RN's in EMS

[BlueSkies]

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

I was merely making the statement of an RN's education is based in long term care and not in emergency medicine. I wrote the statement afterwards because I do know they can specialize.

We are starting to use quite a bot of EBM. Most of the new ACLS, CPR, and PALS changes are EBM. So the argument of a Nurse led EMS team will lead to greater improvements in medicine due to EBM instead of rituals is kind of nil at this point.

Now my wife has a BSN and I am sensitive to others feelings when it comes to RN vs. Medic disagreements so I'm not willing to get into a large debate about all this. Take what I say with a grain of salt.

[WelshMedic]

I was merely making the statement of an RN's education is based in long term care and not in emergency medicine. I wrote the statement afterwards because I do know they can specialize.

We are starting to use quite a bot of EBM. Most of the new ACLS, CPR, and PALS changes are EBM. So the argument of a Nurse led EMS team will lead to greater improvements in medicine due to EBM instead of rituals is kind of nil at this point.

Now my wife has a BSN and I am sensitive to others feelings when it comes to RN vs. Medic disagreements so I'm not willing to get into a large debate about all this. Take what I say with a grain of salt.

Don't worry, I wasn't put out by your statement, just putting my 2 cents worth into the discussion. I happen to have a great deal of respect for my paramedic colleagues, both here and in the real world. I just don't subscribe to the idea that nurses can't make the transfer into EMS. We can and do with a great of success. But to be fair to you, you didn't actually present that as a statement of fact.

The truth is that whilst I do defend my position here, in the real world (here in the Netherlands) I may be one of a dying breed. It's becoming increasingly difficult to find suitably qualified RN's. Which is why the first degree in EMS has started here this year. We seem to be slowly making the transition into the Anglo-Saxon model of EMS delivery.

WM

[RaceMedic]

Well, the way i took this thread at the beginning wasn't was a Medic vs RN.. since having both i will stay out of that argument, besides the fact that it is completely counter productive.We have to work with RN's no matter what we do. Yes there is animosity taught towards each other in the respective classes. Even in the medic to RN bridge programs you can tell ( college based not mail order). There is an undertone. I am trying to belay that as much as i can not matter where i work in my corner of the world.

There was a question as to why wouldn't a nurse just become a medic first if the want to work in an ambulance? To that i ask this, If you want to expand the medic field and work in an ER why didn't you become a nurse first?

No i am not pointing fingers and saying that the poster that asked that is wanting to work in the ER, I don't know if they do or not. and Happiness posted that they are trying out medics in the ER's there in Canada. well thats been going on for yrs here i know of many hospitals that use Medics in the ER. BUT they still do no have full medic scope. The operate the same as an RN no intubations period, No meds or IV's with out a direct written or verbal order. AND they still make less money than the RN doing the same job, also they report to the RN and are supervised by the RN not the doc. (before someone gets a nipple twisted yes i know there are protocols that are followed in the ER than allow things to be started given specific criteria but it is nothing compared to and ambulance service.).

I personally have benefited greatly from becoming an RN/Medic. It has expanded my knowledge base, the way i base my treatment plan, the holistic approach. it has opened so many things. Personally i feel that if they could find a way to blend the two philosophies and practices with out losing the highlights of what makes each special in their own right and turn it in to a Bachelors degree program for initial certification/licensure. That would be incredible, toss in the math, chem, ect .. and make it a PreMed degree... it would satisfy many things we are struggling to achieve as a career. However then there would be the fight over who would be in control ... well enough day dreaming ...

Race

*edit*

Ohh and as far as skills between a nurse and medic, The only things we did not have to check off on in my nursing bridge that we were taught in medic was intubation and surgical airway management. ohh well of course LSB, splinting, that sort of thing as well. But NG, OG, Foley, IV, ... Ect.. all of that was taught to my medic class by the nursing instructors at our college.

Edited October 21, 2011 by RaceMedic

[flamingemt2011]

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

Like the physician staffed ambulance that killed Princess Diana ?

[RaceMedic]

Like the physician staffed ambulance that killed Princess Diana ?

How many people do medics kill everyday ? Thats not helpful to the thread. troll somewhere else...

[krumel]

There's still some truth in what he said...

The physician based systems in Germany, France and Austria have huge problems finding enough qualified personel.

In Germany there we're cases that during nights a area comparable to the hole state of Rhode island had only one physician available. As the scope of practice varies widly amongst the diffrent regions in this case it means: No ALS care (including NO i.V.'s, NO pain reduction, NO Airway) for everyone who didn't get the doc...

But back to topic:

I just wanted to add another european point of view to this discussion.

In Switzerland most EMS are hospital based.In the smaller hospitals the Paramedics usually rotate thru the anaesthesia department, the ER and the ICU beside doing the normal "roadside" work. This gives us the opportunity to train certain skills (intubation, RSI, etc.) and makes it easier to get a "broader" expierence.

On the other hand the anaesthesia and ER nurses work with us on the ambulances and do their "own" rotation as well....

So they are pretty used to the "roadside problems"...

[JPINFV]

Dwayne, what we need is licensure instead of certifications. That commands higher standards, and hopefully, with that comes higher respect.

The licensure vs certification debate is a distraction. No one important cares what the card issued by the state that allows you to practice is called. Heck, in California, the term "certificate" and "license" is deemed synonymous when it comes to physicians. So if the people who write the laws can't get it straight in regards to a profession that no one questions is licensed, why do you think it matters for a trade trying to become a profession?

Every paramedic who calls medical control because they're too afraid or incompetent to make a decision, thus making them want to put the liability on medical control does more in that medical control call to destroy paramedicine as a profession than if all 50 states were to call their card a certificate.

[Asysin2leads]

Like the physician staffed ambulance that killed Princess Diana ?

I heard a car crash killed Princess Diana. Geez man, at least go with Michael Jackson's physician if you want a good example. Yes, he wasn't on an ambulance, but boy, what a screw up.

I think paramedics trained as RN's are the best providers out there. Your day to day RN on an emergency scene? Ummmm, not so much. I'm not sure what it is about RN training that makes them fall apart on the scene of an emergency but its been my luck that it has happened unilaterally with me. I can give you the horror stories of ACLS instructors and RN sometimes but you probably get the picture. Paramedics: Good in an emergency, bad at just about everything else. RNs: Good at everything else except emergencies.

[ERDoc]

Like the physician staffed ambulance that killed Princess Diana ?

Yeah, it was the physician that killed her, not the hole in her pulm vein. She coded on scene, her chances will minimal at best to begin with.

[WelshMedic]

I heard a car crash killed Princess Diana. Geez man, at least go with Michael Jackson's physician if you want a good example. Yes, he wasn't on an ambulance, but boy, what a screw up.

I think paramedics trained as RN's are the best providers out there. Your day to day RN on an emergency scene? Ummmm, not so much. I'm not sure what it is about RN training that makes them fall apart on the scene of an emergency but its been my luck that it has happened unilaterally with me. I can give you the horror stories of ACLS instructors and RN sometimes but you probably get the picture. Paramedics: Good in an emergency, bad at just about everything else. RNs: Good at everything else except emergencies.

That's Dutch EMS FUNBAR'd then,,,