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 nursing responsibilities LPNs are able to perform within their scope of practice cannot be performed by medical assistants 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's 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 physicians who only use RNs or LPNs in their offices. Better still, talk to your physicians if they do not use RNs or LPNs in the office. You can work to help change the physician's mind to use licensed health care providers for patients' care and treatment.
Cordially, Nancy
