End of CCT Nurses in California?

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It looks like the California EMSA is advancing its proposal for the Critical Care Paramedic in California. This provides for an expanded scope of practice which may surpass that of the RN even without the Associates degree.

http://www.emsa.ca.gov/paramedic/default.asp

I know the effects will be felt in both Flight and ground CCT. It will also extend into Maternal/OB and Neonatal Specialty transports. Some counties have already been watching this and are ready to make the transition from RNs to Paramedics on flight and CCT. This has already been heavily discussed in Orange county. It has both pros and cons. I am still a firm believer in education and that one should actually have worked in a critical care environment for at least a couple of years before transporting an ICU patient. But, that also may now become a reality for the Paramedic as the CCP is moving into the hospitals in Kansas, Oklahoma and Colorado. A few hospitals are using Paramedics to replace Respiratory Therapists for nightshifts and in the ERs. Some smaller hospitals in California are considering this also since the Paramedics will now have point of care devices and mechanical ventilators as part of their scope of practice. This could serve many purposes.

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The paperwork is now being finalized in California.

California County Expands Role of Private Ambulances - News - @ JEMS.com

Bye-Bye CCT-RNs.

Orange county will be the first to start eliminating RNs from transport. I do find it ridiculous that they are stating nursing shortage as a reason. There is NO nursing shortage in California. There is a shortage of CCT trucks on the road mostly due to high call volume with services being centralized by specialty in the hospitals.

The Critical Care Paramedic is now a reality and soon they will expand to flight, NICU and PICU teams in California as they have in other states.

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Wow that is very interesting

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Specializes in ICU + Infection Prevention.
the CCP is moving into the hospitals in Kansas, Oklahoma and Colorado. A few hospitals are using Paramedics to replace Respiratory Therapists for nightshifts and in the ERs. Some smaller hospitals in California are considering this also since the Paramedics will now have point of care devices and mechanical ventilators as part of their scope of practice. This could serve many purposes.

Links?

Anything to push the bottom line a little bit, right?

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This is very interesting - thanks for sharing.

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Being an EMT on a CCT unit for many years in so cal, and knowing these IFT medics that will be filling these positions will be scary. I am assuming they are mostly pushing this because of the cost of a medic vs. an RN. It is weird that orange county is the first place because private ambulance medics do not even exist out there right now only fire medics can operate as medics in orange county.

Okay I re-read it and it seems medics will not be doing CCT calls, but they will be able to do ALS calls because in orange county they are unable right now. This is not goodbye CCT-RNs in cali by no means it is simply allowing RNs to be freed up from ALS calls like cardiac monitoring or basic drug therapy. Unless I am missing the part where they are training medics on mechanical ventilators and transferring patients with blood transfusions and multiple drips on a pump then I do not think this article means what you think it means.

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Specializes in ER.

Intriguing!

The nursing shortage in CA is a HUGE LIE. And it's a huge insult to my CA graduating class where over 40% of us didn't have a nursing job 18 months out of school.The CA board of nursing sent me a letter apologizing for the lack of jobs and said the situation was "unprecedented". It might feel like a shortage of nurses because nurses are expensive labor and an easy place to cut back or not hire to save. Maybe there is a shortage of specific types of nurses - like critical care nurses with 5+ years of experience that people don't want to pay a decent wage to. DUH...

Even though it might suck for nurses, if it winds up being more practical and evidence shows no danger or change in level of care provided, then whatever. Business is business.

I'm happy as long as the nursing scope of practice keeps growing and evidence shows that it's safe and effective. pursuing FNP or ACNP programs right now :-) Woot!

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Even though it might suck for nurses, if it winds up being more practical and evidence shows no danger or change in level of care provided, then whatever. Business is business.

I'm happy as long as the nursing scope of practice keeps growing and evidence shows that it's safe and effective. pursuing FNP or ACNP programs right now :-) Woot!

Unfortunately for the patient, it is all about the money.

California Paramedic Expansion Encounters Opposition - News - @ JEMS.com

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Unless I am missing the part where they are training medics on mechanical ventilators and transferring patients with blood transfusions and multiple drips on a pump then I do not think this article means what you think it means.

Keep up to date. All of this is now in the Advanced Paramedic's scope of practice. Also refer to the link I just posted. This is nothing new since we have been kicking this around for over 3 years.

http://510medic.com/2011/09/21/california-paramedic-regulations-are-open-for-public-comment/

From the EMSA website:

"The Critical Care Paramedic (CCP) is a new level of provider, with a distinct scope of practice in addition to the Paramedic scope. To enter a CCP training program, an individual must be currently licensed and accredited in California as a paramedic with three (3) years of basic paramedic practice. The minimum hours of CCP training are 202 hours and are divided into a minimum of 108 hours of didactic and lab and a minimum of 94 hours of clinical training in various clinical areas. After completion of an approved CCP training program, the Paramedic must successfully pass the examination given by the Board for Critical Care Transport Paramedic Certification (BCCTPC), and receive accreditation from the Local EMS Agency."

http://www.emsa.ca.gov/emsa_dispatch_june_2013#EMTandParamedicRegulationChanges

The additional education required is truly a joke since the base requirements to be a Paramedic consists only of about 1090 hours of training and no college level courses are needed.

From the statutes:

The total paramedic training program shall consist of not less than one thousand and ninety (1090) hours.

I am all for the Paramedic advancing but not if it puts the patient at risk by putting those who have NO experience in critical care just taking a few hours of training and passing an easy test on top of the bare minimum to enter into the EMS profession.

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and receive accreditation from the Local EMS Agency.

You can fight if off locally, the counties have to allow it individually.

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Specializes in NICU Transport/NICU.

No way in hell will a paramedic be able to do a neonatal transport. I'm not sure of California, but florida requires a minimum of 2000 hours in the NICU as an RN before you can perform a NICU transport. The skills are way different than an adult transport.

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No way in hell will a paramedic be able to do a neonatal transport. I'm not sure of California, but florida requires a minimum of 2000 hours in the NICU as an RN before you can perform a NICU transport. The skills are way different than an adult transport.

You might be surprised at how many NICU teams use RN/Paramedic or Paramedic/Paramedic even for high acuity respiratory patients. Miami Childrens is a good example. Several other teams are also in the process of dumping an RN or RT for a Paramedic. Recently a CCT and Flight program in OR eliminated all RTs off their critical care transfers for all Paramedics.

There are exceptions in the FL law. It also states nothing about the Paramedic who can be used as having NICU experience. This also pertains only to neonates. It is still a free for all and whatever picksup for any child outside the definition of neonate.

"The Medical Director shall confirm the paramedic is a Florida-licensed paramedic with a minimum of 5,000 hours experience and has an AHA NRP Certification."

Essentially just a year or two on the job and nothing about the number or type of calls. T

The tragic situation in the recent headlines is a great example of inappropriate staffing for kids regardless of title. Unfortunately this is way too common.

Lawsuit filed over death of Emerald Isle youth - Tideland News: News

Asthmatic Boy Dies during Transport to Third Hospital in 11 Hours | EMS Airway Clinic

And very few in EMS will ever find fault with this situation. To most the crew members are heroes and this was a save.

Florida Verdict Could Change Way Paramedics React to Calls - News - jems.com

Even with this critique.

Lessons to learn from Fla. $10M birth lawsuit outlined at EMS Expo

EMS has some huge lobbying advocates and health care is looking to cut costs. Using Paramedics with a lot less education is a great way for hospitals, CCTs and air ambulances to save money.

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