In Michigan paramedics seem to have a very expansive scope of practice while working in the ER (at least in this one hospital system). They are able to push medications such as morphine, start critical drips such as cardizem, intubate patients, set up vents., do EKGS, administer breathing tx's, insert foleys, start IV's ect. It seems as if they are functioning more as a Nurse/RT then a medic. Granted they do these interventions in the field, but not usually in the ED. Do you think Is this because they are performing these duties via delegation from an RN or due to an expanded protocol basis from the Medical Director?
My main question however is relative to using paramedics outside of the ER realm and integrating them into the pt. care team on medical surgical units in the hospital in a supportive role to the RN team.
Meaning that they would function in essence similarly to a Nurse Tech with an expanded scope of practice allowing their skills to be used as a paramedic. Thus in turn allowing the RN work load to be lightened a bit, and letting the medic cover for Rx's, insulin, foley insertion, drsg. changes ect. Additionally they could prove to be a valuable asset on respiratory units with ventilator dependent patients - as medics are trained in vent initiation, use and maintenance as well as pt. trach care.
Another situation that seems to really stick out is when a pt. codes on a unit: staff on the unit becomes short because most are assisting in the code. However, a medic would be able to alleviate this by working on the floors code team (ACLS cert.) and provide intervention in which they are trained based upon Dr. orders. Additionally medics are trained in detailed EKG interpretation on the defib./mont.
What is your opinion on a hospital piloting the use of paramedics in this role in an acute care setting out of the traditional ER setting you find them in and on a med./surge. Unit? Of course they would not be there to step on anyones toes so to speak, but to help lighten the work load of the RN team.
