why do nurses hate medics?

[loboracer]

Not to offend anyone, but I have been in this game for over 12 yrs. I have worked with sone very good nurses but I have found that the majority of ER nurses are quite hateful to paramedics. It seems to be the younger nurses too. With the most current survey showing paramedics making an average of 14.xx per hr and nurses making 30.xx and hr... you would think it would be the medics with the problem. I am not talking about low educated medics either. In this area medics have ACLS, PALS, NALS, PHTLS, ABLS, proficient in 12 and 15 lead interpretation, etc.. We have medics that work in the ER not as techs but actually are assigned rooms as RNs. Can do everything as an RN except hang blood although you are trained in it. Medics have to choose the med they give in the field based on assessment not by dr. Order on the computer. Some opinions from nurses? I am not wanting a war here just enlightenment.

[PMFB-RN, RN]

I don't even know where to begin with the errors here. I think I'll just say this, Paramedics practice skills that are different because of their focus (prehospital). Can nurses do what paramedics do? Yes, can nurses do what doctors do? Yes, that doesn't mean they're trained to do it safely. If I'm sick and require long term care, I prefer a nurse, if I'm at the mall and go into cardiac arrest then give me a medic or EMT, keep the nurse away as chances are I'll end up brain dead in that setting

I would be very interested in any errors you can point out. I didn't find any.

I am interested to know why you think you would end up braid dead if a nurse shows up at your arrest? If you arrest in a mall around here the EMS crew that arrives is likely to be made up of an RN and a medic. I guess you better hope the RN is fatter so that the medic arrives first and you don't end up brain dead.

As a former medic, and a nurse who works closely with medics, I have tremendous respect for what they do and how well they do it. I don't see EMTs as being even close to medics. More like CNA compaired to RN. I will take a good ER, ICU, or step down RN over the EMT in that situation every time. In most hospitals critical care and ER nurses will take part in enough codes to run them in their sleep, and unlike the EMT, they can push drugs.

[liberated847]

I would be very interested in any errors you can point out. I didn't find any.

I am interested to know why you think you would end up braid dead if a nurse shows up at your arrest? If you arrest in a mall around here the EMS crew that arrives is likely to be made up of an RN and a medic. I guess you better hope the RN is fatter so that the medic arrives first and you don't end up brain dead.

As a former medic, and a nurse who works closely with medics, I have tremendous respect for what they do and how well they do it. I don't see EMTs as being even close to medics. More like CNA compaired to RN. I will take a good ER, ICU, or step down RN over the EMT in that situation every time. In most hospitals critical care and ER nurses will take part in enough codes to run them in their sleep, and unlike the EMT, they can push drugs.

Error/misleading comments:

1. PHRNs are not "just RNs", they are RNs with additional training on pre-hospital care, so your comparison to Paramedics for RNs is misleading.

2. "The Sad thing is that some do not have the opportunity to practice this skill [intubation]" - This is just plain wrong, Paramedics are required yearly competency reviews by their medical directors, even if they do not intubate in the field, they are required to perform the skill in the OR and / or mannequins.

As far as my "brain dead" comment, I much rather have an EMT/Paramedic run my code at the mall than a nurse which may not even be familiar with ACLS (potentially). I am not saying nurses are bad but I would not want to take my chances with an RN unfamiliar with how to run a code effectively. Let's face it, we all (Paramedic and RN) have our specialty areas and trust me, an RN just out of school will not and cannot run a code on their own.

[Esme12, ASN, BSN, RN]

It sounds like you are a flight nurse, or something similar... which is completely different than an ER nurse, which is what this discussion is regarding. I think it is pretty safe to say, and I am surprised if you don't already know this, that most nurses are not flight medics, and most nurses are not trained to intubate (any form). I understand that it is highly likely that there are ERs that train their nurses beyond what is typical, and I think that is great. However, I do not think it is the majority of nurses that are trained this way.

While most nurses in the ER are not flight trained. They do take ACLS, PALS, ENPC and TNCC. While they do not intubate they do know the skill. It is unnecessary for nurses to add intubation to the lists of responsibilities when there are equally quality personnel to perform this task...ie: respiratory therapy and the ED doc.

[NurseOnAMotorcycle, ASN, RN]

And I wouldn't want a dentist doing my lap chole. And I wouldn't want a cardiac nurse running the birth of my child. Etc, etc, etc.... These arguments are just another version of the usual specialties war.

[liberated847]

And I wouldn't want a dentist doing my lap chole. And I wouldn't want a cardiac nurse running the birth of my child. Etc, etc, etc.... These arguments are just another version of the usual specialties war.

Thanks for agreeing

[NurseOnAMotorcycle, ASN, RN]

I do intubate, I don't do field work.

Most of the RNs I work with are both paramedics and emergency RNs. They are different.

