Scope of Practice

North Carolina Medical Assistants in Inpatient Settings

I recently received the following question from a manager at a health care system in North Carolina: 

We are looking at ways to assist nurses in the hospital setting due to the nursing shortage. Can medical assistants practice in a hospital setting without a nursing assistant certification? 

Medical assistants are permitted to meet the requirements and register with the state as certified nursing assistants (CNAs) and medication aides. Short of this, medical assistants are considered unlicensed assistive personnel (UAP) when working under nurse supervision in inpatient settings. 

The North Carolina Board of Nursing has issued some detailed and helpful position statements on what nurses are permitted to delegate to UAP. See the following documents for additional details: 

On the Job, Scope of Practice

NP Delegation in South Carolina: State Law Permits Nurse Practitioner Delegation to Medical Assistants

Conflicting information has been circulating about whether South Carolina nursing law permits licensed nurses—including advanced practice registered nurses (APRNs), such as nurse practitioners (NPs)—to delegate tasks to medical assistants.

Nevertheless, South Carolina law specifically authorizes licensed nurses, including NPs, to delegate certain nursing tasks to knowledgeable and competent unlicensed assistive personnel (UAP), such as medical assistants, who are working under appropriate nurse supervision.

Administration of medication, however, is a task licensed nurses cannot legally delegate to UAP (such as medical assistants) under South Carolina nursing law.

Review the supporting evidence in the January/February 2020 Public Affairs article, “NP Delegation in South Carolina,” on the AAMA website.