Nurses vs. Paramedics

i will never understand this "beef"... we are all essentially working towards the same outcome--- help/treat the patient.

i think its great, for such a high level of care that paramedics have to give, you would think this would give them an opportunity to be the best they can be.

caliotter said it

We have become liscensed in Arkansas, but the hospitals in rural areas that are so short on staffing haven't come around to the idea of having us as more than PCTs yet. It would be great to have the option, but the nurses that are worried about losing a job to a paramedic have no need for concern.

i think its great, for such a high level of care that paramedics have to give, you would think this would give them an opportunity to be the best they can be.

Describe a higher level of care? Paramedics can barely hold their own on some ALS transfers without an RN being placed on the truck due to the limited scope of practice for meds and equipment. SCTs and Flight will also usually have an RN as a member of the team and many will have 2 RNs instead of a Paramedic.

People are going to oppose any action they deem as a threat to their own employability.

Valid point. If a tech (Paramedic) with no degree can easily do everything you can in the ED, they would probably be cheaper and schools can churn out as many as the hospital needs quickly just as they do every 6 - 8 months for the FDs and ambulance services.

LVNs were taken out of many EDs because they only had 1 year of technical training for their license. It is a slap in the face to these LVNs and anybody else who has at least one year of education to be replaced by someone who can get a cert and license in 3 - 6 months. Yes, there will be some who will argue their 1000 hours were stretched out to 2 years to accomondate their once a week schedule. A few Paramedics may even have a two year degree but that may be few and far inbetween. If they can now get a job to be "just like an RN" why would they even want to waste a whole two years in college when they could have a great job in 3 months.

Also, if Paramedics are allowed to be just like RNs there will never be an incentive for EMS and the ED jobs are not that plentiful for just a few lucky ones to benefit from the license of Paramedic. There also becomes an issue in the EDs where assignments have to be changed for patients requiring medications, drips, equipment and lines that a Paramedic is not trained or educated for.

The other issue is reimbursement since CMS barely recognizes anything a Paramedic does in the field so it would be difficult to do much more than a few general tech charges rather then professional.

Other professsions are trying to go forward and magnet hospitals want their RNs to have BSNs and all the other licensed professionals to have the highest possible degree available above and beyond the minimun. Now is not the time to go backwards.

EMS, not nursing, wrote their own statutes/regulations specifically to state prehospital and also made set boundaries to keep nursing from the prehospital field. This is why some RNs must have a dual license in some states to do flight or any prehospital work. However, there are now a few states have come up with their own nursing prehospital credential.

It is time EMS steps up to be its own profession by increasing its own standards and monitoring the quality instead of trying to be just like nurses.

Totally agree with caliotter3. As unfortunate as it is for the overall work environment, it is true!

I agree with caliotter.

Also, many places use paramedics in the ED already. But they work under the supervision of an RN, like a CNA would. Only difference is they often (depending on facility) can draw labs, start IVs, do sterile dressing changes less than 48 hrs old (which a CNA can't), and in some places the paramedics do the initial triage of patients coming in. There are a few other skills too. But my state's BON does allow it, they just have to have a CNA2 certification with their paramedic cert, and they have to work under the RN supervision.

It is listed on my BON website here http://www.ncbon.com/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=2046

I agree with caliotter.

But my state's BON does allow it, they just have to have a CNA2 certification with their paramedic cert, and they have to work under the RN supervision.

Interesting point about the CNA2 in your state is that the Paramedics attempted to challenge it and were denied because almost nothing in that certification is covered in a Paramedic program.

LVNs were taken out of many EDs because they only had 1 year of technical training for their license. It is a slap in the face to these LVNs and anybody else who has at least one year of education to be replaced by someone who can get a cert and license in 3 - 6 months. Yes, there will be some who will argue their 1000 hours were stretched out to 2 years to accomondate their once a week schedule. A few Paramedics may even have a two year degree but that may be few and far inbetween. If they can now get a job to be "just like an RN" why would they even want to waste a whole two years in college when they could have a great job in 3 months.

Also, if Paramedics are allowed to be just like RNs there will never be an incentive for EMS and the ED jobs are not that plentiful for just a few lucky ones to benefit from the license of Paramedic. There also becomes an issue in the EDs where assignments have to be changed for patients requiring medications, drips, equipment and lines that a Paramedic is not trained or educated for.

