Heated debate between civilian ED RN and FMF Hospital Corpsman.

[testing109]

before i begin this thread, i'd like to take a moment for those that may not be familiar with what a fmf hospital corpsman is exactly, so that there is a better understanding of my frustration:

for seven boot camp-like, rifle-toting, blister-breaking weeks down south at camp lejeune, n.c., the navy and marine corps team up at field medical service school (fmss) east to mold standard navy-issue corpsmen into sailors good enough for the fleet marine force (fmf). the good ones will earn the marines' respect. the great ones earn the title, "doc." there are corpsmen and then there are 'docs.' a doc is someone you can count on. he's someone in your platoon that when something happens to one of our fellow marines, you can call on him and not have to worry. he's your buddy, a comrade in arms, a person who you count on to cover your back, to lay down fire, dig fighting holes or do whatever marines are doing. that's who a doc is. one of the first things a good fmf corpsman learns is that the very last thing he's worried about is himself. in combat it goes through your mind, 'ok, there's a guy that got shot, i can stay here and i'll be safe and if i do, that marine's probably going to die. having the self-confidence needed by a successful battlefield corpsman can grow and many of the scenarios the medical and marine corps advisors put their students through are centered on precisely that--building confidence in the sailors' knowledge and their abilities. the fmf corpsman are taught what the marine corps will demand of them from the very first day with boot camp-style inspections, relentless physical fitness training and unyielding tolerances for marine corps discipline, all the while being tested academically both in the classroom and in the field. being book- or street-smart alone isn't enough to make it as an fmf corpsman. you have to be both because being with marines means always thinking outside the box, way outside the box. navy corpsmen are one of the most combat decorated rating in the navy, and most of those medals were earned by corpsmen serving with their marines. it's a glory only a select few dare to chase. to become an fmf corpsman stems from a reputation the marine corps has for expecting a lot more responsibility from its junior personnel, especially their corpsmen and it's a character trait fmss instructors look for on the very first day of school. going greenside, fmf corpsman will have a lot more people depending on them to know what they have to do, and they will have the opportunity to do it. by serving with the marine corps they will learn more about what a corpsman ought to be sooner rather than later. as an fmf corpsman you have an immense amount of responsibility sometimes more than you really want. you have a group of marines whose medical care is assigned to you--just you. you are in charge of everything that happeneds to them and their medical records are your responsibility. fmf corpsman are in charge of making sure their marine's immunizations are up to date as well. if they get hurt you have to fix them, and if i get hurt they have to fix me. you're never going to be a leader of a group of individuals in a hospital as an e-2, but in the marine corps, when it comes to medical care for the marines, you are. and that's the most rewarding thing there is, to take a group of people like that into combat and bring them back alive. so in conclusion, the duties of a fmf hospital corpsman consist of and are not limited to:

assisting in prevention and treatment of disease and injuries;

caring for sick and injured;

administering immunization programs;

rendering emergency medical treatment;

instructing sailors and marines in first aid, self aid and personal hygiene procedures;

transporting the sick and injured;

conducting preliminary [color=#366388]physical examinations;

performing medical administrative, supply and accounting procedures;

maintaining treatment records and reports;

supervising shipboard and field environmental sanitation and [color=#366388]preventive medicine programs;

supervising air, water, food and habitability standards;

performing clinical laboratory tests and operating sophisticated laboratory equipment;

taking and processing x-rays and operating x-ray equipment;

filling prescriptions, maintaining pharmacy stock;

serving as operating room technicians for general and specialized surgery;

performing [color=#366388]preventive maintenance and repairs on biomedical equipment.

so, with all of that being said, i would like to share a situation that i encountered. today, i was informed by a 1 year civilian rn that as a fmf corpsman, i was inferior to her due to the fact that she was a rn and i was merely a military medic. further more she voiced her opinion (which i found quite undeducated) that due to her "formal" class room education, she was superior to me because i am not licensed and she is, stating that my level of education and skill is only that of a basic cna.

i found this to not only show her ignorance, but her extreme disrespect for our military service members who work in the medical field and put their lives on the line every day, and seeing how i am a fmf hospital corpsman and i am referred to as "doc" by my fellow marines, i took this quite personal. no i did not sit through your everyday civilian rn training and nor do i put myself above the ones that have, but by no means do i feel like my level of skill is in anyway inferior to a difference in training.

so, this is what i am asking the current and/or prior corpsman out there and the current and/or prior ed rn's out there: is this the attitude that is to be expected once i enter into the civilian world? is there really no respect for the men and women who serve our country performing the same level of critical care that you do, only we put our lives on the line in a time of combat to get the job done and take care of the ones that have put their lives on the line for your freedom?

i will close with a statement i heard once from a fellow service member: "to all of the civilians out there they may not respect or understand your countries military and what we are fighting for, late at night when you lay your head on your pillow and you wrap up in that warm blanket and go to sleep in peace, just remember, that blanket is called freedom which is provided for you by the same people you insult"

[Gracian]

I wouldn't take it personally - look at how long it took to explain your job to us.

