Article: Paramedics equal to RNs

lindarn · Jun 1, 2015

I have never been an ER Nurse, but a Critical Care nurse for over 30 years. There is NO SUCH THING AS COOK BOOK MEDICINE, AND THERE IS NO SUCH THING AS COOK BOOK NURSING!

I believe that much of what paramedics do is base on set protocols, with no critical thinking involved.

I related a story a while back, about a dialysis nurse, who would come to my unit to dialize ICU patients. She saw the ICU nurse sitting and charting information from the monitor, VS, etc, and thought that ICU nursing was just a piece of cake.

We had an opening on day shift, and she grabbed it, and applied for it.

She went through our ICU orientation, did OK. But when the peddle hit the metal, she lost it.

She had to take an unstable patient to Radiology, said patient coded while on the table, said nurse had to run a code from the Radiology Department, we sent ICU nurses down to help her.

She resigned the next day, and went back to In-Patient Dialysis.

She never asked to come back to work in ICU again. Impressions, can get you in trouble. Her impressions of ICU nursing was way off the mark.

My Nurse manager was more careful selective when deciding who to hire for the ICU.

JMHO and my NY $0.02

Lindarn, RN ,BSN, CCRN (ret)

Somewhere in the PACNW

RobBSNRN · Jun 2, 2015

LICENSED PARAMEDIC
Don't say a Paramedic's license means NOTHING.
Paramedics don't need to be an RN. They have their own license and scope of practice which consists of many of the same things an RN does.

Many of the same yes but definitely not close to all.

I don't think anyone believes a Paramedics license means nothing. Paramedics are the difference between life and death for many people.

Red Kryptonite · Jun 2, 2015

Girls, girls....you're both pretty!

BR157 · Jun 2, 2015

I have never been an ER Nurse, but a Critical Care nurse for over 30 years. There is NO SUCH THING AS COOK BOOK MEDICINE, AND THERE IS NO SUCH THING AS COOK BOOK NURSING!
I believe that much of what paramedics do is base on set protocols, with no critical thinking involved.
I related a story a while back, about a dialysis nurse, who would come to my unit to dialize ICU patients. She saw the ICU nurse sitting and charting information from the monitor, VS, etc, and thought that ICU nursing was just a piece of cake.
We had an opening on day shift, and she grabbed it, and applied for it.
She went through our ICU orientation, did OK. But when the peddle hit the metal, she lost it.
She had to take an unstable patient to Radiology, said patient coded while on the table, said nurse had to run a code from the Radiology Department, we sent ICU nurses down to help her.
She resigned the next day, and went back to In-Patient Dialysis.
She never asked to come back to work in ICU again. Impressions, can get you in trouble. Her impressions of ICU nursing was way off the mark.
My Nurse manager was more careful selective when deciding who to hire for the ICU.
JMHO and my NY $0.02
Lindarn, RN ,BSN, CCRN (ret)
Somewhere in the PACNW

Are you seriously comparing Paramedics to a dialysis nurse who can not run a code? Paramedics do run codes and without nurses.

In your hospital, you have the luxury of sending ICU nurses and probably a doctor or two to help that nurse. You are also in a Radiology department where you can scan the patient and even Xray for tube placement. This is not the case for a Paramedic who might only have an EMT with him or her.

No critical thinking? You obviously have not been around Paramedics. Who takes or brings your critically ill patients from one facility to another? Paramedics have protocols but every patient is different and there isn't a lot of people around with lab results and Xrays or MD behind their name to work the patient in the field or on a transport ambulance.

No one is suggesting that every Paramedic will be qualified or will even want to work in an ER any more than the dialysis nurse story you told. I think your story is rather belittling to that nurse and it sounds like she was set up to fail. But your story did make a point that not all nurses are equally trained for emergencies or critical care.

BR157 · Jun 2, 2015

Girls, girls....you're both pretty!

No need to be rude to Rob or Linda.

Do you have anything constructive to comment on about the scope of practice of a Paramedic in the ER?

Did you read the proposed bill? I am also asking that of those who are commenting here.

