Paramedics in the ER

Specialties Emergency

Published

Hi,

Does anyone allow paramedics to work in their ER? If so, do you have a job description you would be willing to share?

Thanks!

Yes, there are some nurses that think they could be an ER doc too...

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I have to agree that paramedics are essential in the ED, however, I do not think that paramedics should "see" their own patients EVER. Never in my time has any medic, emt, rn, lpn, or cna had the duty to "diagnose" a patient in the hospital or out in the field. You can honestly tell which posts belong to which occupation. And as far as the previous comment about medics spending more time in clinic settings then nurses, this is depends on your learning facility.

Jaded/lazy experienced nurses??? YOU CAN SAY THAT AGAIN. These are the type that say " I love working with medics" because they pass the **** work off on them. "You put the patient on the bed-pan, I have a med to push and orders to sign".

I just want to know why some paramedics get the idea that they know just as much or more than a nurse? You may have similar hands on abilities, but can you back up your actions with sound rationale? Because you can do similar things doesn't mean you know what you are doing or exactly why you're doing it, what it may cause how to treat that, how that reaction was caused. Like ALS protocol, any hobo can pick what they are going to have off the McDonalds menu. You match n/v with zofran, YAY!! isn't that a form of the memory game designed for childlren 3 and up? That's covered under protocol so you did nothing wrong.

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Specializes in ER,ICU,L+D,OR.

I have seen some very good paramedics. I liked one ER where they had zones and you had RN and Paramedic teams. Worked out excellently for all. As long as I got a cute young guy to work with.

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What a shame to waste such valuable resources. I am glad the state I work in values their medics to allow them to function with more autonomy in the ED setting. Here, medics are licensed and work off of protocols or doctor's orders. What state do you work in that has such disregard for their medical professionals?

Again you would be wrong and would have lost your life savings. ABG's were taught in my medic program along with anatomy and physiology and disease processes. We also spent many clinical hours in the resp dept.

Again I say you are dreaming.

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Again I say you are dreaming.

Really? Well I have gone to paramedic school and speak from experience. When and where did you go to medic school?

how does zofran work in the body, are there any food/ med contraindicaions, what should you tell the patient about this med, what are potential adverse reactions? Through experience, a medic may know this, but this is not a general standard that an EMT-P would be held to.

I totally disagree. This may have been true 12-15 years ago, but not now. Each week in paramedic school we were given 10 drugs. We had to hand write drug cards for each drug listing type, indications, contraindications, cautious uses, dosages, routes etc. These were not limited to code drugs but included various types of medications even herbs and supplements. My class was 18 months long so you can imagine at 10 drugs a week how many drugs we learned about.

Never in my time has any medic, emt, rn, lpn, or cna had the duty to "diagnose" a patient in the hospital or out in the field.

Medics do it all the time. For instance a medic has to know how to diagnose an MI based on clinical presentation and a 12 lead. What would happen if a medic just blindly hung a nitro drip because a pt had CP without first doing a 12 lead? What if it was an infarct on the right ventricle? The pt would most likely die. Medics diagnose every day. Nurses do it as well, but generally on a smaller scale.

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Really? Well I have gone to paramedic school and speak from experience. When and where did you go to medic school?

I totally disagree. This may have been true 12-15 years ago, but not now. Each week in paramedic school we were given 10 drugs. We had to hand write drug cards for each drug listing type, indications, contraindications, cautious uses, dosages, routes etc. These were not limited to code drugs but included various types of medications even herbs and supplements. My class was 18 months long so you can imagine at 10 drugs a week how many drugs we learned about.

Medics do it all the time. For instance a medic has to know how to diagnose an MI based on clinical presentation and a 12 lead. What would happen if a medic just blindly hung a nitro drip because a pt had CP without first doing a 12 lead? What if it was an infarct on the right ventricle? The pt would most likely die. Medics diagnose every day. Nurses do it as well, but generally on a smaller scale.

Sorry brother, you can make a field diagnosis, working diagnosis, or provisional diagnosis; however, the final verdict is up to somebody else.

It is still true today. We have 6 month shake and bake medic schools and EMT-I's with a couple hundred hours of training taking on paramedic like roles. There are well educated and highly competent medics out in the streets; however, until EMS can get some of this craziness under control, I will continue to disagree.

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Really? Well I have gone to paramedic school and speak from experience. When and where did you go to medic school?

I totally disagree. This may have been true 12-15 years ago, but not now. Each week in paramedic school we were given 10 drugs. We had to hand write drug cards for each drug listing type, indications, contraindications, cautious uses, dosages, routes etc. These were not limited to code drugs but included various types of medications even herbs and supplements. My class was 18 months long so you can imagine at 10 drugs a week how many drugs we learned about.

