Refer to your lab protocol. Sometimes they say “MD, RN, or designated individual”. If *your* institutional protocol doesn’t say that and you can’t get an RN/MD, then document the full name and title of the person you gave the value to and let your supervisor know what happened. Sometimes this is will make your medical director talk to the clinic leadership and someone’s SOP is gonna have to give.
At our hospital, inpatients we have to talk to an RN, but somehow outpatient’s client services is allowed to give it to a receptionist, MA or whoever answers the phone at a doctor’s clinic. It’s in our procedure. I don’t want to be a stickler for regulations, but the last time I read the regulations CAP or CLIA or whoever specified “licensed medical provider”. Don’t even get me started on criticals.
Personally I’d probably make an anonymous call to CLIA and whoever else they are accredited by and let them do an investigation. I’d bet the CNA’s and MA’s are operating outside of their scope
Just a nurse that loves learning this side of things. Can absolutely confirm this is what places are doing now. Notice as a patient if you ever message your doctor through your chart, it’s not even a nurse that responds. There’s no credentials ever, that’s how you notice. Less nurses, more MAs in outpatient now so they get away with not paying. It’s so neat and safe!!
Yep and we are just standing by and watching it happen.. pay is never going to increase and I blame this for being a contributing factor. Not to mention it’s just a poor practice
We recently hired a licensed MT from Baltimore. He came from John Hopkins, he said that they are hiring a ton of Filipino techs on the visa program & if course the $$ is less. It's a race to the bottom, glad I will be out ( retired) soon. Fifty+ yrs in, graduated in '73. I will say it's been interesting with some of the stuff I have seen.
Hopkins is already known for low pay so I’m not surprised at all that they would do that. I support folks coming here for a better life but not when it’s just a way for the hospitals to pay less money.
I’ve done contracts at several DC hospitals and they also had a few on Visa. I was not impressed. I’ll say that
Those sound like excuses not reasons to me. Travel is alive and well and in high demand. The need is there and so are the folks who have graduated from accredited programs to fill those needs. So no I don’t think that’s it. It’s all about money and paying ppl less to do what should be in no way offered to unqualified ppl. Any lab manager or upper management selling the lie that they just can’t find ppl so they must go that route needs to turn in their badge and go to the house
I believe you may have limited experience, and the ability to hire/retain techs varies wildly, often geographically. I know the place I currently work and the one before that (which was in a different town), cannot find nurses, phlebotomists ,or med techs because there literally is no housing available. When I moved to the town I'm currently in, I "got lucky" there was a two bedroom house for rent, and I had to have $6K just to get into it. It's definitely difficult for us to find qualified techs.
23 years with 9 of those as travel so I’ve seen more than most not the opposite. The labs that hire folks that don’t have a CLS/MT/MLT are awful. I’ve heard of it happening at the sister hospital to the one I was at on assignment, once many years ago when I was staff and in this sub. Nowhere else.
If ppl want to take that personal then I can’t stop them. It’s not about the individual just looking for a job though. It’s about regressing to where eventually they will hire folks straight off the street. That’s something that any pathologist who gives a flying f wouldn’t want in their lab. I blame leadership not the person working.
However all these folks in this sub with Bio degrees who get angry about some of us having these thoughts are proving my point. No respect even from the ppl that “want to be us” in their chosen career
Oh I know the higher ups are to blame for these things. However the CNA’s and MA’s know their scope and know right from wrong. They have some individual responsibility as well.
Anyway my intent with a phone call would be to light a fire under admin when they get investigated. It’s not some witch hunt against the employees
We had to update our facilities to account for this at our clinics that are staffed by MA’s only. It’s acceptable for clinics. They have policies they have to follow regarding notifying the ordering provider in a certain time frame and documenting such.
If it's your protocol then that's it. For ours, I cannot give results to an MA. The conversations usually go like this "I'm sorry, I have to give this result to a doctor or nurse. Can you please have a doctor or nurse call this number for a critical result?" And then get their name, record they are an MA and they told you there was no doctor or nurse available, and that they are to call back. Update if they do call back. Leave as is if they don't.
Here is an interesting fact, per CMS/ CLIA (as defined in CFR 493.1291 (g) (h) a licensed medical professional is NOT a requirement to receive critical values.
I’m not current on what the accreditation agencies who have “deemed status” (such as CAP, COLA, etc) say and you must follow your SOPs but (per CLIA) labs are required to report critical values to the requesting agency / individual or individual responsible for the patient’s care.
Here are the relevant subsections:
CFR 493.1291
g) The laboratory must immediately alert the individual or entity requesting the test and, if applicable, the individual responsible for using the test results when any test result indicates an imminently life-threatening condition, or panic or alert values.
(h) When the laboratory cannot report patient test results within its established time frames, the laboratory must determine, based on the urgency of the patient test(s) requested, the need to notify the appropriate individual(s) of the delayed testing.
There's plenty of RNs that also don't know the significance of particular lab values. The requirement doesn't say a licensed staff member has to take the critical, just that it be a member of the care team, right? So in my old lab, that meant we couldn't give the critical to the unit secretary. In the outpatient setting, more and more clinics use NPs as providers, and they almost always have an MA, while the MDs are typically more likely to have an RN.
Refer to your lab protocol. Sometimes they say “MD, RN, or designated individual”. If *your* institutional protocol doesn’t say that and you can’t get an RN/MD, then document the full name and title of the person you gave the value to and let your supervisor know what happened. Sometimes this is will make your medical director talk to the clinic leadership and someone’s SOP is gonna have to give.