But if you expect this kind of response frequently, maybe try to link it to a short, relatable sentence or two of explanation. Like maybe "Our function was a combination of paramedics, nurses, biotech engineers...."

[testing109]

Thanks for the tip

[jeckrn, BSN, RN]

As both a former FMF Corpsman and ED RN I can see both sides. This is a common arguement between paramedics and RN's.

The big thing is the a HM(FMF) is taught how and the RN is taught why something is done. Remember there is plenty of things that the RN can do that if you can not do even in the field. Also, there are thinks you can do in the field that a RN can not do in the ED. But, like you the RN can also do them in the field.

When I worked as a HM(FMF) I worked more at the LPN or Paramedic level then at the RN level. HM's are not taught the same critical thinking skills as a RN. Since you are not licensed if you worked in a civilian setting you would work as a UAP. This is not taking anything away from your skills, but without that piece of paper that is the way it is in the civilian world. In your own words you put it best "seven boot camp-like, rifle-toting, blister-breaking weeks" training vs 2-4 years of education. Did you ever wonder why RN's are officers in the Navy and HM's are enlisted?

The RN is showing poor leadership style and how some nursing schools push a attiude that if you are not a BSN you are not a real nurse. Ask the civilian RN if she is a ADN or BSN.

As a HM there are things that you can only do while you are treating military personal/dependents while in a military setting. Without knowing your whole background do not know if you worked at a MTF. If you have you know you can not use the same skill sets at a MTF as you would in the field.

Sounds like you qouted the job description for a HM off the recruiting site not what a FMF does which hurts your arguement since no HM does all these duties.

Do not take this the wrong way, what any HM or medic from one of the other services do is very important. What you need to do is further your education, become a RN and remember what it was like being belittled by this RN and use anyone who falls under you to the best of their abilities.

Also as Gracian stated do not take it personal since the RN does not know what a HM(FMF) does. As with everything in life use it as a learning experience to avoid the same behavior.

[DIVA-RNMOM24]

As both a former FMF Corpsman and ED RN I can see both sides. This is a common arguement between paramedics and RN's.

The big thing is the a HM(FMF) is taught how and the RN is taught why something is done. Remember there is plenty of things that the RN can do that if you can not do even in the field. Also, there are thinks you can do in the field that a RN can not do in the ED. But, like you the RN can also do them in the field.

When I worked as a HM(FMF) I worked more at the LPN or Paramedic level then at the RN level. HM's are not taught the same critical thinking skills as a RN. Since you are not licensed if you worked in a civilian setting you would work as a UAP. This is not taking anything away from your skills, but without that piece of paper that is the way it is in the civilian world. In your own words you put it best "seven boot camp-like, rifle-toting, blister-breaking weeks" training vs 2-4 years of education. Did you ever wonder why RN's are officers in the Navy and HM's are enlisted?

The RN is showing poor leadership style and how some nursing schools push a attiude that if you are not a BSN you are not a real nurse. Ask the civilian RN if she is a ADN or BSN.

As a HM there are things that you can only do while you are treating military personal/dependents while in a military setting. Without knowing your whole background do not know if you worked at a MTF. If you have you know you can not use the same skill sets at a MTF as you would in the field.

Sounds like you qouted the job description for a HM off the recruiting site not what a FMF does which hurts your arguement since no HM does all these duties.

Do not take this the wrong way, what any HM or medic from one of the other services do is very important. What you need to do is further your education, become a RN and remember what it was like being belittled by this RN and use anyone who falls under you to the best of their abilities.

Also as Gracian stated do not take it personal since the RN does not know what a HM(FMF) does. As with everything in life use it as a learning experience to avoid the same behavior.

VERY WELL PUT!!!!! FOR BOTH SIDES:yeah:

[Dennis Horn]

Hey Doc, just like in the military the RN no matter how good or bad is in charge, b/c of her/his license. I too am a former FMF HM2. I challenged the LPN test, wiped butts in the VA system unitl I finished mt RN, worked 6 more years in a busy ICU, then went CRNA. The same argument is made between CRNA's and anesthesiologists. I finished my career in the reserves, and when deployed to Afghan. I was the solo anesthesia provider. I placed central lines, a-lines, placed a few upper extremity blocks, etc. With that said, I am not a physician, I am a well read clinically sound physician extender, who is able to work independently in a war zone (Frwd Surgical team) Back in CONUS, I have to bite my tongue and tolerate direction/supervision. I believe this from rising frivilous law suits. I see good and bad CRNA's, medics, PA's Surgeons, etc....like in anything some people should not be doing what they do professionally. My advise, don't take what people say personally, I am sure you are a well read, clinically competent medic, and knowing that you are able to perform professionally, and smoothly with the skills you have acquired should reinforce in your mind what you are about. Don't let the petty stuff get you down. Life is a pecking order, and the hierarchy in health care is brutal. I see cardiothoracic surgeons tear up other surgeons, pathologist are very disrespected followed by anesthesiologist...and it continues. I stay focused on my job, and let my abilities do the talking.

