paramedics in the ER

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Do any of you have paramedics in your ER? If so what do they do?

Specializes in ER, Outpatient PACU and School Nursing.

I'd rather have a medic any given day instead of a tech...

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:uhoh3: Interesting opinion

Medics are trained for and belong in the field, not in the ER other than as a tech under the nurses.
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Specializes in ER, Flight.
I'd rather have a medic any given day instead of a tech...

I agree completely :)

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We use EMT-B medics. Paramedics are used in other areas of the system for more of an augment for the nurses. Our EMT-B and EMT-P medics do no meds, no assessments, no triage, no IV infusions (only cath placement and phlebotomy) all per state law.

Umm...EMT-Bs are not medics...

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I think one of the biggest problems that results in this argument is the difference in pay.

While one may love being a paramedic, you just don't get paid enough to do it. Should the education be increased to raise pay? Maybe. But it is just hard to be a paramedic and live.

I know I am a 2nd year BSN student & going to medic school in the fall. I am an EMT-B now and I love it way more than just staying in the hospital.

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Specializes in Emergency/Critical Care Transport.

We had techs that were EMT-I's (Higher than an EMT-B but short of being a Paramedic) They were huge helps, did vitals, inserted IV's, NG tubes, foleys. Great bunch of guys and gals as well.

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Specializes in Trauma Administration/Level I Trauma.
I always get a kick out of this subject when it comes up……

Nurses = 2yr degree Medics = 2 yr degree

The ER that I work in has the same amount of Medics as nurses staffing it. We have the identical job description. The only except is that the Medics have extended roles as “Physician Extenders” under the MD License, along with having our own license. We take our own Pts, Triage, take written and verbal orders, admin drugs, call report and transport our Pts to the floor. We also do Emergency cut downs for airways, Chest tube insertion, Needle decompression, ETT, Central lines, and run all in-house codes, to name a few things that nurses can’t do. (These are the things that fall under the MD license).

I'm both a EMT-Paramedic and a Level I Trauma R.N....

While nursing school is often "2yrs" that doesn't include pre-rec's, so it's actually longer. FYI Paramedic school was only 1 year for me. Does your state issue you a license? I ask because all NREMT provides is a certification which is a BIG difference from a license.

My question is why are Medics running the codes in the E.R. and not the Physicians? ANY ACLS provider can run a code, but don't understand why a M.D. would be sitting at the desk while you (a medic) is running a code??

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I would like to respond to some of these. I recently went through my ACLS instructor renewal course. A nurse educator and I started a conversation about the changing roles in the ER. At one point this major hospital, the paramedics were doing IV's, 12 lead EKG, Foleys, Meds, Discharge instructions of simple cases (those without medications, fractures), triage, NG insertion, ongoing assessments, labs, suture removal. The medications were limited to what the local protocol stated which was about 35 drugs listed. She went to state that paramedics had no business giving meds, triaging, or discharging patients. So in response from the nurses union the hospital limited their use to no more than glorified techs. This has caused some stir in the EMS system with no nurses covering certain areas or having to have nurses come down from the floor when census is down. There has been longer wait times to give reports, proper transfer of patient care, and longer wait times to be seen by patients coming in on there own. But they have a critical transport ambulance that the critical care paramedics do all the above. In response to this I would like to see any comments about this. Now, I understand that giving meds maybe a legal issue or discharging patients. So please comment.

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Specializes in Emergency Department.

I agree that paramedics are trained for the "Out of hospital environment" or field work, and RNs are trained for the hospital environment. However, a RN is not necessarily better than a Paramedic and a Paramedic is not better than an RN.

I have two full time careers; one as a fire department firefighting Paramedic, and another as an Emergency Dept Registered Nurse. Therefore, I also get to perform and observe both areas of health care.

I would rather have a Paramedic provide care to me in the field, and I simultaneously would prefer the care of an RN in the hospital.

I have responded to many emergencies where a clueless RN was on scene freaking out, not knowing what to do. Most RNs do not experience emergency situations outside of the cushy hospital and therefore, they often are no better than an untrained bystander on scene.

On the RN side of the issue, I get to experience and do so much more in my ER than I ever do in the field and I am a much better paramedic because of my RN experience. I am also a better RN because of my Paramedic experience as well and will not spaz out the way a few other nurses do during a crisis.

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Specializes in Emergency Nursing..
Nothing I said was in the least bitter, if you took it that way that is all up to you. Statement of fact is all. PMs are trained for their work in the field. Their knowledge base is all geared to that. RNs are trained for what we do. And an ER RN is far superior to any PM in the ER. Thats our area.

This comes from a former Hospital Corpsman 1968 to 1972, Er tech, Emt, Pm, then an RN. Ive been there and done that.

And now personally I wouldnt want to be in any ER that had paramedics functioning over nurses. That is a simple truth.

I agree.. I have been a medic for 7 years and now an ER RN. there is a huge difference! never in a hospital based setting should an EMT-P outrank an RN, that is the simple truth. Look at flight programs, they are required to have an RN on board to give blood, titrate drips, do assessments. Having evaluated paramedic throughout the country, precepted for many programs, there is no scenario that a paramedic should be doing the things listed by others in thsi thread, for example, chest tube insertion, RX writing, patient assessment, treatment plans, that is ridiculous and a huge liability, and to be quite honest, I think it might be an little white lie. This is NOT part of any paramedic's education or scope of practice. Mid-level providers should be CRNP or PAC only. From a logical stand point both CRNP and PAC have a minimum of masters level education, compared to a paramedic certification or an associates degree in paramedicine. Which brings me to a final resting point, RNs have a license, paramedic's have a certification. According to the DEA you must possess a license to write perscriptions, therefore, I call ******** on the paramedic being a mid-level provider.

Here is the simple truth. Been a medic, Been a RN. There is a huge difference in teh amount of education and the scope of practice. I think both a medic and RN should be paid more; however, I think that the difference in pay is adequate. Though when I was a medic I didn't think so, but now being an RN, it is approriate.

Ok I'm done now :)

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Specializes in ICU, Trauma, CCT,Emergency, Flight, OR Nursing.

I believe that paramedics have a role to play, but not in a hospital position. If we as RN's keep allowing non-nursing personnel into what were traditionally Nursing positions, then in essence we are taking away jobs from RN's. There are many nurses, both new grads and also highly experienced RN's searching for jobs right now. I think it would be totally unacceptable that nurses jobs are being cut and that they are being replaced by Non-nursing personnel. I do not think that the ANA or the nursing trade unions will go along with this.One only needs to look at OR's to see how RN's have now been almost exlusively replaced by Surgical Techs who scrub for cases. Do the math and calculate how many nursing positions have been given away. Don't allow our profession to be diluted by non nursing personnel.

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While I enjoy working with Paramedics in the ER, and I've worked in several ERs that employ them, my only "beef" is that they get paid the same as the nurses and do far less work. In our system, they can't take pts, can't give meds, have no responsibility for patient care, no pt assignment, etc. They're just regular ER techs who can start IVs, and if they work in a PRN status, they get paid the same as an RN. How is that fair? I have to run the pt assignment, give all the meds, but more importantly the responsibility of the pt care falls on me, and I make the same as the tech??

If our system utilized them effectively, and gave them the same amount of work and responsibility then I wouldn't mind them getting paid, rightly so, for the work they do. But I'm sorry, I don't see how just being able to start IVs gets you $10 more than the other ER techs.

Now, hopefully this is just our system, and the rest of your hospitals are better about distributing pay and work!

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