The other issue is reimbursement since CMS barely recognizes anything a Paramedic does in the field so it would be difficult to do much more than a few general tech charges rather then professional.

Other professsions are trying to go forward and magnet hospitals want their RNs to have BSNs and all the other licensed professionals to have the highest possible degree available above and beyond the minimun. Now is not the time to go backwards.

EMS, not nursing, wrote their own statutes/regulations specifically to state prehospital and also made set boundaries to keep nursing from the prehospital field. This is why some RNs must have a dual license in some states to do flight or any prehospital work. However, there are now a few states have come up with their own nursing prehospital credential.

It is time EMS steps up to be its own profession by increasing its own standards and monitoring the quality instead of trying to be just like nurses.

Its funny, much of your post sounds just like physician's forum where they are complaining about mid-levels and NPs trying to take over their "turf" or as they call it "mid-level creep."

I've yet to see paramedics or anything trying to get paramedics to be "just like RNs" I think you've read too far into the OP's post. Everything I've seen is allowing paramedics to do a few more advanced skills then NA2s, by allowing them to do blood draws, start IVs, give O2 and monitor a pulse ox. ALL of the same things they can already do in the field. Actually, it allows them to do only a FEW of the skills they can perform in the field, but not all. They are not replaceing RNs, they area only there as an additional tech in the ED to perform some routine skills. I'd think the ED RNs would like it, less routine skills for them to do, so they can focus on much more important things.

Also, i've yet to see any paramedic program completed in 3-6 months. Perhaps you've seen EMT classes, which must be completed before one can take a paramedic class. Please don't forget that very important pre-req. DOT curriculum for paramedics is for 1000-1200 hours of classroom instruction. Then there is usually around 150 hours of hospital clinical time, and about 250 hours of field clinical time. Just 1000 hours, doing five 8 hour days would take 25 weeks to complete, just over 6 months. 3 months for a paramedic class doing 1000 hours plus all the clinical time would be impossible. I do agree they don't go to school for as long as an RN does, but they come out with a wealth of knowledge, lets not discount that.

As with nursing education, there are various educational routes to becoming a paramedic. A major university in my region offers a 4-year bachelors degree in emergency medicine, something that might shock those of you who seem to have a vested interest in viewing paramedics as technicians with 3 months of training.

This is probably the most ill-informed post I have ever read regarding paramedics. Maybe the paramedics where you live are as unskilled as you describe (doubtful), but the ones where I live are outstanding. They have made the difference between life and death for many people, and they do their jobs under extreme circumstances.

Prove me wrong.

Here are the ALS protocols for your state. They are not much different than any other state for scope of practice. What do the Paramedics in your state do that others do not?

http://www.dsf.health.state.pa.us/health/lib/health/ems/als_protocols-effective_07-01-07.pdf

Paramedics in your state follow a very, very strict sedation intubation protocol. But, some PHRNs can do RSI.

You also need to get your head out of the clouds with the hero worship. Just like the ED, over 95% of the patients are not "life and death". And, most of the time all some provide is a really fast ambulance ride to the hospital. How many nurses also make some really good saves in the hospital? Do you say the same thing about them? What about the flight RNs? How about all the others who work outside? I bet you would walk right over the Electric lineman and never give him the time of day.

Do I think paramedics should take positions that could be filled by a nurse? No. But I can't tolerate seeing a profession that has done so much for so many being described in such a dismissive manner.

EMS has managed to dismiss their own profession for over 40 years and still can not figure out why they get very little recognition for what they do. It is time for no more shortcuts. If Paramedics want to be in a hospital, they should take the same education as the PCTs who training is directed at inhospital duties. Believe me a Paramedic would dismiss a nurse in a heartbeat in an ambulance except for ALS and CCT IFT.

I wish this wasn't so. I have advanced my own EMS education to a Bachelors level and beyond with another degree. What is frustrating is reading so many of these forums, just like on the EMS side, where some want something for nothing. Yes, my Bachelors degree does not get me any more status in the EMS world than the 3 month wonder. But EMS can not continue with the tech still few hundred hours is good enough status where you have to rely on the uniform and cool ambulance to get your respect rather than what you actually know and should be able to do.

Raise the bar for Paramedic education and then maybe we can talk about branching out into other fields.