Tech vs. RN

[ER Soldire]

This has been eating away at me for a long time, in our ED we also have techs (who are all Paramedics) It gets really, really annoying when some techs act and talk like they know it all, or feel that what they are doing is in fact more important than other things. For example, in a code they would be more concerned about starting a 5th iv than actually moving away to let meds be pushed, or drips started. Also it seems in my experience that a lot of them just don't get acuity of a patient or importance of certain interventions.... You are going to walk a pt back to a room who is having active cp or complaining of SOB and not hook them to a monitor? Or even better not tell the RN a pt is in the room? Even after that rant I still want to say that there are good techs, I guess it's just those few who are lazy and not so with it ruin it for those who are really on their game.

[akulahawkRN, ADN, RN, EMT-P]

Those bad apples probably do ruin it for the ones that really good and on their game. There's probably other factors that play into whether or not those techs have any sort of incentive to perform at the level they're capable of. Some of those factors may be state law, state regulation, or even simply facility policy or unit attitude toward ED Techs... aka UAP's.

[SpaceCoastRN]

It all depends upon background (well attitude helps too). I have worked with several seasoned field medics now working as ED techs that I would much rather code a patient with than some nurses I have worked with, everyone should know their roles ahead of time though to limit confusion of task delegation and expectations. Dropping off patients in a room without notifying anyone let alone failure to start treatment as simple as placement on a monitor is a pet peeve though. Appropriate mentoring can help remedy that situation though.

[Aliakey]

Just my humble opinion here: I'm an RN, a paramedic, and have worked as an ED Tech and yeah, there are bad apples that ruin the whole lot. The way this problem was fixed where I worked years ago was to clearly outline the expectations of the techs with chest pain patients, during a code, whatever. In other words, give them some sort of "protocol" and expect it to be followed. Protocols are a paramedic's bread n' butter, but our sense of autonomy in the field sometimes gets us into trouble in the ED if that clear direction and expectation to follow it is not offered. I'm not saying to treat the techs as trained monkeys, but looks like from the original post that there's some clear lack of guidance from the powers above. When my EMS Medical Director says you will not walk ANY chest pain patient in the field, we obey. Simple. The ED needs to offer these guidelines to their techs as their protocol, and respectfully enforce them. A few kind words to those techs who do abide by the guidelines goes a long way as well.

[Ciale]

ED Tech here (RN in one month WAHOO!). I tend to agree with you, OP. Similar situation in my department. I think a lot of it has to do with them feeling like they worked hard to become a paramedic and have seen/done a lot already compared to some nurses and yet they don't make nearly the same pay and I think that's a totally valid feeling. I'd probably be pretty frustrated about that too, but hey, go get your RN and shut up about it! A couple of our paramedics need constant affirmation that they are valued and it gets really old. Now that I'm about to be working on the unit as an RN and really don't know crappola compared to everyone else, the paramedics like to point this out when we work together. I can only imagine how it's going to be when I delegate stuff to them...ugh.

[dkhunt]

Ciale I am in the EXACT SAME situation as you. I am also an ED tech and graduate in a little over 4 weeks. The ED offered me a job starting in the beginning if June. I do know as a tech I work my butt off because there is ambition to learn more and do more for once I am a nurse. Many techs I work with don't have the same ambition or they feel as if they get ran around so much, it won't matter because no one appreciates the work they do. They constantly need to hear "thanks for your help" and "I really appreciate you helping me." Now don't get me wrong, these are absolutely necessary and should be encouraged, but you should still want to help your teammates out even if everyone isn't always praising you-- ultimately it's about the patient. They are also some techs who are only around to help when there is a trauma or a really exciting rescue. But when it's time to clean an incontinent patient waiting for an admission room or place granny on a bedpan, they are nowhere to be found. They feel as if those tasks are beneath them. I can only imagine how this is going to be once I am a nurse working with these same techs who may think they know more than me....This should be INTERESTING.

[SweetMelissaRN]

I completely understand what you are saying, OP. There are 3 absolutely AMAZING techs that I work with in my ER, to me they are worth their weight in gold... Then we have 2 really not so great ones. They are always rude or get offended when you ask for help, OR they are "stocking" in the break room, and by stocking I mean eating off of left over food trays. Luckily the 2 that are not so great only work the first 3 hours of my shift while the remainder is spent with 2 awesome techs!

[al7139, ASN, RN]

Hi I am a nurse in a very busy ED. My techs are any level from EMT-B to Paramedic. I have worked with some great paramedics (one actually works in our cath lab as a tech) and some really bad ones. As a nurse, all my patients are urgent and when I get orders, I feel like they need to be done STAT. If I have 4 patients and 2 have the full workup ordered, I ask a tech to help. I say I will go to this room if you get that room. My definition of a good tech? One who pays attention when you askk for help. The attitude of some techs is tough sometimes, but the one who will jump up and work is worth the weight in gold. It does not matter what the creds are, they are good or they suck.

[turnforthenurse, MSN, NP]

The techs in the ER are fabulous and they are good with looking at our patient list in the computer to see what needs to be done. If I have a difficult IV start, they are my go-to people. I have delegated things to them without a problem. I do agree with the OP, though, sometimes they do other things that they think are more important. I had just gotten a patient who was discharged earlier that day, but was in respiratory distress and had developed increased secretions. Patient needed to be suctioned. They had advanced Alzheimer's, too. One of the techs beat me to the room and established an IV and got all of my labs, which is great, but then another one comes in and asks why I haven't gotten any vitals yet. I was in the middle of suctioning all of those secretions from the patient and told them they gotta remember those ABCs. A set of vitals can wait a few minutes.

[amygarside]

It would definitely depend on the attitude and flexibility of the person

[txERgrl79]

I am just starting nursing school and was a former UAF medic and ER tech and there wasn't anything I wouldn't do. But I love my job and even though there were days I wondered why on earth I worked there, at the end of the day, I knew something I did during my shift was appreciated. I worked with nurses that trusted me and taught me so much. I didn't need "thank u" 24/7 but I knew they appreciated me. Somedays I think all I did was play housekeeper lol but then there were more days I got to get my hands dirty with everyone else! So much just depends on the attitude of the tech, like everyone has said here.

[A.Brook]

If I have a difficult IV start, they are my go-to people. I have delegated things to them without a problem.

Wow..really? Things must be different where I live.