Horizontal Violence - EMT's and Paramedics VS LPN's and RN's - page 3
by realmaninuniform 4,504 Views | 27 Comments
Ok, so I'm a male nurse. I worked hard to get where I am in my career and consider myself not only competent but an exceptional nurse. Unfortunately the EMS personnel I encounter from the field, the first responders, fire... Read More
- 0Nov 24, '12 by jadelpn GuideMy EMT course was 180 hours. It varies by state, and those 180 hours can be M-F, just weekends, or a few hours a night. Then you have to not only take a written exam, but you have to do a multi-task set of clinical exams, that is just you and an instructor. And if you do not do everything to protocol, "see ya". Not to mention continuing ed that is a LOT of hours, plus a refresher clinical you have to go and demonstrate competency all which has to be approved. There's no booklet that you read a do tests and you can renew your EMT license, it is really a process of continuing ed that is approved. Or you lose your EMT certification, plain and simple. Parmamedics are specific to both EMT and ACLS with the added "bonus" of intubating someone. They are task specific, however, have a number of protocols that they need to follow, and as an LPN (18 month course of study) who is also an EMT. the 2 protocols are far different. Paramedics in most states need to have some large amount of ER clinical experience. As do LPN's. RN is all of this, plus a lot of theory, which for the EMS system is more protocol based. With all that being said, it is paramount that we all do what is best for the patient, and put egos aside. It is not the nurse's issue that the paramedic believes themselves to be "above" transporting and elderly person. If a paramedic wants all action all the time, then perhaps a huge city is where they need to be. Or perhaps they should become a PA and work in a trauma ER. Part of what we all do is has its ups and downs. However, I really would at this point look at the ambulance companies that you deal with, go to administration as far as the issues you have encountered, and see if you can make a difference by putting "out to bid" specifically what you are looking for in an ambulance company, and go specifically with them. (you could be the one that makes the difference--what is the worst that can happen? They say "nooooo"-?! I would go for it to make changes that will work for the patient).
- 3Nov 24, '12 by akulahawkRNQuote from realmaninuniformBack yourself up to when you first entered Nursing School. There's this set of core courses... called "prerequisites" that had to be taken for entry. While many Paramedics might not have taken the same coursework you did prior to you getting into Nursing School (which prepares you to be a Nurse), many others have. From there, their educational path deviated from yours. Nursing school does NOT prepare you to be a field provider. I have met more than a few excellent Nurses that would be blatantly unsafe in the field, simply because they've never, ever, been educated for that role. Paramedic School doesn't prepare the Paramedic to function in a clinical setting.As for education, I did all of the core classes for nursing prior to paramedic school. That was two years. Plus a year of EMT school and a year of paramedic school. I have an associates degree and I have taken the same core classes as any adn. And now I am in an adn program. Please don't assume all paramedics are idiots.
This is why I have a problem with medics. They all seem to think this same way. Ooo I took all the same classes, blah blah blah. No, you didn't. You have NO CLUE what it is like to actually work as a nurse, which btw, is NOTHING like they teach you in nursing school. You may have shared a few english courses, A&P, at most, but certainly not the actual nursing clinicals. As for EMT taking a year... You are either lying, or someone ripped you off big time. Regardless of my status as a nurse, I could as a lay person, go through a 2 week course and be an EMT-B. The standard is 3 months, and that's 4-8 hours a week.
Sure, you could take an EMT course in 2 weeks and be certified as an EMT. In 3 months, (more typical), you'd be safer. You could try to get through a Paramedic course and get through their internship, but you could easily fail out because you failed to think appropriately. Paramedic and Nurse thought processes are very different, and have very different purposes in life. I have met my fair share of clinically dumb nurses. I have also met my fair share of Nurses that believe that they're superior to all other care providers, except for physicians, simply because they've been through Nursing School. I have met my fair share of Paramedics that believe they're GODS because they work in the field.
