why do nurses hate medics?

PMFB-RN, RN · Dec 30, 2014

Hospitals are also seeing the value of Paramedics running their code and rapid response teams.

I was unaware that any hospitals were using medics on their rapid response teams. By "seeing the value" are you referring to medics willingness to work for very low and substandard wages and benefits despite their education and valuable skills?

BR157 · Dec 30, 2014

I was unaware that any hospitals were using medics on their rapid response teams. By "seeing the value" are you referring to medics willingness to work for very low and substandard wages and benefits despite their education and valuable skills?

I guess you learned something today about Paramedics.

There are still many EMS departments which are totally volunteer or supplemented by volunteers. They don't deserve your attitude or whatever that was you were trying to express. They serve a vital purpose in their community when the tax base does not support a paid EMS department.

There are also those of us who prefer to make $80,000 plus working for county EMS or Fire Departments. Good Fire Departments pay well over $100,000 for their Paramedics.

Then there are those who no longer want to volunteer or work 24 - 72 hours shifts with few benefits as well as sleeping in the truck on a street corner are finding that working 36 - 40 hours per week in a hospital making the same as 72 hours/week on an ambulance and with excellent benefits to be great. So I guess you might say they are willing to work in situations like a hospital. Some hospitals are allowing them to not only use their full scope of practice as a Paramedic but also expanding it. The set up in some Iowa, New Hampshire and Massachusetts hospitals are great examples. Kentucky, Oklahoma, Colorado and West Virginia may also have similar settings. Even California has now joined in with Community Paramedics and expanded critical care scope of practice.

Medicare does not recognize Paramedics, yet. This is the reason behind the low pay. As Paramedics gain more visibility in the hospitals and more states adopt the Associates degree for entry that will change. Paramedics should be able to charge for intubation and ventilator management just as easily as an RT. Paramedics are already being recognized as Community Paramedics which are expanding throughout the country. Several states have even set up reimbursement systems and Paramedics are often compensated for the extra cert. I see a future where Paramedics will be the established link in the ER and hospitals to help with the discharge planning.

Esme12, ASN, BSN, RN · Dec 31, 2014

I was unaware that any hospitals were using medics on their rapid response teams. By "seeing the value" are you referring to medics willingness to work for very low and substandard wages and benefits despite their education and valuable skills?

That depends on where you work....when I moved to New England they had their EMS systems set up very differently.

BLS was fire department based or private company based....the medics were called from private companies OR hospital based programs and they responded in a ALS bronco.

The facility where I worked had a paramedic program based out of the ED. They covered all of the surrounding communities....about 10 of them (crazy right?) There was a building attached to the ED with a garage fro the Bronco and sleep quarters for the medics. BLS was dispatched from the fire department with the big rig and them the fire department called the ED on a special phone and ALS was dispatched from the ED...heck we still had an old HARE radio....LOL

The paramedics answered all codes and and difficult IV starts if available. They ran the codes and intubated the patients. So yes....they responded to rapid response when not on a call.

akulahawkRN, ADN, RN, EMT-P · Dec 31, 2014

A good friend of mine, who is a paramedic, was frequently a code team lead at one of the hospitals he worked out of. His hospital was basically the only major ambulance ALS service provider for about 4 hours in any direction. This kind of thing where a paramedic is allowed to be on a code team isn't just limited to the New England area.

Edit: I should clarify one thing... Even I recognize that it is not the usual practice to allow this. As I recall, in California, paramedics aren't usually authorized to provide their full scope once inside the hospital itself. Just remember that especially in smaller or more remote places, it isn't a bad idea to allow/credential nurse, paramedic, or RT personnel to be on the code team or be team lead until the appropriate physician is present.

PMFB-RN, RN · Dec 31, 2014

There are still many EMS departments which are totally volunteer or supplemented by volunteers. They don't deserve your attitude or whatever that was you were trying to express. They serve a vital purpose in their community when the tax base does not support a paid EMS department.

Yes I am well aware of that since I live in just such an area, Our local EMS is teachers, mechanics, nurses, ect who volunteer on the EMS and fire departments.

There are also those of us who prefer to make $80,000 plus working for county EMS or Fire Departments. Good Fire Departments pay well over $100,000 for their Paramedics.

They more than deserve it as far as I am concerned. However are they making that money working in hospitals? Hospital based medic is what I was asking about. Do you have any examples of medics making $80-$100K working in hospitals?

