ER tech forum.

  1. Hello All

    I cant believe I have been a tech for almost four years, its been a great experience and may have helped to change my plans for the future. I hope to start taking my pre reqs soon with the intent to give a real effort into getting into nursing school, I had been leaning towards medic school. I have gained great insight and knowledge from this site and would like to contribute more. Would there be any interest in putting together a forum for techs? I think it would be a great resource and an excellent place to network. Most of our techs move on to nursing anyway and there is so much that can be shared by techs and RN's. Thank you for your consideration.

    Doug
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    About FirefighterDoug

    Joined: May '05; Posts: 41; Likes: 9
    Steering wheel holder.; from US
    Specialty: Pediatric emergency medicine

    9 Comments

  3. by   cjcsoon2bnp
    I know that we already have a CNA form but maybe we could rename somehow to include techs. too. I'm not sure, its just a suggestion

    !Chris
  4. by   MurseMikeD
    No, I think the tech's job is different enough to justify their own forum.

    Way to go on the decision to pursue nursing Doug. I was working as a firefighter/EMT and ER tech and "leaning towards paramedic school" when I made the opportunity to go to nursing school myself. I've never looked back, best decision I ever made.

    Good luck!
  5. by   Roy Fokker
    Quote from MurseMikeD
    No, I think the tech's job is different enough to justify their own forum.
    Please pardon my ignorance but how/why is a Tech different from a CNA?

    I'm asking because I'm genuinely curious.

    Thanks!

    cheers,
  6. by   MurseMikeD
    Quote from Roy Fokker
    Please pardon my ignorance but how/why is a Tech different from a CNA?

    I'm asking because I'm genuinely curious.

    Thanks!

    cheers,
    Good question.

    Well, the simple answer to your question is, "CNAs and ER techs are different because not all ER techs are CNAs." Many ER techs are in fact certified EMTs, or licensed paramedics. Also consider that some hospitals will not employ CNAs as ER techs, preferring to fill those positions with either EMTs and paramedics, or only paramedics.

    This is significant because while in many places CNAs, EMTs, and paramedics can all be hired and trained to function as ER techs, their respective educational backgrounds and scopes of practice differ greatly.

    I won't delve into the differences in curriculum or scope of practice too much, because that's more about what differentiates ER techs of different backgrounds (CNA vs. EMT vs. paramedic) and less about what makes techs different from CNAs. Briefly though... some of the differences that come to mind: CNAs don't learn to work with traction splints and aren't trained in patient assessment, EMTs don't learn much if anything about assisting with ADLs, and paramedics can do everything an EMT can and a lot more. Paramedics can administer breathing treatments, insert advanced airways, and perform procedures like needle cricothyrotomy; EMTs can generally assist patients with certain medications; and CNAs cannot do any of the above.

    The difference is more about "point of view" in my opinion. An ER Tech, whether he/she was educated as a CNA, EMT, or Paramedic, is concerned with very different skills and tasks than a CNA employed either in a non-ED inpatient setting or an outpatient setting. I just don't see an ER tech, regardless of their training background, having a whole lot to talk about with a home health CNA or med/surg CNA. It's apples and oranges.


    Sorry for going on so long... hope I've clarified the matter somewhat.
  7. by   Roy Fokker
    Quote from MurseMikeD
    Sorry for going on so long... hope I've clarified the matter somewhat.
    Well yes and no.

    What an ER tech can do differs from State to State and sometimes within the State, from institution to institution.
    Example: At my old hospital in Illinois where I worked on an ortho floor, inserting foley's was within the scope of practice for LPNs/RNs and CNAs. This is not the case in my current State (somewhere on the East Coast ) where only nurses are allowed to insert catheters.

    The educational background matters only up to a certain degree - because ultimately the scope of practice doesn't change.

    For example: There are some physicians I know who were educated and trained abroad but work here under an RN license. As such, while they have been trained to do anything from interpret X-rays to insert advanced airways and central lines; they can't do that now as it is beyond their scope of practice as an RN.


    There is also the question of authority. Techs and CNAs in my State derive authority either from the practicing physician or nurse.

    The only difference I have noticed is that ER techs are trained to do straight sticks for blood while most practicing CNAs aren't trained as such.

    cheers,
  8. by   FirefighterDoug
    ER techs where I work are allowed to practice with no Oregon state certification. New hires are required to have education equal to EMT,MA,CNA or some comparable level of training in emergency services. We also have to keep our BLS/CPR up to date. I started on the adult side, last year I was offered a position in the children's emergency department. I still pull shifts on the adult side because they have more techs and more holes to fill, techs seem to only stay 12-18 months then its on to bigger and better things. Our duties include the following.

    EKGs (We only run the test we don't interpret the results)
    Blood Draws
    Splinting
    Wound cleaning, preparation and dressing
    Trauma recording
    Monitor placement
    Assist with procedures
    Transport
    Stocking,stocking and more stocking

    There are other duties but these are the ones we perform the most. We do have CNA's but they are usually not prepared for the jobs and experiences the ER offers. Once they have some training they are great as long as they have the desire to work in the department. We all know that most ER folks are here because this is what makes them happy and they thrive on the challenge and ever changing setting the ER offers. You can almost always make an EMT a tech but its not so easy with some CNA's. I have great respect for CNA's and they have definitely been hard working when I have had the rare opportunity to have one in for training when I was working.

