FirefighterDoug

ER tech at a level 3 in So Cal. Started at 14.50 plus 2.00 NOC. Most new hires will start out lower it all depends on experience. At the level 1 I worked at in Portland,OR I started of at 11.25 plus 1.00 evening and 2.00 NOC. When I left after 6 years I was at 16.25 plus diffs.

How did you come up with the idea that working on the road as an EMT is nothing like the ER? I have been working as a tech for seven years and some of the best ER techs and RN's I work with all have prior or current field experience. Many ER managers look for tech as well as RN candidates with thier EMT (basic or medic) and field experience. The reason is that EMT's and RN's with field experience tend to have better critical thinking skills and have the ability to multi task effeciently when it gets busy. At the level one I worked at I helped train the CNA's that came down to the ER from the floors. I noticed that most were very hard workers but just by the nature of thier CNA education and training they think differently than people I trained with thier EMT and field experience. Rather than trying to think ahead or act alone during traumas and codes they rely on being directed by an RN or other provider.

Just started a new position here in So Cal pay is 14.50 plus 2.00 for night shift.

Apply and apply often,know the department and facility your interested in. Your education will help but it all comes down to the interview,are you ready to set yourself apart from the pack. Remember its somewhere around 200 applicants for each position at least in the ER.

Portland OR level one adult ER and seperate level two peds ER.16.50 plus differentials 1.00 evenings 2.00 nights. That was after 5 years,started in 2005 at 13.50. I think the current starting pay is 14.00 plus differentials.

Just checking you know there are some ER folks that look down on the out side providers. Might have even been a thread or two on the whole rivalry thing. No worries.

Of course you do not have to work as tech to get hired in the ER but it sure cant hurt. I know several ER nurses that were techs prior to being hired as nurses and they without a doubt are among the best nurses I have worked with. Having experience and knowing how the ER works will get you noticed when it comes time to wade thru the yearly conga line of freshly minted nurses with the goal of joining the ER team. As you know most ER managers are looking for at least one year of experience for a new hire. Having the proven abilty to function and perform in the ER is going to always help not hurt."The ones EMT's miss"....not cocky but Im thinking just possibly a little shot at our hard working brothers and sisters in the field. Feel the need to share a negative experience you have had with one of your field providers...having supervised many field providers over the years I might be able to help you out.

Great advice but before you take on the additional burden of an EMT class let me offer the following. One thing that will help you the most in the ED is the abilty to develop and use critical thinking skills. CNA's and other non emergency trained providers are not taught this skill but field providers if they are good will develop it over time. Over the years I have seen some very competent RN's wash out of the ER because they just could not develop this skill. They were very educated but could not function in the fast paced setting. CNA's make great techs if they can be taught to think like an ER nurse or an EMT. Having trained CNA's from the floors I can tell you some will never be able to learn the skill of multi tasking in an often hectic and fast paced environment. Many ER managers when looking to fill tech positions will look for applicants with field experience because they know they have the abilty to apply critical thinking skills. Being able to stay two steps ahead of your nurses is a skill that will be greatly appreciated and is an example of critical thinking. Anticipating a need and being able to follow thru is another example. Being a nursing student is great and may work in your favor but many managers would rather have someone that can jump in and help the department than someone who really wants to work in the ER but might be more student than provider. The best advice for you is to concentrate on doing well in school this is your job for now and should be your number one focus. Get your face known in your ER,as an employee you have a huge advantage and should be able to get by on a regular basis and talk to the techs and RN's. Do not dissapper from your current assignment to hang in the ER but get by on your lunch or after work. If your interested in working as an RN you should be networking and learning the culture of your ER anyway and as an employee you have a great opprutunity to make contacts that may be helpful in the future.

Here in Portland where I work the tech pay range is 13.00-21.00 per hour. There is differential pay for evenings (1.25) and nights (2.25). With six years in I make 16.41 plus differential pay.

