Paramedics in the hospital setting

Specialties Rural

Published

Our facility, a twenty-two bed Critical Access Hospital, has hired two paramedics to work in-hospital. When asked what they can do, the DON said, "Everything, under the supervision of an RN". I am an RN.

I have not been able to find any verification of the Paramedic Scope of Practice in the hospital setting through the Kansas Board of Nursing or the Kansas EMS site. Where can I find their Scope of Practice? I am comfortable working with them. I am just wanting verification of what a Paramedic can/cannot do in the hospital setting. Our facility has two Paramedics working, but is still writing the policy.

What effect does the opinions of a bunch of anonymous strangers in a profession you obviously don't respect have on you?

Think hard about that, and maybe consider the fact that you have projected the above opinions onto us from your own insecurities.

Honestly you are spitting into the wind, with a predictable result, if you don't like it, there is an easy answer.

Ok, now I'm done for real, no more kibbles from this nurse.

Your comments are again from someone who is not familiar with the current issues in US EMS or heathcare. No surprise that Emse12 would support you who is now equally out of touch with EMS. Your attempt at personal insults is juvenile especially at a time when emotions run high in health care as changes are made. Some of us are awaiting the results of what happens at this hospital and a few others to see what changes might need to be made in legislation. If your world is perfect, control yourself from mouthing off with criticisms of others in matters which is of no concern to you and you could care less about. If the roles were reversed I bet you would have a strong opinion also.

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Specializes in Nephrology, Cardiology, ER, ICU.

BR157 - we are going to have to agree to disagree on this. I practice as APRN in the state of IL. I am also a licensed and practicing PHRN (pre-hospital RN on rural fire/EMS squad).

I do not pretend to speak to the practice acts of other states.

I am however very able to speak to the difference in IL.

There are differences in each state and it always is important to be aware of what is and isn't allowed.

Lets be respectful, civil and PROFESSIONAL. I think we ALL should have these attributes.

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Specializes in ER, Addictions, Geriatrics.
First, don't insult my intelligence. Second, I wasn't responding to the OP's question, as I don't live in his/her state. I was addressing your tone, which has been repeated on every paramedic thread on which you've posted.

Likewise. My reply had nothing to do with the OP and everything to do with the multitude of redundant posts being spewed in several threads regarding medics.

My dad is a paramedic and he'd never speak with such disrespect. We are all working towards the same goal, to provide a service to our patients.

Nurse, medic... One is not better or more important than the other.

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Specializes in Outpatient Psychiatry.

Frankly, nurses don't know what paramedics do, and paramedics don't know what nurses do. The same applies to what each other learns in school.

I went through paramedic school, passed the national registry exam, and never did anything with it. The community college I was enrolled in was only about $41/credit hour, and it was really interesting. Once I got my ride time in, however, I realized I didn't want to work as a paramedic, lol.

Later, I went to nursing school, received a BSN, and passed the NCLEX. I worked med-surg as a charge nurse for a year, and realized I didn't like that either. I floated around to the ICU and ER and although educational and offering a good bit of entertainment value as well I didn't see those as a fit for me. Mental health was really interesting so off I went into psych NP school and love it. I can't wait to get into it professionally.

In the meantime, I work in an office dealing with administrative stuff. It's a good job and although it required me to be a RN I don't really do anything nurse related. I do run across bickering every now and then about RN v. Medic and vice versa. So I really have no experience in either field other than the initial academic perspective. What I can say is that nursing school and paramedic school have almost no overlap. My nursing program didn't cover 20% of what my paramedic program covered, and although my nursing program had a lot more generality I don't think nursing school taught me how to do any one thing well. Paramedic school I think taught their respective scope quite well, but it dealt almost entirely with trauma, assorted respiratory emergency and airway management, a lot of cardiology and cardiac emergencies, environmental emergencies (drowning, poisoning, heat stroke, hypothermia, etc.), seizure management, and diabetic emergencies. Beyond that, my program didn't really offer a whole lot more. We know what nursing school covers because everyone likely reading this is a nurse.

