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- Apr 3 by TraumaSurferQuote from Nursing_chickLet's take "love" out of the equation here. Personal preferences should not blind you on the job. How much training do your Paramedics receive in an actual ICU working with IABP and Ventilator patients? Here is an example of one "outstanding" CCT course...a whopping 72 hours. National EMS Academy offers Critical Care Transport Training for Acadian Ambulance Medics In California the CCTs use 1 RN and 2 EMT-Basics. What state are you from which requires 2 CCEMT-P and an RN for each patient? Unless the patient is on ECMO, usually 2 CCT trained professionals and an EMT (or not) driver is sufficient.So I'm a RN that works for a private Ambulance company that does CCT. We have rigs with: 1 RN an 2 CCEMT-P medics for the nurse calls and for independent CCT rigs with 2 CCEMT-P. The regular medics EMT-P have to work at the company for a while & be high performers even before they are considered for the CC team. They are then put thru the class before they are allowed to function on the team, even then they are paired with experienced CCEMT-P partners - I love & trust the medics I work with - I fully trust they know how to handle vents &/or IABP, just b/c I have RN behind my name doesn't mean we aren't equal - we just have different roles to play in the back of the ambulance.
- Apr 3 by SummitRNTrauma Surfer... what is your opinion of air ambulances (which primarily deal in CCT) using Nurse/Medic staffing? That seems to be the most common staffing (a few are Nurse/Nurse or Nurse/RRT or even Nurse/MD).
- Apr 9 by TraumaSurferQuote from SummitRNAfter reading what other countries put their Nurses, RRTs and Paramedics through, I see some CCT transports as a band aid offering a speedy transport while hoping the patient doesn't die or require much intervention.Trauma Surfer... what is your opinion of air ambulances (which primarily deal in CCT) using Nurse/Medic staffing? That seems to be the most common staffing (a few are Nurse/Nurse or Nurse/RRT or even Nurse/MD).
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You also must consider that the base education requirements for nurses, RRTs (Canada) and Paramedics in other countries are higher than the US. The US lags behind the rest of the civilized world in these professions which makes it disheartening to hear some RNs in the US complain about "all that time in school for an ADN" and see no use for the BSN.
Several of the teams which utilize RN/RN or RN/RRT also require them to obtain the EMT or Paramedic cert. Most can do this with an abbreviated course from a community college. But, it is still just an additional cert for a few specialty skills and knowledge to compliment the education (degree) and experience they already have in critical care. In some places an RN on a hospital based transport team will get more intubations in 1 month than many Paramedics get in 1 year or even 5 years according to the statistics. If that is the case, I would prefer two providers who have extensive critical care bedside experience over someone who has just a 2 week CCEMT-P certification.
But, some companies can not provide the intubation or current code experience for the RN so they rely on a Paramedic as the 2nd (and also for cost). This puts the majority of the "don't let them code" stress on the RN while the Paramedic might be very useful IF the patient codes. A Paramedic might be able to read a book or watch a video about an IABP or a ventilator to pass a test but until you have stayed for hours titrating meds and settings along with troubleshooting on multiple patients, you really are not equal for critical care experience and management of these patients. Short term management which is the focus of the Paramedic with a few meds and long term stabilization are two very different practices. The RN is accustomed to many more guidelines for titrating more meds specific to a disease process. The Paramedics goes with an algorithm which can be pretty generic for a short term transport. It is easier to teach an RN a few skills to compliment their education and experience from a critical care setting.
Of course not all RNs come from high acuity ICUs and not all Paramedics are equal. But, in the US, the expectations of the Paramedic is much lower for CCT teams. If you look at the ads, all they want from Paramedics are the basic requirements to maintain a Paramedic cert. Some might want the Flight or CCP certs but those are not that difficult and no additional degrees or experience is required. Some companies do want the RNs to hold BSNs along with a CCRN and other alphabet.
If the CCT also transports children and neonates, I think it should be an absolute requirement to have at least 1 year of experience in a Pediatric ICU and at least 1 year in a neonatal ICU. If the team is RN/Paramedic, it is just not safe for neither crew member to not have extensive bedside critical care experience for kids/babies and try to fly with just the "small adult" mentality.
Another thing I hear in the EMS community is that nobody supports them. But, few seem to have gotten involved to see who is going to bat for them for standards. This is an example from CAMTS. There are many organizations associated with EMS and Paramedics on various committees or directors which represent them.
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But, CAMTS is also a voluntary accreditation.
This is a good article. While what you said is true about RN/Paramedic being the most common crew configuration, the RRT is use as a 3rd 73%. Sometimes that might mean bumping the Paramedic.
