Are registered nurses considered First Responders?

  1. I am a Registered Nurse in MA, I am also a part-time Sheriff. I was informed that I must take a first responder course in order to continue working as a Sheriff. Would a registered Nurse be considered trained to the level of a first responder or above?

    Thanks in advance for any help
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  2. 15 Comments

  3. by   TazziRN
    RNs are a totally different animal. First responders are EMTs, medics, law enforcement, and fire.
  4. by   medicin79
    Check with your state EMS office; they should be able to answer this for you.
  5. by   traumaRUs
    I'm a pre-hospital RN in the State of Il and volunteer on my rural rescue squad.
  6. by   GregRN
    It can get pretty dicey when you are working in a different role but are an RN. I would want to protect my RN license at an accident scene by being trained as a first responder. As an RN your scope of practice may be beyond the resources available at an accident scene. If you identify yourself as an RN the expectations go up cosiderably and your duties at the scene change based on that. Instead of being held to the responsibilities of a first responder, you would then be held to the standard of what a reasonable RN would do. Without resources available to you as a Sherriff, you are set up to fail and could risk your license. I would consider it a blessing in disguise that they are asking you to train as a first responder. It protects your RN license and lets you be held to the standard of other first responders.
  7. by   wordstew
    Well from all the info I have gotten here and various other sources, it appears a nurse must take a certifying course to be considered a first responder. Thanks everyone for your replies. See you in class
  8. by   RN4NICU
    Quote from GregRN
    It can get pretty dicey when you are working in a different role but are an RN. I would want to protect my RN license at an accident scene by being trained as a first responder. As an RN your scope of practice may be beyond the resources available at an accident scene. If you identify yourself as an RN the expectations go up cosiderably and your duties at the scene change based on that. Instead of being held to the responsibilities of a first responder, you would then be held to the standard of what a reasonable RN would do. Without resources available to you as a Sherriff, you are set up to fail and could risk your license. I would consider it a blessing in disguise that they are asking you to train as a first responder. It protects your RN license and lets you be held to the standard of other first responders.
    Actually, you would still be held to the standard of an RN - you are always held to the standard of the highest license you hold, regardless of what your role is at the time.
  9. by   Pat_Pat RN
    First Responders have protocols to follow. If you are acting under those protocols and they are set for BLS response, then you can only act as a BLS First Responder.
    We have Medics on volunteer departments here that can only act as a First Responder if they are responding with that department.
    Besides, what can a nurse do on a scene that a First Responder can't?
  10. by   GregRN
    Quote from RN4NICU
    Actually, you would still be held to the standard of an RN - you are always held to the standard of the highest license you hold, regardless of what your role is at the time.
    Are you sure about that?? If I'm working as a NURSE, then I may be held to the standard of the highest NURSING license I hold. But if I"m not working as a nurse then I'm held to the standards of the position I'm working. Otherwise, no matter what my job, not matter what the context, I would always be working as a nurse, whether I'm a teacher, lawyer, first responder, etc. I would NEVER have a time where my nursing license ISN'T at stake.

    Pat_Pat, so long as first responders are following first responder protocols then each team member will perform at the same level as any other team member, regardless of title. However, there may be certain situations that requires drugs to be pushed that are outside these protocols, ordered by an MD, let's say, in which case an RN would be needed. It would be up to the RN to then identify him/herself as such and then be able to push the drug. However, the RN license is now on the line whereas before, the MD would have to push the drug and his/her license is on the line if anything adverse happens as a result.

    I've been involved in many discussions around this topic as I've looked into wilderness emergency medicine. PA's, as an example, are asked by their suprvising MD's to NEVER identify themselves on scene as PA's, only as trained in first aid or ACLS. That way it protects the MD's license, which is the license the PA is practicing under. Same thing goes for RN's practicing in lesser, non nursing roles.
  11. by   RN4NICU
    Quote from GregRN
    Are you sure about that?? If I'm working as a NURSE, then I may be held to the standard of the highest NURSING license I hold. But if I"m not working as a nurse then I'm held to the standards of the position I'm working. Otherwise, no matter what my job, not matter what the context, I would always be working as a nurse, whether I'm a teacher, lawyer, first responder, etc. I would NEVER have a time where my nursing license ISN'T at stake.

