Nurses and ambulances

[celticcare]

Hi guys, look I am really sorry about this if this is in the wrong area or if its been brought up in a forum before but as you guys and gals know I'm now an ER nurse and whilst doing some research...... ok I was bored on the weekend and watched season 2 of ER on dvd, I'm human, I have needs and on the show, Carol Hathaway had to do ride along time to maintain her ACLS certification and trauma nurse certification. Now I am actually curious do any of your services do this taking nurses with you on the truck for a few shifts and they have an agreement that with certain things the nurse can do some of the work, like at a code, they can cannulate or intubate or defib seeing as we do it in the ER anyway?

I am wanting to know if anyone does this or if there are any programs set up with services for RN's to maintain ER creditintals to go on the road like say one block of shifts a year or something like that, I think it would give the ER nurses an insight more into what the patients present with, assist in getting the patient triaged more effectivly, be able to start the hospital documentation side faster as we know what has to happen on the other side, and do some things to shorten the wait time like draw bloods or something like that.

Please leave the ER nurse vs paramedic crap out of this also, I am looking at just plain and simple.... do you guys take ER nurses out on a ride along basis with you to maintain their ACLS/ATLS etc credentials?

Thanks look forward to some good replies

Scotty

[tniuqs]

Firstly ... turn off that TV that is hollywood fiction.

We do have ride along programs in some places in Canada but pretty much the RN is just an observer. The title designation of Paramedic is required to provide ACLS care in an Ambulance in Alberta. Even in ER here intubation is not in RN scope of practice and RN can "as in" Paramedics can only audit the ATLS course, so no scope of practice for RN in CT insertion or Central line placement.

I can see your point about care yes in a perfect world.

ok ok I have one ... What do ER RNs use for birth control ? Umm their attitudes ! just kidding, a very old joke.

Late Entry: celtic if you ever get to Kanukistan ... there are some loop holes to get you on car ... ps bring warm clothing

Edited February 4, 2011 by tniuqs

[chbare]

No, ambulance time is not required to maintain ACLS, PALS or TNCC credentials. Some employers may have a ride requirement, but AHA and the ENA has no such requirement.

Take care,

chbare.

[JakeEMTP]

Hey Scotty,

While I don't think it is a requirement for the nurses to ride along to maintain their ACLS here (they run plenty of codes as you are aware),we have had nurses ride just to see what we do in the field.

Jim

[Bieber]

Around here, I'm not especially convinced that the nurses have much of any idea of who we are or what we can do, and as far as I know I've never heard of any nurse doing a ride along with EMS (or having any desire to). Also, around here nurses don't intubate or place central lines.

On a side note, I love ER!

[celticcare]

Around here, I'm not especially convinced that the nurses have much of any idea of who we are or what we can do, and as far as I know I've never heard of any nurse doing a ride along with EMS (or having any desire to). Also, around here nurses don't intubate or place central lines.

On a side note, I love ER!

If the nurse has done the ACLS course, we are able to intubate if the need arose, I had a code I was doing and had the laryngascope in hand, blade in mouth, bout to place the tube *visualised the cords beautifully* and then bang some upstart intern puhsed me out the way and took over. Bastard. Added another 30-40 seconds without oxygen despite protesting and saying for me to at least bag the patient. There is some attitude still that nurses are only good for bedpans.

Hey tnuiqs, I think that is very true Mainly the triage nurses

Scotty

[tniuqs]

If the nurse has done the ACLS course, we are able to intubate if the need arose, I had a code I was doing and had the laryngascope in hand, blade in mouth, bout to place the tube *visualised the cords beautifully* and then bang some upstart intern puhsed me out the way and took over. Bastard. Added another 30-40 seconds without oxygen despite protesting and saying for me to at least bag the patient. There is some attitude still that nurses are only good for bedpans.

Scotty

Working in hosp as RRT, or even Medic if some upstart intern tried a move like that (besides my sharp tongue ) the attending MD would send "it" to laundry for time out. Absolutely no place for anything other than what is best for the patients good, Dood you have every right to be steamed !

I am all about clinical bedside teaching and have assisted lots of interns residents medics to gain confidence shooting tubes ... but no place for rank pulling when you are a half a second away from securing an airway in an arrest.

cheers

[HERBIE1]

Seems to me the ride alongs aren't nearly as common as they used to be. I believe various specialty courses allow for riding as an option to maintain their certifications. Obviously you would think telemetry nurses would be mandated to ride- but most do not.

Is it a good idea? Of course it is. Prehospital folks know far more about what ER nurses do than the other way around. All it takes is a shift or 2 in the ghetto and these nurses have a whole new perspective on what we do.

I especially love the nurses who occasionally come from "nicer" areas and have no idea what ghetto life is like.

One day I had a couple 20 something cute little nurses from the ER I worked at (busy urban Level 1 Trauma Center) ride with me in the worst area of town. Both were from small towns and although they worked in the ER for awhile, they were still pretty naive. As we were returning from a call, one of the "working girls" stepped up to the rig as we were sitting at a light. We exchanged pleasantries- how's business, nice day, etc, and as the light changed, the "business woman" decided to flip up her shirt and show me her wares. My partner and I laughed. Apparently the riders were looking out the window at the side door and I suddenly heard shrieks from them. "Oh my gawd- why would she do that??" I said it was like the yellow pages- she was doing a little advertising for her business. To this day- 15+ years later- these nurses still talk about that incident. LOL

Coming from someone who has done both ER and prehospital-I still really think that to this day, nurses need more exposure to what we do- and vice versa. We get quite comfortable in our own little worlds and forget there are different perspectives on the same thing. I try to explain to new folks what it's like working in an ER.

Many nurses flat out admit they do not like being on the rigs- they enjoy the controlled environment(as chaotic as it can be sometimes) of an ER. All the help in the world is just a call away- security, a doctor, lifting help, another nurse, a tech, housekeeping- essentially whatever they need. In the field, we have no such luxuries. They love hearing the stories, but are happy to leave it at that.

[tniuqs]

To this day- 15+ years later- these nurses still talk about that incident. LOL

Brought back some memories of the "DMZ" and the "fruit loop" ... My line was always:

Do I get a discount if I bring my own bed ?

te he.

[Richard B the EMT]

Nearest I can get to this, is, a few years ago, a number of Army "Medics" and Navy "Corpsmen" in training did a rotation of several tours where they rode as JAFOs on several BLS units and tours from my station. Approved by FDNY HQ, with all prior applications adhered to.

FYI, the term JAFO? From the Roy Scheider movie, "Blue Thunder", and, cleaned up for our genteel audience, translates to "Just Another Frustrated Observer".