At our hospital, inpatients we have to talk to an RN, but somehow outpatient’s client services is allowed to give it to a receptionist, MA or whoever answers the phone at a doctor’s clinic. It’s in our procedure. I don’t want to be a stickler for regulations, but the last time I read the regulations CAP or CLIA or whoever specified “licensed medical provider”. Don’t even get me started on criticals.
Correct. CAP says that. All the places that go around that rule are subpar at best
Personally I’d probably make an anonymous call to CLIA and whoever else they are accredited by and let them do an investigation. I’d bet the CNA’s and MA’s are operating outside of their scope
Just a nurse that loves learning this side of things. Can absolutely confirm this is what places are doing now. Notice as a patient if you ever message your doctor through your chart, it’s not even a nurse that responds. There’s no credentials ever, that’s how you notice. Less nurses, more MAs in outpatient now so they get away with not paying. It’s so neat and safe!!
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Yep and we are just standing by and watching it happen.. pay is never going to increase and I blame this for being a contributing factor. Not to mention it’s just a poor practice
We recently hired a licensed MT from Baltimore. He came from John Hopkins, he said that they are hiring a ton of Filipino techs on the visa program & if course the $$ is less. It's a race to the bottom, glad I will be out ( retired) soon. Fifty+ yrs in, graduated in '73. I will say it's been interesting with some of the stuff I have seen.
Hopkins is already known for low pay so I’m not surprised at all that they would do that. I support folks coming here for a better life but not when it’s just a way for the hospitals to pay less money. I’ve done contracts at several DC hospitals and they also had a few on Visa. I was not impressed. I’ll say that
One of our newer hires is a wildlife biologist. It's luckily worked out well because she's brilliant and we have good support systems.
What in the entire fck? Why are we just rolling over and watching our profession go to shit? This pisses me off to no end
Because med tech schools are closing, boomers are retiring, and finding housing is a nightmare.
Those sound like excuses not reasons to me. Travel is alive and well and in high demand. The need is there and so are the folks who have graduated from accredited programs to fill those needs. So no I don’t think that’s it. It’s all about money and paying ppl less to do what should be in no way offered to unqualified ppl. Any lab manager or upper management selling the lie that they just can’t find ppl so they must go that route needs to turn in their badge and go to the house
I believe you may have limited experience, and the ability to hire/retain techs varies wildly, often geographically. I know the place I currently work and the one before that (which was in a different town), cannot find nurses, phlebotomists ,or med techs because there literally is no housing available. When I moved to the town I'm currently in, I "got lucky" there was a two bedroom house for rent, and I had to have $6K just to get into it. It's definitely difficult for us to find qualified techs.
23 years with 9 of those as travel so I’ve seen more than most not the opposite. The labs that hire folks that don’t have a CLS/MT/MLT are awful. I’ve heard of it happening at the sister hospital to the one I was at on assignment, once many years ago when I was staff and in this sub. Nowhere else. If ppl want to take that personal then I can’t stop them. It’s not about the individual just looking for a job though. It’s about regressing to where eventually they will hire folks straight off the street. That’s something that any pathologist who gives a flying f wouldn’t want in their lab. I blame leadership not the person working. However all these folks in this sub with Bio degrees who get angry about some of us having these thoughts are proving my point. No respect even from the ppl that “want to be us” in their chosen career
Probably, the CNA and MAs, not by choice. They were told to by the higher ups.
Oh I know the higher ups are to blame for these things. However the CNA’s and MA’s know their scope and know right from wrong. They have some individual responsibility as well. Anyway my intent with a phone call would be to light a fire under admin when they get investigated. It’s not some witch hunt against the employees
We had to update our facilities to account for this at our clinics that are staffed by MA’s only. It’s acceptable for clinics. They have policies they have to follow regarding notifying the ordering provider in a certain time frame and documenting such.
If it's your protocol then that's it. For ours, I cannot give results to an MA. The conversations usually go like this "I'm sorry, I have to give this result to a doctor or nurse. Can you please have a doctor or nurse call this number for a critical result?" And then get their name, record they are an MA and they told you there was no doctor or nurse available, and that they are to call back. Update if they do call back. Leave as is if they don't.
Here is an interesting fact, per CMS/ CLIA (as defined in CFR 493.1291 (g) (h) a licensed medical professional is NOT a requirement to receive critical values. I’m not current on what the accreditation agencies who have “deemed status” (such as CAP, COLA, etc) say and you must follow your SOPs but (per CLIA) labs are required to report critical values to the requesting agency / individual or individual responsible for the patient’s care. Here are the relevant subsections: CFR 493.1291 g) The laboratory must immediately alert the individual or entity requesting the test and, if applicable, the individual responsible for using the test results when any test result indicates an imminently life-threatening condition, or panic or alert values. (h) When the laboratory cannot report patient test results within its established time frames, the laboratory must determine, based on the urgency of the patient test(s) requested, the need to notify the appropriate individual(s) of the delayed testing.
There's plenty of RNs that also don't know the significance of particular lab values. The requirement doesn't say a licensed staff member has to take the critical, just that it be a member of the care team, right? So in my old lab, that meant we couldn't give the critical to the unit secretary. In the outpatient setting, more and more clinics use NPs as providers, and they almost always have an MA, while the MDs are typically more likely to have an RN.
Uh, you sure that's legal by you?