Immediate care

Flare, ASN, BSN · Dec 9, 2008

You eventually get a wider knowledge base as a nurse, but it depends largely on what type of nursing you get into. I know psych nurses that haven't touched a wound in years. I know l and d nurses that wouldn't have the first idea on how to stabilize a broken femur.

Nursing students are not taught emergency medicine because they are not EMTs. Same as EMT's are not taught nursing functions such as inserting foleys. It's a different type of medical discipline. If you want to be trained to give immediate care in the event of an emergency, then look into taking a basic EMT course.

IcanHealYou · Dec 9, 2008

Hm thats actually what i've been told a couple of times. However I feel as any health professional its important to know those things.

I wouldn't feel adequate as a health professional and not know what to do in a crisis situation. Do doctors learn these things with experience as well?

Flare, ASN, BSN · Dec 9, 2008

Not having been through medical school myself, I can't tell you from first hand experience. However, my good friend just finished up his internship following medical school. For them it's more like hands-on training. He told me that he didn't really know much about emergency medicine until after his rotation there beyond what was discussed in theory classes.

I understand your rationale that when there is a crisis, everyone looks to the nearest medical professional (or professional in training). But it's just not how it's done in schools. I tend to think that it falls under the auspices of giving someone a little knowledge and them getting into trouble with it.

IcanHealYou · Dec 9, 2008

Hm i never thought of it that way, it makes sense though =D

Aneroo, LPN · Dec 9, 2008

As you gain experience, depending on the field you enter (ICU or ER), ACLS and PALS will give you some great experience that you can use in a hospital setting.

It's important to remember though, when out in public, not on the clock, you scope of practice is limited. Sure, I was taught how to intubate during ACLS (not sure if they do that or not anymore), but it doesn't mean it is within my scope. If you pull up on the scene of an accident, you have to keep that in mind.

chevyv, BSN, RN · Dec 9, 2008

I'm a ns as well, but I see that many nurses can go on to get specific certification in their chosen areas. ICU nurses can do this as well as ER nurses. I would bet almost all areas of nursing could gain certification, you just have to look into it. A basic emt course would be good, but once you get through school, you'll have greater opportunities to expand your knowledge base as well as learning on the job. I wish I had the time to take additional courses, but I barely have time to renew my cpr! UGH.

Thornbird · Dec 10, 2008

To learn what paramedics know, you have to go to paramedic school. Once you have your RN, you can become certfied as a Certified Emergency Nurse or a Critical Care RN. Once you have your RN there are many classes you can take to learn specialty skills. You can also become a flight nurse, which usually involves taking paramedic courses on top of RN.

Emergency Medical Services Providers are trained in Pre-hospital Care. Nurses are trained for hospital care. It's a whole different field. That's why Flight Nurses and Critical Care Transport Nurses are generally required to have dual licensure as paramedics.

Medic09, BSN, RN, EMT-P · Dec 10, 2008

To learn what paramedics know, you have to go to paramedic school. Once you have your RN, you can become certfied as a Certified Emergency Nurse or a Critical Care RN. Once you have your RN there are many classes you can take to learn specialty skills. You can also become a flight nurse, which usually involves taking paramedic courses on top of RN.
Emergency Medical Services Providers are trained in Pre-hospital Care. Nurses are trained for hospital care. It's a whole different field. That's why Flight Nurses and Critical Care Transport Nurses are generally required to have dual licensure as paramedics.

Actually, in most of the flight services around the country the crews are not required to have dual licensure. Of those that do, some only require a nurse to have EMT-Basic. BUT, what is true is that the nurses have to be taught the paramedic skills that they need. It doesn't take them long. The bigger adaptation that the nurse makes is the mind-set and unique challenges of pre-hospital care.

Thornbird · Dec 10, 2008

Actually most air services nationwide do require dual licensure as a paramedic or an RT. This is the case throughout the Northeast and Mid-Atlantic states, as well as other regions. If not, they require that the paramedic classes be taken which was what my original statement was. It is absolutely true that different services have differing requirements. Also there are bridge programs for RN's to get paramedic licensure.