- Apr 11 by FuturePsychNPQuote from TraumaSurferI sense that you too were a paramedic or some other level of EMS provider but are disturbed by the educational pathway of paramedics and unhappy with how EMS is administered so you make jabs at the occupation. I'd wager that you left the field to work as an ER tech. That's ok. I say some of the same things about nursing. Nursing isn't even on the same page with what "nursing" is defined as, and we're all entitled to our opinions.Kinda cool to be called a Critical Care Paramedic after just 2 - 3 weeks of training in a class that is basically a no fail. Then you take a couple more tests which have books that feed you the Q&As. You then want more money even though you may have never seen the inside of an ICU or worked with a ventilator or IABP patient. No college is required with such classes like A&P or even college level math. This is more of a scam for charging a hired rate to CMS than actually providing quality competent care.
However, I submit that CMS, particularly the medicaid side, is the scam and not a two week training course. There's only so much that can be done in back of an ambulance so two weeks seems more than adequate as a supplement to the provider's cognitive state. To be certified in emergency nursing, for example, one only needs to pass a test (as of last year at least). Work experience is preferred albeit not required. No extra training is required, and I can assure you that academic programs to develop registered nurses present little to nothing that prepares a newly graduated RN to work in an emergency, let alone trauma, setting.
- Apr 13 by TraumaSurferQuote from FuturePsychNPAfter 20 years as a Paramedic with a FD I moved on to getting a BSN to work as an RN. I already had a Bachelors in another field which was heavy in the sciences. Advancing one's education is a great experience and it really opens one's eyes to see how much they thought they knew but were very wrong. Currently I am working on my Masters to teach at the university level and not just a tech school or community college.I sense that you too were a paramedic or some other level of EMS provider but are disturbed by the educational pathway of paramedics and unhappy with how EMS is administered so you make jabs at the occupation. I'd wager that you left the field to work as an ER tech. That's ok. I say some of the same things about nursing. Nursing isn't even on the same page with what "nursing" is defined as, and we're all entitled to our opinions.
Quote from FuturePsychNPDo you want to justify why you think CMS is a scam? Do you believe the elderly and children do not deserve access to medical care? What should be used instead?However, I submit that CMS, particularly the medicaid side, is the scam and not a two week training course. There's only so much that can be done in back of an ambulance so two weeks seems more than adequate as a supplement to the provider's cognitive state. To be certified in emergency nursing, for example, one only needs to pass a test (as of last year at least). Work experience is preferred albeit not required. No extra training is required, and I can assure you that academic programs to develop registered nurses present little to nothing that prepares a newly graduated RN to work in an emergency, let alone trauma, setting.
There are some very basic differences between RN and Paramedic.
The education to be an RN is essentially a few technical skills with a broad base of knowledge. Not every aspiring nurse to be wants to work in the ER which is the true beauty of being an RN. There are literally hundreds of opportunities in nursing with all the specialties. To train in just half of them would take well over 100 years.
The Paramedic education in the US is basically a cert at the technical level whether you get a couple semesters at a community college or a few months at a votech school. It is a very focused area of study for dealing primarily with emergencies and transporting a patient quickly to a hospital.
The CCEMTP is also a tech cert of a few hours. There are several Paramedic schools which include the CCEMTP as an option at the end of the program. Often it is just included in the financing for the school to make a little more money especially since there are usually dropouts. The scarier part is there are brand new Paramedics with CCEMTP or FP-C or CCP (both BCCTPC cert easily obtained by just a test) can be hired by some of the Flight and CCT companies just looking for warm bodies who want to work cheap for the glamour title.
Realistically new RNs usually know their limitations and would not even consider being responsible for an ICU patient. They have seen critically ill patients. Paramedics are given the idea that they are prepared for anything and everything which puts them into a bad place when they easily get in over their heads during a transport. This is why even for emergency calls, they have a back up with online med control. With a CCT they may not have that option so easily. RNs are also given weeks or months of training and education in a specialty after they finish their nursing degree. The same is not true for Paramedics. This includes CCT where some employers think the CCEMTP course is all they need to know. No new RN would believe (or at least I hope not) that simple 2 week course is all you need to know to be a critical care RN. Also, even with the CEN, a nurse manager is going to see what you know and don't know in an interview. Without prior experience, you will still get additional training and education to work in that ER. Even with experience, you will probably still get additional training and education to work in THAT ER.
- Apr 27 by FuturePsychNP"Do you believe the elderly and children do not deserve access to medical care?"
Not indefinitely, no. It's mostly the adult welfare leeches who abuse our social welfare programs who I can't stand being on Medicaid.