I have to respectfully disagree with you. Granted we don't know the whole situation and because things can vary greatly from facility to facility its hard to know what would be expected of a tech at the OP's facility. With that said may I point out that its up to each person to work within their designated scope of practice and to know their boundaries. In my case I can do more in the field setting as an EMT-IV Tech than I can in the ER. On the other hand I find myself doing things in the ER as a tech that I could never do in the field even at the paramedic level. Most of the nurses I work with know I can start lines but only in the field and I could never see anyone I work with asking me to cross the line and I know it would never be suggested by a charge or someone in management that I step outside of my scope of practice even in the worst of situations. I know it confuses some of the MD's and resource RN's that I can draw labs but am not able to start a line but thats the way my employer and the state of Oregons nursing board want it. Its crucial that we as providers especially new ones keep up our skills and stay in the game so to speak this includes providers in both the clinical and field settings. Anytime you can be in the position of getting patient contacts it can only help you especially if ER nursing is in your future. I have seen a few of our RN's pick up tech shifts over the years and have never heard of there being any problems with respecting boundaries,of course these were former techs which could make a difference. I would encourage the OP to pursue the tech position and learn as much as they can. It always helps to have an RN with a tech perspective on the floor when it gets crazy.

Could you imagine what it's like for a new grad that comes into the ER with zero experience. You had a tremendous advantage coming in with an intimate knowledge of the department. There is nothing like having the tech perspective when you move into the nursing role. We have several former techs that went your route and they all survived and have turned out to be great nurses. Some of the best nurses I have had the pleasure to work alongside over the years started as techs. Don't give up ever and always remember tomorrow brings a fresh start and a whole new set of challenges. You know you like the challenges or you would not have stayed on in the ED after graduation. Remember us ER people are different and you must feel at home or you would have been gone as soon as you had the chance.

You should without a doubt apply but be aware these are very competitive positions and you will be up against some very well qualified people. Our last on call tech position in the peds ED brought in 200 applications before they took the position down and many more came in after that. Most ER managers will want to see some type of experience preferably some time in a prehospital 911 setting,but I have seen people come into the ED as nursing students with zero experience. Don't be surprised if you don't get in on the first try,it took me three times before I got in and I had years of experience in Fire/EMS. The good news is that most techs move on to bigger and better things so the turn over rate is high. On call is different at every hospital,where I work they have supplemental,on-call and per diem. Per diem and on call will usually require a commitment to cover a set number of shifts per month. Supplemental offere no guarantee to either party and works well for people like me who have full time jobs or who are still in school. Most ER schedulers are used to students schedules and will work hard to let you know in advance when shifts are open. You will also get sick calls but most of the time you will be covering holes in the schedule and should know well in advance what is available. I think you might be looking at my ED we get students in from all the nursing programs in Portland. We have had several techs over the years move into RN spots after they finish school its not a given but if you work hard and fit the culture you have a very good chance. Regardless you will pick up alot of valuable experience and will have a good insight onto ER nursing,you might even find that its not for you. You need to be ready to smoke your interview so do your home work and let me know if I can be of any assistance. Good luck!

You should call and ask the ER manager exactly what if anything you will need to apply for the position. The people in HR may not be on the same page as the ER manager so your better off knowing for sure what is required for the job. Most of the skills like preforming EKG's, straight stick phlebotomy, tele monitoring and others are taught either during your unit orientation or shortly after your hired when a class is offered by the hospital. Be very careful about shelling out big dollars for programs or classes that teach skills like the ones mentioned above. You may be out of luck when you find that the hospital wants you trained their way and wont accept your outside training. If your serious about the ER tech position you should be working very hard to be prepared and should know that hospitals ER and how they do things. You will have alot of very well qualified applicants to compete with if the tech job is as popular in NJ as it is in most parts of the country. Our last on call peds tech position brought in 200 applications before they pulled the posting and many more came in after that. Everyone from EMT's to RN students to PA and MD students are after that job because of the great deal of experience it offers. You will need to give the interview of your life so be prepared, if you get an interview I can share some things that might help push you to the front of the line. Good luck!

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.

