Paramedics saying they are nurses---is this legal?

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Hello my fellow nurses,

I am not trying to knock the paramedic profession, however, I work in a small, inner city hospital that employs medics and RNs. I get so frustrated when medics introduce themselves as RNs, sign as RNs, do RN assessments, triages, discharges and then do not give our profession any respect. I am not saying ALL medics do this, however, I wonder the liability they have when working in an RN role. In my state of Missouri, I do not how the Board of Nursing allowed RNs to be "replaced' so easily. Is this legal?

And what about Medicare/Medicaid? The hospitals (in general) charge them for IV pushs, procedures performed by RNs- is the reimbursement the same if a medic gives it?? Would that be considered fraud??

I honestly respect the pre-hospital profession, however, I do not feel they have a place in an ER. For example, are they taught wound care, non-ACLS pharmacology, basic nurse skills such as NG, trachs, foleys?? Are they taught that antibiotics need to be taken all the way through when discharging a patient with a UTI?? I have watched many medics do foley caths and the sterile technique is less than desirable.

Has anybody researched what they 'legally' can do based on their training?? I am going to research this and ask my board of nursing to try to find answers. I worked so hard to obtain my nursing license and get so frustrated when people who have not suffered through all white uniforms, care plans, critical thinking scenerios, and of course the dreadful NCLEX can call themselves nurses.

Thanks for listening....:bugeyes:

Specializes in EMS, ER, GI, PCU/Telemetry.
How do you know this? Where is this all documented at? I have looked at the board of Nursing, Missouri Hospital Association webpage and EMT sites, I cannot find this anywhere.

I started this post to find out where the rules were documented and could be found, not to debate RN vs Medic.

If it is legal for them to "play nurse" that is fine, if they want to do to my work with less pay, that is FINE WITH ME! I just sit back and watch them "play nurse" at $17/hr while I AM a nurse at $32/hr!!

I do not think it is legal and just want to know where to find the information at.

you need to check your hospital's policy and procedure and ask your medical director in regards to this question. every hospital has different stipulations for placing paramedics in a hospital setting. like many posters here have already said, some hospitals will allow us to work to full scope, some will place their own limits, some will let us work as PCT's. it is completely up to the hospital that hired them as to what their job duties are in your facility.

it sounds like you have alot of hostility towards paramedics. why not try to work together instead?

How do you know this?

First hand experience. I have worked in house as a paramedic in MO and as an RN have worked along side PM's in the ER.

Where is this all documented at? I have looked at the board of Nursing, Missouri Hospital Association webpage and EMT sites, I cannot find this anywhere.

http://www.dhss.mo.gov/EMS/

This is who regulates ems in MO.

I started this post to find out where the rules were documented and could be found, not to debate RN vs Medic.

The state board of nursing has nothing to do with regulating pm's. PM's operate under their own license. In MO they are licensed by the department of health and senior services. As someone else mentioned, a paramedic can generally do whatever their medical director and facility will allow.

If it is legal for them to "play nurse" that is fine, if they want to do to my work with less pay, that is FINE WITH ME! I just sit back and watch them "play nurse" at $17/hr while I AM a nurse at $32/hr!!

They are not playing nurse. They are hired to work as a paramedic. This can be very similar to a role of an RN in the ER in MO depending on what the medical director allows them to do. You do bring up a wonderful point though on how paramedics are underpaid. Perhaps the next time you are working with one you can appreciate what they are doing for half of what you are paid.

Specializes in ED, Flight.

I don't have the regs handy, but (by way of example) the state EMS Act here in NM was amended so that paramedics could explicitly work outside their normal scope of practice if they were working in a facility whose medical director had signed off on this.

Now, paramedics normally push IV drugs. So, to do so in-house wouldn't be a big deal. The difference would be that, here in NM, there is a specified formulary. So, for instance, a paramedic would be allowed in normal scope of practice to transport a patient already on IV Abx, but not allowed to initiate the infusion. When I worked as a paramedic in a facility, the doc signed off on us initiating Abx therapy (with orders) after training and verification.