However, I also feel bad that you've so beautifully proven that while most EMTs are wonderful teammates, some EMTs are complete and utter buttholes.

Guess I'm the rude one. Again.

[liberated847]

I do intubate, I don't do field work.

Most of the RNs I work with are both paramedics and emergency RNs. They are different.

However, I also feel bad that you've so beautifully proven that while most EMTs are wonderful teammates, some EMTs are complete and utter buttholes.

Guess I'm the rude one. Again.

I agree 100% and would add that we all RN and EMT, etc. can sometimes be what you said. As far as being rude, I didn't think you were.

[GrannyRRT]

Error/misleading comments:

As far as my “brain dead” comment, I much rather have an EMT/Paramedic run my code at the mall than a nurse which may not even be familiar with ACLS (potentially). I am not saying nurses are bad but I would not want to take my chances with an RN unfamiliar with how to run a code effectively. Let’s face it, we all (Paramedic and RN) have our specialty areas and trust me, an RN just out of school will not and cannot run a code on their own.

I am getting a laugh out of your comparison to a new RN just out of school to a Paramedic. That is, in a way, insulting to the Paramedic. If the EMS agency is in any way respectable, they will have the new Paramedic with a preceptor for several months.

If an RN is responding to a code in the mall and has the same equipment and meds (or more) as the Paramedic, you can bet they also have the training. Off duty nurses don't run around with life support packs on them just waiting for a code to happen. If neither the Paramedic nor the RN has any equipment and are responding the same as any lay person witnessing a cardiac arrest, your survival will depend on their CPR skills and not their title.

1. PHRNs are not “just RNs”, they are RNs with additional training on pre-hospital care, so your comparison to Paramedics for RNs is misleading.

A Paramedic must also have additional training (hopefully) to do CCT or Flight. The PHRN is the way to go rather than the RN just getting a Paramedic certification. It expands their scope of practice into another area without any conflicts between boards. Just the Paramedic state scope of practice is too limiting for a nurse in the field. I will provide examples to back this up.

Pennsylvania PHRN:

PA Bulletin, Doc. No. 04-1372

A PHRN with medical command authorization may perform, in addition to those services within an EMT-paramedic's scope of practice, other services authorized by The Professional Nursing Law (63 P. S. 211--225.5), when authorized by a medical command physician through either on-line medical command or standing medical treatment protocols.

2. “The Sad thing is that some do not have the opportunity to practice this skill [intubation]” – This is just plain wrong, Paramedics are required yearly competency reviews by their medical directors, even if they do not intubate in the field, they are required to perform the skill in the OR and / or mannequins.

There may be some companies which do provide ETI competency but many don't. I know this after being approached by Paramedics for assistance in establishing more intubation training for them in our skills lab. Unfortunately, unless there is cooperation by their agency and their medical director, we can't do much for them. There has also been an issue with some Paramedic schools which have failed to provide the required proof of intubation education for us to allow their students to intubate in our hospital system. Apparently the state does not stress live intubations and will accept those done on manikins.

We have over 3000 active Paramedics in our city but we are not much different than other major cities. In very large departments it is very difficult for the Medical Directors to know everyone and some are mostly signatures on the protocols. Some Medical Directors are for the entire county. Some departments do have very involved Medical Directors but that is just not the case for every working Paramedic.

But, after talking to Paramedics and doing my own research on the topic as you should also, I see this is an issue in EMS and now understand why the King is being used more often in the field.

I will provide a few links for your reading which are EMS related and not authored by RNs or RTs. Be sure to follow the links listed as references for more information.

Why Paramedics are Going to Lose Intubation

Why Paramedics are Going to Lose Intubation - Medic Madness

Experts Debate Paramedic Intubation - Patient Care - @ JEMS.com

As for hours of training, even the new standards for EMS providers still fall short and any decent EMT or Paramedic will admit this.

Emergency Medical Technician-Paramedic - CAAHEP

EMT 110 hours of training

Advanced EMT 200-400 hours of training

Paramedic 1,000 or more hours of training

If the training course just does the minimum, the hours total are 1310 from EMT to Paramedic. That is less than just the clinical hours for some health care professions. There are some programs which exceed these hours. But, EMS is not regulated the same as other health care professions which leads fire departments and private ambulance companies the ability to do just the minimum for a cost factor or the ability to staff ambulances quickly with Paramedics.

This was not intended to be a ******* match but when you make strong statements which are more just your personal opinion and fail to provide any evidence that a nurse doing CPR or running a code is less effective, expect some comments which you might not like.

[liberated847]

I am getting a laugh out of your comparison to a new RN just out of school to a Paramedic. That is, in a way, insulting to the Paramedic. If the EMS agency is in any way respectable, they will have the new Paramedic with a preceptor for several months.

