Nurses and ambulances

[Happiness]

The only time I have had a nurse ride along with me is if there is a med being run through a IV that I am not qualified to run. I havnt heard of a nurse going with us to get qualifications.

[celticcare]

Thank you all so far for your replies, one of the other nurses and I in the department have been talking about having ride along time as a mutual agreement time between us and the ambulance service. We want to see more of the ambulance officers world and they see ours. And work it into our technical competencies to maintain ER nurse credentials. Mainly in the aspect that to understand things like MOI, further develop our IV skills *like majority of us can cannulate bloody well in the ER, but work on enhancing them out in the patients home*, acute coronary presentations in patients homes etc.

It's also an aim to strengthen relationships between medics and RN's and move out of our comfort zones. I would love to achieve ECP status one day as an NP working on the rapid response units with the advanced paramedics and nurses and Medics working together to get patients stabilised and perhaps with the NP scope of practice, doing things in the homes to minimise ER admission and patients can be followed up by distric nurses etc.

Look forward to more input, thank you all again

Scotty

[zippyRN]

Thank you all so far for your replies, one of the other nurses and I in the department have been talking about having ride along time as a mutual agreement time between us and the ambulance service. We want to see more of the ambulance officers world and they see ours. And work it into our technical competencies to maintain ER nurse credentials. Mainly in the aspect that to understand things like MOI, further develop our IV skills *like majority of us can cannulate bloody well in the ER, but work on enhancing them out in the patients home*, acute coronary presentations in patients homes etc.

It's also an aim to strengthen relationships between medics and RN's and move out of our comfort zones. I would love to achieve ECP status one day as an NP working on the rapid response units with the advanced paramedics and nurses and Medics working together to get patients stabilised and perhaps with the NP scope of practice, doing things in the homes to minimise ER admission and patients can be followed up by distric nurses etc.

Look forward to more input, thank you all again

Scotty

Has a certain person being praising the Army (TA) and Johnner Nurses of his acquaintance ... and their flexibility , willingness to do transfers and their all round rugged charms !

Has the same person been praising the relationship between the ED and the Ambulance staff at his previous place of work as well ?

ECP ( Emergency Care Practitioner) works the biggest boundary in the UK has been the obsession with the A8 response time which lead to ECPs being used as overpaid responders ( to the point I know of people who voluntarily 'demoted' themselves back to an ambulance line as a band 5) or alternatively being BONGOs as the sector controllers were too busy playing catch up on the A8 target to think aobut deploying the ECP to ECP able calls

Edited February 5, 2011 by zippyRN

[NYCEMS9115]

Well the question was answered.

To touch up on the intubation stuff. The reason that Paramedics can do somethings a RN can't, is because the field we are in: Pre-Hospital Care. We don't have (for the most part) other higher Medical Authority onscene, providing care. We learn all the ACLS & PALS stuff without taking these classes; its our Scope of Practice. The way Paramedic Training is; we have rotations in many areas like the ICU, ER, AMB, OR, etc. Many RN Prigrams only require Med-Surg clinicals. If a RN wants to work in the ER, CCU, PICU, or any specalty floor; they must take an internal Critical Care Course and many will require the RN to become a CCRN. Its the nature of the game. A RN fresh out of school can not work a code but a Paramedic can. Its just not the fundamental skillset of the RN.

That being said, the RN has so much more movement than any EMS Provider can imagine (unless I get my way from NREMT, NAEMSE, NHTSA, etc for higher learning). The RN from the Crimean War days, has advanced so far. The Degrees like ASN, BSN, MSN, & PhDN. The Advance Licensed Titles like Clinical Nurse Specialist, Case Manager, Nurse Practitioner, Nurse Anesthetist, & Doctor of Nursing Practice. Its on a WOW factor. So much more movement for the RN, clinically and administratively. RN can work in so many settings. They can pursue further in the Nursing field. EMS must mirror what Nursing has achieved through the years but we won't due to Politics: skills w/o edu.

Go and push yourself to the limit. Keep up the success. I respect the Nursing field. I'm in my last quarter of classes to get my ASN; hope that NCLEX is easier than preached about. So I can appreciate the difficulties.

My theory is that EMS will remain stagnant because what it has evolved into: a hobby for most. A Volunteer Ambulance Service as the only means of EMS in areas is ridiculous. Nothing against the concept of Volunteering but in the most powerful country (Next to China), most suburban residents depend on Volunteer EMS for care & transport to the ER. At least Paramedics will always be a paid service. I've worked in a flycar ALS service and the longest I've waited for the Ambulance was for 45minutes because the VAC and the neighboring VACs didn't have members available. My company had to send one of our Ambulances (which was for Private Transport) to come to the scene. But Volunteering is great but it shouldn't be this way & in some areas the only way. I love being a Paramedic, the adrenalin rush was great when I was younger. Now I want something more stable and progressive. Bring on the replies; I know many will thrash me. Its my opinion based on fact. All the best...

[byoung57]

We actually had the nursing school ask about having nursing students do an 8 hour shift with our service. It worked really well.

Bill

http://emseducation1.blogspot.com/

[GhostMedic29]

ER nurses are a great asset to EMT's and Paramedics. Nurses are not required to "ride along" in my area in order to maintain ACLS or any other professional certification.

At the present time I have inquired to my state public health officials about making it a requirement for nursing students to be required to complete a set number of hours riding with a paramedic service just so they can better understand our job.

Some nurses not all of them but some seem to regard EMS workers as cot jockeys and ambulance drivers. As a paramedic I for one HATE being referred as a cot jockey or ambulance driver. The nurses in my area have received several tongue lashings from my collegues and myself.

On a more personal note it would be nice if EMS workers were paid more than what we are.

[Carl Ashman]

We have a program where we take BSN students on for an internship of 6 months. In that time they learn all about EMS (EMS is nurse led here) and undertake a clinical research project. I think it really raises awareness of the job. The group I'd personally like to see ride-along is the dispatchers. They'd then get for more understanding of their own job too. Currently they are required to do just 1 day during their initial training and that's it.

Carl.

[Richard B the EMT]

As all EMD personnel in the FDNY EMS are EMTs, supposedly, they already know.

EMD folks can work overtime on ambulances, but EMTs assigned to ambulances can NOT work overtime in EMD, due to the training needed there

[FireMedic65]

Here in PA there a certification "PHRN" pre-hospital registered nurse, which fall under healthcare professional. They work on the same level as a paramedic. Nurse, are also allowed to transport patients on a number of different medications and administer a few others that a paramedic cannot.

[PCP]

We do not have nurses riding with us to keep their certification, but just last week there was a sign up sheet for any paramedic who is okay with allowing nursing students to come out and ride with us for a shift. I think it is a great idea, so that they can see what we do at a call before we bring the patient to the hospital. Sometimes I feel some of the nurses that have been working at the hospital for a while need to come out and ride with us, as there have been times when they question us as to why are the clothes cut off or question why a certain procedure was not done by the time we arrive at the hospital. I feel they don't understand that there are times we are very busy on a call and the transport time is short to the hospital, so we may not get all the things done we would like to before arriving or we need to cut the clothes to do our assessment properly.

Hopefully by the nursing students coming out for a ride along, they will understand and not forget that the patient may be presenting differentley on our arrival then when we arrive at the hospital and not question what I tell them in my report.

Sorry I got off topic, but just wanted to add a few things.

Brian