Prehospital RN training

Published

PLEASE READ THE WHOLE POST BEFORE GOING OFF!

I am an RN who is interested in prehospital training. I understand very well that EMT/Paramedics and nurses differ greatly in their training and focus, and I respect both sides as valuable members of the team. The differences are what drive my question.

I am working in a prison setting where I am the first responder, and often the only trained provider, for 1400 patients. As an RN, I have very little emergency/prehospital training, because that is not the focus of an RN's education. I am wondering if there are any courses I could take that might help me respond to trauma better. It is not unusual for us to have work injuries (i.e., major lacerations, amputations), stabbings, blunt force trauma, and fractures in this setting. I want to be able to better deal with these before transporting them out (our EMS takes as much as 30 minutes to arrive) or be able to patch them up until a PA or MD sees them the next business day.

Let me be very clear. I do not want to be a paramedic or flight nurse. If that were the case, then yes, I would go all the way and go to paramedic school. I am looking for some training, but I do not want to repeat what I already know. For example, EMT-B class is 150 hours, $750 to cover a lot of assessment and such that I already know.

I am considering BTLS class and Trauma Nurse Core Curriculum. Does anyone have any other thoughts?

Up Vote Up Vote ×
Specializes in Nephrology, Cardiology, ER, ICU.

Pre-hospital Trauma Life Support (PHTLS) would be beneficial as would TNCC. I applaud your efforts to seek out additional training. BTW BTLS became PHTLS recently. Do you have a crash cart? Can you start IV's and give meds? If that is the case, ACLS would be nice to have. Good luck. Personally, I wouldn't go the EMT-B route either. Does Texas have a Pre-hospital RN program? IL does and I do that too.

Up Vote Up Vote ×

I started pre-hospital and then went to nursing school. Go to the local FD and explain to them that you want some road time. We loved having nurses ride with us. Medics have a lot to show nurses and visaversa. If you volunteer as little as one shift a month the dept will pay for you to get your EMT or Medic. They will also pay for your fire standards. Good Luck

Up Vote Up Vote ×
Specializes in CCRN, CNRN, Flight Nurse.
I am looking for some training, but I do not want to repeat what I already know. For example, EMT-B class is 150 hours, $750 to cover a lot of assessment and such that I already know.

I would have to disagree. Tell me what kind of pre-hospital assessment skills you have/already know. Nurses are trained for long-term care (generally >48 hours). On the same token, long-term care to EMS is anything longer than 30 minutes. Nursing is focused on the overall long-term health of the patient. EMS is focused on patching the patient up and getting them to the hospital using whatever 'tricks' they know (BLS vs ALS). Nurses have the luxury of sitting and watching a patient to determine patient trends and potential needs. EMS must treat what they see within moments of seeing it. Generally speaking, nursing is a controlled environment. EMS is chaos. I don't know how to explain it other than nursing and EMS are two totally different ways of thinking, but yet, very much alike.

While I agree PHTLS, TNCC and ACLS would be of great benefit, I think you'd also benefit from the EMT-B class (you could probably audit a class for little or no cost). Maybe your employer might even pay for it.

Please don't flame me. It's only my opinion.

Roxan EMICT, RN

Neuro Critical Care

Up Vote Up Vote ×

TNCC in absolute a joke. Learn the stupid letters of the alphabet and you've passed the course. I think I could have done it alone without the class. Find a PHTLS or ATLS program.

Up Vote Up Vote ×
Specializes in IMC, ICU, Telemetry.

What about ECA (Emergency Care Attendant)?

Up Vote Up Vote ×
Specializes in Nephrology, Cardiology, ER, ICU.

Curious - what's an ECA??

Up Vote Up Vote ×
Specializes in CCRN, CNRN, Flight Nurse.
Curious - what's an ECA??

Emergency Care Attendant

Depends on the state. It could be a First Responder or it could be an EMT.

Roxan

Up Vote Up Vote ×
Specializes in IMC, ICU, Telemetry.
Curious - what's an ECA??

In Texas it's a step below EMT-B. When I took it several years ago, it was about 60 class hrs, and no clinical. It covers emergency 1st responder skills for medical & trauma.

Up Vote Up Vote ×

You should definately take an EMT-Basic course-this is the basis of emergency care. You have to look at what you can legally do in your state. and what you are covered to do. Just because you take and pass a course does not mean you can do everything that was taught in the course. If you are am EMT-B, recognized by your state, and the prison recognizes you in that position, then you can perform the skills. Immobilization, stabilization, basic stuff. If you take a phrn course, or paramedic course, then you learn a lot of things that you can only do under the direction of a command physician. I don't think the prison has a medical command physician on staff. Why does it take 30 minutes for EMS???? Please remember, don;t do anything that you are not legally covered to do.

Up Vote Up Vote ×

I am a training coordinator for a Sheriff Dept, and teach PHTLS to corrections nurses. The response has been great. My background is in trauma and flight nursing, but there are instructors here who have been in corrections for a while. What you have to do is tailor the course to your setting. It would definitely be beneficial for any corrections setting. I know what kinds of things you see in corrections, and PHTLS (and AMLS, we do both) would be great for you.

Up Vote Up Vote ×
Specializes in Pediatric emergency medicine.

You may want to try asking the same question over at emtlife.com for a different set of opinions and suggestions. Try the education and training forum,I'm sure you will get all the information you need as well as opinions from all sides. There are several RN/EMT-P's that contribute to the site as well as regular RN's and of course thousands of EMT-B's,I's and P's.

On a side note I would like to see as many RN's as possible posting on that site because your education and experience are very helpful to the new crop of young people looking to enter the health care field. Since a large majority of these folks start out in prehospital EMS its a benefit to all of us in the ER when they get people with a solid grasp of emergency medicine answering questions. If you spend any time over there you will realize quickly that people with very little experience and training are offering up answers to questions that are well beyond their level of education. If a few of you would pop in once and a while you would be doing a great service to those coming up behind us. Another side benefit is that it helps show the new folks that we in the ER are on their side and that we value our prehospital providers and that they need not feel intimidated by the ER staff. Those of us with prehospital field experience have all heard the stories of horrific treatment by ER staff, I must say I have never seen such treatment but the stories are out there.

Up Vote Up Vote ×
+ Join the Discussion