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When did physician's offices start using medical assistants instead of RNs and what can nurses do about it?

Wednesday August 6, 2014
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Dear Nancy,

I have noticed many physician's offices are using medical assistants instead of RNs or LPNs. It concerns me that these assistants are able to give injections and medications that in other settings would be done by a nurse. When did this change and what can licensed nurses do about this?


Marvin



Dear Nancy replies:

Dear Marvin,

The use of medical assistants in physicians' offices in the place of RNs and/or LPNs is most likely due to the lowered cost of the salary of a medical assistant in contrast to that of an RN or LPN. Keep in mind, however, that a medical assistant is not an RN and therefore cannot perform nursing responsibilities that are only to be done by a licensed RN. Such responsibilities would include a nursing assessment, patient and family teaching, making a nursing diagnosis and utilizing the nursing process.

Likewise, the assistant is not an LPN so the nursing responsibilities the LPN is able to perform within his or her scope of practice cannot be performed by the medical assistant either.

Using a medical assistant in lieu of a licensed nurse is short-sighted. Since the assistant cannot, or should not, be performing the nursing responsibilities listed above along with others not listed, the physician's patients are not being evaluated from a nursing perspective.

The physician is delegating medication administration to the assistant without the benefit of an RN or LPN's observations of the patient and the identification of health issues the patient may bring up to
the nurse.

Physicians are often able to delegate the administration of medications to assistants because of a state Medical Practice Act that allows them to delegate patient care to others.

As a licensed nurse, you can help educate the public about the difference between a medical assistant and a licensed RN or LPN. If possible, see a physician who only uses RNs or LPNs in his office. Better still, talk to your physician if he does not use RNs or LPNs in the office, and help change the physician's mind to use licensed health care providers for the patients' care and treatment.

Cordially,
Nancy




Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.