MICN/Radio Nurse: Why do we need them?

[CTXMEDIC]

true. luckily i don't have that dilemma. prewritten instructions, i like that. If patient is coughing turn to page 3 paragraph 4 for instructions.... :roll:

[medic_texas]

Actually, we say do you have any questions or orders when giving radio report to a .... nurse.

And we can give orders, just not medication orders. A lot of Nurses work under protocol too, not just medics. And it does sound like the nurse in this situation CAN give orders because they are able to by medical direction.

If someone gives me attitude like "do you have any questions" that would be the last smart ass radio report they ever gave me. Our doctors don't put up with that crap from paramedics, and I know this from both sides of the fence. We are supposed to be a team in place for the patient.. Sorry your service sucks, there are others out there.

Good post AK.. <tear>

[ccmedoc]

Exactley. this is why when we call a report to whoever picks up the phone, the last thing i say is "Do you have any questions?", not 'orders'. i dont take orders from nurses. our calling the nurses is a courtesy and may expedite a bed for the patient. if i have a serious case i call report to the doc and he can tell the nurses.

This is the wrong attitude. It is a co-op for the benefit of the patient. If the medical control gives this person authority to provide additional orders above, or in addition to, your scope of practice, then it is a good thing... Right?

I think we would all agree that blind arrogance is bad. If the Nurse was also to be required to be a paramedic, would that change the attitude??

-Just curious..

Just a side note..The requirement of the nurse being at least Baccalaureate trained puts their situational thinking way ahead that of the average paramedic, or nurse for that matter..I expect this will not sit well with some, but it is what it is.

If this is not a requirement for the MICN, then it should be..

edit:

A lot of Nurses work under protocol too, not just medics.

I would venture to say that if not working under direct orders, all nurses work under protocols. haven't seen an opportunity yet to freelance..well not too many anyway

[akflightmedic]

true. luckily i don't have that dilemma. prewritten instructions, i like that. If patient is coughing turn to page 3 paragraph 4 for instructions.... :roll:

No different than most paramedic guidelines or protocols. By prewritten, I was implying that for certain conditions, the nurse may be authorized to request various medications/procedures up to a certain level in the algorithm. At a certain point in her autonomous decisions, she must then consult with a physician. However, allowing that much time to elapse is highly unlikely anyways as most of the transport times would be near complete in this area.

[CTXMEDIC]

I work as a medic in San Diego and for every call we run we have to give a full report to an MICN en route. I'm not aware of any other system that uses the MICN to the extent that we do, so I'm wondering if anyone could tell me if they work(ed) in a system that also utilizes MICNs and is in the process of eliminating them, or already has, and what it took to do so. There is a movement going on here to try and eliminate them since they're seen as little more than an unnecessary middle-man(woman), but the problem is that they rule the system, and basically developed it, so the goal is to prove how the system can be just as successful without them.

in short, i'm looking for any similar experience out there. likewise, i'd be more than willing to hear from anyone who thinks their system could benefit from them. thanks!

ive never worked in a system that had an MICN. to me they sound like an anchor. i can call our unit clerk or the county if i want to know if we're on divert. no need to pay 70k a year to someone to tell me that. to me they seem VERY unneccessary. are you guys allowed to dial a doc or is the nurses word gospel? how restrictive are your protocols? you kind of painted a picture of 'mother may i' medicine. i should say not JUST you but medics from california in general.

[CTXMEDIC]

No different than most paramedic guidelines or protocols. By prewritten, I was implying that for certain conditions, the nurse may be authorized to request various medications/procedures up to a certain level in the algorithm. At a certain point in her autonomous decisions, she must then consult with a physician. However, allowing that much time to elapse is highly unlikely anyways as most of the transport times would be near complete in this area.

ahh ok. how restrictive are these guys's protocols? and i dont mean to slam california medics here, i really want to understand this. why is the paramedic not equipped with either the knowledge or authority to make his/her own decisions about treating their patient? the only thing we have to call for orders (from a doc) for are paralytics. and thats just "Hey doc this is what i got, i wanna RSI" havent been turned down yet...

[Timmy]

It’s a shame your paramedics don’t have ‘guidelines’ and your nurses can’t ‘initiate’ treatment and medications.

[akflightmedic]

It’s a shame your paramedics don’t have ‘guidelines’ and your nurses can’t ‘initiate’ treatment and medications.

Do not know what you are referring to Timmy but it is inaccurate.

ALL paramedics have guidelines/protocols, it is the law.

Nurses can and do initiate treatments and medications.

[Timmy]

No, I mean how your paramedics can’t perform certain interventions or give medications without consultation. Most times our paramedics don’t even give a heads up before they rock up at the ED doors.

[VentMedic]

No, I mean how your paramedics can’t perform certain interventions or give medications without consultation. Most times our paramedics don’t even give a heads up before they rock up at the ED doors.

They can Timmy. At least 90% or more of the time no extra orders or permission is needed. Having an RN with specialty training to take messages and provide some assistance if needed frees up the other RNs who have patients and the doctors who are over burdened.

These MICNs also do CCT without Paramedics and can perform all the skills and interventions of a Paramedic as well as the advanced therapies/technologies of the ICU patients.

And, it is rude to just rock up to the ED without some announcement for a patient that will need a bed and not just a chair in the front triage.