a few minutes. Sign In Register Now! Search Search. Nurses Professionalism. At my boiling point Posted Sep 27, Register to Comment. Prev 1 2 3 Next. What do you do when it's a friend doing this?
What do you do when it's a health care coworker? Medical assistants are cross-trained to perform both clinical and administrative duties. Their primary responsibilities include:. Nurses are health professionals who provide critical health care to the public. They perform physical exams, review medical histories, provide health counseling, administer medications and coordinate care with other health professionals.
Nurses work primarily in hospitals, clinics, specialized treatment centers and assisted living facilities. In some cases, nurses also visit patients in their homes. Here is a look at the primary differences between nurses and medical assistants:.
Medical assistants are assigned a variety of duties that include both patient care and administrative responsibilities. While nurses have some administrative responsibilities, they focus primarily on patient care. Medical assistants must only perform the type of patient care as instructed by the physician. There are differences also in the type of administrative work that each professional conducts. Medical assistants perform tasks like answering phones and scheduling patients, while a nurse typically only performs tasks related to patient care, such as documenting their condition and writing care plans.
Medical assistants work directly under the supervision of a licensed doctor or, sometimes, a registered nurse. A nurse works under their own individual license, whether they are a registered nurse or licensed practical nurse.
This allows for a wider scope of responsibilities than a medical assistant. And because they receive more advanced training than medical assistants, they can perform more skilled or complex tasks when caring for patients. Medical assistants are generally expected to complete a two-year degree program in medical assistance, although some are trained entirely on the job by shadowing experienced employees or participating in employer-led training programs.
Some accredited training programs are available online for aspiring medical assistants. This includes Board Rule The referenced position statement establishes that a nurse has a responsibility and duty to a patient to provide and coordinate the delivery of safe, effective nursing care, through compliance with the NPA and Board Rules and demonstrates the importance for nurses to intervene or advocate on behalf of their patients.
The steps combine BON references and resources with additional references and resources policies and procedures from the employment setting and nursing and healthcare research and literature and use reflective questions to guide a nurse's practice decisions.
Since a comprehensive nursing assessment would be necessary to conduct a MSE, the RN level of licensure would be required. Some of the standards in Board Rule Regardless of practice setting, the nurse's duty to keep patients safe cannot be superseded by physician orders, facility policies, or administrative directives; see Position Statement Advanced practice licensure is not sufficient on its own to qualify an APRN to perform all types of medical screening exams.
The APRN would have to be licensed in an appropriate role and population focus, e. The appropriately licensed APRN should have a signed protocol or collaborative agreement with a physician, in accordance with Board rules, that specifically delegates medical aspects of care to the APRN. Although the laws regarding immunizations are not within the BON's authority, an Attorney General opinion in MW determined immunizations are preventative, thus no medical diagnosis is required or made when a person receives an immunization.
Board staff recommends that a facility have standing physician delegation orders that guide the nurse when to give pneumococcal or influenza vaccines. Board staff recommend review of documents located on our web site. Some of the documents to consider for review are Rule The number for the Immunizations Branch is Can an RN delegate vaccination administration?
Both the advanced practice registered nurse and the registered nurse delegate in the same manner — through the rules in Chapters and The Delegation Resource Packet contains access to the delegation rules in Chapters and as well as other resources related to delegation.
In general, vaccination administration would be prohibited from delegation by an RN to unlicensed assistive personnel UAP. The delegation rules in Chapter are more restrictive than the rules in Chapter All medication administration and routes of medication administration are prohibited from delegation in the acute delegation rules with the exception of the medication aide permit holder. An RN cannot delegate the injectable route to a medication aide with the exception of insulin in compliance with Rule RNs may supervise UAPs performing tasks delegated by other licensed healthcare providers.
If the RN cannot verify all of these responsibilities, the RN must notify the delegating licensed healthcare provider that the UAP is not capable of performing the task Rule Nurses have a duty to promote safety for their patients. Can a nurse do a medical screening exam in the ER during a pandemic? In the definition of nursing, found in the Nursing Practice Act section If the purpose of a medical screening is to determine a medical diagnosis, this would be beyond the parameters of nursing practice.
A nurse is required to implement measures to prevent exposure to infectious or communicable conditions [Rule One way to accomplish this standard is to identify incoming patients who might be infectious and provide them with a separate waiting area so as not to expose others to communicable conditions.
When a physician is delegating to a nurse, the nurse is expected to comply with the Standards of Nursing Practice just as if performing a nursing procedure. Nurses are to implement measures to prevent patient exposure to infectious pathogens and communicable conditions as stated in Board Rule Nurses may choose to receive a vaccination to prevent exposing patients to the flu and to protect them from possible infection.
A person may be contagious prior to developing symptoms with seasonal flu and thus may expose others to the disease. Can an LVN be a school nurse? Can an LVN train unlicensed diabetes care assistants UDCAs or serve in other roles consultative relationship, administratively responsibility?