In our peds ER we have a mix including EMT-B's,I's and P's and CNA's that work as ER techs. On the adult side the mix is the same but there are also med,nursing and PA students that float through from time to time. Our duties are much the same in both units they include EKG's (preforming not interpreting),straight stick phlebotomy,splinting,assisting with procedures,wound cleaning and prepping for sutures,recording and circulating on traumas,CPR on codes,rooming patients,getting vitals,getting patients on monitors,transporting to other units,covering the desk and stocking,stocking and more stocking. Much of what you can do relies on the trust you have earned and of course what your charge RN feels you are able to do. As an EMT-I have done things that are above what many paramedics do in the field but it has always been after I have demonstrated that I can be trusted. For those that are looking to work in the ER as techs,PCT's or whatever the position is called in your neck of the woods I can offer a little advice. In most ER's the position is very competitive and there are usually many more qualified applicants than there are positions. Our last on call ER tech position in the peds ED brought in over 200 applications before they removed the post and many more continued to come in after that. On the adult side the odds are about the same. Knowing how to smoke your interview is what will put you ahead of the other applicants. Having a good package means nothing if you don't know how to sell it, you may only have one shot so you need to be ready. Most ER managers want to see that you have some experience preferably in prehospital EMS. You don't need to have alot of time under your belt but its nice to know that you can function well in the hectic environment that is the norm in most ER's. It also is very beneficial to have the critical thinking skills that are developed after some time in the field. Being able to stay two steps ahead of the action is a skill that will be well appreciated by your over worked RN's.

I have not seen any advice for working with our littlest patients so if I may I have a few things that might help you out when it comes to working with children in the ER. I am not an RN but have worked as a tech in our level one children's ER for six years and have learned so much from and about the nurses I have worked with over the years. Our children's ER has people that want to be there because they enjoy the challenge that comes with caring for sick and injured children. On the other hand I know nurses that work in mixed units that would gladly pass on caring for a peds patient if given the chance,face it kids make some nurses very uncomfortable and that's okay,we all have are likes and dislikes. If you enjoy working with the little ones and are good at it you could become the go to peds person on your crew in a mixed ED. A great opportunity if your up to the challenge and have an intrest in childrens emergency medicine. Remember the basic rule, children are not small adults they are complex and can compensate for a long period of time before abruptly crashing. Always expect the worst possible outcome and treat with that in mind. When I worked in the field I always kept this in mind along with all the other tricks I learned from the nurses in the peds ER and it made me much more comfortable on scenes where pediatric patients were involved. The parents and or caregivers of your pediatric patient can be the best tool in your box and should be utilized whenever possible. From providing important and pertinent history and information for your assessment to helping with holds they are an invaluable resource. On the other hand they can be a real problem and can even become your next patient. Knowing when to have a parent leave the room could reduce the stress level for all involved. Most parents are very open to our suggestions and once a procedure is explained and they know what they may have to experience they usually will opt for a quick cup of coffee or a little walk. On my last shift we had a very sick 4D old that was proving to be a very tough stick, mom was already weak from her recent delivery and the stress that comes with caring for a sick newborn this along with some other medical problems had me really worried and I was sure we were going to be wheeling her across the hall. After a little apple juice and a short break she was good to go and even sat through the LP. Treat your parents and caregivers like patients and you will always be ahead in the game. Sick and injured kids can be stressful but use your tools and you should be fine. Good luck in your new position and remember to have fun and be nice to the techs.

It seems the folks upstairs have heard the threats of lynching or worse from the first floor and have backed off the masks at all times order. I think sailormedic came up with the number one reason that administration revisited the issue and that is how other non flu patients would view the always masked staff and the panic it could potentially cause. We serve a very diverse community and have many non english speaking patients and waits for interpreters can be long especially for the more exotic languages. I do believe that staff disapproval came in a close second but im not sure what other factors played into the reversal. I found out that we have an H1N1 steering committee that is working system wide with flu policy but because I'm not sure who's on it I will refrain from publicly ridiculing their earlier actions. We all have are jobs and some of the decisions we make might seem sound at the time but after you run it around the block a few times it can really begin to look like a boneheaded move. I feared we might lose good people to this decision and to be honest I was thinking of taking the flu season off myself. Since I have only been working six to eight shifts a month I could easily make up the difference with my full time outside job. I'm just glad things have worked out because I really enjoy my time in the ER and would hate to see us lose any of our people.

