blueeagle11

hi ~mi vida loca~ i've been an emt-basic since 2004 with experience on bls, ils, and als services. (basic life support, intermediate life support, advanced life support). i am also a new rn who has just finished a critical care orientation program where i worked in the icu. (now going to er bc i miss the faster-paced life and variability!) your posts caught my attention in regards to cna vs emt. it's not really a matter of "higher level of training." it's more a matter of focus of care and scope of practice. cnas actually do many other things that emts are never trained to do and emts do many things that cnas do not do. it's just that one is in an acute, emergency setting focusing on what needs to be fixed rapidly (respiratory distress, seizures, gsws, amputated limbs...) and the other a more controlled environment where every aspect of the patient's care/life (level of consciousness, breathing, intake & output, diet, hygiene, medications.....) must be managed. ems in general has four levels of training (w some variations of name and scope of practice by state). first responder, emt-basic, emt-intermediate (aka emt-advanced) and emt-paramedic. mostly first responders have the same scope with a few exceptions and also frs do not independently transport patients. basics perform assessment, trauma packaging of patients, splinting, use nasal and oral airways, and can give only a few drugs: oxygen, nitro, aspirin, oral glucose, activated charcoal, and epinephrine auto-injector. some may use a combi-tube, an airway similar to an endotracheal tube but is a "blind drop," or a similar airway. emt-bs are not generally taught to obtain or read an ekg. emt-intermediates do have a higher level of training than basics. their assessments are more in depth. they can start ivs, give fluids and other medications: lasix, lidocaine, morphine, ativan, and more. emt-paramedics are the highest level in ems. emt-ps can do everything bs and is do and a couple of more drugs and procedures like a needle decompression for a pneumothorax or a cricothyroidotomy. now take all this as general guidelines bc i'm only familiar with illinois myself and each state has their own regulations and each region has its own set of protocols, meaning what one emt can do in one place may not be allowed in another. also, many places have done roll-out classes and "upgraded" some levels. in illinois, first responders can do nearly the same things as a basic and emt-is have been taught advanced skills so that their scope and the p's are very very close to the same. oh, and in indiana basics do take an iv maintenance class. they can transport someone with fluids running, etc. but cannot start the ivs. i hope this hasn't bored you to death and you glean some useful/interesting info from it. ems and nursing can be two totally different worlds, but you'd be amazed what each can learn from the other. sounds like you may have found your niche and would enjoy the emt class - go for it! one more quick note-- the history of ems, how it really got started (defibrillators especially) and how it's developed over the past 30 yrs is quite fascinating.

aura_of_laura ....it's a power thing. classicdame might turn out to be a blessing in disguise. you now have the opportunity to start over and shine! jiminocala she is your s.o. and is running you down about work? sounds like jealousy to me..... take a hard look at your situation. mamamerlee seems to me like the problem is her, and she is attempting to bring you down with her.... kooky korky i think you'll do great! jbudd you are listening to the wrong person; keep repeating to yourself what everyone else said. put a lot of distance between yourself and the toxic relationship, you called her your "ex" but you are still devoting way too much energy to her. talk to a pastor, or your pastoral care department person, a police chaplain (ours is great), a real friend; anyone, until you can't hear "ex's" voice anymore. virgo_rn there is a world of difference between those who offer constructive criticism to assist us to learn and grow, and people who just make you feel badly about yourself. my advice is to try to learn this distinction, and surround yourself with people who fit into the former category. canoehead ditch that poisonous person. you'll feel better after a few days of not having to listen to her. even if you were a total klutz as a nurse her role was to build you up, not make you doubt yourself. short term counselling might help you purge the poison. try eap. power thing...opportunity to start over...jealousy...bring you down with her..... my best friend is having a huge "i told you so!" moment. thank you all very much for your words of wisdom, time and support. i come back and reread your posts when i need to clear out negative thoughts and refocus. jbudd, perhaps i shouldn't have to ask, but how did you know it's still her voice i can hear in my head? virgo_rn, you sound like my aunt, also a virgo! and, when i was very young the only person who talked with me as an equal and helped me think through whatever the situation may be. canoehead and jbudd, there is one of our chaplains who is very nice and i'd be comfortable talking with. i may go speak with him this week. i am still in that low place and "ex" calls or texts every so often. (this is when i think most about your posts.) three more nights in the icu this week and then i start orientation in the er. i don't want to get through this low time to be back where i was-i want to get through this and be that much better for it.

:DThank you! I appreciate your support. And definitely take note of the Hint!

hello all, i'm new to allnurses, although i've been browsing threads for a few months. you all have provided some insightful views and great resources. for these reasons, i want to lay out an ongoing 'predicament' and hopefully gain different perspectives. i am 24 years old. spent 5 yrs as an emt-b, completed nursing school and was accepted into a nursing excellence program (approx. 6 to 8 months of training in a critical care area.) of course, my real passion was er, but i listened to my don at the time who insisted i needed to develop my nursing skills and icu would be perfect. here is the 'predicament': (yes, against my better judgment) i began dating someone who worked in the same unit (icu), only on weekend night shift. now, i'm the quiet, i-don't-know-enough-to-be-doing-this type. (wasn't always like that, of course, i learned that over the yrs in ems. the farther i go, the less i know!) now i struggled a lot to go from ems thinking to icu nursing thinking, but nearly everyone was encouraging. except i started to hear negative things from my significant other. she would tell me how 'no one likes you,' 'everyone hates taking patients from you,' 'you're just not an icu nurse,' etc. i was devastated. i've never had something i was an utter failure at. all along, i thought it was all me. this started around oct/nov. my program had started in august. over the past month, i've noticed that i don't hear negative from anywhere else. she says the things she's saying come from her night crew-and not her. i've spoken with my manager (she is one of the rare, great ones whom i have trust and loyalty for) and she said that last week one of the weekender night shift nurses had come to her saying how well i'm doing and how much improved i am. (before that a nurse of 30+ yrs had called her from home to brag about how well i did one day, and this is a nurse i highly respect and hope to be half as good as one day.) in the past 7 yrs, i don't think my confidence has ever been this low. my best friend told me the other day, "you haven't been positive in months, you've been a debbie downer, negative nancy, the only time i've heard you happy was when you called a few weeks ago and you'd signed your lease for your new place. and that's just not who you are." i love the people i work with in icu, i'm just not crazy about the job. i start in the er night shift on april 5th. this is where i've wanted to be. (my manager who is now over er and icu offered me a job, twice. and i was offered a job at a facility in our corporation that sees about 10,000 more patients a year than ours. if i really am *that* bad, why would i still be here and why would i have these job offers?) my ex has been in several abusive relationships before. this is not meant as an excuse for any behavior. she would often accuse me of 'not making up your mind or knowing what you want', 'not being happy with yourself' and 'nothing is ever your fault' etc. after thinking about this for a while, these are traits and behaviors i've seen in *her.* ok, so, over the past month i've come to a tentative conclusion: i entered into a relationship that quickly became verbally and emotionally abusive and allowed it to go on. i allowed her to play on my insecurities to her benefit. i am very excited about finally getting to er, but my trepidation is overshadowing it. what is your perspective on this situation, and can i regain my confidence and perform well (as well as possible) in the er? thank you for your time and consideration.