Paramedics are taking our Nursing job!

oslogirl · Jun 15, 2009

How are the hospitals replacing RNs with Paramedics? Sorry, I did'nt understand your post.

tulip928 · Jun 15, 2009

Obama's healthcare plans call for cuts in medicare, medicaid and an "increase in productivity". If paramedics cost less than nurses, and can legally provide the same services, that would fit the President's goals.

The details are *not* in the news on purpose, nurses. The politicians don't want the resistance that happened the first time around when the details came out about Clinton's healthcare plans.

SandraCVRN · Jun 15, 2009

Alot of ER's have medics working in them, been happening for over 10 years around here.

MacERRN · Jun 15, 2009

Default Re: Paramedics are taking our Nursing job!

How are the hospitals replacing RNs with Paramedics? Sorry, I did'nt understand your post.

It's mostly in the ED's; Instead of hiring RN's they're hiring EMT-P's. Saves the hospital a boat load on $$$. But we all know , and the research is well documented on this:The more RN's taking care of pts, the better the outcomes.

in2b8u · Jun 15, 2009

Aloha everyone! I am a rookie here...

I normally do not entertain blogs with a response, but I felt compelled to comment here. I have some personal experience with this particular topic as I am a paramedic that has worked in the RN capacity. I worked in EMS for 10 years in Honolulu and 10 years in Las Vegas, with many years as an EMS instructor and preceptor.

Upon returning to the islands, I worked for 7 years as the night ER-nurse at a local hospital. It was the only facility in Hawaii to hire a paramedic to work in an RN capacity. I not only could employ all of my paramedic skills, but all of the RN duties as well. The things I could do that the RNs couldn't do was intubate, IO insertions, pericardiocentesis, thoracentesis, cricothyrotomys, EJ's and select CVC's, 12-L interpretations. I had 2 days of orientation before I was left on my own. My shift was 9pm to 8am four days a week. I was literally by myself after 9pm on week days and after 10pm on weekends. It is a small rural-designated hospital with 21 beds upstairs comprising acute, sub-acute & swing, with a few LTC beds. An O.R. suite and 2 OB rooms. The on-duty ER doc was the only MD on campus, with 1 OB doc on call from home. Needless to say I've had to deliver several babies while on duty. Not a problem though, I've delivered approx. 300 babies in my career. The only part of ER nursing I had to get used to was most of the Abx's and a few other meds that typically are not carried on the rigs. On my shift I was PBX, security, triage nurse, primary nurse,....the ONLY nurse! Upstairs on the floor there was one RN and 2 to CNA's. The RN couldn't leave her post, so there was no such thing as a "lunch break" and you had to eat and use the restroom when ever you had the chance.

Typically I would order labs & Xrays, start fluid, give meds etc, then call the doc down after the results were back. Of course if I believed the pt. to be serious or surgical, or obviously critical I would alert the physician immediately. The hospital was taken over by another entity a little over a year ago and their insurance carrier wouldn't insure my position, so I was let go. The doc's and other nurses fought to keep me but to no avail. A couple of doc's left the hospital as a direct result of my being let go. I was flattered, as these are very good ER doc's and would entrust them with my life. I miss my fellow ER nurses there and we still get together for lunch or dinner and special occasions.

In closing, it is my opinion as well as all the doc's I've worked with that paramedics can make the transition to ER nursing and do as well of a job if not better, than the RNs. And I mean no disrespect to you nurses out there. All the nurses I've worked with will be the first to agree with what I am saying and will tell you great things about my nursing skills (I'm not boasting, so please forgive me if it sounds that way...). Now, after working in Vegas for 10 years, I've worked with paramedics from all over the country. My observation is that training & skill levels do vary and I'm sure you would have strong ER paramedics and weak ER paramedics. But I've also found the same to be true among RNs. Some times I wonder how a person made it through school!

With the nursing shortage and the economy the way it is, and the pandemic (with worse things to come), I think more hospitals, ER's in particular, should adopt policys to allow paramedics to transition to the ER. It's a perfect marriage. Anyway, gotta get back to my studies....yep, nursing. Eventually on to CRNA.

