Er and ems liason

[celticcare]

Hi all. Have a question for you lovely people out there. I had a situation recently in the er I work in in where a fellow collegue was unsure of certain things the EMS providers here can provide and do such as in field spinal clearance or tourniquet application. So am just curious does your ER have a nurse assigned as an EMS liason to assist with education or staff issues? If so, how does this system work? I would like to create this role within our ER and would love some input including what would you envision the nurse in this role to have and what would you expect them to do for your voice in the ER?

Thanks in advance guys

Scotty

[hatelilpeepees]

You really want a Nurse to decide what you can and can not do ? Your State EMS Office and Medical Director should clearly define what you can and can not do, it is not the job of any ER or ER Nurse to be knowlegable about your scope of practice. Are you a practicing EMT ?

Edited July 10, 2011 by hatelilpeepees

[celticcare]

Woah, back the horse. I am an ER RN as well as certified EMT-I. I am more meaning on the aspect that this other nurse I work with didn't know what EMS staff could do in the field, as in lack of knowledge of the scope of practice and procedures available etc.

I am not saying the RN makes the decisions about paramedic skills etc, far from it. I am asking is there an RN at your local hospitals that acts like an EMS liason or support person between RN's and EMT's? Like if an RN pisses you off, do you have a nurse there that you can talk to about it or find passages to rectify situations, or an RN that is involved with your service also that educates staff back at the ER about new equipment or procedures in the field to ensure continium of care is processed etc.

Remember I am in New Zealand, we generally have a good rapport between EMS and Emergency Nursing here, but just curious if there is anything like I have asked in any of your hospitals. And I personally think its good for ER RN's to know what Paramedics/EMT's here can do and what sort of skills are in the tool box. It is not a pissing post for anyone, merely a support network for each other and also a chance for each speciality to see into the world of each other.

Scotty

[fiznat]

We have "EMS coordinators" where I work, hospital employees who serve as intermediaries between EMS and the medical control physicians. They have a lot of other jobs I'm sure, but they manage EMS paperwork like cert and con-ed maintenance, CME classes, field complaints and concerns, general Q&A, etc etc. Out of the 3 in the region, two are paramedics with BA degrees, and one is a paramedic/RN.

If there is a basic question like "what are we allowed to do," though, shouldn't that question be easily answered by consulting the written protocol in your area? Scope of practice and "what to do when" stuff should be pretty much black and white save the occasional weird issue. Around here, EMS workers are expected to know the protocols cold, and if there is an issue the documents are posted on line and at the hospital.

[tniuqs]

Woah, back the horse. I am an ER RN as well as certified EMT-I. I am more meaning on the aspect that this other nurse I work with didn't know what EMS staff could do in the field, as in lack of knowledge of the scope of practice and procedures available etc.

I am not saying the RN makes the decisions about paramedic skills etc, far from it. I am asking is there an RN at your local hospitals that acts like an EMS liason or support person between RN's and EMT's? Like if an RN pisses you off, do you have a nurse there that you can talk to about it or find passages to rectify situations, or an RN that is involved with your service also that educates staff back at the ER about new equipment or procedures in the field to ensure continium of care is processed etc.

Remember I am in New Zealand, we generally have a good rapport between EMS and Emergency Nursing here, but just curious if there is anything like I have asked in any of your hospitals. And I personally think its good for ER RN's to know what Paramedics/EMT's here can do and what sort of skills are in the tool box. It is not a pissing post for anyone, merely a support network for each other and also a chance for each speciality to see into the world of each other.

Scotty

Looking for a new job Scotty ? LOL.

[tcripp]

I am not saying the RN makes the decisions about paramedic skills etc, far from it. I am asking is there an RN at your local hospitals that acts like an EMS liason or support person between RN's and EMT's? Like if an RN pisses you off, do you have a nurse there that you can talk to about it or find passages to rectify situations, or an RN that is involved with your service also that educates staff back at the ER about new equipment or procedures in the field to ensure continium of care is processed etc.

That is what our chief is for...the liaison between the hospital and our service. Just as they would go to their director of nurses if they have a problem with us. Of course, I always prefer the direct approach. If you have a question or issue with what I'm doing...ask me about it. I may have a rational answer for you as to why I did it that way this time.

[DwayneEMTP]

I got the feeling that he was asking more about training together, helping one hand understand more fully what the other hand is doing, rather than dispute resolution. And I think that it's an awesome idea. So much of the bullshit that goes on between medics (Paramedics) and nurses is caused by misunderstandings. I've met a ton of medics that truly believe that they are smarter than any nurse could possibly be, and a ton of nurses that were shocked to discover that a medic can start an IV without permission.

Continuity of care would be accomplished at a much higher level much more smoothly I believe if these myths were vanquished.

But, to answer your question brother, other than a program at one service that allowed us to go and get tubes in the OR every quarter, the only representation between EMS and ER was secondary to conflicts and that was management alone. Though in the small town we had a great relationship with most of the hospital staff, whatever the level, but I still believe something formal would have been very beneficial.

Dwayne

[Kiwiology]

Wait until September, then show them the foreword of the 2011 Clinical Procedures with the new practice levels and scopes of practice

[zippyRN]

the biggest problem is if the relationship is only between 'big wigs' and/or risk management , the only structured way of delivering feedback and asking questions is a shitstorm , where a clearly documented liasion person for the ED liasing with the Station Officer ( or equivalent) for EMS is a way for 2 way communication to be taken onto a more official but not management centred level.

Never officially had the post in any of the EDs I worked in but there have always been go to people to smooth out interservice friction whether that's been Johnners ( becasue we are 'bilingual' in hospital ese and ambulancese), people in relationships with ambulance staff ( not just spouses , in one of the EDs i've worked in one of the Nurses was cousins with one of the paramedics, and i know an ED (and Helicopter) Doc who has a brother who is a Paramedic) , or those who have 'changed codes' ( whether from the hospital to EMS or t'other way) -

A lot of it is about being 'bilingual' and having a real understanding of what being on a scene is all about - not just a couple of obs shifts in the deep dark past)

Edited July 11, 2011 by zippyRN

[tcripp]

I got the feeling that he was asking more about training together, helping one hand understand more fully what the other hand is doing, rather than dispute resolution. And I think that it's an awesome idea. So much of the bullshit that goes on between medics (Paramedics) and nurses is caused by misunderstandings. I've met a ton of medics that truly believe that they are smarter than any nurse could possibly be, and a ton of nurses that were shocked to discover that a medic can start an IV without permission.

Continuity of care would be accomplished at a much higher level much more smoothly I believe if these myths were vanquished.

But, to answer your question brother, other than a program at one service that allowed us to go and get tubes in the OR every quarter, the only representation between EMS and ER was secondary to conflicts and that was management alone. Though in the small town we had a great relationship with most of the hospital staff, whatever the level, but I still believe something formal would have been very beneficial.

Dwayne

And, see I read it that he wanted to know what reality was...not what would actually be beneficial. I would love to see some type of relationship where maybe a medic/RN acted as liaisons for each others organization. What a concept!!!