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Specializes in Emergency Department.
Your comments are again from someone who is not familiar with the current issues in US EMS or heathcare. No surprise that Emse12 would support you who is now equally out of touch with EMS. Your attempt at personal insults is juvenile especially at a time when emotions run high in health care as changes are made. Some of us are awaiting the results of what happens at this hospital and a few others to see what changes might need to be made in legislation. If your world is perfect, control yourself from mouthing off with criticisms of others in matters which is of no concern to you and you could care less about. If the roles were reversed I bet you would have a strong opinion also.

I suggest you follow your own suggestion. You clearly have little actual understanding of what Nurses do, and you have a highly inflated idea of what Paramedics can actually do. I very much understand that Texas has a very different scope of practice for Paramedics than most other states. However "open" Texas is about the scope of practice that a Physician delegates to the Paramedic, that doesn't mean the Paramedic's scope is unlimited. The scope of practice is exactly what your Medical Director authorizes and nothing more. While I'm essentially an "urban" Paramedic, I'm quite capable of coming up with a plan of care that goes beyond what the protocols allow, and that was before I got into nursing.

I am a Paramedic and I am also going to be a Nurse. I understand both worlds quite well and the training I've gotten from both sides will only help me work better with patients regardless of which side of the hospital doors I'm on at the time.

I'm not at all surprised that you haven't figured out what a protocol monkey is, even though you claim that your state requires that paramedics have an Associate's Degree. Last time I checked, Texas has two levels of Paramedic and the only difference that I've seen is that the Licensed Paramedic has a degree. Oregon also requires a degree, but then again, that education doesn't mean the Oregon Paramedic meets the same entrance or educational standards as a Nurse in the same state.

My own state has some significant issues with Paramedic practice, but that doesn't mean that all Paramedics in California are under-educated for practice outside of that state.

I happen to hold a Bachelors Degree and my science background was basically adequate for me to transition over to any healthcare field.

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Sorry,but i have to ask...

Do paramedics have 2 yr or 4 yr Degrees?

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Specializes in Complex pedi to LTC/SA & now a manager.
Sorry,but i have to ask...

Do paramedics have 2 yr or 4 yr Degrees?

Depends on the state. In NJ they have a certificate of completion and national registry certification, no degree, unless obtained out of state

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I had wrote something but deleted it after seeing I misunderstood someone's post.

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INCORRECT paramedics can intubate, do cricothyrotomies, needle decompressions, call and treat STEMI's like with heparin, plavix, etc. Way more I'm not gonna list, just google it. Paramedics don't need MD orders they have protocols but way more autonomy. I know because I am both!

Why did you say the post you quoted was incorrect when you said the same thing?

For the ER I do not agree with you or BR.

I have never seen a Paramedic do any of that in an ER and if they could it would need a doctor's order. All the Paramedics working our hospitals are supervised by RNs. I doubt if any hospital would allow a Paramedic perform a Cric in their ER with no order or before the ER doctor or surgeon. The ER doctors will also be treating the patient. After that there are PAs and NPs.

For any discipline, protocols are written and endorsed by doctors. Essentially they are orders. It would be silly to believe nurses do not have protocols especially for emergent situations.

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No nurse should ever be supervising a Paramedic. That should just not happen. Paramedics do not work under a nurse's license. Only a doctor should be giving us orders.

As Akulahawk pointed out, Paramedics don't think like nurses. Paramedics use critical thinking skills in the field where we don't have a doctor or many doctors telling us what to do every step of the way. Akulahawk is wrong in that the Paramedics' scope of practice is much more broader than a nurse's. We can do many more things they can't and will never be able to do. It is a shame we are restricted in the ERs by nurses as to what we can do.

Hah!.... never? Ever hear of a flight nurse, sonny? How 'bout a nurse anesthetist. Better wipe that nose, kiddo,... seems to be a bit runny!

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Hah!.... never? Ever hear of a flight nurse, sonny? How 'bout a nurse anesthetist. Better wipe that nose, kiddo,... seems to be a bit runny!

Many flight nurses are also required to get the Paramedic certification and license.

CRNAs have their own issues ongoing with doctors and the supervision or oversight wording.

This discussion seems somewhat outdated. Paramedics now have the ability to work under their own licensing and skillset or expanded scope of practice directly under physicians in the ER and clinics in most states. Some places are opening up the ICUs to Paramedics. They are already working in home health. It sorta makes the whole issue of RNs going for a BSN seem silly when Paramedics can do everything and more with a year or two of training.

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