Paramedics in the ER - page 8

by errneducator

Hi, Does anyone allow paramedics to work in their ER? If so, do you have a job description you would be willing to share? Thanks!... Read More


  1. 2
    Cannot agree with you on this one. The problem being, paramedic programs range from shake and bake courses lasting six months to comprehensive programs that rival or exceed the length of their counterpart nursing programs. Unfortunately, EMS is very much a mixed bag right now regarding core educational requirements. Heck, EMT-I's are out providing nearly identical levels of care to a paramedic in some places, and they are doing so with less than 200 hours of training in some cases.

    Once EMS pulls things together and eliminates shake and bake protocol schools we may finally realize the full potential of the paramedic. Until then, all of this will only bring the truly educated and competent paramedic providers down. Work on solidifying the role of the paramedic in the field, then come take the ER from us.

    Look, PM students are in the ER to get skills checked off and see patients. They do not go to ER to learn how to function as nurses.

    I think I really like 09's point. The core techniques are essentially the same. An assessment is an assessment and an IV is an IV; however, translating that into the EMS or hospital environment is the real trick. A PM is no more qualified to work as an ER nurse than an ER nurse is qualified to work as a paramedic.
    nuangel1 and Altra like this.
  2. 0
    The problem being, paramedic programs range from shake and bake courses lasting six months to comprehensive programs that rival or exceed the length of their counterpart nursing programs.
    You bring up a good point. EMS is in it's infancy compared to nursing. Until an associates degree is required for entry into the field and EMS has a bigger voice in government, it will still be viewed as more of a vocation than a profession.

    I think we can find some common ground that a paramedic is currently an expanding roll that will most likely evolve quite a bit in the years to come. They should not be viewed as a replacement for nurses but as simply one answer of many to a nursing shortage that will only get worse in the years to come as the baby boomers age.

    Look, PM students are in the ER to get skills checked off and see patients. They do not go to ER to learn how to function as nurses.
    I see what you are saying, but ED nurses focus mainly on the very same things that medic students are trying to get checked off in skill wise. ED nurses have very limited time with their patients. It's been my experience that a typical day in an ed for an rn is very technical in nature. The focus is not so much on a "nursing care plan" and moving the patient from sickness to wellness. It seems more focused on assessing the situation, stabilizing and treating the pt, then moving them to the appropriate place (be it discharged to home or admitted to a specific unit). Correct me if I am wrong but these are all technical skills. Much like a paramedic would do.
  3. 0
    Quote from Medic15251
    I have to disagree. Most programs today require a great deal of time in the ed. Much of a medic student's time in an ed is spent following an rn. They see and experience first hand what an rn does in an ed.
    Perhaps......a medic should open up an NCLEX review manual and try their hand at answering some of those questions and see how well they do.
  4. 1
    Quote from Medic15251
    I have to disagree. Most programs today require a great deal of time in the ed. Much of a medic student's time in an ed is spent following an rn. They see and experience first hand what an rn does in an ed.
    What we do (a task or skill)....is totally different then where our knowledge base comes from and frankly I personally take offense in your thinking that because they see and experience first hand what an RN does means they could be an RN without years of study and passing the NCLEX in order to become licensed.
    nuangel1 likes this.
  5. 0
    Quote from Medic15251
    I'm not saying that a brand new paramedic would be 100% proficient working in an ED in a nursing role. What I am saying is that this medic would be better prepared than a brand new nurse. Of course there would be some minimal, additional training needed.



    Then you need to open your eyes. As I said earlier I spent 200 hours of clinicals in an ED. It is probably typically more than that now. The training in the majority of states now is all standardized, meaning that a medic student in Wisconsin would have a comparative program to a student in Tennessee. This is compared to a traditional ADN RN who might do two shifts in the ED of "observation time".

    I guess what I am trying to say is that paramedic school prepares a medic to be a competent and capable medic on day one, while nursing school teaches more theories and basics that leaves a new grad rn needing an extensive amount of orientation time and on the job training before they are prepared to function independently. This is why many hospitals offer new grad programs to their rn's that combine class time and clinical time that typically last up to a year where as a new medic might have 2-4 weeks riding as a third person or a double medic before they are turned loose.

    Again the two professions are very different, but they do overlap and have similarities. With the right additional training a medic can become a great nurse or vice versa.
    What are you smoking.....lol...the medics that do rotations through our ED (Level II Pediatric/Adult Trauma Center...65 bed ED) are they're to get their....listening to 30 breath sounds, 30 ivs, observe a few traumas, take some vitals signs, pass a few PO meds, a few IM injections, start IVs, draw some blood.....blah blah blah....and if I ask them why are you doing this or that for the patient,, most of the time they look a me like ummmmmm crap, I didn't know I would have to know this or that...I just need checked off...
    Being an RRT for 14 years prior to getting my RN and going to the ED....any nurse...or medic who thinks they could jump into an RRTs job is cazy as well. Just because a medic intubates and puts a patient on a mobile vent with presets......does not nor will it ever mean they could work as a RRT...the same holds true for, RNs...etc. We employ medics in our ED.....they work as techs.....under the guidance of a licensed RN. They answer to us.....
  6. 0
    I do not smoke, at least not tobacco, just kidding