    Pat_Pat, so long as first responders are following first responder protocols then each team member will perform at the same level as any other team member, regardless of title. However, there may be certain situations that requires drugs to be pushed that are outside these protocols, ordered by an MD, let's say, in which case an RN would be needed. It would be up to the RN to then identify him/herself as such and then be able to push the drug. However, the RN license is now on the line whereas before, the MD would have to push the drug and his/her license is on the line if anything adverse happens as a result.

    I've been involved in many discussions around this topic as I've looked into wilderness emergency medicine. PA's, as an example, are asked by their suprvising MD's to NEVER identify themselves on scene as PA's, only as trained in first aid or ACLS. That way it protects the MD's license, which is the license the PA is practicing under. Same thing goes for RN's practicing in lesser, non nursing roles.
    Yes, I am sure about that. If you are working in A HEALTHCARE CAPACITY (does that work better for you), you are held to your highest standard of practice (in this case, your RN license).

    An RN is not the same as a PA - the RN has a license of his/her own, the PA does not - hence, the same thing does NOT go for RNs.

    Why do you think the PAs are asked by their supervising MDs not to identify themselves as PAs (even though they are not functioning in that role at the time)? Because the LICENSED PERSON (the MD in the case of a PA) could be held responsible - even if that person was not even there. Since RNs practice under their own license, they are held to that level of knowledge and accountability when working in a healthcare (first responder or otherwise) capacity.
    Last edit by RN4NICU on Mar 15, '07
  12. by   Pat_Pat RN
    [quote=GregRN;2113150]
    Pat_Pat, so long as first responders are following first responder protocols then each team member will perform at the same level as any other team member, regardless of title. However, there may be certain situations that requires drugs to be pushed that are outside these protocols, ordered by an MD, let's say, in which case an RN would be needed. It would be up to the RN to then identify him/herself as such and then be able to push the drug. However, the RN license is now on the line whereas before, the MD would have to push the drug and his/her license is on the line if anything adverse happens as a result.
    [quote]

    My thinking is that if there is a drug on a scene where you are a First Responder, someone (ALS EMS) had to have brought it. Let them push the drug.
    Plus, lets say you are on a scene as a FR, hyperglycemia in a known diabetic. If you *did* have contact with the MD and he *did* order insulin, *HE* ordered insulin. You give it. Just as you would in a hospital setting, or doctors office, or anywhere else.
    I'm just stating things as I understand them here in Indiana.

    Pat
  13. by   GregRN
    Pat_Pat, you're right, and I think that's the key difference. We're talking about three different things here: our role as an RN as a first responder (for hire), our role as an RN who stumbles across a situation and we are a volunteer, and what's allowed by state. Here in Colorado if I don't identify myself as an RN when I stumble across a situation that requires some assistance, I'm not acting as one. That protects my license for things out of the ordinary and I like having that protection. It's going to vary by state, however.
  14. by   Pat_Pat RN
    i emailed our state training department:

    tony,
    this might be out of the realm of things you know, but maybe you could forward it on to someone
    who does know.
    if an rn is also on a volunteer department that is cert'd as bls non-transport, and they are also cert'd as a first respoinder. when they are on a scene, which are they using, their fr cert, or rn license? can they "switch hats" under direction of medical control of their department and start an iv for instance? or are they then (as i understand it) essentially taking things into their own hands at that point? some guidance is appreciated. i am in nursing school and was on xxxxxxx fd, and hope to get back on once i'm finished with school.
    are you always held to the standard of the highest level of care you are (in this case rn) or does it depend on which "hat" you are wearing?

    the root of this question comes from a nursing forum where a similar question was asked.
    thanks a lot,

    he replied:
    you cannot function as an rn on an emergency scene when you are there with your fire department. you are held to the standard of care of that department.

    tony pagano
    section chief, certification
    indiana department of homeland security
    training division
    (317)232-3985
    tpagano@dhs.in.gov
    www.in.gov/dhs

    i think greg made some good points above also, it depends on *why* or *how* you are there.
    pat

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