Paramedics in the ER - page 8

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. Visit  TraumaNurseRN profile page
    0
    It has been already said but I feel a need to restate it. RNs and medics are both necessary and dignified PROFESSIONS. They are vastly different and are trained to excel in their chosen field. Being great at one does not mean a person will be great at the other.

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  3. Visit  Dinith88 profile page
    0
    Quote from Iam46yearsold
    As long as I got a cute young guy to work with.
    Oh yeah! Again, the REAL reason why most female ER nurses (vast majority) think EMTs are "good help in ER...we should embrace them" (no pun intended!)

    Awesome!
  4. Visit  Medic15251 profile page
    0
    It has been already said but I feel a need to restate it. RNs and medics are both necessary and dignified PROFESSIONS. They are vastly different and are trained to excel in their chosen field. Being great at one does not mean a person will be great at the other.
    I agree 100% with that but also feel that with the appropriate orientation and additional training that paramedics could be utilized in an er functioning in a role very similar to a RN.

    Secondly in my state medics to not hang nitro nor do they diagnose.
    Then remind me to never have an MI in your state!

    10 drugs a week is nothing, try that daily as in nursing school.
    Wow! An ADN program is typically 2 years of school. That's 730 days x 10 drugs a day. That comes out to 7300 drugs you memorized. I am completing nursing school myself and have not memorized 7300 drugs. My nursing drug book only has about 2000 pages in it. Could you please tell us what program you attended that has such high standards?
  5. Visit  Hilinenursegrl profile page
    0
    Quote from Medic15251
    Then we have a fundamental disagreement. It has been my observation that traditional adn programs in my area put their students through a couple of shifts in an ed. They basically just observe and might attempt an iv start or pass some po meds.

    The math is not difficult. It comes down to what is more, both time wise and experience wise... Two shifts of observation time only or 200 hours of practicing assessments, pushing meds, starting iv's, intubating, doing pt education, etc. To me the answer is clear. Paramedic school provides more clinical experience that is more relevant to working in an ED than nursing school does.

    This is why many hospitals won't even let new grads work in their ED. They want them to get "work experience" on the floor first. Those hospitals that are willing to hire a new grad do extensive orientation programs for a year or so before they turn the nurse loose.
    I have to agree with you. I went through a two year program for an ADN and I spent a total of 18 hours in the ED. We spent way more than that on the medical floor. I started in the ED fresh out of school, I was very lucky, and its a small ED. When I watched the EMS and paramedics go to action in our ED I felt very inept. They were much better at starting IVs, drawing blood, putting in caths and the like. We have plenty of EMS students who are here everyday following us and assessing pt on their own and doing procedures, under supervision of course. I have to back 15251 on this.
  6. Visit  TraumaNurseRN profile page
    0
    Quote from Medic15251
    I agree 100% with that but also feel that with the appropriate orientation and additional training that paramedics could be utilized in an er functioning in a role very similar to a RN.



    Then remind me to never have an MI in your state!



    Wow! An ADN program is typically 2 years of school. That's 730 days x 10 drugs a day. That comes out to 7300 drugs you memorized. I am completing nursing school myself and have not memorized 7300 drugs. My nursing drug book only has about 2000 pages in it. Could you please tell us what program you attended that has such high standards?
    Our medics do not diagnose, nor hang nitro, enroute they give SL nitro, start the Ivs prior if they can, if no IV access..... even sl nitro is not given and they do prehospital care....Never do they hang nitro drip or titrate....in my almost 30 years have I've NEVER seen EMS hang nitro drip and titrate ever, and knowing their protocols and work closely with the State EMS coordinator are they allowed (it's beyond their scope of practice). And yes 7300 drugs is a bit, and I thinking about it now realize a bit of fluff...but we did them say half that amount. Now that you too........ have figured out that there is MORE SCHOOLING REQUIRED TO BE AN RN,(as you are required additional education to become an RN and are in a program) YOU'LL SOME DAY REALIZE.....IT'S A TOTALLY DIFFERENT FIELD WITH TOTALLY DIFFERENT KNOWLEDGE BASE.....you get your ADN.....

    and the program I attended was a private university, 100% pass rate, thankyou....Good school, highly accredited......and back then paid $390 a credit hour as well....hate to see what it is now. Obviously, you are getting your RN because your state does not allow you to practice above your scope of knowledge/practice. I commend you for going on to school....goodluck....
    Last edit by TraumaNurseRN on Dec 14, '08
  7. Visit  Medic15251 profile page
    0
    Obviously, you are getting your RN because your state does not allow you to practice above your scope of knowledge/practice. I commend you for going on to school....goodluck....
    Nope. My state values ems. As I said before, it's common here for medics to work in ER's and function essentially the same as an RN...doing the same skills, triaging, taking pt's, doing education etc. Medics here are actually allowed to do more skills than RN's. It's not that I want to practice above my scope (my scope is already broader than the rn's here) I simply want to be paid better for doing the same work! Thank you for the good luck wishes.