Then there are those who no longer want to volunteer or work 24 - 72 hours shifts with few benefits as well as sleeping in the truck on a street corner are finding that working 36 - 40 hours per week in a hospital making the same as 72 hours/week on an ambulance and with excellent benefits to be great. So I guess you might say they are willing to work in situations like a hospital. Some hospitals are allowing them to not only use their full scope of practice as a Paramedic but also expanding it. The set up in some Iowa, New Hampshire and Massachusetts hospitals are great examples. Kentucky, Oklahoma, Colorado and West Virginia may also have similar settings. Even California has now joined in with Community Paramedics and expanded critical care scope of practice.

Is this because they can pay medic much less to do nurse's work?

I see a future where Paramedics will be the established link in the ER and hospitals to help with the discharge planning.

I can certainly see the attraction for the hospital of replacing relatively expensive RNs with low paid medics in these rolls. Just another attempt, along with the deliberately created glut of nurses, or reducing nursing from a good career with decent pay to just another low paid service position all in the name of profits.

PMFB-RN, RN · Dec 31, 2014

Edit: I should clarify one thing... Even I recognize that it is not the usual practice to allow this. As I recall, in California, paramedics aren't usually authorized to provide their full scope once inside the hospital itself. Just remember that especially in smaller or more remote places, it isn't a bad idea to allow/credential nurse, paramedic, or RT personnel to be on the code team or be team lead until the appropriate physician is present.

Non physician code team leaders, weather a nurse or medic (medic in ER only in my experience) is a well established and normal practice among the more advances states and medical systems. In my hospital the RRT RNs are the code administrators. We have residents as code leaders, when one is available, but we are responsible for the running of the code and will correct the resident, or even kick them out of the room if needed. They only "run" the code to gain experience. The responsibility of each code being run appropriately is up to us.

LilgirlRN, ADN, RN · Dec 31, 2014

Just my 2 cents worth here.... yes, shoot the messenger. Get out of my way messenger, this is my patient now. I just got report from you when you called in. Unless something drastic has happened since you talked to me then I don't need another report. Has NOTHING to do with you. All to do with my stress level. If I'm not busy and you're bringing me a stable patient, its a completely different story. I didn't read all the posts, you can do everything an RN can do except hang blood? Not that you're not smart enough to handle all that, just blows my mind. In the field yes, in the hospital, no. So, it may be a territory thing too. You're taking over the RN's turf. They don't like it. However, I would say any help is help. I'd take you.

BR157 · Dec 31, 2014

Yes I am well aware of that since I live in just such an area, Our local EMS is teachers, mechanics, nurses, ect who volunteer on the EMS and fire departments.

Aren't you exploiting EMTs and Paramedics by paying them ZERO? Why should a community pay for services if someone is always giving it away? If you have that many high paid professionals in your community, you should be able to support paid ALS EMS.

They more than deserve it as far as I am concerned. However are they making that money working in hospitals? Hospital based medic is what I was asking about. Do you have any examples of medics making $80-$100K working in hospitals?
Is this because they can pay medic much less to do nurse's work?.

I did clearly state FIRE DEPARTMENT and COUNTY EMS when typing that salary. But, I also stated reasons why an EMT or Paramedic might choose to work in a hospital. Private ambulance companies pay just above minimum wage due to the way insurance reimbursement works. Many of the transports they do are uninsured. Some people have families, old injuries or age working against them. Working 24 hours shifts or even 48 or 72 hours straight with very little sleep sitting in a truck for most of those hours can be very tiring. That Paramedic who brought a patient to the hospital at 0700 might also bring several more throughout the 24 hour shift with no sleep. There are just so many Fire Department jobs to get. To work only 36 or 40 hours a week with 2x the pay in a hospital might just be a good option.

You don't really seem to understand the whole insurance thing and how a profession is reimbursed or even recognized as a profession. The Paramedic is very new compared to RNs but I think EMS has made greater advances than nurses in some ways. It took nursing over 100 years to make a 2 year degree the standard entry and to be accepted as a profession. Nursing hasn't raised its entry requirement in over 50 years. The Paramedic came to be about 50 years ago and the profession is on the rise quickly now. It won't be long before it is recognized as a profession. The Community Paramedic already is in several states.