Whichever path it is, this is a specialty for post-BSN. Not something taught in basic nursing education programs. The OP will find that pre-hospital care is entirely separate from nursing so will require the nurse to take EMT-P classes, if not actually obtain licensure, to work in the field.

In nursing school, you will eventually learn some immediate care, like what to do when a person is seizing for example, so that you can provide patient care while awaiting MD orders. These things do come in handy when you are out and about and a situation arises so that you can provide help and prevent the well intentioned from doing harm until help arrives. Paramedics work under strictly controlled protocols and are in constant contact with Medical Control (MD) for further orders when needed. They can give meds and teatments based on their assessment and the protocols. They have all the necessary equipment on hand. A bystander, even a nurse or doctor won't have all that. In an out-of-hospital emergency, all a nurse can do is render first aid, cpr if needed, and provide comfort and reassurance to the person (who is not a patient because you are not on the job).

Medic09, BSN, RN, EMT-P · Dec 10, 2008

i know i picked up a tangent here, but thornbird, you are misinformed concerning requirements nationwide for flight nurses.

a survey was published in air medical journal, which all the members of astna and iafp receive. here's the relevant info:

ems certification requirements for flight nurses . air medical journal , volume 23 , issue 5 , pages 38 - 40

abstract

emergency medical technician (emt) or paramedic (emtp) certification requirements for flight nurses (fns) providing on-scene patient care vary. we surveyed those requirements and evaluated the relationships between flight team composition or program location and fn ems certification. telephone survey of all 184 rotor-wing programs responding with a nurse to scenes the overall ems training requirement for fns was: none—57.6%, emt—21.7%, emtp—14.7%, local credential (not emt or emtp)—6.0%. second team members were emtp, rn, physician, or respiratory therapist (rrt). overall, team configuration related significantly to fn ems certification (p = .01). fn/emtp and fn/rrt teams were individually significant (p

as you can see, the majority (over 57%) require no ems certification for nurses. of those that do, more require only emt-basic than require emt-paramedic.

now this only covered the rw programs. fixed wing programs (i presently work fw critical care transport) typically have even less reason to require formal ems training. we don't respond directly to scenes, such as mvas. the nurses are required to learn a variety of 'paramedic skills' such as intubation and chest darts. most programs teach that themselves or in their associated hospital (if they are affiliated with one), rather than farm out their crews to train at ems training programs. we initiate little of the ems sort of care, though. our service flies to central and south america, so occasionally we initiate care that wasn't done there. not often at all. most fw work is interfacility, so we are already maintaining or building on what has been started. especially in the domestic us flights. when things start to go bad, well then we do what we have to do.

the nurses in camts certified programs (such as ours) are required to do some ems ride-alongs each year, just as the medics are required to do some icu time. lucky folks like me (working rn and working paramedic) just fulfill the requirements in the course of work and training.

so, to summarize: "most air services nationwide do" not "require dual licensure as a paramedic or an rt." (rts, btw, are pretty rare in the air services nationwide, less than 3%. you're in ct. iirc, the service in hartford is one of the few that uses an rn with rt crew.) and they do not require "paramedic classes" for the nurses, though they do provide the needed supplementary training.

Thornbird · Dec 11, 2008

I had no intention of starting an argument over this. You are obviously more informed on this subject than I am, Medic09, as it is your specialty area. I suppose maybe I could have said "paramdic type classes". The point that i was really trying to make here for the OP, who was asking about learnung paramedic skills, that pre-hospital care for nurses is a specialty that one obtains certfications for after obtaining an RN. Unless, of course, like you, they are already paramedics. How this is achieved, I think we both agree, may vary by region or employer. Thank you for your input, you have given me information that I was misinformed about. And although the OP isn't asking about flight nursing, per se, others read the threads, so i would not want to contrubute to misinforming them.