    Our medics do not diagnose, nor hang nitro, enroute they give SL nitro, start the Ivs prior if they can, if no IV access..... even sl nitro is not given and they do prehospital care....Never do they hang nitro drip or titrate....in my almost 30 years have I've NEVER seen EMS hang nitro drip and titrate ever
    Again, I am sorry you live in such a backwards state. I'm not sure what you teach in your state, but here we understand that time is muscle and if we can re-perfuse in the field instead of waiting until we get to the hospital then why not right? Our medics here are taught how to diagnose an MI. We carry the same pumps they use in house and do nitro, dopamine, lidocaine drips etc. When we do inter-facility transports who knows what other drugs might be hanging.

    Some of the EMS services in my state are doing trials of using troponin labs in the field. We have the capability of sending 12 leads over our cell phones. Field thrombolytics are also in use by some of the services in my state. And here if we can not get an IV, we carry IO guns or drills to get access.

    And yes 7300 drugs is a bit, and I thinking about it now realize a bit of fluff...but we did them say half that amount.
    I still call bs on this. There is around 1700 pages in my nursing drug book. Some of these drugs obviously take up more than one page, meaning there is less than 1700 drugs in the book. You are claiming that you learned about 3500 drugs in nursing school. Could you please explain how you learned about 1800 additional drugs that are not even known to the current nursing drug books?
  8. Visit  GilaRRT profile page
    1
    Mine is bigger than yours! Cannot say anything productive is developing from this topic. The bottom line still remains: PM's are not educated to provide nursing care and RN's are not educated to provide EMS care. It is that easy. Obviously, a certain amount of knowledge and modality crosses over.

    Not to say paramedics cannot work in the ER; however, a certain amount of experience and education is required to make a successful transition. The same is true of nurses working in the pre-hospital environment.

    This could change if EMS in this country decided to push for standardization of education. Instead, many programs can simply interpret the DOT NSC. Even with the NREMT pushing to have approved programs, I suspect many places will drop the NREMT requirement and simply maintain a state certified shake and bake school.

    EMS has a long way to go in this country before they can start looking at taking over the traditional RN role within the hospital. Outside of the USA, a different story.
    TraumaNurseRN likes this.
  9. Visit  Iam46yearsold profile page
    0
    Quote from Dinith88
    Oh yeah! Again, the REAL reason why most female ER nurses (vast majority) think EMTs are "good help in ER...we should embrace them" (no pun intended!)

    Awesome!

    Whats wrong with a good embrace. Good for the morale. Ive never known a paramedic to complain after I have given them a hug.

    There is also no reason they can not work very well together as a team in the ER.
  10. Visit  Medic09 profile page
    1
    Like Gila, I thought the utility of this thread died a few pages ago. BUT, at my age I've been around the block a few times, and Medic15251 I'm just dying of curiosity. What state are you in, that you've been describing in all your posts?

    Thanks.

    mordechai-sleepy-after-a-small-hours-patient-flight-and-going-to-sleep-before-my-shift-in-the-ED
    TraumaNurseRN likes this.
  11. Visit  TraumaNurseRN profile page
    0
    Quote from Medic15251
    Nope. My state values ems. As I said before, it's common here for medics to work in ER's and function essentially the same as an RN...doing the same skills, triaging, taking pt's, doing education etc. Medics here are actually allowed to do more skills than RN's. It's not that I want to practice above my scope (my scope is already broader than the rn's here) I simply want to be paid better for doing the same work! Thank you for the good luck wishes.



    Again, I am sorry you live in such a backwards state. I'm not sure what you teach in your state, but here we understand that time is muscle and if we can re-perfuse in the field instead of waiting until we get to the hospital then why not right? Our medics here are taught how to diagnose an MI. We carry the same pumps they use in house and do nitro, dopamine, lidocaine drips etc. When we do inter-facility transports who knows what other drugs might be hanging.

    Some of the EMS services in my state are doing trials of using troponin labs in the field. We have the capability of sending 12 leads over our cell phones. Field thrombolytics are also in use by some of the services in my state. And here if we can not get an IV, we carry IO guns or drills to get access.



