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TraumaSurfer 6,472 Views

Joined Aug 8, '10. Posts: 433 (41% Liked) Likes: 375

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  • Feb 16

    Quote from PatMac10,SN
    I think nurses should be able to. Even if it is only when there isn't a Doc available.
    How many times will you be able to intubate? How will you maintain proficiency? How often will the doctor not be available? If this is an ER without a doctor being available I think the state and Federal agencies should be made aware for possible penalties. How much will you leaving your patients to intubate affect other nurses? Who will push the medications if you are intubating? Can the RTs at your hospital give all the medications AND set up the ventilator while you are at the head of the bed which might be for awhile if you are not able to get enough intubations to maintain proficiency? What about the liability? If you are not able to maintain proficiency and botch up the airway badly or even cause death, neither the BON nor the legal eagles will be kind if you can not demonstrate you were able to maintain an adequate skill level. Just recertifying every 2 years in ACLS or PALS is a joke and demonstrates nothing. Just saying "they can why can't we" is not good enough as a defense. Even Paramedics have felt the pain of losing a skill like intubation. Too much emphasis is placed on a skill without embracing the responsibility which goes with it. There are several EMS departments which will not allow Paramedics to intubate children. There are also EMS departments which will not allow Paramedics to do ETI and supraglottic devices or BVM are the only options. If one does not get the experience through many, many intubations, you will suck at it. Ask any CRNA how many intubations they must do to be really good and not do more harm to a patient. Just wearing a Paramedic patch or RN pin does not automatically make you proficient at a skill.

  • Oct 7 '15

    Try to get a serious focus on your health and fine tuning your body to accept night shift until you pay your dues to transfer.

    Become a q3 eater. Package small portions in little containers to munch on easily and quickly throughout the night. Eat a well balanced light meal for your main break.

    Drinks lots of water. Night shifter workers are dehydrated constantly.

    Avoid sugar loaded products and caffeine. Yes, no coffee or only in moderation at the beginning of the shift. Drink green tea which may have some caffeine. Read the labels.

    Get a routine which might be simple stretching before and after work.
    Drink a warm non decaf beverage and read something when you get home. Get to a quiet place or personal space in your home or favorite park and in your mind.

    Make sure your shoes are comfortable. Simple as it sounds, it sets the mood for the night if your feet hurt.

    Try to at least take a long brisk walk on your days off.

    Once your body adjusts, your mental outlook will gradually get better.

    Cut yourself some slack. You are new. Night shift people tend to be a crusty bunch at first but most will warm up to new comers eventually. Don't be afraid to ask for advice.

    But, until then, focus on your body and health. Keep work at work. I don't even wear my clothes to and from work. Once I clock out, I change clothes and become who I like most. My personal space might be sitting on a beach for awhile after work and appreciating I can do that because I work in a profession which allows me to live just about anywhere. Remember you work to LIVE and not live to work.

    Doing 12 hours shifts you are only spending 36 hours at work. The rest of that time is yours. Make plans on your first day off to do something in the afternoon. Make an appointment to pamper yourself. Go to the mall and window shop. Meet a friend for a movie and/or dinner or late lunch. Make a list of all the stuff you haven't done lately like a museum, the theater, a concert or some attraction in your community or nearby.

  • Oct 3 '15

    Quote from Murse901
    Are you serious? All of that, and you still don't get the difference between state EMT-P licensing and NREMT-P.

    Quote from Murse901
    Repeat after me: Eligibility for state licensure is not the same as eligibility for National Registry.
    I have posted links. I have quoted from the links. I don't know how many more ways I can come up with to make this easier so you can understand it.

    The NREMT is an organization which most states use to give their EMS exams including the Paramedics. The NREMT essentially tests at the very basic minimum standards for each test to make it fair to the states which only require the bare minimum of the US DOT National Standards for the curriculum. Some states feel 600 hours are enough for Paramedic while others might want 1000 - 1200. One state wants the equivalent of an Associates degree and one states sorta wants that. Regardless of the number of hours for the minimum requirement, the test is the same for Paramedic no matter how many hours of training. A few states few the NREMT tests at a standard too low for their liking so they use their own state test for Paramedic.

    Once you take either the NREMT or a state test which "certifies" you have met the bare minimum for testing knowledge, you apply to the state for a license or an official certification to work as a Paramedic in this state. Just having the NREMT certification alone does NOT allow you to work in that state.

    I posted a link which describes how many states allow for other professionals such as RNs to obtain their Paramedic license without going through the whole Paramedic program which usually are not taught at a college level. If a state reviews the RNs applications and feels that person has met all the educational requirements and whatever additional things like all the weekend certs and school accreditation along with some ride time, the state may have an agreement with the NREMT to allow this person to test for the Paramedic exam. This again is only a certifying exam to test a basic knowledge. I repeat, again, the NREMT does not provide the license but merely contracts with states to provide a test to those who meet the requirements for Paramedic in that state. The NREMT also has a few requirements like being 18 y/o to take the test which for Paramedic that is the same in all states. The states which allow 16 y/o to test for EMT-B will use their own state exam.

    The RN who holds a BSN and has over 1000 hours of just clinical experience in school along with a couple years of experience in the ICU and/or ED along with about 40 hours of extra skills training and a few states want 40 ALS patient contacts by far exceeds what some Paramedics get for education and training. It is not uncommon for a Paramedic student to not have any intubations or IV sticks on a live patient. Some Paramedics may not see 40 patients in a year depending on where they live so their clinicals might just be killing time at an ambulance or fire station.

    But, again, the NREMT is an organization which is contracted to provide a test...period. The NREMT does not license. It can also make an agreement with each state to test a professional whom the state feels have met the minimum requirements to be a Paramedic. With the wide variations in EMS education throughout the US, this is only reasonable.

    Read the NREMT website and the different state EMS sites which myself and others have stated as allowing RNs to bridge relatively easily to Paramedic.