EMT-B in Doctors offices

[pillsrus]

Ya I guess each state is different with its rules about EMt's and the way they refer to them. I am an EMT as well except I did things backwards. I've been a nurse for 17 years and started working on the ambulance 2 years ago. I went through the EMT class just last year. I was humbled!! A lot of the information I already knew but I was supprised at how much I didn't know or better yet didn't know how to apply it in the immediate emergency, pre-hospital setting. I was a great class. I sit in on some of the "I" class for the review. I would like to take that as well but I have too much going on right now.

As for the EMS dirctor - He knows what is going on. He has turned people in too but the BME doesn't do anything. He has tried talking to the EMT's and they say that the good doctor says what they do is legal - and according to this rule 800- most of what they do its. It seems someone has to really be hurt or be killed before the "good-'ole-boys" (meaning physicians) stop protecting each other. Personally I think Doctors have far to much power. Maybe the answer is public education.

[jrenae]

I am in Tennessee, and an office I know of has an EMT and trained her(if you want to call it training), they have one LPN , and the other girl is just someone they trained without any medical background. I was very afraid when I was there, they would come and get me to give childrens injections and got upset when I wouldn't give the injection they had drawn up. I love nursing and it scares me to think that the law will allow anyone to give medictions, preform procedures, and inform patients about what they need to do as far as health care. It falls back on the MD, if they are good then usually they will adequately train their staff regardless of licensure.

[Alnamvet]

As for EMT's working in a physician's office, there is nothing illegal about it; the physician assumes the responsibility for their acts, and the onus is on the md if there is a grave error. Insofar as med errors, I am always amazed at the number of RN's in the ED who still cannot calculate drips, mix drips, or even know the difference between Humulin N and Regular Insulin...errors are made all the time, but it is easier to place blame on the lowest ranking in the medical hierchy. As far as training goes, EMT's must do 1 semester at a local college; to become a Paramedic, it is an additional 3 semesters...essentially, 2 years of training culminating with a AS degree in Emergency Medical Services. Experienced Paramedics can and do work in what I call "Doc in a Box", as First Assist in surgical/dental procedures in offices, monitoring vital signs, and intervening prn should there be a problem such as the patient going into anaphalaxis, or worse, coding. The bottom line is, there are outstanding practitioners of pre-hospital medicine, as there are RN's...and unfortunately, there will always be the slugs, who somehow gained the license/certification, title, but do nothing to improve the image of the profession.

[Gldngrl]

Is there documentation of the wasting/administration of controlled substances? I know you wrote that the MD charted the correct amount of medication was adminstered, but is there a separate narcotic sheet that might have the discrepancies listed? That documentation and your testimony regarding witnessing these events might be enough to at least start an investigation...unfortunately, otherwise it may require patient injury or fatality before the BOM steps in.