    So now we are throwing RTs into the argument, cute


    Paramedics have their use, I am one, However I am now only all RN. Being in the field had difficulties I did not approve of. I kept breaking my nails. That might seem trivial to some of you, but not to me. So if breaking your nails is not important to you, then a paramedics life is for you.
  7. 0
    What we do (a task or skill)....is totally different then where our knowledge base comes from and frankly I personally take offense in your thinking that because they see and experience first hand what an RN does means they could be an RN without years of study and passing the NCLEX in order to become licensed.
    The "knowledge base" you draw from in an ED as RN is hardly taught in nursing school. You learn theories in nursing school. You learn how to be an ED RN mostly on the job and during an orientation time. Doing clinicals with an RN in an ED is only a portion of why a medic is qualified to work in one. Believe it or not, medics also go to school and have to pass a licensing exam!

    and if I ask them why are you doing this or that for the patient,, most of the time they look a me like ummmmmm crap, I didn't know I would have to know this or that...I just need checked off...
    If your demeanor in the ED is anything like your smug, condescending demeanor on this board, then I would bet you probably belittled and intimidated this medic student. It may have been so in the past, but the medics that are coming out of today's programs have a good understanding of not just how to do something but also why they are doing it.

    Just because a medic intubates and puts a patient on a mobile vent with presets......does not nor will it ever mean they could work as a RRT
    You have to understand that a paramedic is a bit of a jack of all trades and a master of none. That being said, today's medics are being taught how to do many of the things RT's do. Intubations, RSI's, surgical airways, end tital co2 capnography, vent settings, CPAP and BiPAP administration, breathing treatments, etc.
  8. 0
    Quote from Medic15251
    The "knowledge base" you draw from in an ED as RN is hardly taught in nursing school. You learn theories in nursing school. You learn how to be an ED RN mostly on the job and during an orientation time. Doing clinicals with an RN in an ED is only a portion of why a medic is qualified to work in one. Believe it or not, medics also go to school and have to pass a licensing exam!



    If your demeanor in the ED is anything like your smug, condescending demeanor on this board, then I would bet you probably belittled and intimidated this medic student. It may have been so in the past, but the medics that are coming out of today's programs have a good understanding of not just how to do something but also why they are doing it.



    You have to understand that a paramedic is a bit of a jack of all trades and a master of none. That being said, today's medics are being taught how to do many of the things RT's do. Intubations, RSI's, surgical airways, end tital co2 capnography, vent settings, CPAP and BiPAP administration, breathing treatments, etc.
    I understand exactly what the medics these days are learning. I actually work quite closely with the paramedic program at our hospital and have never intimidated or belittled anyone thankyou. Nor have any of them acted or suggested that they are quite capable to doing the same job as an RN, let alone in a specialty area such as the ER.

    A jack of all trades in the field is certainly different than assuming care and the knowledge base needed to care for the patient in the hospital. We have medics that work in our ER.....they work as techs....by law they can only perform "tasks" delegated by a licensed RN. Their protocols in the street are not the same in-hospital. Nor is their knowledge base. Now sure, lets put the patient on a vent prehospital, but do you think, and I bet my life's savings, there isn't one medic who could look at a set of ABGs, along with disease process/co-morbitities and suggest then give reasons why vent settings are picked and how to change the values through the vent settings for the proper health of the patient. I could go on and on about the difference between a medic and an RN. But basically, if medics want to be RNs....go do it...no-one's stopping them....My 14 years as an RRT, in the ICUs and ER certainly gave me an edge when it came to nursing school but I couldn't nor would I ever say, working right along side an RN.... that I could have done the job without going to nursing school. That's insulting!
  9. 0
    Quote from Iam46yearsold
    I do not smoke, at least not tobacco, just kidding


    So now we are throwing RTs into the argument, cute


    Paramedics have their use, I am one, However I am now only all RN. Being in the field had difficulties I did not approve of. I kept breaking my nails. That might seem trivial to some of you, but not to me. So if breaking your nails is not important to you, then a paramedics life is for you.
    I was throwing it in there too because medics intubate in the field and this medic spoke about vents in an earlier post.
  10. 0
    We have medics that work in our ER.....they work as techs....by law they can only perform "tasks" delegated by a licensed RN.
    What a shame to waste such valuable resources. I am glad the state I work in values their medics to allow them to function with more autonomy in the ED setting. Here, medics are licensed and work off of protocols or doctor's orders. What state do you work in that has such disregard for their medical professionals?

    I bet my life's savings, there isn't one medic who could look at a set of ABGs, along with disease process/co-morbitities and suggest then give reasons why vent settings are picked and how to change the values through the vent settings for the proper health of the patient.
    Again you would be wrong and would have lost your life savings. ABG's were taught in my medic program along with anatomy and physiology and disease processes. We also spent many clinical hours in the resp dept.


Top