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

I just wanted to add here that some of the dogma touted by TraumaSurfer is found not only in the "medic mill" he often complains about in Texas but also here in Arkansas where nurses do not have anything to do with the training and regulation of EMS. However, when I was in paramedic school, even with what I'd say was an excellent instructional team, I can recall asking some questions and being given the "nurses are better trained in that so ask them in clinicals" answer.

One of the reasons I chose to go to nursing school was to learn more. I was no longer content with what I'd learned in paramedic school and what I was picking up on my own from books. I wanted more exposure. Let it be known that I haven't worked as a paramedic in a few years now and frequent readers of my posts are probably aware that I've dedicated my work life to law enforcement - something I want to continue to some degree even after nursing school.

Unfortunately, I've learned that nursing isn't the end all be all that our friend, TS, believes it is. I was in his shoes though thinking that because RNs required certain prereqs (all of which I took with my first B.S. degree sans nutrition) and tests that they may be held to a higher standard. I find that's not the case - at least not here. Not to step on any toes, but I find nursing school to be a lot like my old 10th grade world history class: it covers a lot but nothing in depth. The frustrating thing about it (and I'm not bashing it) is that, at times, faculty and other students think we're covering something in great depth when the topic takes a page in a book. Sadly, you could read volumes of books dedicated only to the topic listed on our little page, yet we can walk out of class and hear a student complain, "Why are we learning all this? We're not doctors." (insert eye roll here)

This is why I'm continuously frustrated with the bashing of paramedic education and praise of nursing education. RN training is not the end all be all of patient care. Until you've done both or at least have gotten involved with both - you can't speak for both....so stop. They are not the same fields. The two fields were never designed to serve the role of the other.

Why don't we start harping that LPNs should take all the RN prereqs first in order to get an associate's degree and heck make EMT a required class for RNs and while we're at it throw in some basic radiographic, dental hygiene, and vet tech classes...

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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?

How many Paramedics have you met? Do you think all the FDS that requires ALL of their FFs have time to put ALL of their FFs through a 2 year degree to be a Paramedic? Only two states want a two year degree to get a cert as a Paramedic and Oregon has exceptions to that requirement.

You may think you have done very well without advancing to a BSN but then you might not have anything to compare it with just like "all" the Paramedics you have met with degrees.

I do know RNs who are educated and work in critical care, flight and CCT which is why I would like to see the bar raised for Paramedics. The majority of the nurses I know who work in these areas are well educated with at least a BSN Having a BSN does NOT make a nurse stupid nor does having a Paramedic who has at least an Associates degree. One shouldn't just rely on "street medicine" for everything and if you want to advance your knowledge, education is NOT a bad thing nor should anyone apologize for having an education. It is usually the ones who only meet the minimal requirements for education that present such ridiculous arguments about "All" the Paramedics I know rely only on experience (and luck) or "ALL" the good RNs only have an ADN.

The other argument that education is only for management is absolutely silly. Ever look at college courses and see all the science, pharmacology and additional medical specialization courses? Not all are "intro to being a manager".

Actually you might say I've had bad experience with Paramedics who do only the minimum. They are the ones that recipes must be written for. Their medical director will not trust them to deviate from a very limited scope and for good reasons.

If you don't want to do anything beyond your "minimum" just to get a license, whatever. Just don't expect everyone else to share you lack of interest in the profession or medicine.

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Okay, what about medics in the ER? All this degree and critical care erotica is great, but going back to the original question...

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I just wanted to add here that some of the dogma touted by TraumaSurfer is found not only in the "medic mill" he often complains about in Texas but also here in Arkansas where nurses do not have anything to do with the training and regulation of EMS. However, when I was in paramedic school, even with what I'd say was an excellent instructional team, I can recall asking some questions and being given the "nurses are better trained in that so ask them in clinicals" answer.

Obviously you have not looked at your AR state EMS agency to see who is on the councils and committees.

From the AR EMS site, these are the requirements to be a Paramedic. Yes they are 2x are more than TX but still 1200 hours is not much.

Program Hours

1. Didactic and laboratory, 600

2. Clinical, 300

3. Field Internship, 300

One of the reasons I chose to go to nursing school was to learn more. I was no longer content with what I'd learned in paramedic school and what I was picking up on my own from books. I wanted more exposure. Let it be known that I haven't worked as a paramedic in a few years now and frequent readers of my posts are probably aware that I've dedicated my work life to law enforcement - something I want to continue to some degree even after nursing school.

