End of CCT Nurses in California? - page 2

It looks like the California EMSA is advancing its proposal for the Critical Care Paramedic in California. This provides for an expanded scope of practice which may surpass that of the RN even... Read More

  1. by   akulahawkRN
    Quote from DramaMomma
    On a side note, MOST people have no clue what the different levels of transportation are EMT vs ALS vs CCT. Maybe that should be taught across the board
    Most people have no clue exactly what the scope of practice is for EMT, AEMT, Paramedic, or CCT-P. I've worked as a Paramedic for quite a while and in my experience, most nurses don't know that EMT and Paramedic are two different levels with very different scopes of practice for transport. All they know is that the "Ambulance Drivers" are here for the patient. I have had to refuse to accept a patient for transport because the patient required monitoring that was out of my scope of practice and it could be something as simple as having a patient on a potassium drip. Depending upon my Paramedic scope of practice for a given EMS system, I'm either not allowed to monitor any potassium drips and PIV only, OR I can monitor potassium drips up to 40 mEq/L through a central line.

    Sure we can teach the basics of what each scope of practice is for each level of EMS provider but to go beyond the very basics, you'd have to be able to explain the scope of practice for all the different EMT/Paramedic personnel in all the different EMS systems in existence. What's driven into the heads of every EMT, AEMT, and Paramedic student is they must know their scope of practice because nobody else will and that they're not to exceed that scope. Ever.

    Incidentally, this thread is about 5 years old and since the thread began, CCT-RN work hasn't decreased... even with the use of the CCT-P. The CCT-RN isn't going away any time soon.
  2. by   heinz57
    Quote from akulahawkRN
    Most people have no clue exactly what the scope of practice is for EMT, AEMT, Paramedic, or CCT-P.
    This is an old discussion but some attitudes don't change.

    In all fairness, most EMTs and Paramedics have no clue about the many different specialties of nursing or any other hospital or clinic health care professional either. Many in EMS are clueless about the scope of practice of a flight or critical care nurse and assume all nurses must call a doctor to hold their hand for every order and procedure.

    EMS has also changed some of its titles or has so many titles you need a continuously updating app to keep up with the "EMT-I is now EMTA (sort of) although it is more of an EMT-B, which is now EMT, with some of EMT-I but not quite. Some use the NREMT and some still don't. The Paramedic varies from State to State, county to county, city to city and company to company. Privates hate the fire department EMS. Fire department Paramedics think the privates are stupid and only good to transport BLS even if they have a Paramedic patch. Don't put this all on nurses for not knowing every little detail of your scope of practice for you patch. When contracts are negotiated, a cheap sheet should be given to the hospital to avoid confusion. It is really not that difficult. I will say the hospitals which have their own CCT teams with CC trained RNs are the easiest to deal with so I hope they stay or even expand more into transport.

    OMG don't get me started on the "Ambulance Driver" bullpoop! "The "ambulance driver" got a ticket" or "Tell the Ambulance Driver to move their rig" and you get holy heck raining on you even if it does not pertain to anything medical. Who cares what their medical certification is if they were doing a 100 mph in a school zone going back to the station? The person driving the ambulance (Ambulance Driver) probably has the most responsibility of all getting everyone where they should be safely in a timely manner regardless of which EMS title they hold. This includes the routine medical transport rigs which have to keep on schedule to get patients to their schedules appointments.
  3. by   JQuam
    It's never NOT going to be about the money. EVER. Like it, hate it, or indifferent, SOMEONE has to watch the bottom line--it DOES matter. And, the person or people doing it, are going to have to make unpopular decisions and no matter what, there will always be those who disagree. I wouldn't want to have that job/jobs, would you?

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