Can EMTs work as tech's in your hospital?

Anna Flaxis, BSN, RN · Jul 22, 2011

Our hospital ED will not hire EMT-Bs anymore, because of their limited scope of practice. It's really not very helpful to have a tech who can't do IV starts and blood draws or do monitored transports. We only use EMT-I and Paramedics as techs in the ED.

The inpatient units will only use CNAs.

netglow, ASN, RN · Jul 22, 2011

That is pretty much true in my area as well. Only CNAs on the floors. I did know a paramedic who worked as an ER tech while in RN school. He was not allowed on the floors, and of course he was annoyed at that. CNAs do not know phlebotomy unless they take a course somewhere specifically for that. Hospitals train for "thier needs" around here, no CNA in hospital does draws or starts around me. They might do EKG, glucose checks, collect urine or stool samples, etc. Some hospitals near me now have lab come up and do all draws. Some have an IV start team as well. I guess they can bill for that too (they don't do a thing unless there is more money in it somehow).

Best is to call and ask.

Oh and in IL at least a CNA is not a licensed professional, it's just a certificate. You get placed on a registry lookup to verify you've been to the short edu process for it and have taken a certification test.

GreyGull · Jul 22, 2011

In my area, to work in patient care areas other than the ED, the CNA, PCT or some recognized certificate would be required. It is doubtful an EMT, which is also a certificate, could challenge any of these in the majority of states since the knowledge and skills are vastly different. In our ED we prefer CNAs with a phlebotomy and ECG certificate which then allows them to work under the title of ER Tech. This way they can also float to where they are needed if they want to work and some particular shift is overstaffed. By hiring only EMTs or Paramedics in the ED, we still had to train them and also get them certified in phlebotomy which I believe now requires over 140 hours and an additional state certification. The CNAs we use are actually PCTs who already have met these extra certification requirements.

AgentBeast, BSN, RN · Jul 22, 2011

Oh and in IL at least a CNA is not a licensed professional, it's just a certificate. You get placed on a registry lookup to verify you've been to the short edu process for it and have taken a certification test.

In all states a Certified Nursing Assistant (Or State Tested Nursing Assistant) is just that Certified and placed on a registry. It is a FEDERALLY mandated program. Designed to prevent abuse of residents in nursing homes. In every state I've researched CNA's fall under the purview of the state's department of health which is run by the state medical board. The State Nursing Boards have nothing to do with CNAs.

classicdame, MSN, EdD · Jul 22, 2011

in my state the first responder's license does not permit them to do the same tasks in an acute care setting. Their license is only good "in the field". They cannot start IV's, give meds, etc. We have some working prn as ER techs.

Anna Flaxis, BSN, RN · Jul 22, 2011

in my state the first responder's license does not permit them to do the same tasks in an acute care setting. Their license is only good "in the field". They cannot start IV's, give meds, etc. We have some working prn as ER techs.

Our Paramedics can intubate and give all kinds of meds in the field, but are not allowed to do so in the ED. They can start lines, draw blood, and hang fluids at the direction of the RN and do monitored transports, but not if the patient is on a vasoactive drip or going to ICU.

northernguy · Jul 22, 2011

@Greygull

I'm an EMT and a CNA. EMTs are licensed by the state they work in, along with having NREMT certification. Its not just a certification like CNA.

Also, why would a Paramedic or EMT-I have to be certified in phlebotomy? I would think that is already within their scope of practice.

Not_A_Hat_Person, RN · Jul 22, 2011

When I was an ER volunteer in Massachusetts, techs in the ER were CNAs with additional training, but a growing number of hospitals were requiring ER techs to be EMTs. A lot of ambulance crews had RN-EMTs.

In all states a Certified Nursing Assistant (Or State Tested Nursing Assistant) is just that Certified and placed on a registry. It is a FEDERALLY mandated program. Designed to prevent abuse of residents in nursing homes. In every state I've researched CNA's fall under the purview of the state's department of health which is run by the state medical board. The State Nursing Boards have nothing to do with CNAs.

In Vermont, the state board of nursing licenses nursing assistants. LNAs have their own licenses and scope of practice. You can even look them up on the Office of Professional Licensing website.

Fumanchuesday · Jul 22, 2011

My hospital hires nurse assistants with no certification or experience. I did this for a year full time on a med surg floor... mowed yards before

ally100500 · Jul 23, 2011

At UPMC in PA we have Advanced patient care techs in the ED's. They are usually people in nursing school or with EMT-B. PCT's from the floor can be promoted into it if they are good enough. APCT's can start IV's, take LLM transport, place foleys, and do phlebotomy. That in addition to all the regular NA stuff.

akulahawkRN, ADN, RN, EMT-P · Jul 23, 2011

@Greygull
I'm an EMT and a CNA. EMTs are licensed by the state they work in, along with having NREMT certification. Its not just a certification like CNA.
Also, why would a Paramedic or EMT-I have to be certified in phlebotomy? I would think that is already within their scope of practice.

Because of the limitations placed on EMT-I and Paramedic personnel in terms of where their scope of practice may be utilized, while phlebotomy is usually in a Paramedic's scope of practice, in the clinical (non-field) setting, that scope often may not be utilized under their cert/license. This means that means that phlebotomy may not be practiced by a Paramedic (or an EMT-I) in that clinical setting unless it's part of an educational program.

End result: That person that may legally perform Phlebotomy in the field has to sit through 140 hours of training they already have. An RN who has Phlebotomy already in their scope can do it, and yet they may receive fewer hours of classroom time to do the same thing. Providers that whose scope of practice includes Phlebotomy as part of their license for clinical work (not field only) are usually exempted from Phlebotomy cert requirements.