We have always taken precautions with potentially infected patients(masks,isolation)but for some reason the powers to be are very concerned and the old way of treating suspected flu patients is not going to be enough. This was not an idea our manager came up with to torture us, it was not long ago he was on the floor as our charge so he knows how these things affect staff morale. We generally have a very casual ED especially on night shifts and as long as we get things done we have freedom and privileges other departments have had to get rid of(music,food and fun). In the five years I have been around there have been some dumb ideas that have floated down from upstairs but this is going to be the biggest blow to staff morale so far. I will have to dig a little deeper to find out who is behind this decision and what they are thinking. I was quick to point out in my post that CDC guidelines are far less radical and that adherence to standard infection control policies should be sufficient in most settings. I'm sure everyone will have their own opinion but I don't make the policy so it is what it is. Masks will be changed as needed throughout your shift,you would not wear the same gloves all shift so it goes with masks. I think the underlying issues are two fold and have to do with staffing and possible infection of family and others off site. I could be wrong but in administrations eyes having a large number of staff out at any one time could be an issue,I may be totally off base but its a guess.

We just received word from upstairs that all ED employees MD's,PA's,RN's,Techs,Unit Secretaries and support staff will have to wear masks at all times while in the department until further notice. This is for H1N1 precautions, we are an inter city level one facility and are anticipating our fair share of flu patients. To say our manager is not a very popular guy at this point would be an understatement. I just got the e-mail and have only seen a few responses challenging the benefit of mask wearing at all times to prevent the spread of the virus but I'm sure there will be much more to come. It seems the CDC is taking a somewhat less radical stance and some of my fellow ED members are trying to get this decision reversed. We are also limiting visitor access to patients in high risk units ICU,L and D and of course the ER. Anyone else seeing any major changes like these with the upcoming rise in H1N1 patients.

We have a limited number of ER internships for new grads but the competition is fierce and there are many more applicants than positions. I do think going the tech route is the natural progression into the ER RN position. I would recommend all students to try and get on as a tech especially if your looking to go ER. Its a great way to figure out if the ER is really your cup of tea and the pay is better than most EMT-B jobs plus most tech schedules are very student friendly. We have had a few techs hired as RN's right out of school and they are all doing very well. Its not a given that if you tech that you will be offered a job but it does give you a leg up. If you have built a solid reputation and have the trust and respect of the ER staffI think your a great candidate for a new grad position even in a level one setting. As techs we really do have our hands full taking care of our nurses but we are also always learning by watching you, you may not realize how much you teach us and even when you make that rare mistake its a learning opportunity for us. I have always thought that being a tech in the ER compliments my field experience as a FF/EMT and if and when I go to nursing school the years of working with the best in the field will benefit me greatly.

Most hospitals will teach ER techs EKG's during orientation to the department, this is only training to preform the test it does not give you the training to interpret the results. Phlebotomy is usually offered as a hospital based class, it is however becoming more common that states are requiring advanced level certification for phlebotomy. Is your friend interested in the emergency environment or leaning towards LTC or general CNA, also what area of the country is your friend looking for this training. I still don't like the sound of this "tech training" class at least not for 9K.

Can you be a little more clear on what duties this person would preform after dumping that much cabbage on a training program. There are paramedic programs that cost around the same but you have much more in the way of personnel marketing power as a paramedic. Please be very careful, there are programs that will gladly take your money but leave you with very few opportunities for employment. I work as pediatric ER tech, in some regions of the country the position is also known as a patient care technician. Let me know what the PCT position entails and I will try and give you some advice for your friend.