Red Kryptonite · Jun 3, 2015

No need to be rude to Rob or Linda.
Do you have anything constructive to comment on about the scope of practice of a Paramedic in the ER?
Did you read the proposed bill? I am also asking that of those who are commenting here.

Someone can't take a joke.

BR157 · Jun 3, 2015

Someone can't take a joke.

EMS and Paramedics are not a joke nor is their desire to expand their profession. I could easily have tossed some insults about your profession but I did not. I expect the same courtesy.

I had started a discussion earlier under another section hoping to elicit some input at a professional level. The bill mentioned here is real and hopefully it will pass now that it has gained a lot of attention thanks to the ENA. Even with Summit's initial direction of this discussion, this could still have been a great chance to explore the pros and cons so both nurses and Paramedics could have gotten a better understanding of what it means. Change can be a good thing for all involved.

ixchel · Jun 3, 2015

Oh dear lord.

ReKr, I can't decide if this thread or the UPS one is more relentless.

Red Kryptonite · Jun 3, 2015

EMS and Paramedics are not a joke nor is their desire to expand their profession. I could easily have tossed some insults about your profession but I did not. I expect the same courtesy.

You must be a riot at summer barbecues.

Oh dear lord.
ReKr, I can't decide if this thread or the UPS one is more relentless.

Right?

SummitRN, BSN, RN · Jun 3, 2015

I think that BR157 actually believes he/she is actually convincing others and "scoring points" with the incessant diatribes and continuous blowing of smoke, along with the personal attacks against anyone who disagrees. Pretty transparent and sad...

lindarn · Jun 3, 2015

This nurse was not, "set up to fail". She went through, and passed a Critical Care Orientation. If she was not safe to practice, she would not have been allowed to pass.

There was another case, when I worked in California, concerning a med surge/telemetry nurse, who wanted to be an ICU nurse, came to work on my unit, went through an ICU orientation, was let loose on the PM shift. Her care was sketchy, she did not seem to, "be getting it". No one intervened and put her back on orientation.

She proceeded to kill a patient, who she was administering KCL boluses, over a few hours, did not think to check,make note of, connect, that her urine output was scant, the patient was not diuresing like she should have, and continued to administered the KCL boluses until the patient coded from hyperkalemia.

All she kept saying in her defense was, "if the doctor wanted me to hold the potassium if the patient did not diurese, than he should have written that into the order like that"! She was fired the next day. THAT is also an example of a nurse, who just did not, "get it".

I am not saying that paramedics cannot function in a critical care environment, but there are aspects of their education/training, that are part of every nursing program, that are NOT part of a paramedic program.

JHMO and my NY $0.02

Lindarn, RN, BSN, CCRN (ret)

Somewhere in the PACNW

ixchel · Jun 3, 2015

This nurse was not, "set up to fail". She went through, and passed a Critical Care Orientation. If she was not safe to practice, she would not have been allowed to pass.
There was another case, when I worked in California, concerning a med surge/telemetry nurse, who wanted to be an ICU nurse, came to work on my unit, went through an ICU orientation, was let loose on the PM shift. Her care was sketchy, she did not seem to, "be getting it". No one intervened and put her back on orientation.
She proceeded to kill a patient, who she was administering KCL boluses, over a few hours, did not think to check,make note of, connect, that her urine output was scant, the patient was not diuresing like she should have, and continued to administered the KCL boluses until the patient coded from hyperkalemia.
All she kept saying in her defense was, "if the doctor wanted me to hold the potassium if the patient did not diurese, than he should have written that into the order like that"! She was fired the next day. THAT is also an example of a nurse, who just did not, "get it".
I am not saying that paramedics cannot function in a critical care environment, but there are aspects of their education/training, that are part of every nursing program, that are NOT part of a paramedic program.
JHMO and my NY $0.02
Lindarn, RN, BSN, CCRN (ret)
Somewhere in the PACNW

Oh, man this is scary. I'm not going to lie - my unit doesn't do hourly I&O, especially if they have no foley, and we regularly give IV K+. I imagine this could be a somewhat easy one to miss. Although..... The output trend would likely be something mentioned in report or noted while reviewing charting, in addition to high BUN and creat. It does make me wonder, though.... How many K+ PB did the pt get and how low was the K+ beforehand?