If an RN is responding to a code in the mall and has the same equipment and meds (or more) as the Paramedic, you can bet they also have the training. Off duty nurses don't run around with life support packs on them just waiting for a code to happen. If neither the Paramedic nor the RN has any equipment and are responding the same as any lay person witnessing a cardiac arrest, your survival will depend on their CPR skills and not their title.

A Paramedic must also have additional training (hopefully) to do CCT or Flight. The PHRN is the way to go rather than the RN just getting a Paramedic certification. It expands their scope of practice into another area without any conflicts between boards. Just the Paramedic state scope of practice is too limiting for a nurse in the field. I will provide examples to back this up.

Pennsylvania PHRN:

PA Bulletin, Doc. No. 04-1372

There may be some companies which do provide ETI competency but many don't. I know this after being approached by Paramedics for assistance in establishing more intubation training for them in our skills lab. Unfortunately, unless there is cooperation by their agency and their medical director, we can't do much for them. There has also been an issue with some Paramedic schools which have failed to provide the required proof of intubation education for us to allow their students to intubate in our hospital system. Apparently the state does not stress live intubations and will accept those done on manikins.

We have over 3000 active Paramedics in our city but we are not much different than other major cities. In very large departments it is very difficult for the Medical Directors to know everyone and some are mostly signatures on the protocols. Some Medical Directors are for the entire county. Some departments do have very involved Medical Directors but that is just not the case for every working Paramedic.

But, after talking to Paramedics and doing my own research on the topic as you should also, I see this is an issue in EMS and now understand why the King is being used more often in the field.

I will provide a few links for your reading which are EMS related and not authored by RNs or RTs. Be sure to follow the links listed as references for more information.

Why Paramedics are Going to Lose Intubation

Why Paramedics are Going to Lose Intubation - Medic Madness

Experts Debate Paramedic Intubation - Patient Care - @ JEMS.com

As for hours of training, even the new standards for EMS providers still fall short and any decent EMT or Paramedic will admit this.

Emergency Medical Technician-Paramedic - CAAHEP

If the training course just does the minimum, the hours total are 1310 from EMT to Paramedic. That is less than just the clinical hours for some health care professions. There are some programs which exceed these hours. But, EMS is not regulated the same as other health care professions which leads fire departments and private ambulance companies the ability to do just the minimum for a cost factor or the ability to staff ambulances quickly with Paramedics.

This was not intended to be a ******* match but when you make strong statements which are more just your personal opinion and fail to provide any evidence that a nurse doing CPR or running a code is less effective, expect some comments which you might not like.

So sad you spent all that time putting this post together and managed to miss the entire point. By wasting your time in pursue of irrelevant blabber. You missed the point you left me to die at the mall (sort of speak) because you did not get the simple fact that a new nurse is not as good as a new medic IN THAT SETTING. LMAO!!!!

[emtb2rn, BSN, RN, EMT-B]

Not for nothing but in the mall scenario being discussed the best actual treatment for the patient is quality cpr. Which is a basic skill that can be taught effectively in about 15 seconds on scene (been there, done that).

[GrannyRRT]

So sad you spent all that time putting this post together and managed to miss the entire point. By wasting your time in pursue of irrelevant blabber. You missed the point you left me to die at the mall (sort of speak) because you did not get the simple fact that a new nurse is not as good as a new medic IN THAT SETTING. LMAO!!!!

If an RN is responding to a code in the mall and has the same equipment and meds (or more) as the Paramedic, you can bet they also have the training. Off duty nurses don't run around with life support packs on them just waiting for a code to happen. If neither the Paramedic nor the RN has any equipment and are responding the same as any lay person witnessing a cardiac arrest, your survival will depend on their CPR skills and not their title.

If an EMS company places any value on human life or prefers to not just toss a new Paramedic onto the streets without any preceptor and additional training, then a disservice is done to all.

Other professions have seen the value of having training and education before taking on different responsibilities. This is something you don't seem to understand and want to get into a peeing match between professions. A new nurse would know enough to not put him or herself in the position of carrying medications to run a code in a mall. Part of being a professional is knowing what you are qualified to do and doing what you know you can do rather than being led by your ego. Regardless of the profession, one should never assume you are fully prepared right out of school. Even though I know my intubation training in school exceeded that of most Paramedic programs, I am not going to be so cocky to say I learned everything.

But, if I am having a medical crisis which isn't blatantly obvious, my money is on the nurse who had a broader understanding of many different medical situations rather than just focusing on a "code". They may recognize an emergency before it develops into a code before a Paramedic. This is why I support PHRN legislation to become a standard in the US.

[liberated847]

We agree on this:

"But, if I am having a medical crisis which isn't blatantly obvious, my money is on the nurse who had a broader understanding of many different medical situations rather than just focusing on a "code". They may recognize an emergency before it develops into a code before a Paramedic. This is why I support PHRN legislation to become a standard in the US."

Which is my point, we all have our strengths, so simple that I can't understand why you're so confused