You haven't worked as a Paramedic in years but still you claim to be the leading authority on EMS. You are not even in the profession and have no vested interest in it. Why do you continue to argue that EMS is great just as it is? Don't you think that those who do make EMS a career deserve to see their profession advance just as all the other professions have including nursing?

Unfortunately, I've learned that nursing isn't the end all be all that our friend, TS, believes it is. I was in his shoes though thinking that because RNs required certain prereqs (all of which I took with my first B.S. degree sans nutrition) and tests that they may be held to a higher standard. I find that's not the case - at least not here. Not to step on any toes, but I find nursing school to be a lot like my old 10th grade world history class: it covers a lot but nothing in depth. The frustrating thing about it (and I'm not bashing it) is that, at times, faculty and other students think we're covering something in great depth when the topic takes a page in a book. Sadly, you could read volumes of books dedicated only to the topic listed on our little page, yet we can walk out of class and hear a student complain, "Why are we learning all this? We're not doctors." (insert eye roll here)

Never said it was the end all to everything. Actually I have stated it is just the beginning with a great foundation to build from. Do you honestly think everything about medicine can be covered in just 2 years or even 4? You seriously have a lot to learn. Medicine is a vast topic and Nursing is also very large and one would have a very difficult time covering every possible specialty nursing offers opportunities in. All those classes you took that you thought were BS did serve a purpose even if it was just reading comprehension or writing. Many people who enter college don't know what they want to do and have 4 years to get pointed in a direction that interests them. How many times have you changed careers? 3? 4? You still don't seem to know what you want to do.

This is why I'm continuously frustrated with the bashing of paramedic education and praise of nursing education. RN training is not the end all be all of patient care. Until you've done both or at least have gotten involved with both - you can't speak for both....so stop. They are not the same fields. The two fields were never designed to serve the role of the other.

Again, you are not in the profession so why do you want to keep EMS from advancing? The minimun standards in EMS are no longer good enough. Do you realize other countries require degrees for their Paramedics?

Do you know that RNs were on ambulances before Paramedics in the U.S.? Do you realize other countries have nurse based EMS systems? Do you realize that the U.S. Paramedic is a very limited tech cert? Do you realize RNs can get specialty certs in just about anything including Emergency or Paramedicine?

Why don't we start harping that LPNs should take all the RN prereqs first in order to get an associate's degree and heck make EMT a required class for RNs and while we're at it throw in some basic radiographic, dental hygiene, and vet tech classes...

You really haven't been around nursing for very long. At one time RNs did all of the "skills" that have now evolved into specialty fields with their own professional licenses. RNs ran the labs, did radiology, respiratory therapy, ambulance transport and a variety of different "skills". RNs can now specialize in a variety of "skills" and areas of medicine. An RN can probably use the sciences from nursing to transfer to a vet program also.

As far as the LVN or LPN, many of us have seen where they have been displaced from the acute hospital setting and have become practically non existent in some areas. I believe the LVN/LPN in Canada is now an Associates degree.

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Okay, what about medics in the ER? All this degree and critical care erotica is great, but going back to the original question...

Without the appropriate education and recognition as a profession for the insurances, what do you suggest? Maybe we can give Paramedics another cool title to make up for what their curriculum doesn't cover.

As an RN you may find this to be "erotica" just for amusement but those of us in EMS are striving to become a profession but at some time we must face sobering facts about the limitations. If we don't, we continue to stagnate. I would rather advance the education in the profession rather than handing out more titles such as ER Paramedic or Paramedic Practitioner.

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Trauma, I can be a little dense; however, when admin suggests going back on topic it's a hint...

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Trauma, I can be a little dense; however, when admin suggests going back on topic it's a hint...

Did you not read my last post?

The Paramedic is trained for emergent situations and not for the 90% of the patients that are seen in the ED. The opportunities should come with education and not just for a couple of skills. However, they can be techs but would have to adjust to doing just that as part of a team.

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Specializes in NICU, Infection Control.

HI. Moderator here. I'm closing the thread for a cooling off period. Don't hurt me! Might be re-opened in the am.

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

Nope, we're leaving it closed. Have a lovely day.

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