RN's in EMS

[BlueSkies]

On the topic at hand I do think that RN's can bring a lot to the table. Having flown with RN's they tend to know their strengths and weakness just like the rest of us should. I understand that some ar anti-paramedic being in the ER just like we are anti-RN being in the field. I do believe that most of this comes from our inate sense of job security and self preservation.

Pro's:

As previously stated it does aid in the ER "overcrowding" issues. How you may ask? Simple, an RN's knowledge of disease and illness pathophysiology far outweighs the average paramedics making it more likely that the Pt can be left to their own vices at home, ie OTC's and things of that sort.

They are also able to take a seat in the call center and play an "Ask-a-Nurse" role and phone triage most calls instead of sending an ALS unit emergency traffic to the corner payphone at 0200 just because the cold homeless guy used the magic phrase of "chest pain".

Cons:

An RN's education is geared more toward long term care. I do understand that RN's can specialize. All I am refering to is their base knowledge.

An RN's skill base isn't as large as a paramedics when it comes to life saving procedures. Again I understand they can specialize and broaden their scope.

As a matter of fact, like I said previously, the RN's I flew with knew where their skills were lacking and generally let the medics lead on scene calls and difficult airways. Although there were some strong RN's on the aircraft that could do as much if not more than we could.

So back to the point at hand, generally RN's do not want to be in pre hospital care so as far as RN's one day taking over the EMS world I do not see that happening in the states. The lines are kind of drawn in the sand here and although like Dwayne said it would go hand in hand with raising the pay and benefits I really don't forsee a mass of RN's suddenly wanting to ride the ambulance anytime soon.

[ERDoc]

I think we should staff every ambulance with a physician, but I may be a little biased.

[chbare]

I think we should staff every ambulance with a physician, but I may be a little biased.

No worries, nurses have that covered now. You can get both a "doctor" and a nurse all in one if you go with nursing. J/K BTW

[RaceMedic]

I think we should staff every ambulance with a physician, but I may be a little biased.

I would love to work with a doc on the streets, However your unique ERDoc. I have offered our docs here to come on the truck an ride along ... always get lip service " yea ill come out sometime and show you how its done" yadda yadda blah blah blah... lol

They been saying that since i started in 1992.

Race

[Happiness]

http://www.bclocalnews.com/bc_north/interior-news/news/130160053.html this is the opposite of the topic but I thought it was worth making a comment on.

Personally I have no problems with nurses being in the ambulance as the have great skills, but were I have the problem is paramedicine is a skill set on its own and nurses are not trained in the things we do and vice versa. If a nurse wants to be in the back of an amublance why didnt they become a paramedic in the first place?

The artical above tells of the pilot program intergrating paramedics into the emergency hospital system, this has been mentioned through out BC for a few years and my comment was that if I wanted to be a nurse that is what I would have to school for. Now in our community about 10 years back Northen health hired a few of us paramedics to be available to go into the hospital if shit hit the fan, or if they couldnt man the hospital to full staff. It is a good idea in an emergency situation but I kind of think that the paramedics are going to get board as we all know that we are adrenaline junkies and when the pagers go off the heart rate goes up. Well just my two cents...........................

[ERDoc]

No worries, nurses have that covered now. You can get both a "doctor" and a nurse all in one if you go with nursing. J/K BTW

I said doctor, not noctor.

[rock_shoes]

Pro's:

As previously stated it does aid in the ER "overcrowding" issues. How you may ask? Simple, an RN's knowledge of disease and illness pathophysiology far outweighs the average paramedics making it more likely that the Pt can be left to their own vices at home, ie OTC's and things of that sort.

Except in systems where the ALS Paramedics have similar knowledge bases with regard to A&P, pathophysiology, etc. In that case a nurse’s primary advantage is nill. The radical variation in quality of Paramedic education found in the US is responsible for these type of movements. Eliminate the medic mills and nurses muscling in on out of hospital care will have a much harder fight.

Cons:

An RN's education is geared more toward long term care. I do understand that RN's can specialize. All I am refering to is their base knowledge.

An RN's skill base isn't as large as a paramedics when it comes to life saving procedures. Again I understand they can specialize and broaden their scope.

Precisely. In all honesty for CCT I think either a paired Critical Care Paramedic or a CCP/ RT team would be a better choice than a Paramedic /RN team.

[WelshMedic]

Cons:

An RN's education is geared more toward long term care. I do understand that RN's can specialize. All I am refering to is their base knowledge.

An RN's skill base isn't as large as a paramedics when it comes to life saving procedures. Again I understand they can specialize and broaden their scope.

Why did you make these statements and then directly contradict yourself?

An RN's education isn't specifically geared to long-term care. It is, however, a broader knowledge base that utilizes a holisitic approach. That base equips us to assess, treat and release patients, making nurse-led EMS efficient when looking at health care at macro level.

The thing is, I don't actually believe it makes a great deal of difference in "life saving" measures. ACLS and PHTLS are the same principles, regardless of who is carrying them out. I may even beg to argue that, if nurse led, there may be more research which would lead to EBM instead of rituals.

WM

[DFIB]

I once rode a transfer with a poly-traumatized patient and an anesthesiologist stabilizing him. He was delivered to a local clinic in the back of a LE pick-up truck, He had been in a high velocity head on MVC with an 18 wheeler. It was a 2 hour and 45 minute ride. The Doc was a Rock Star at keeping the patient alive. One of the coolest calls I have ever worked.

[chbare]

No worries, nurses have that covered now. You can get both a "doctor" and a nurse all in one if you go with nursing. J/K BTW

"I said doctor, not noctor.

Saving the world from natural selection."

Noctor, Doctor. Tomato, tomato.