[wtbcrna, MSN, DNP, CRNA]

Hey Doc, just like in the military the RN no matter how good or bad is in charge, b/c of her/his license. I too am a former FMF HM2. I challenged the LPN test, wiped butts in the VA system unitl I finished mt RN, worked 6 more years in a busy ICU, then went CRNA. The same argument is made between CRNA's and anesthesiologists. I finished my career in the reserves, and when deployed to Afghan. I was the solo anesthesia provider. I placed central lines, a-lines, placed a few upper extremity blocks, etc. With that said, I am not a physician, I am a well read clinically sound physician extender, who is able to work independently in a war zone (Frwd Surgical team) Back in CONUS, I have to bite my tongue and tolerate direction/supervision. I believe this from rising frivilous law suits. I see good and bad CRNA's, medics, PA's Surgeons, etc....like in anything some people should not be doing what they do professionally. My advise, don't take what people say personally, I am sure you are a well read, clinically competent medic, and knowing that you are able to perform professionally, and smoothly with the skills you have acquired should reinforce in your mind what you are about. Don't let the petty stuff get you down. Life is a pecking order, and the hierarchy in health care is brutal. I see cardiothoracic surgeons tear up other surgeons, pathologist are very disrespected followed by anesthesiologist...and it continues. I stay focused on my job, and let my abilities do the talking.

CRNAs are not physician extenders. We can and do work independently deployed or not deployed/CONUS or not.. Nurse anesthetists have been around as long or longer than anesthesiologists in this county. We didn't extend nursing practice into the field of anesthesia(nurse anesthetists have been around since the beginning of anesthesia) physicians did. Anesthesiologists were few and far between until the 1950's when anesthesiology became a more lucrative speciality.

You choose to work in directed/supervised practice where the only thing you extend is an anesthesiologist's salary. It is not mandatory that any CRNA work in a medically directed practice. There are plenty independent CRNA practices for any CRNA who chooses to work in one.

Don't sell yourself or us short.

[Dennis Horn]

My intention was not to sell us short but after working in the very controlling state of Pennsylvania, and coming back from (Annual Training) at Womack Army Medical Center, where the docs are now coming into the rooms for ASA I-II...and hoarding most of the regional blocks, one most seriously wonder where our practice is heading? Womacks Chief CRNA( a full bird Colonel) was relieved because she brought issue with these young new grad. MD's trying to direct and supervise ASA I-II. I agree with you entirely, no one wanted to supervise me in Bagram, oh that's right I was by myself. Sadly enough I am considering taking a job with Indian Health Service. Hopefully there I can be left alone, and grow as a provider. Thanks for your input.

[wtbcrna, MSN, DNP, CRNA]

My intention was not to sell us short but after working in the very controlling state of Pennsylvania, and coming back from (Annual Training) at Womack Army Medical Center, where the docs are now coming into the rooms for ASA I-II...and hoarding most of the regional blocks, one most seriously wonder where our practice is heading? Womacks Chief CRNA( a full bird Colonel) was relieved because she brought issue with these young new grad. MD's trying to direct and supervise ASA I-II. I agree with you entirely, no one wanted to supervise me in Bagram, oh that's right I was by myself. Sadly enough I am considering taking a job with Indian Health Service. Hopefully there I can be left alone, and grow as a provider. Thanks for your input.

No worries but I can tell you that issue is being worked on at those medical centers. There seems to be a big push right now with certain anesthesiologists to bring the military into ACT practices. On your side of the house (Army) I know USPAGN is working on the issue.

I am looking at USPHS/IHS when my contract is up. The thing to remember with them each hospital is totally different. Some hospitals will be ACT practices and some will be CRNA only hospitals.

[Dennis Horn]

I feel a little bad for the original writer of this thread, I was hoping to reassure him/her. With that being said, I would very much like to hear more about this ACT issue and other practice issues, so please feel free to correspond and enlighten me. The ASA in my state has a strong grip on our practice, and with three small children in school it's difficult to move. My wife is from the west coast, so AZ is a possibilty, I just don't want to make a long distance move and become an LMA jockey for some anesthesia group. Keep in touch, I feel a little more reassured after your last entry. I can't see the US Army retaining AD or reservist if they don't change their policies. I really saw this at Walter Reed a couple years ago, the Doc's ( residents included )were very hostile and derogatory towards the CRNA staff. I hope things change for us. [email protected]

[elumine]

Don’t take it personally, take it as a challenge to further your education..I was a tech or CNA before I entered the nursing program just to make sure nursing is a right career for me. When I was a tech, some nurses belittle me or told me “you are just a tech”. My feeling was hurt, but I get over it. Nurses like that help me to further my education and to become a better nurse. Now, I’m an RN, I appreciate my tech because she/he makes my life so much easier…

[IowaRNBSN]

Testing109,

As medical professionals we each have our own duty and function, be it as a first responder, a staff nurse on the floor, of a Doctor in the OR. The key part is that without each other working in unison together we would get very little done and have very angry patients or very dead patients. In healthcare it shouldn't be about one-upmansship or trying to be superior to each other. Try to brush it off and not worry about it. Remember why you are there and why it is important to the team!

P.S. You guys rock at getting those difficult IV sticks.

IowaRNBSN