Question:
Dear Nancy,
I witnessed a physician allowing a medical assistant to suture a patient's head. I do not think this is legal in my state. The MA took photos of the suturing she had done and showed them to multiple staff members. The MA and MD both work for the hospital, so they are not in a private practice. The physician allowed the MA to suture multiple patients.
Maude
Nancy Brent replies:
Dear Maude,
If you are certain that this type of practice is not allowed in your state ? in other words, that there is no statute or rule allowing a medical assistant to suture if properly supervised by an MD and the MA has had training ? and the facility allows this practice, then you must seriously consider reporting this to the appropriate person at your workplace. If you are not comfortable verbally reporting this issue, you also can do it confidentially through another established procedure there, such as an incident/occurrence report.
Another concern here is the MA taking photos of the patient's head. You did not indicate whether the patient's face was visible in the photographs, but it is probably true that no medical photos of patients can be taken without the patient's consent, whether the patient is identifiable or not. Many times, this consent is contained in the patient's informed consent for surgery, but the question is: What did this patient consent to? It may be that the consent stated that any pictures taken are to be used for educational purposes only (not for "bragging rights").
Your nurse manager can take your information to her immediate superior, and we can hope the practice will be stopped soon, if it is not legally allowed. Often, if a chief nursing officer shares this type of information with the medical director who oversees the medical staff, a faster resolution may result.
If there is no progress in stopping this procedure, and it is illegal, then you must determine your duty to report this to an outside agency, such as the state medical board. You should review your nurse practice act and rules concerning your duty to report illegal, unethical or unprofessional conduct to appropriate authorities. If you want guidance in doing so, which would be a good idea, consulting with a nurse attorney or attorney in your state would be wise.
Cordially,
Nancy
