Understanding the Initials
Far more often than you may want to admit patients do not know who is providing their care and sadly some employers bank on this fact to pass off less educated and less costly staff in the guise of licensed professionals.
How many people do you know outside of the healthcare world who really understand a Medical Assistant in the Dr.'s office is NOT a nurse? How many lay people do you know that can explain the difference between a NA and RN?
For those within the healthcare realm the initials below will be easily understood but, do you insure that your patients understand who is actually providing care?
Do you consistently make sure your staff wears their badges so they are easily read? Do you make sure every staff member understands the importance of introducing themselves with their proper title and simple explanation of their role? Do you take a moment to educate people on the different roles helping them to understand the education, licensing requirement, etc. of each role they may encounter while in the healthcare system?
A Short list of some various roles:
MD, DO, ARNP, RN, LPN, LVN, PA, SA, PCT, EMT, EMT II, CNA, STNA, MA, HHA, RNFA, CST, CRNA
Some basics:
It is imperative that you understand what your team members may or may not do.
Each state in the U.S. has written laws as to which titles they recognize, the education requirement for each title and if there are license or certification requirements. If the state does not regulate or establish guidelines for a particular working title then usually that job title will be guided by standards from those who reimburse for payment such as Medicare and Medicaid.
For example, some states do not regulate the MA or SA (Medical assistant, Surgeon’s assistant). Therefore, a physician could hire anyone they wish and train them on site. Some states do not regulate the HHA but the hiring agency would implement guidelines so their staff follows established guidelines as needed so they will be reimbursed by insurance companies, Medicare, Medicaid, etc.
Some states require a minimum of an A.S. degree to be a paramedic while other states allow certification programs and use the title EMT II.
YOU are responsible to read the laws and understand them. If you are a manager, supervisor, MD, DO, RN (including any advanced practice RN) or LPN/LVN you must be knowledgeable of what duties members of the allied health team may provide and what their qualifications must be.
If you are the patient or a family member, you have every right to ask and understand who is providing care. For example, DO NOT assume just because someone wearing a white coat or is in scrubs in the ER is a Doctor. Far more often than not it will be a paramedic and PA, ARNP, RN.
Staff members must wear a clearly visible ID badge that clearly indicates their name and title.
Let’s decipher some of the abbreviations.
This list is not all-inclusive
MD- Medical Doctor
Initial 4 years of college to earn the basic MD then additional years as resident/intern thus this is a Master level education
DO- Doctor of Osteopathic Medicine
Initial 4 years of college to earn the basic DO then minimum of two years residency thus this is a Master level education
ARNP- Advanced Registered Nurse Practitioner
Initial 4 years to earn BSN then minimum of two years for advanced practice specialty thus this is a Master level education.
RN- Registered Nurse
Entry into the profession can be earned via an AS or BS degree in nursing however many states and facilities mandate a BSN (Bachelor of Science in Nursing) for entry into the profession
LPN- Licensed Practical Nurse
9 month vocational training program.
LVN- Licensed Vocational Nurse
9 month vocational training program
PA- Physician’s Assistant
Entry into the profession can be via an AS or BS degree from an accredited college program.
SA- Surgeon’s Assistant
Some states require the SA earn at least an AS in surgical technology with national certification prior to working while other states have no regulation thus allowing a surgeon or office manager to hire anyone they wish and train them without regard to education, character or criminal history.
EMT- Emergency Medical Technician
Each state regulates entry into practice requirements. Some states accept Vocational training with certification while other states mandate an AS degree with certification. There's various levels of EMT which can include EMT I, EMT II, A-EMT. Each level requires further training and expertise so the caregiver can provide more in depth care.
PCT- Patient Care Technician
Some states use this title rather than NA or STNA. Entry into the workforce can be via a vocational training program or it can be via a facility based training program. Some programs are a few weeks in length while others may be a few months.
CNA- Certified Nursing Assistant (STNA- State Tested Nursing Assistant)
The Federal OBRA laws of the 1970's mandate that all NA's be state certified with a minimum of 72 hours of training.
MA- Medical Assistant
Some states require the MA earn at least an AS and be nationally certified while other states have no regulation thus the doctor or office manager can hire anyone without regard to education, character or criminal history and office train them.
HHA- Home Health Aide
Many states do not have laws that mandate certification for this role however in order for a Home Health Agency to receive reimbursement from insurance companies and/or medicare the HHA must be certified. In most states, in order to become a certified HHA the applicant must first earn the state certification as a NA and prove a minimum of one year facility experience as a NA.
RNFA- Registered Nurse, First Assistant
One must first be a RN who has earned the CNOR (Certified Nurse - Operating Room) and have completed an accredited RNFA program and national exam. As of 2020 the RN must be earned at the BSN level which will then indicate this professional title will be held at the Master level
CST- Certified Surgical Technologist (Scrub Tech)
Some states require the CST earn an AS degree in Surgical Technology and the national certification exam in order to work as a scrub tech in surgery
CRNA-Certified Registered Nurse Anesthetist
Initial RN license is required prior to education at the Master level to earn the CRNA license
For more information and more job titles take a look at the Bureau of Labor Statistics Occupational Handbook
http://www.bls.gov/ooh/healthcare/home.htm
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