Get in line and be patient there are many well qualified applicants but the good news is that the turnover rate for techs is very high. Most techs move on to bigger and better things. In four years I have seen more than 20 people shuffle thru our facility. Outside experience is a plus but not required. Having the ability to multi task and think ahead are the critical skills in the tech position. I like to know what my RN's will need and have it for them long before they ask. Having a patient roomed,gowned,vitals done and on monitor before being asked is a good example of thinking ahead. Knowing who will need an EKG within ten minutes of arrival and having that done is another example. Also have you ever worked or volunteered in an emergency environment? I ask this because you would not be the first person who thought the ER was for them but after a few shifts and some exposure to the less desirable "conditions' decided that maybe another area of patient care might be a better option. Just checking! With that said be ready to give a good interview, you may only have one shot so get ready to shine and out sell the competition. If you get called for an interview PM me and I will give you some "nuggets" and some do's and dont's that will give you a little advantage. Good luck!

MurseMikeD Thanks for the positive feedback, its nice to hear from someone who has changed their direction from medic to nursing, Im sure we are not the only two. I have had support from all I have talked with from RN's to medics and it just makes sense to get the RN then maybe latter challenge the medic test if it can be done. To be honest I would be happy and great at either job but I just seem to function at a higher level in the ER. I think the inspiration and professionalism of the other staff is one of the big things that changed my way of thinking . Not to mention that by the time I'm ready it looks like the medic programs in WA will go to a degree program like OR. Its going to be a big job since I will be starting from square one but I really like being in school and I have always been a big supporter of continuing education. Roy Fokker I hope my post helped with your inquiry about the difference between CNA's and EMT's in the ER. I have found over the years that what each can do does vary from facility to facility but I have learned one real simple fact. Outside providers base their duties and scope of practice on skills, inside providers are under the supervision of higher level providers and gain trust and respect which helps them to advance their level of practice once a certain level of education and understanding is achieved.

ER techs where I work are allowed to practice with no Oregon state certification. New hires are required to have education equal to EMT,MA,CNA or some comparable level of training in emergency services. We also have to keep our BLS/CPR up to date. I started on the adult side, last year I was offered a position in the children's emergency department. I still pull shifts on the adult side because they have more techs and more holes to fill, techs seem to only stay 12-18 months then its on to bigger and better things. Our duties include the following. EKGs (We only run the test we don't interpret the results) Blood Draws Splinting Wound cleaning, preparation and dressing Trauma recording Monitor placement Assist with procedures Transport Stocking,stocking and more stocking There are other duties but these are the ones we perform the most. We do have CNA's but they are usually not prepared for the jobs and experiences the ER offers. Once they have some training they are great as long as they have the desire to work in the department. We all know that most ER folks are here because this is what makes them happy and they thrive on the challenge and ever changing setting the ER offers. You can almost always make an EMT a tech but its not so easy with some CNA's. I have great respect for CNA's and they have definitely been hard working when I have had the rare opportunity to have one in for training when I was working. Now here is where it gets interesting when it comes to CNA vs EMT vs the states of Oregon and Washington. I am an EMT-IV Tech in Washington, I have somewhere around 300 hours of pre hospital classroom training including First Responder, EMT basic, EMT IV tech,PHTLS and tons of additional fire related training not to mention ten years of field experience. I can work in the ER in Washington for my required sticks but I cant tech for pay because I am not a CNA. I wish someone would have told me this ten years ago, I would have made it the foundation of my education. To go back now and get my CNA seems a bit like walking backwards, I know there are skills that I would learn that I don't use now but in my current setting I don't need those skills. I tried to challenge the test but the state would not go for it. I can respond to a call for help render life saving treatment including starting lines arrange transport and package you up but they don't think I could study for and at least get a passing grade on the state CNA test. It makes me question the whole process of licensing health care providers at least in Washington. Over the years I have discovered many things that explain why some of us work on the outside and some of us work on the inside. There are a few like myself who do both and with that comes respect for all involved. Sorry to go on so long but I do appreciate the replies and I felt it would give a better understanding of the tech position at least where I'm at. I really thought there would be more replies from my fellow techs, I know there are alot out there and it would be nice to share some information. Doug