Medics do it all the time. For instance a medic has to know how to diagnose an MI based on clinical presentation and a 12 lead. What would happen if a medic just blindly hung a nitro drip because a pt had CP without first doing a 12 lead? What if it was an infarct on the right ventricle? The pt would most likely die. Medics diagnose every day. Nurses do it as well, but generally on a smaller scale.

First of all you are multi qouting from different posters. Secondly in my state medics to not hang nitro nor do they diagnose. 10 drugs a week is nothing, try that daily as in nursing school. You really have a pumped up idea of your role.

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It has been already said but I feel a need to restate it. RNs and medics are both necessary and dignified PROFESSIONS. They are vastly different and are trained to excel in their chosen field. Being great at one does not mean a person will be great at the other.

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Specializes in CCU/CVU/ICU.
As long as I got a cute young guy to work with.

Oh yeah! Again, the REAL reason why most female ER nurses (vast majority) think EMTs are "good help in ER...we should embrace them" (no pun intended!)

Awesome!

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It has been already said but I feel a need to restate it. RNs and medics are both necessary and dignified PROFESSIONS. They are vastly different and are trained to excel in their chosen field. Being great at one does not mean a person will be great at the other.

I agree 100% with that but also feel that with the appropriate orientation and additional training that paramedics could be utilized in an er functioning in a role very similar to a RN.

Secondly in my state medics to not hang nitro nor do they diagnose.

Then remind me to never have an MI in your state!

10 drugs a week is nothing, try that daily as in nursing school.

Wow! An ADN program is typically 2 years of school. That's 730 days x 10 drugs a day. That comes out to 7300 drugs you memorized. I am completing nursing school myself and have not memorized 7300 drugs. My nursing drug book only has about 2000 pages in it. Could you please tell us what program you attended that has such high standards?

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Specializes in Emergency/Trauma.
Then we have a fundamental disagreement. It has been my observation that traditional adn programs in my area put their students through a couple of shifts in an ed. They basically just observe and might attempt an iv start or pass some po meds.

The math is not difficult. It comes down to what is more, both time wise and experience wise... Two shifts of observation time only or 200 hours of practicing assessments, pushing meds, starting iv's, intubating, doing pt education, etc. To me the answer is clear. Paramedic school provides more clinical experience that is more relevant to working in an ED than nursing school does.

This is why many hospitals won't even let new grads work in their ED. They want them to get "work experience" on the floor first. Those hospitals that are willing to hire a new grad do extensive orientation programs for a year or so before they turn the nurse loose.

I have to agree with you. I went through a two year program for an ADN and I spent a total of 18 hours in the ED. We spent way more than that on the medical floor. I started in the ED fresh out of school, I was very lucky, and its a small ED. When I watched the EMS and paramedics go to action in our ED I felt very inept. They were much better at starting IVs, drawing blood, putting in caths and the like. We have plenty of EMS students who are here everyday following us and assessing pt on their own and doing procedures, under supervision of course. I have to back 15251 on this.

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I agree 100% with that but also feel that with the appropriate orientation and additional training that paramedics could be utilized in an er functioning in a role very similar to a RN.

Then remind me to never have an MI in your state!

Wow! An ADN program is typically 2 years of school. That's 730 days x 10 drugs a day. That comes out to 7300 drugs you memorized. I am completing nursing school myself and have not memorized 7300 drugs. My nursing drug book only has about 2000 pages in it. Could you please tell us what program you attended that has such high standards?

Our medics do not diagnose, nor hang nitro, enroute they give SL nitro, start the Ivs prior if they can, if no IV access..... even sl nitro is not given and they do prehospital care....Never do they hang nitro drip or titrate....in my almost 30 years have I've NEVER seen EMS hang nitro drip and titrate ever, and knowing their protocols and work closely with the State EMS coordinator are they allowed (it's beyond their scope of practice). And yes 7300 drugs is a bit, and I thinking about it now realize a bit of fluff...but we did them say half that amount. Now that you too........ have figured out that there is MORE SCHOOLING REQUIRED TO BE AN RN,(as you are required additional education to become an RN and are in a program) YOU'LL SOME DAY REALIZE.....IT'S A TOTALLY DIFFERENT FIELD WITH TOTALLY DIFFERENT KNOWLEDGE BASE.....you get your ADN.....

and the program I attended was a private university, 100% pass rate, thankyou....Good school, highly accredited......and back then paid $390 a credit hour as well....hate to see what it is now. Obviously, you are getting your RN because your state does not allow you to practice above your scope of knowledge/practice. I commend you for going on to school....goodluck....

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