Is it legal for a medical assistant to supervise nurses doing telephone triage?

By | 2015-08-20T19:26:00-04:00 August 26th, 2015|2 Comments

Dear Nancy,

I am an RN and work as a telephone triage nurse. Our department has RNs, LPNs, and medical assistants. Our supervisor has been there for many years and is an LPN. Recently, a medical assistant was named her assistant and will be in charge if the supervisor is not available. Is this legal? Can a medical assistant supervise LPNs and RNs? Our human resources department approved this, so they have no concerns about it. If it is a concern, who do I report it to?



Dear Anita,

It would be highly unlikely that a medical assistant would be able to supervise an RN or an LPN in relation to patient care and nursing practice. Additionally, it is interesting that the supervisor who has been there for some time is an LPN. The end result of this is that two individuals, one with a license and one without, are making supervisory decisions with less education and training than the RNs.

Although you did not mention this, what “supervision” do these individuals provide? Do they determine such things as when the staff can take breaks, go to lunch, or take time off? Or, are they overseeing an RN and an LPN’s triage decisions and their respective nursing practices?  What happens if the RN and the medical assistant don’t agree on a triage decision? Whose judgment prevails?

You might want to review your state’s nurse practice act and its rules to determine if there is any guidance on this issue. You also have the option of seeking a consultation with a nurse attorney or attorney in your state who can provide you with this information so your practice, and your supervision, is in accordance with the applicable laws. The attorney can provide you with specific information as well as how to report this arrangement, if it is not consistent with your state’s laws.



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About the Author:

Barry Bottino
Barry Bottino is a freelance writer and editor who has more than 25 years of experience at various newspapers and magazines.


  1. Avatar
    Michelle August 31, 2015 at 1:20 am - Reply

    The only way these in individuals can supervise more clinically advanced staff is in an administrative manner, as voiced above. They can supervise through administrative policies related to the aspects of your work that are non-clinical. U.S.Boards of nursing clearly delineate that nursing clinical supervision is done by advanced clinical peers or clinical peers with equivalent licensure and it cannot be performed by those with less clinical and educational preparation. If the above LPN and Med. Assistant are crossing into clinical supervision this is in violation of all U.S. Nursing practice acts. This violation could then lead to legal and ethical issues with patient care.

  2. Avatar
    Evelyn August 31, 2015 at 6:40 am - Reply

    Is it legal to reduce your pay after being paid an hourly salary for almost a year?
    Without any warning and then to be told it was a computer error because in the facility you work they do not pay second shift differential.

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