BR157 · Dec 31, 2014

Non physician code team leaders, weather a nurse or medic (medic in ER only in my experience) is a well established and normal practice among the more advances states and medical systems. In my hospital the RRT RNs are the code administrators. We have residents as code leaders, when one is available, but we are responsible for the running of the code and will correct the resident, or even kick them out of the room if needed. They only "run" the code to gain experience. The responsibility of each code being run appropriately is up to us.

All of your posts here read like a script from House. You seem to be the only one who can do anything. There are no other nurses, radiology techs, lab, respiratory and doctors are useless according to you.

Since you stated your community has a volunteer EMS, you must be either in New Jersey or in a tiny critical access hospital with rural medicine residents. I can't imagine anywhere else which would put up with someone who is not a team player and makes a point to belittle doctors by kicking them out even if they are residents.

GrannyRRT · Dec 31, 2014

We have residents as code leaders, when one is available, but we are responsible for the running of the code and will correct the resident, or even kick them out of the room if needed. They only "run" the code to gain experience. The responsibility of each code being run appropriately is up to us.

"Kick them out"? That should set the tone for these future attendings and their attitude towards nurses.

Your attitude and treatment of others could eventually catch up to you and your fellow RRT RNs will be dragged down also. The autonomy and skills you enjoy now are a privilege and can easily be reassigned by your Medical Director who happens to be a "Doctor".

ajmclean · Dec 31, 2014

Ignorance and bias come when you try to defend that forum and deny the offending posts or discussions exist. That forum is not all honey and roses. For that matter neither is this forum but I can not find that many posts here which are not complimentary to Paramedics. It took less than a minute to find the same tired member measuring discussions on that forum. What could be great discussions always end up the same way with someone getting butt hurt over ego clashes. The intubation scenario is a good example. I respect the knowledge of a CRNA, especially if they were also a Paramedic, when it comes to intubation and medications. What they know I can probably adapt outside of the hospital. Another discussion is about ****** nursing homes and their nurses. Another discussion is about rude ER nurses. Most of the topics about NREMT transitioning are about how to get a certificate in their state because they don't know the process probably because their quick cert poor excuse of a school didn't tell them. Yeah look at me defending nursing. Luckily I only have to address a handful of EMTs and Paramedics who have ventured from EMTLIFE to start the Hate discussions here. I think for the most part nurses and Paramedics get along pretty good in the ER and on transport.

Wow. I love a good joust! I didn't deny anything. While there probably some INDIVIDUAL, anti-nurse comments, overall EMTLIFE is not anti-nurse. I listed several of the sub topics on that forum, and most have nothing to do with nursing, i.e., Military/Wilderness, NREMT, etc. Commenting specifically on the NREMT Transition issue, you make a comment "Most of the topics about NREMT transitioning are about how to get a certificate in their state because they don't know the process probably because their quick cert poor excuse of a school didn't tell them." You again demonstrate ignorance of the overall situation. There are several states that do not recognize or support NREMT. So when the change came out mandating completion of a STATE-APPROVED transition course, many people were left hanging in the breeze. Didn't matter whether they were an NREMT-B, I, or P. I am in Florida, one of those states. As a private military contractor, not affiliated with a local EMS agency I didn't have a FL EMT-B license, I contacted NREMT. They had no answers other than completing a state-approved transition course. Remember the phrase "Catch-22"? The government required a certification, and NREMT worked for the government. My company has a global footprint. If you work overseas, countries only accept NREMT, not a state certification. So a lot of people had no definitive answer on how to keep their certification. So the blanket "quick cert school comment" is not apropos. Nowadays, EMTs go to a college and get a state and NREMT cert. And then they move on to another state or the government. So if they don't get the new state's cert, all they have is there NREMT. I got mine through the Bureau of Medicine and Surgery (BUMED), US Navy. Hardly a "quick cert school". I don't know your background as ALLNURSES doesn't give a detailed profile like other forums do, but I must say, you do a good job at showing you a$$ in an ignorant sort of way.

ajmclean · Dec 31, 2014

Right back at ya...
In regards to your post just above this one, back then the concept of prehospital ALS was very new, and the organized field of EMS was only about 20 years old. In that regard, EMS is still quite young in its development and there is going to always be some friction between some in EMS and some in Nursing because there will be some skill overlap and purpose overlap and a difference in education models between the two fields, and possibly including "chain of command" issues. I'm sure you experienced all that same stuff as an HC in the Navy.
Most will not have issues (either side) because it's all about the patient, not our own egos.

Are you catching the flame spray about EMTLIFE from BR157? She mentioned both of us.