I always enjoy hearing nurses get together and rip on paramedics or visa-versa because, for the most part they are both wrong about their stated prejudices for the other. I have been a paramedic for 15 years and got my BSN coming up on 10 years in June, so I can see both sides of either argument. In this case I have to side with the Paramedics. Except for the percieved rudeness you recieved from them, I can't see what it is they did so wrong and too to such a degree that some posters here are calling this neglect. Please! Some of my fellow RN's need to get out of their comfortable, controlled office or hospital enviorments from time to time and experience what it's like to work in the prehospital world.
To begin, you were only semi-correct to tell the father that he should have taken the boy to the ER, as a family practice office is definately not the place to go for a possible spinal injury. It would have been better, however, to tell him to call 911 next time and have the patient immoblized immediately following the accident as opposed to the next day. The reason he probably didn't call 911 initially was that the boy was probably acting fine after the initial injury and it wasn't until the next morning, after the injured muscles had a chance to swell and stiffen (which is normal for this type of injury) that his son complained that he couldn't move his head.
Secondly, if your doctor was so concerned about the wellfare of the patient she should have taken a minute out of her busy day and done her job. Even though your office is not equipped for this type of situation the fact remains that SHE'S STILL A PHYSICIAN and she should have come out and examined him!!!! At the very least a cursory exam should have been performed which would have went a long way to ruling out crepitus or deformity of the cervical spine. The area should have been visualized and palpated and a neurologic exam performed. Was it? Nope.
As for the medics not providing full spinal immobilization, telling the father he could take the kid to the ER himself and then walking him to the ambulance when dad opted to have junior transported to the ER by the paramedics - they were right! THE KID FELL THE NIGHT BEFORE!!!!
At what point are they not supposed to throw a C-collar on a person if they complain of neck pain from an injury? 2 days? 3? a week? Medics don't immobilize people ad-infinitum after an accident. If the child had an unstable cervical spine fracture it is 99.9999% likely it would have manifested itslf long before dad brought him into your office. While it does sometimes happen that people will have a catestrophic injury to the spinal collum that they initially don't realize they have, and are subsequently walking around at the scene, it is rare, and in this particular case it would be nearly unheard of. Little kids, especially boys, are bundles of energy and motion and I highly doubt that he wouldn't have presented with some neurologic deficits or total paralysis hours earlier if that were case.
In short, I think you over reacted to the severity of the child's condition and your doctor both over and under reacted. The boy had a muscle strain to the neck. The injury was old, with the long time lapse being a pertinent negative to the point of excluding the debilitating c-spine injury that you were concerned with. So, when the medics showed up and found out the accident happened the night before they probably deduced the same thing. I'm sure that opinion was reinforced when they also found out that the doctor couldn't even be bothered to examine the kid. I probably would have rolled my eyes too! The doctor over reacted by going along with the worst case scenario of an unstable c-spine fracture she under reacted by not acting upon that very concern! And if the doctor wasn't treating the situation seriously why do you fault the medics for behaving the same way?
So, were the medics wrong? I really don't think so, but then I'm only going on what you described in your posting. But please keep this in mind. Paramedics are professionals just like nurses. An ancredited paramedic programs takes just about as long to complete as an associates in nursing does and involves a hell of a lot more than just some splinting and bandaging. Paramedics perform proceedures in the field that only doctors are allowed to perform in the hospital. So if you call 911 and you don't necessarily agree with what you see the paramedics do or not do, think it through before you are so quick to judge next time because chances are good that the medics actually know what they're doing.