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]

I think this would upset me. Why is the tech asking you why you haven't gotten vitals? It appears as if they are acting as the nurse and delegating to you as if you were the assistant. The nurse is held to a higher standard in regards to taking care of patients. We are required to document vital signs. I'd try not to utilize them at all unless it is to help reposition a patient.

Here is a protocol. Don't ask any nurse why they haven't done anything. Only ask is there something extra you would like me to do.

Yet you say that you foster good teamwork. You try to not use them at all except when you need extra hands. Now this could very well be the case where you work and perhaps your Techs aren't given any additional tasks/skills/whatever beyond manual labor. My point had to do with Techs that have a greatly expanded role.

HINT NOT NEEDED....

There was nothing stated about consistently disrespecting any subordinate. I treat subordinates, colleagues as well as supervisors the same. And it does not matter whether the tech is a CNA or paramedic. It all boils down to following chain of command and/or who is ultimately responsible for a patient should anything negative occur in whatever setting it may be. Teamwork is important and to effectively prevent tension there must be some sort of job description that clarify roles so there is no confusion.

And I stand by the statement that instead of asking why something wasn't done, (unless for educational purposes of course) the tech whether paramedic or CNA should just pitch in and get them or ask the nurse would you like me to get the vitals...... (This has Nothing to do with slavery but nice teamwork)

If nursing was male dominated, this would not even be up for discussion.

Given your previous post, I guarantee this would have been up for discussion. You're right in that a good team would have the Techs pitch in and help. If you simply see "your" Techs as extra muscle, and they learn that, they won't be all that eager to help you out. Also, your previous statement doesn't lend itself to fostering good teamwork. To me, and I'm sure a lot of others, it reads as "don't question the nurse" and "yes, master, is there anything else I can do for you before I go do something else?"

I would also assume that they are not there to intimidate and frustrate the nurse under a high stress, saturated workload environment. They help [not delegate, not run, not supervise, not antagonize, not exert superiority complex, not (feel in the blank)] and do a DARN GOOD JOB!

I'm sure no nurse wants to be called master. I believe nurses want to be respected for the education and experience that we bring to the table. And add in a side order of AUTONOMY, so that every joe, dick, Tom, Harry and Jessica won't think they are qualified to boss us around.

I don't think I read very many posts above where an ED Tech was somehow magically elevated to delegate, supervise, or exert a superiority complex over a Nurse. In fact, most of the Techs I've met over the years generally have a great deal of respect for the Nurses they work with. If they don't like a Nurse, believe me, it's specific to a particular Nurse.

I also notice a bit of territorialism there. I've seen enough of that to recognize it when I see it. Is it possible for me to become territorial? Sure. You don't want me to, and I don't want to because it doesn't foster good teamwork.

So, I'll reiterate my point. You foster a good working relationship, your crew will bend over backward to help you out. I hope you really do foster a good relationship with the people you work with.

Please don't get me wrong. I'm all for respecting the chain of command. Accepting that is part of accepting the job. You know where you fit and what your role is. I hope you also noticed that in my original post in this thread that I wouldn't be all that comfy with a Tech appearing to delegate a task to me, were I the nurse. In fact, that tech and I would have a discussion about that. I have had to have that discussion with certain subordinates, in a previous job. If they kept doing the behavior, it usually resulted in the matter being escalated and they were usually pretty quickly out of a job.

[SweetMelissaRN]

I would also assume that they are not there to intimidate and frustrate the nurse under a high stress, saturated workload environment. They help [not delegate, not run, not supervise, not antagonize, not exert superiority complex, not (feel in the blank)] and do a DARN GOOD JOB!

I'm sure no nurse wants to be called master. I believe nurses want to be respected for the education and experience that we bring to the table. And add in a side order of AUTONOMY, so that every joe, dick, Tom, Harry and Jessica won't think they are qualified to boss us around.

I agree. However, I feel like you're generalizing a particular situation to all techs. If it's such a problem, why not discuss it with them? Perhaps you just took what they said the wrong way?

Also, when you said that "if this were a male dominated profession, this wouldn't even be up for discussion", can you please explain to me how that pertains to this situation and how having this profession be dominated by males would have changed things? I'm just curious.

[TraumaSurfer]

Dude, you totally missed the point of that post. Most techs don't get paid to know that information. And actually, all of the techs I work with have a pretty good idea about important lab values. Quit generalizing. All of our techs know the first thing to check in a rapid response is blood sugar.

Have you ever heard of the saying if you have a problem with everyone, maybe you should look at the common denominator in the equation?

Isn't checking glucose part of most RRT protocols? You seem to make it sound like they saved the day because they thought to check the glucose. Or, maybe you meant that to be insulting.

The nurses in the southern part of the US make a lot less than those in California or New York. Does that mean those in the south should know less? Many RNs are under paid but they are still required to have a good working knowledge of why they are doing things to patients.

Fluffing off the importance of education in any profession is not the way to advance regardless of what your title is.

My statements for the education of the Paramedic are based on the national curriculum, the survey of education requirement for Paramedics by state and by the number who hold at least an Associates degree. All the data is available on the internet.

The common denominator is those who put more emphasis on the title they held on the ambulance rather than the title, job description and duties of the position they were hired for.

If a Paramedic expects to function as a Paramedic in the ER, may he or should read the job description of ER Tech before applying. But, that does not mean he or she can not advance their education to have a better understanding of why certain things might be asked of them and how patient care as a whole is a carried out.