The BON does not preclude LVNs from being employed in school settings; however, the BON regulates the nurse, not the setting, and has no jurisdiction over employment practices. In all cases, LVN practice is a directed scope of nursing practice under the supervision of a registered nurse, advanced practice registered nursed, physician assistant, physician, podiatrist, or dentist [ Board Rule The LVN participates in the planning of nursing care needs of patients and contributes to the development and implementation of nursing care plans for patients and their families with common health problems and well-defined health needs.
LVNs may teach from a developed education plan as well as contribute to its development. Who is responsible for determining which school employees will be trained as unlicensed diabetes care assistants UDCAs and who is responsible for training UDCAs in schools? In schools that do not have a registered nurse, the principal assures that training is provided by a health care professional with expertise in diabetes care.
Can a healthcare provider with expertise in diabetic care be contracted to do all of the training for an individual school or a school district?
A school nurse RN is assigned to 3 different elementary schools within one district and rotates between the schools. The principals also assume administrative responsibility for these staff whether they are functioning within their job descriptions or in the "extra" role of UDCA.
Working with the principals at all 3 schools, the school RN coordinates training of all UDCAs through another RN with expertise in all aspects of the care of children with diabetes.
How does the RN provide adequate communication and information to the UDCAs at each school related to the diabetic care needs of each child? What is the LVNs role? Congruent with the diabetes management and treatment plan and the individualized health plan IHP for each child with diabetes, the RN can develop information sheets with emergency contact numbers, reportable conditions, and how to intervene in a number of possible emergency situations that could occur with each child.
Health and Safety Code, Chapter and school policy mandate that this information be given to any school employee transporting a child or supervising a child during an off-campus activity. Based on maturity, intellectual understanding, or other factors, if a student with diabetes is unable to safely accomplish self-management, then the nurse should assure that this issue is addressed in discussions with the principal, parents, physician, and teacher s in revising the IHP as necessary to protect both the child with diabetes as well as others, including children, in the school setting.
The IHP may require multiple revisions as the child's ability to engage in responsible self-management increases. Who is required to conduct the training of the unlicensed diabetes care assistants? Texas Health and Safety Code Section Who will oversee that the evaluation of competency is acceptable?
The school nurse or the healthcare professional who conducts the training will determine if competence of clinical tasks is acceptable and safe. Can a nurse train unlicensed diabetes care assistants UDCAs , teachers, and other school personnel in the administration of glucagon?
While the BON has no jurisdiction over school district policies, nurses do have the obligation to promote a safe environment for students and staff [Board Rule Glucagon is prescribed to thousands of students with diabetes. Both students and their parents or guardians are instructed by providers and pharmacists on administration of glucagon should a hypoglycemic reaction occur. Even during an emergency situation in the school setting, the RN cannot delegate tasks that require unlicensed persons to exercise professional nursing judgment; but, the unlicensed person may take any action that a reasonable, prudent non-health care professional would take in an emergency situation.
Additionally,a series of algorithms that serve to provide delegation decision making guidance for RNs in the school setting along with BON Position Statement Each nurse will need to exercise sound nursing judgment to decide when it is appropriate and safe to delegate in emergency situations, remembering the supervision requirements of delegation as well. May I administer a medication if the use is considered to be off label?
The BON does not have a list of tasks that nurses can perform because each nurse has a different background, knowledge and level of competence. Off label use indicates that the medication is being used in a way not specified in the U.
All prescription drugs marketed in the U. The label provides detailed instructions regarding approved uses and doses which are based on the results of clinical studies that have been submitted by the drug maker to the FDA. Off label use of a medication may be supported by research and literature that addresses the necessary knowledge, required safeguards and risks associated with the off label use of the medication.
When a nurse is considering giving a medication, there are resources available on the BON website under the Practice tab and by selecting Nursing Practice Information to assist the nurse in arriving at a decision based on the topic at hand. The DMM is designed to be used in sequence, beginning at the top with question number one. In the model, nurses are asked reflective questions, and depending on how they answer, they are directed to continue through the model or stop.
Keep in mind, the answer may not be the same for each nurse. In the Scope of Practice Decision-Making Model , question one includes references to documents and information on the BON website, including statutes, rules, and position statements. While there is nothing specific in the Nursing Practice Act or Board Rules and Regulations that allows or prohibits the administration of medications for off-label use, there are laws and rules that licensed vocational nurses LVNs and registered nurses RNs should consider in this scope of practice decision.
For example, the LVN cares for patients whose healthcare needs are predictable. When considering the administration of a medication, the predictability of the patient, the patient's response and the nurse's skill set required to address the needs of the patient, must be considered. If any of these cannot be addressed by the LVN, then it would be beyond the scope of practice of the LVN to administer off-label medications.