Theoretically, then, if a facility wanted to train a paramedic to do all those extra duties in-house, and if the state EMS Act allows for it (as stated, the BON has nothing to do with it), then it can be done. The medic would be allowed to work according to this expanded scope in the facility that took responsibilty for that. Outside, the scope of practice would remain the same.

Specializes in Emergency.
I don't have the regs handy, but (by way of example) the state EMS Act here in NM was amended so that paramedics could explicitly work outside their normal scope of practice if they were working in a facility whose medical director had signed off on this.

Now, paramedics normally push IV drugs. So, to do so in-house wouldn't be a big deal. The difference would be that, here in NM, there is a specified formulary. So, for instance, a paramedic would be allowed in normal scope of practice to transport a patient already on IV Abx, but not allowed to initiate the infusion. When I worked as a paramedic in a facility, the doc signed off on us initiating Abx therapy (with orders) after training and verification.

Theoretically, then, if a facility wanted to train a paramedic to do all those extra duties in-house, and if the state EMS Act allows for it (as stated, the BON has nothing to do with it), then it can be done. The medic would be allowed to work according to this expanded scope in the facility that took responsibilty for that. Outside, the scope of practice would remain the same.

You bring up another thought though that comes from my flight nurse experience. A lot of states EMS rules and statues that regulate these programs require everyone one to have an EMS certification. So even the flight nurse on the helo has to have at least a basic EMT certification. A lot of them I know just challenged the exams without much difficulty when allowed. Though again some states dont allow that either.

Specializes in ED/trauma.

Love paramedics and EMTs (especially, the young buff ones) that I work with. Don't wanna get into this, but also think this post is kind of confusing. We don't employ medics in our hospital, not for er or flight, but our flight nurses must have RN+BSN+paramedic-B and several years of experience before the can get on the birdie. I think it would help my job to have medics working with us especially (see first sentence), but I would be upset to find out that they were using the title "nurse" since they are not credentialed that way-not better just different. It would be like an RRT, PT, PCT, ect using the RN after their name, and that would be illegal. But if they are using their correct credentials, even if the line says, "RN signature" then you just need new forms-simple as that.

Specializes in Family Practice, Mental Health.

some folks here are comparing tasks.

the thread is about comparing the situation of who can call who by what title, not who can do what task.

there are some darn smart lvn's and lpn's out there who could run circles around some rn's and paramedics out there, because they are able to "do tasks", with full understanding of the theory behind them - but they will never be able to call themselves an rn or a paramedic until they acquire the license to do so.

i say, do whatever it is that you do that is covered by whatever hospital that you are affiliated with, but do not call yourself something when you have no license to show for it.

it just causes a whole lot of aminosity between folks who probably otherwise all get along.

:trc:

i don't have the regs handy, but (by way of example) the state ems act here in nm was amended so that paramedics could explicitly work outside their normal scope of practice if they were working in a facility whose medical director had signed off on this.

now, paramedics normally push iv drugs. so, to do so in-house wouldn't be a big deal. the difference would be that, here in nm, there is a specified formulary. so, for instance, a paramedic would be allowed in normal scope of practice to transport a patient already on iv abx, but not allowed to initiate the infusion. when i worked as a paramedic in a facility, the doc signed off on us initiating abx therapy (with orders) after training and verification.

theoretically, then, if a facility wanted to train a paramedic to do all those extra duties in-house, and if the state ems act allows for it (as stated, the bon has nothing to do with it), then it can be done. the medic would be allowed to work according to this expanded scope in the facility that took responsibilty for that. outside, the scope of practice would remain the same.

Specializes in ER, L&D, RR, Rural nursing.

In alberta nurse is a protected title. By legislation. You have to be liscenced or registered as one to call yourself one. Even the implication (by signing where the nurse is designated to sign) is wrong. Think of the lawyer and his/her questions....

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