[netgeek]

Hi,

I live in Canada and we dont EMT's or CNA's in the ER. Its mostly just the nurse. I am interested in becoming an ER nurse in the states. I have my bachelor of science in nursing.

I was wondering what does the ER nurse do when there are techs and CNA's? Is the nurse on the bottom of the pack when it comes to the "hierarchy" of the ER?

Thanks.

[purplemania]

Depends on state law. In our facility we do not have CNA's in the ER. We have some Paramedics (more education than EMT). They are allowed to assist the nurse or MD but cannot plan care, make patient assignments, determine the type of education needed, access central lines, infuse blood --- a few other things. They are VERY helpful and professional in our facility. There is a great deal of crossover in skills, but the RN has more delegatory authority and responsibility.

[purplemania]

Depends on state law. In our facility we do not have CNA's in the ER. We have some Paramedics (more education than EMT). They are allowed to assist the nurse or MD but cannot plan care, make patient assignments, determine the type of education needed, access central lines, infuse blood --- a few other things. They are VERY helpful and professional in our facility. There is a great deal of crossover in skills, but the RN has more delegatory authority and responsibility.

[Dixielee]

I suppose if you had to consider a hierarchy in the ER, the doc would be at the top, followed by the RN, then everyone else depending on facility. The RN is responsible for primary care for a group of patients and can delegate as needed if others are available to help. I have not worked with paramedics but with lots of EMT's working as techs. They don't give meds, but can do procedures, start IV's, draw labs, insert catheters, NG tubes, and assist with other procedures such as chest tube insersions, sutureing etc.

The RN does everything no one else can or wants to do. I have worked where techs, EMT's etc, chart procedures but are not responsible for the "whole chart" like the RN is. Some CNA's draw labs and do many of the things the EMT's do, but it depends on the facility and any special training they may have had.

[bill4745]

In Pennsylvania, our CNAs do ekgs, draw blood, & transport patients. They cannot start IVs as they cannot inject saline to flush

[vamedic4]

Originally Posted by purplemania

Depends on state law. In our facility we do not have CNA's in the ER. We have some Paramedics (more education than EMT). They are allowed to assist the nurse or MD but cannot plan care, make patient assignments, determine the type of education needed, access central lines, infuse blood --- a few other things. They are VERY helpful and professional in our facility. There is a great deal of crossover in skills, but the RN has more delegatory authority and responsibility.

As a "tech" (paramedic) I can draw blood, perform 12 lead EKGs, start IVs/hep locks, assess IVs/HLs, perform caths for urine (I/O and indwelling), vitals (of course), interpret EKG strips, change CL dressings/ CT dressings...the list goes on. Whatever I can do to help my nurses.