One of the main rules applicable to a nurse's practice is Board Rule When a nurse is considering performing a task, such as the off-label administration of medications, several standards in section one of this rule, will apply to all LVNs and RNs. Patient safety must be considered in every assignment a nurse accepts [ Board Rule A nurse must know about the medication, why it is being used, what effects can be expected, and how to administer the medication correctly in order to administer it safely [ Board Rule Some medications may require an assessment, vital signs, and a pain description and pain level provided by the patient.
Certain medications require the presence of equipment or monitoring during and following the medication administration due to the potential or known effects of the medication. Some medications require the nurse administering the medication to have specific skills and current competencies to include emergency interventions should adverse outcomes occur.
Last, but not least, medication administration is not complete without accurate documentation [ Board Rule There are several Position Statements that apply to the off-label administration of a medication. Some medication administration is initiated through physician standing orders as addressed in Position Statement Occasionally, a physician delegated act includes medication administration; see Position Statement There are two position statements that specifically address either the RN or LVN scope of practice in broad terms.
These are Position Statements Question two of the Scope of Practice Decision-Making Model directs nurses to look for a valid order authorizing the activity or intervention. Question three asks if the activity or intervention is consistent with current policies and procedures in the employing organization or facility.
Facility policy may identify specific levels of licensure for the administration of certain medications, or specific areas or units within the facility where the administration of medications may occur. There may be specific requirements related to current competencies of the personnel who will be administering medications, and for monitoring the patient after the administration of medications.
There may be a policy distinction between label uses and off-label uses of medications. When a nurse identifies the safety issues involved in administering any off-label medication correctly, looking for an employer's policy outlining the safety measures required for the safe administration of the medication may assist a nurse in determining if off-label administration of medications will be safe in a specific setting. Nurses are required to administer medications correctly, using evidence to support or refute giving a medication.
If there is literature to support the safe off-label administration of a medication, a nurse should consider questions five, six, and seven of the Scope of Practice Decision-Making Model. If a medication is being given via the IV route, having current skills to assess and intervene are important. If a pump is being used to administer the IV medication, then being familiar with the pump is essential.
Question six asks for the nurse to consider whether a reasonable and prudent nurse would administer the off-label medication in a similar circumstance. Finally, question seven is a personal reflective question and asks the nurse to accept accountability for the provision of safe care and the outcome of the care rendered. Question eight is specifically for LVNs and asks if there will be adequate supervision available. This is a reminder that the LVN has a directed scope of practice under the supervision of a registered nurse, advance practice registered nurse, physician, physician assistant, dentist, or podiatrist [ Board Rule Both the mission of the Board and the nurse's duty to the patient align in favor of patient safety.
Therefore, a nurse is obligated to make the safest decision for the patient and using the Scope of Practice Decision-Making Model for determining scope of practice is one tool to help nurses with the decision of whether to accept or refuse an assignment related to the off-label administration of medications. Nurses on guard-best practice in patient safety: Off-label administration ok ketamine for pain management by a nurse.
Texas Board of Nursing Bulletin, 43 4 , Code, Sec. Are there rules regarding nurses performing radiologic procedures? Yes, Board Rule There is no cost for registering. The RN who is registered with the Board must notify the BON within 30 days of any changes that render the information provided on the application incorrect, such as, changes in the identity of the practitioner or director of radiologic services under whose instruction or direction the radiological procedures are performed [Board Rule The Board does not prescribe a specific course that must be completed.
Depending on the specific procedures to be performed, the training content, method, and length may vary. These laws and regulations also require an RN to demonstrate competency in performing radiologic procedures. Each RN is responsible for maintaining a record demonstrating completion of an appropriate training program that has adequately prepared the RN to perform the radiologic procedures.
This record must be maintained for a minimum of three consecutive renewal periods, or 6 years, for auditing purposes. Some radiologic procedures may be considered delegated medical acts. BON staff recommend caution when performing a task as a delegated medical act. The Board's Position Statement Delegated medical acts do not diminish the responsibility of the nurse in any way to adhere to the Board's Standards of Nursing Practice, found in Board Rule Included in Board Rule Other nursing organizations related to a nurse's specialty practice setting may provide further guidance.
Additionally, national patient safety organizations may provide resources and procedure guidelines for evidence-based practice. Examples include:. The Nursing Practice Act and Board Rules and Regulations do not address LVNs performing radiologic procedures; therefore, an LVN would need to obtain the required license or permit necessary to perform radiologic procedures, such as, a medical radiologic technologist license regulated by the Texas Medical Board.
Texas Senate Bill amended Section There was legislation some time ago that allowed nurses to pronounce death in long-term care and hospice facilities. Texas laws and regulations regarding pronouncement of death may be found in Texas Health and Safety Code Chapters and respectively.
Even though the Texas Board of Nursing BON does not have purview over the laws surrounding pronouncement of death and death records, because Board Rule In addition to obtaining approval to sit for the NCLEX, a student who has successfully completed a nursing program must also hold a current valid temporary permit from the Board to practice as a GN or GVN in the state of Texas. Although the GN or GVN may not practice in an independent setting such as home care until licensed, the BON has no requirements for co-signatures on anything.
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