    Now here is where it gets interesting when it comes to CNA vs EMT vs the states of Oregon and Washington. I am an EMT-IV Tech in Washington, I have somewhere around 300 hours of pre hospital classroom training including First Responder, EMT basic, EMT IV tech,PHTLS and tons of additional fire related training not to mention ten years of field experience. I can work in the ER in Washington for my required sticks but I cant tech for pay because I am not a CNA. I wish someone would have told me this ten years ago, I would have made it the foundation of my education. To go back now and get my CNA seems a bit like walking backwards, I know there are skills that I would learn that I don't use now but in my current setting I don't need those skills. I tried to challenge the test but the state would not go for it. I can respond to a call for help render life saving treatment including starting lines arrange transport and package you up but they don't think I could study for and at least get a passing grade on the state CNA test. It makes me question the whole process of licensing health care providers at least in Washington. Over the years I have discovered many things that explain why some of us work on the outside and some of us work on the inside. There are a few like myself who do both and with that comes respect for all involved.

    Sorry to go on so long but I do appreciate the replies and I felt it would give a better understanding of the tech position at least where I'm at. I really thought there would be more replies from my fellow techs, I know there are alot out there and it would be nice to share some information.

    Doug
  9. by   MurseMikeD
    Quote from Roy Fokker
    What an ER tech can do differs from State to State and sometimes within the State, from institution to institution.
    Oh believe me I know. I've done most of my work California and they're the worst. EMT certification and paramedic accreditation are done at the county level, so scope of practice and protocols change every time you cross a county line!

    Quote from Roy Fokker
    The educational background matters only up to a certain degree - because ultimately the scope of practice doesn't change. For example: There are some physicians I know who were educated and trained abroad but work here under an RN license. As such, while they have been trained to do anything from interpret X-rays to insert advanced airways and central lines; they can't do that now as it is beyond their scope of practice as an RN.
    That's kinda what I was trying to say, and looking back I didn't do the best job of it. My bad, and thanks for calling me on it. You're right, it usually won't matter. Because, as your example illustrates, scope is dictated by your current role. Back when I was a student precepting in neuro ICU and someone needed to be reintubated, I couldn't very well jump in and do that myself (licensed paramedic or not) because I was acting in my role as a student, not a paramedic. I get it, really, I do.

    It's like that for medics in most EDs. Most everywhere I've been or know of the ER techs scope of practice will lie somewhere between what CNAs and EMTs do elsewhere, and what paramedics do elsewhere. Meaning, CNAs and EMTs will often learn a few new skills (i.e. phlebotomy, 12-lead, bed-baths and such for the EMTs) that weren't part of their original curriculum & scope in order to work within their scope as a tech, the paramedics will shed many of their skills (i.e. crics, needle decomp, etc.) to act within the more limited scope of a tech. They all end up doing the same job in the ED.

    Not... always... though... and that's partly why I tried to gloss over the whole scope of practice thing, brevity. Your question pleaded ignorance (I didn't see you had ED experience) so I was trying to make things a bit simpler than they really are. Point being, that there are places where a paramedic-trained ER tech has a different scope of practice than one who was trained as an EMT or a CNA. I worked in an ED where the medic techs did most of the intubations, IV starts, and 12 leads. That's what they were there for, and they did it beautifully. The CNA and EMT-trained techs could only help set up 12 leads. Same job title, their scope based in part on their respective certification and licenses.

    Quote from Roy Fokker
    There is also the question of authority. Techs and CNAs in my State derive authority either from the practicing physician or nurse.
    I think it's like that everywhere, because they're both unlicensed. Even with EMTs and medics in the field. They have a heck of a lot more autonomy than any acute care nurse, but it's because they're following protocols backed up by a medical director.

    Quote from Roy Fokker
    The only difference I have noticed is that ER techs are trained to do straight sticks for blood while most practicing CNAs aren't trained as such.
    Again, not everywhere. Sometimes the differences are much greater. I tried to gloss over the whole scope thing, because as you helped point out... that's not really the issue with ER techs and CNAs sharing a forum. Like I said, it's more that an ER tech (whatever their background) is concerned with very different tasks then a CNA on a med/surg floor or home health. I think it's different enough that they deserve there own forum, assuming there's enough interest.

    We're on the same page I think.
  10. by   Roy Fokker
    Fascinating discussion gentlemen!

    I have to rush to work but will attempt a better response later today (assuming I don't pass out comatose post work today! )
  11. by   FirefighterDoug
    MurseMikeD

    Thanks for the positive feedback, its nice to hear from someone who has changed their direction from medic to nursing, Im sure we are not the only two. I have had support from all I have talked with from RN's to medics and it just makes sense to get the RN then maybe latter challenge the medic test if it can be done. To be honest I would be happy and great at either job but I just seem to function at a higher level in the ER. I think the inspiration and professionalism of the other staff is one of the big things that changed my way of thinking . Not to mention that by the time I'm ready it looks like the medic programs in WA will go to a degree program like OR. Its going to be a big job since I will be starting from square one but I really like being in school and I have always been a big supporter of continuing education.

    Roy Fokker

    I hope my post helped with your inquiry about the difference between CNA's and EMT's in the ER. I have found over the years that what each can do does vary from facility to facility but I have learned one real simple fact. Outside providers base their duties and scope of practice on skills, inside providers are under the supervision of higher level providers and gain trust and respect which helps them to advance their level of practice once a certain level of education and understanding is achieved.

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