Nurses in Pre-Hospital

Editorial Team / Moderator · Mar 13, 2016

Are the nurses receiving training or do they have special training already to be on the ambulances? I assume you're somewhere in the UK based on the reference to Accident & Emergency, so I don't know what kind of prehospital training your nurses get. Personally I would love it, but I was a paramedic before I was a nurse. As long as they are competent, why not? What potential issues are you seeing?

Jaws23 · Mar 13, 2016

We are based in Europe. Yes we are receiving training in the pre-hospital settings bls ils and pre-hospital courses, as well assessment is done by our PDN. Actually we don't have paramedics, we have EAR (emergency ambulance responders) they are only trained as BLS, and Nurses from A&E are Daily allocated on rotation bases on ambulance. the thing is now our Health Departments want to separate ambulances from a&e

Trauma Columnist · Mar 14, 2016

I live in IL where we do have a license for a pre-hospital RN. I practice at the ALS (Advanced Life Support) level on my rural emergency squad - we are volunteers.

Editorial Team / Moderator · Mar 14, 2016

We are based in Europe. Yes we are receiving training in the pre-hospital settings bls ils and pre-hospital courses, as well assessment is done by our PDN. Actually we don't have paramedics, we have EAR (emergency ambulance responders) they are only trained as BLS, and Nurses from A&E are Daily allocated on rotation bases on ambulance. the thing is now our Health Departments want to separate ambulances from a&e

Then your health department needs a plan to staff those ambulances with qualified individuals. If the nurses actually belong to the hospital, then your health department will need to hire separate advanced life support providers.

Grant97 · Mar 14, 2016

The ideal prehospital ambulance would have both an RN and a paramedic, as well, of course as an EMT/driver or simply an EVO (emergency vehicle operator). As a paramedic I can tell you that not all nurses will be comfortable with EMS, just like all paramedics would not be comfortable with nursing. It does take a different mindset. If, however, you as a nurse have that mindset then you are 90% of the way to making a great EMS provider. There are some skills you will need to learn that are not LIKELY part of your current skill set. Examples would include intubation, chest needles, chest tubes, pericardiocentesis, cricothyroidotomy, etc as well as extrication and a few other things, like BEING IN CHARGE in very chaotic circumstances. However, you already bring to the game many more of the skills than would a paramedic moving to nursing. The skills I mentioned above, and a few others, can be taught in relatively short order. The biggest hurdle is mindset, and if you are already craving the opportunity then mindset should be no problem. My personal feeling is that paramedicine should be a bachelor's level career that would involve much more "nursing" content. And, of course, that it should pay at the same level. Many physicians are now of the belief that paramedics are truly clinicians, because they are. Many nurses are most comfortable having someone else, the doctor, making the decisions and then following his or her orders. That is NOT the mindset of the paramedic. At the same time, there are plenty of nurses who already have the mindset of being a decision maker and acting independently on those decisions. With learning a few extra skills THOSE nurses are closer to being the ideal prehospital provider than are most paramedics. The ideal situation is, as I started off by saying, having both skill and knowledge sets on the ambulance. Because most jurisdictions require crews of at least two, and you must, of course, have a driver, consider Emergency Vehicle Operators. Having EVOs lets both the paramedic and the nurse remain "in the back" with the patient while the driver just gets better and better at knowing his or her territory, routes, safe driving skills, etc.

Jaws23 · Mar 14, 2016

Thanks allot for the great information that you gave me. Actually nurses already work on ambulance and the crew system is of 3 ( with the nurse ). In regard chaotic situations we are use to them, although we are not aloud to do them i mean intubation, chest needles and tubes pericardiocentesis and cricothyroidotomy, etc ( as they specify that only doctors able to do them) our EAR ( emergency ambulance responders) are only trained for Basic life support and driving.