Take care and thanks for listening, I hope you all keep an open mind:nuke:

FlyingScot, RN · Jun 15, 2009

Aloha everyone! I am a rookie here...
Upon returning to the islands, I worked for 7 years as the night ER-nurse at a local hospital. It was the only facility in Hawaii to hire a paramedic to work in an RN capacity. I not only could employ all of my paramedic skills, but all of the RN duties as well. The things I could do that the RNs couldn't do was intubate, IO insertions, pericardiocentesis, thoracentesis, cricothyrotomys, EJ's and select CVC's, 12-L interpretations. On my shift I was PBX, security, triage nurse, primary nurse,....the ONLY nurse! Typically I would order labs & Xrays, start fluid, give meds etc, then call the doc down after the results were back. Of course if I believed the pt. to be serious or surgical, or obviously critical I would alert the physician immediately. In closing, it is my opinion as well as all the doc's I've worked with that paramedics can make the transition to ER nursing and do as well of a job if not better, than the RNs. And I mean no disrespect to you nurses out there. Take care and thanks for listening, I hope you all keep an open mind:nuke:

2b8u I think it would be easier for all of us nurses here to keep an open mind if you would first refrain from calling yourself one because you are not. In fact it is illegal to identify yourself as one and you might find yourself in a heap of trouble if you continue to do so. In addition the skills you are obviously very proud of are skills that a large number of nurses also perform. Our scope of practice is actually very wide and limited mostly by our employers. Most of us ER nurses also order x-rays, labs and fluids in triage. We do not order medications because that would be practicing medicine which it sounds like you were doing. You are very lucky nothing went wrong. Also it mystifies me how people think that adding a disclaimer such as "I mean no disprespect" prior to or after saying something completely disrespectful mitigates the negativity of the statement. I've worked with paramedics for a very long time. I have the deepest respect for them which is why I don't get on their boards and tell them how a nurse with some extra training would transition easily to being a paramedic and be better at it. Good luck in your schooling.

whatchamacallits · Jun 15, 2009

"I worked for 7 years as the night ER-nurse at a local hospital."

Please do not refer to yourself as a nurse. "Nurse" is a legally protect title. There's a reason why the new insurance carrier wouldn't insure you, (not meant as a personal attack, really) you are not qualified to fill the position you were filling.

Good luck in school.

gonzo1, ASN, RN · Jun 15, 2009

n2b8u,

You did not work in an RN capacity. You worked doing the things an RN does, but without the education. In your post you keep saying you worked as an RN, but you are not an RN yet. To work as an RN is illegal. If you are doing the RN job and are not an RN you can get yourself in legal trouble.

After you graduate from nursing school.. if you do graduate... and you have passed your boards and worked as a real RN for a few years I think you will understand why it upsets us real RNs that you profess to do our job without our training.

It is sad that you have so little respect for your own profession (EMS) that you feel you need to function as an RN, and brag about it, when you are not one. And shame on the hospital system for fronting you as one when you are not.

I wonder who will be helping all of us on the outside (car wrecks, heart attacks, etc) when all the paramedics are working in the hospitals?

gonzo1, ASN, RN · Jun 15, 2009

I went back and read your post again and all I can say is that if I knew who you were I would turn you in to the BON for impersonating a nurse, which is illegal.

If indeed you are as skilled as you are then I say great. But you show poor judgement coming on a nursing board and telling everyone how much better you are at their job then them.

Shame on you

MacERRN · Jun 15, 2009

In2b8U, Are you doing brain surgery too? A few meds not carried on rigs that you had to get use to...yeah right. You hang propofol?? Your way out of your scope. We are Nurses' here. You are NOT!!

piratemum · Jun 15, 2009

I'm not a nurse or an EMT. I am a professional manager and I find this entire thread to be very frightening.

The nurses on this thread have handled the "nurse impersanator" issue very nicley. The hospital is another story.

How a hospital can justify putting its patients at risk by not hiring a nurse when a nurse is needed, is ridiculous and borderline arrogant. It decided that cost was more important than outcome. It decided that your mom, dad, child, sibling, wasn't worth the cost of an actual nurse. Shameful is an understatement.

That an EMT is comfortable in this situation begs the question of ethics. Just because you're hired for a job doesn't mean its ethical to perform that job. You do have culpability in that. I've been asked to do unethical things by my employer and because I knew it was wrong, I refused to do those things. Had I gone along with them, I would have been on the proverbial hook right along w/my employer. Why? Because I am a prudent professional and I knew better!

This is disturbing to say the least