Guess what? I hold a Bachelor of Science in Sports Medicine. Would you like to know why it is that there aren't any significant numbers of Nurses providing care to sports/athletic teams? I'll give you a hint: not enough education. You might find a school nurse being drafted to provide some kind of first-aid care during practices and games at the Elementary or even Middle/Junior High levels. The care they'd render would be sub-standard. If you wanted to work in that field, you couldn't learn everything you would need during a 6 month orientation, and possibly even during a year-long orientation period. Even the thought processes are very different.
Yes, I can take an athlete from pre-season through injury, evaluate the injury, decide whether or not to refer out to a surgeon based on the same exam techniques they'll use, devise an appropriate rehab plan, including a post-op rehab plan, that will take that athlete back to their maximum ability, all while making appropriate adjustments on the fly, all while taking into consideration their psychological needs. When I worked in that field, I got to know ALL of my athletes. All 200-300 of them. I knew their baseline, how they reacted to injury, and could do all the above for the 40 or so that I'd have in my training room at any one time. Oh, and communicate their status to the Coaching staff... in the 15 or so different sports that they played, and had to be familiar with the demands of all those sports and positions within each of those sports.
Do you think you can learn to do all of that, competently, in 6 months? I have yet to meet a Nurse that can, having completed only Nursing School, even at the BSN level. I know of a very small number of Paramedics that can... only because they followed the same educational path I did.
I don't doubt that you're an excellent nurse in your own right. It's horrible that you have had to put up with some transport providers that seem to be less than brilliant. Keep your eyes out for the ones that have a clue. No, they haven't been to Nursing School and aren't Nurses. That's not their job, any more than it is your job to be a Paramedic.
- 1Nov 24, '12 by medic9872Quote from realmaninuniformAs a matter of fact, yes, I did indeed take the nursing prerequisites prior to attending paramedic school or even EMT school. Why? Because I was initially headed to nursing school. I was even accepted into a very competitive ADN program prior to attending paramedic school. I declined the spot because I wanted to be a paramedic first. No, most medics do not do this. But some do. Those classes were not required for paramedic school. Many of them were required for the associates degree, which is what I have. And yes, EMT school did take a year. I live in GA and the standard for an EMT is not basic, it's intermediate. And now as of 2012, it's advanced. So yes, in GA EMT school does take a year. And that's a minimum of two days a week with at least four hours of class each day. Some programs have class for eight hours a day, two days a week. That does not include clinicals. I am also a part time EMT instructor. Our students are required to test for their basic (which is available but not recognized by most 911 services in GA) at the nine month point in their program. After they obtain their basic cert, they can go work for a non-emergency transport service if they want. Of course an EMT or paramedic does not do nursing clinicals. They do their own clinicals in many areas. An EMT must do clinicals on the ambulance and in the ER. A paramedic does clinicals on the ambulance, in the ER, peds, L&D, ICU, OR at the minimum. Some also do clinicals at nursing homes or on med/surg floors. It really depends on the program, but there are minimums that must be met. Just like nursing students have minimums that must be met. When you say that all medics think the same and think they have taken the same classes as a nurse, you are being a little ridiculous. Of course they haven't taken the nursing classes that a nurse has. But you as a nurse have not taken the same classes that a medic has taken. You complain about medics having terrible attitudes towards you. Maybe you need to take a step back and make sure that you don't have a terrible attitude toward the medics. Respect is earned, not freely given.As for education, I did all of the core classes for nursing prior to paramedic school. That was two years. Plus a year of EMT school and a year of paramedic school. I have an associates degree and I have taken the same core classes as any adn. And now I am in an adn program. Please don't assume all paramedics are idiots.