    I still call bs on this. There is around 1700 pages in my nursing drug book. Some of these drugs obviously take up more than one page, meaning there is less than 1700 drugs in the book. You are claiming that you learned about 3500 drugs in nursing school. Could you please explain how you learned about 1800 additional drugs that are not even known to the current nursing drug books?
    REREAD MY POST ABOUT THE AMOUNT OF DRUGS....THEN BACK OFF YOUR HIGH HOURSE MISSY....
  12. Visit  TraumaNurseRN profile page
    0
    Quote from Medic15251
    Nope. My state values ems. As I said before, it's common here for medics to work in ER's and function essentially the same as an RN...doing the same skills, triaging, taking pt's, doing education etc. Medics here are actually allowed to do more skills than RN's. It's not that I want to practice above my scope (my scope is already broader than the rn's here) I simply want to be paid better for doing the same work! Thank you for the good luck wishes.



    Again, I am sorry you live in such a backwards state. I'm not sure what you teach in your state, but here we understand that time is muscle and if we can re-perfuse in the field instead of waiting until we get to the hospital then why not right? Our medics here are taught how to diagnose an MI. We carry the same pumps they use in house and do nitro, dopamine, lidocaine drips etc. When we do inter-facility transports who knows what other drugs might be hanging.

    Some of the EMS services in my state are doing trials of using troponin labs in the field. We have the capability of sending 12 leads over our cell phones. Field thrombolytics are also in use by some of the services in my state. And here if we can not get an IV, we carry IO guns or drills to get access.



    I still call bs on this. There is around 1700 pages in my nursing drug book. Some of these drugs obviously take up more than one page, meaning there is less than 1700 drugs in the book. You are claiming that you learned about 3500 drugs in nursing school. Could you please explain how you learned about 1800 additional drugs that are not even known to the current nursing drug books?
    OBVIOUSLY THERE'S A REASON YOU REQUIRE ADDITIONAL SCHOOLING....WITH THAT.....I AM DONE ARGUING WITH MEDIC TO RN....MY BACKWARDS STATE JUST PERFORMED THE FIRST FACIAL TRANSPLANT...BUT OH WELL....YOU KEEP UP YOUR SCHOOLING, GET YOUR JOB AS AN RN IN THE ED....THEN TELL ME ONCE AGAIN A MEDIC IS JUST AS QUALIFIED TO WORK AS A LICENSED RN IN THE ED, DOING THE SAME STUFF, RESPONSIBLE FOR THE SAME LICENSE.....OH WAIT....THERE IS NO LICENSE AS A MEDIC.......LOL
  13. Visit  TraumaNurseRN profile page
    0
    Again, I am sorry you live in such a backwards state. I'm not sure what you teach in your state, but here we understand that time is muscle and if we can re-perfuse in the field instead of waiting until we get to the hospital then why not right? Our medics here are taught how to diagnose an MI. We carry the same pumps they use in house and do nitro, dopamine, lidocaine drips etc. When we do inter-facility transports who knows what other drugs might be hanging.


    You as a medic cannot....legally diagnose!!!!!!!!!!!!!!!!!!!!!!!You are not educated enough.....
  14. Visit  Medic09 profile page
    4
    Back on page 6 of this thread, post #51 (please read it), I already pretty clearly presented a perspective on why it is fair to say that paramedics practice a limited form of medicine.

    To use the frequently dredged-up-here example of an MI: when I enter a home, and based on patient Hx, presentation, exam, and 12-lead EKG that I run and interpret all by my little self decide the patient is having an MI - I have made a diagnosis. There is no other word for it. What's more, in the rural service where I work (and have had quite a few MI patients over the years) there usually isn't another paramedic to confirm my thinking. We don't carry IStats on the ambulance or aircraft, so I have no labs. Some crews have them.

    So, based on that diagnosis I initiate care. True, limited by protocols. But that is still a limited manner of practicing medicine, according to the MDs I work under. My present medical director doesn't let us forget it. His words. Practicing medicine. I still have to make the decisions and choices. That's a lot of autonomy and responsibility, especially given that there's no one to clean up my mess if I goof up. IV NS, ASA, NTG SL, Morphine, O2. NTG gtt possibly. Withold NTG for a right-sided MI. Electricity for the suitable arrhythmias or pacing. Intubate if needed. Set up and run vent. Dopamine. Etc. If the patient codes in the living room, I completely run that code to the limit of the tools available. All decisions to be made, not just an algorithm.

    You know, there's a group of doctors who started out in EMS. They call themselves the Street Medicine Society. Because what they did out there on the streets was street medicine. When I was a small-team combat medic, I was practicing the lowest level of combat medicine.

    The practice of medicine isn't characterized by what piece of paper is in your wallet. It is characterized by assessment, diagnosis (even if only tentative), and intervention. Paramedics all over the world do that every day. So, btw, do nurses who move into the prehospital field as flight nurses.

    I personally don't like the way some things were represented by medic15251. I don't, however, want that to detract from a true perspective on what paramedics do and are indeed expected to do.

    'Nuff said.
    TraumaNurseRN, JBudd, Altra, and 1 other like this.


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