Paramedics in the ER

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Do any of you use paramedics in your emergency departments? if so, are they allowed to triage, assess, discharge? Does the RN have to sign their charts?:nurse::redbeathe

Actually, the term "technician" has been officially removed from the paramedic title IAW the national SOP model.

Not all states have adopted that terminology nor do all states use the NREMT. Regardless of the title, the minimal education requirements have not changed. The new standards have not changed much of anything for education for the Paramedic. There are also states that have used the term "Paramedic" for many years, probably since the start of that state's certification, but at less than 1000 hours of training total and not even an Associates degree required it is difficult to view the Paramedic as anything but a technician. The LVN requires almost 2x more training in some states than the Paramedic and they were booted from the EDs in many places. They do have the education and skills, such as colostomies, to take care of the 90% of patients who are not emergencies. So why bring in someone who has half the education and is very specialized for a few specific emergenecies to replace those with a broader knowledge?

You can read more about the description of each level for EMS at this website.

http://www.nhtsa.gov/people/injury/ems/EMSScope.pdf

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Interesting. Around my neck of the woods it's paramedics teaching ACLS to nurses and doctors. Oh well. Regional.

How difficult is it to get an ACLS instructor cert? Not very. Even the ACLS cert is not what it used to be.

Many new Paramedics who have never worked a code on a real patient are teaching ACLS while trying to find a job in EMS. The pay for teaching is not much so you probably will not find many RNs teaching ACLS outside of the hospital. I am one who also prefers to take PALS and NRP at a hospital where it is taught by RNs who work in these specialty units as opposed to someone who just memorized the material from a book. It is also refreshing to take an ACLS class taught by CCU RNs who not only know the code stuff but know many of the mechanisms leading up to it and the extensive stabilization part. Dumbing the course down to just memorizing an algorithm gets a little boring.

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I dont know anything about colostomies either.

As an RN (FF-PHRN) did you not get any training on colostomies? What nursing program did you go through?

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How difficult is it to get an ACLS instructor cert? Not very. Even the ACLS cert is not what it used to be.

It's not difficult. I personally think it's boring. I only pointed that out because you implied (I've forgotten the context) that nurses were teaching paramedics because they knew more, lol. I only stated this, albeit it truthful, to get at your craw a little.

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Specializes in ER, Prehospital, Flight.

Not alot of professional love for the paramedics here...it is a nursing forum I guess.

yes, I learned about colostomies. That was sarcasm.

I appreciate and respect the medics I work with.( that went to 2yr programs with 700hrs of clinical alone in the 2nd year;) They aren't simple uneducated techs.

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How difficult is it to get an ACLS instructor cert? Not very. Even the ACLS cert is not what it used to be.

Many new Paramedics who have never worked a code on a real patient are teaching ACLS while trying to find a job in EMS. The pay for teaching is not much so you probably will not find many RNs teaching ACLS outside of the hospital. I am one who also prefers to take PALS and NRP at a hospital where it is taught by RNs who work in these specialty units as opposed to someone who just memorized the material from a book. It is also refreshing to take an ACLS class taught by CCU RNs who not only know the code stuff but know many of the mechanisms leading up to it and the extensive stabilization part. Dumbing the course down to just memorizing an algorithm gets a little boring.

Why don't you just go to nursing school since you like kissing their *** so much?

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It's not difficult. I personally think it's boring. I only pointed that out because you implied (I've forgotten the context) that nurses were teaching paramedics because they knew more, lol. I only stated this, albeit it truthful, to get at your craw a little.

You also seem to be forgetting RNs taught and still teach Paramedics in some programs. Some Paramedic programs and state EMS boards also have RNs in their upper ranks.

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Not alot of professional love for the paramedics here...it is a nursing forum I guess.

yes, I learned about colostomies. That was sarcasm.

I appreciate and respect the medics I work with.( that went to 2yr programs with 700hrs of clinical alone in the 2nd year;) They aren't simple uneducated techs.

There are also many RNs who have BSNs and MSNs. In some places their education is recognized and respected and in some places they are still held to those with the minimum required just to get a license.

The majority of Paramedics in the U.S. do not have a degree of any type. Those that do may have it in some other field like nursing. Those that do obtain higher education may no stay in EMS unless it is for a FD promotion. They usually get bored and frustrated from working with those who keep the minimum low and measure themselves with one or two heroic skills. If they try to point out there is much more to medicine that accompanies the skill, they will get an argument.

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Why don't you just go to nursing school since you like kissing their *** so much?

I guess you would like that. As long as Paramedics who have an education and want to raise the standards are still in EMS there is a danger that someday somebody might realize the minimum as it is now is no longer good enough.

You have to have respect for other health care professions. EMS has a lot to learn about being part of a team which is also one of the reasons they have a difficult time in the ED. There is a lot to learn from a profession as large as nursing that is constantly striving for professionalism.

You can learn alot if you just stop bashing nurses and see how their profession can help EMS. Other professions have allied with nursing to gain their status since they found making enemies with a group as large as nursing would not get them anywhere.

It's not difficult. I personally think it's boring. I only pointed that out because you implied (I've forgotten the context) that nurses were teaching paramedics because they knew more, lol.

Many Paramedics do not have a quality A&P or Pharmacology class on their transcript. I would also like to see the typical Paramedic attempt to match the knowledge of an ICU RN who responds to codes and Rapid Response calls or just works in a decent ICU. Not only will they know many things about different disease processes leading up to the need for ACLS, they may also know the follow through with a long stabilization process, recovery and rehab.

If anything, I would like to see just 25% of the Paramedics in the U.S. strive for the same minimun time for education as the RN and the same knowledge as a decent Critical Care RN. Right now that is only a dream.

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Specializes in ER, Prehospital, Flight.

So.. thats a broad brush you are painting with for nursing and paramedics. It is also not at all accurate. I have met plenty of paramedics with degrees. I don't know the name of it other than its some kind of associates( along with other various degrees)

What is your point? Is this some kind of jab at my ADN also? My little associates degree has taken me far in nursing even though its the "minimum required to get a license". The minimums are just that. Sooo....Not everyone want to get into management. I don't. Experience and work ethic have more to do with my succes in nursing than if I would have an RN or a BSN behind my name. The majority of the flight nurses I work with are ADNs that have very impressive resumes and my medic today has an EMS related associates degree. My experience has been alot of mutual respect between paramedics and nurses. Not the ******* match you describe.

Have you had much experience with paramedics other than taking over the pt care? Had some bad experience or dealt with some bad ones or what? Have you done any ride days like with ECRN or TNS?

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

Before we veer too far off topic ... let's get back on track, please. Thanks.

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What was the topic?

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