This is why I have a problem with medics. They all seem to think this same way. Ooo I took all the same classes, blah blah blah. No, you didn't. You have NO CLUE what it is like to actually work as a nurse, which btw, is NOTHING like they teach you in nursing school. You may have shared a few english courses, A&P, at most, but certainly not the actual nursing clinicals. As for EMT taking a year... You are either lying, or someone ripped you off big time. Regardless of my status as a nurse, I could as a lay person, go through a 2 week course and be an EMT-B. The standard is 3 months, and that's 4-8 hours a week.Last edit by medic9872 on Nov 24, '12 : Reason: n/a
- 1Nov 24, '12 by medic9872Quote from realmaninuniformActually, it's not the dispatcher's job to give a pt report to EMS. Dispatchers generally dispatch a call over the radio and it's an FCC violation to give personal information over the radio without that person's express permission. Plus that dispatcher probably has more calls to dispatch than just that one particular call. They have to keep up with all of their units, possibly also police and fire units as well, field all radio traffic in regards to each call (en route, on scene, en route again, at hospital, etc) and sometimes answer all the phones for the incoming calls. The dispatcher doesn't usually even want to know all the details of your pt. That's not their job! And no, EMS does not cater to the people who walk into the ED without insurance, without jobs for a migraine or cold symptoms. Most people in EMS don't care if you have no insurance or job. My concern isn't billing, it's pt care. And I treat them all the same whatever their complaint might be.Thank you LVNbayarea. This is the exact point I am trying to make. First if I give report to the dispatcher, it is the dispatchers responsibility to relay this to the medic, which apparently they don't do, so I again give report to the medic, then after they leave I call the hospital. That is a total of 3x's giving the same report. These people ought to be grateful for such information. Often times in an emergency situation they don't even know the pt name, let alone medical history, current medications, etc, etc until long after they've been admitted to the hospital. Yet they give me a hard time, and cater to the people who walk into the ED with no insurance, no job, etc. etc. for a "migraine" or "cold symptoms".
- 0Apr 6 by Lillexiii92Wow, for a bunch of "kind compassionate nurses" you all sure are pretty nasty!!!! And I have to say even before I went into the medical field for employment and saw how nasty and stuck up nurses can be towards EMS, I had horrible experiences with rude, arrogant, condescending nurses when I was a patient in the hospital for surgery on my back. Maybe its because your butthurt about the fact that your MDs boss you around all day while you change old people's GI bleed diapers. I don't know what it is, but I will say that most of the EMS personnel I have ever worked with have always been very fun, modest, friendly, and know where they stand education-wise and have no problem with it. (most of them don't have Master's degrees if you know what I mean) EMS and fire rescue personnel don't go into the field for reputation or money, or any kind of "heroic" status. (Obviously, if an EMT-B is willing to work with blood, guts, vomit, poop, and other disasters, for sometimes less than $10 an hour) But when I was in college, I would sometimes speak to the lofty nursing students who walked about in groups with their noses in the air and ask them about their career decision. All you hear is about how much money they will be making by the time they are 40, and how smart their tough homework assignments make them feel. So maybe when all you fantastic nurses on this page are talking about how rude EMS personnel are, you are seeing their reaction to experiencing such a hostile environment every time they walk into an ER, and its just so sad that all these nurses who go through so much hard schooling, and get payed more than a decent amount of money to work here, are so rude and stuck up towards patients, and the cheerful EMS crew.
- 2Apr 6 by TheCommuter Senior ModeratorMaybe its because your butthurt about the fact that your MDs boss you around all day while you change old people's GI bleed diapers.
The overwhelming majority of nurses do not have MDs as bosses, nor are we bossed around by MDs. I just wanted to make that friendly clarification.
- 1Apr 6 by Nola009Once, before becoming a nurse (and before getting married, lol) I went on a date with an EMT. He told me they see truly horrible things (like he said he saw the aftermath of a toddler who was raped by moms bf for example). After seeing so many horrible or stressful things (think car accidents), you might come off harshly after awhile yourself! I dont think they get paid very well, either!
- 1Apr 7 by uRNmywayQuote from TheCommuterThere are a few more clarifications I wanted to make on that gem of a post, but I thought heck, it's 5am, and I'm too tired to write a mod-appropriate response lol.Welcome to Allnurses.com!
The overwhelming majority of nurses do not have MDs as bosses, nor are we bossed around by MDs. I just wanted to make that friendly clarification.
I will summarize my thoughts by bringing up the story of a certain pot and a certain kettle. Butt-hurt about not bring doctors? In the words of the fabulous George Takei: 'Oh My'.