EMT working in ER: Does anyone know process and rules?

[ambodriver]

I am talking about Washington state. As I am sure you know, state offices are hard to get ahold of, my boss and I have both been playing phone tag with them. The state has a cert called a Health Care Assistant. In that, the state decides what you can do according to your training, which should be what I can do as an EMT-ILS/AW.

In response to the hospital policy, There is only one other person doing this job and it has come under scrutiny as well in regards to certification required to work there and the scope of practice. The hospital isn't even sure of the rules, since they have never had experience with this sort of thing. The hospital doesn't have policies and procedures for this and the nurses don't have any idea of what our scope is. My understanding is that I would be working under the liscence of a RN (even though a doctor has to say you are working under them). I am only one step below a medic (be it a long step). The reason I am asking about all this is so I can figure out if I will actually be able to work there or I should go get another job.

Besides the money, It will be nice to have pt contacts, considering our service runs an average of 2 calls a day. The first car runs about 85% of the 911 calls. I am on the second rig so you see how that sucks. I am worried about being the gopher which I am sure I will get to do quite a bit. I guess I'm just not sure of what to expect and am a little uneasy about the whole thing, not knowing and fully understanding the whole process. I appreciate the response.

Nick

as an emt you won't do much except for what an EMT does. You will also do PCT work, wiping crap, stocking, taking pt.s to CT. No reason to take away a B cert in the ER, B's don't do much anyways so it's all good. Great to work in an ER until you are done w/medic school. gluck

[krumel]

In the german speaking countries (mainly Switzerland and Germany) its very common to EMT-P's to work in the hospitals.

Normally they work in the E.R. and the anaesthetic site of the OR.

For myself I worked 6 month in an emergency department.

My task were:

- Managing the cases (due to the fact we didn't have a special case manager) (means: Find beds within the inpatient units, managing certain examinations in the departments, organizing interfacilitiy transport)

- Being the contact person for the dispatch and the ambulances.

- Leader of the "emergency department code team". Due to the fact that the physicans often change between inpatient units and the E.D. the "E.D. Code Team leader" was a kind of a Leader for the organization of the arrest (etc. control the change of the persons whos compression, make sure the "lab runner" is there, = everything not medical). When imminent action was necessary and no physician (or no physician who know what to do) I was allowed to do all EMT interventions I would be doing "outside" (i.V.'s, intubation, needle decompression, some meds).

I had very little to do with the "everyday work" in the E.D. due to the fact that those tasks normally took enough time. But when boredome grabbed all of us (yes, happended sometimes) or the E.D. was overcrowded with "non criticals" of course I was able to do foley's, apply bandages, took labs, etc...But this was more "nurses works".

Due to the facts that E.D. nurses here aren't allowed to do invasive interventions and are normally not "that fit" in emergency medicine as well as the fact that I had very wide comptences given by the chief of the E.D. my rank was clearly above the nurses on the same "height" as the chief of the nurses/shiftleader of the nurses was. But: Not once I feeled I had to use a "rank" due to the fact that this hospital was one of the best teamwork jobs I ever saw.

(I could still kick my own ass for leaving for that stupid gurl....)

[disabled emt]

The ambulance service I work for is trying to have me work in the ER. We are a critical access hospital (less than 15 pts a day on average). I have heard conflicting stories that I have to get what Washington calls a Health Care Provider. Other people have told me that I don't have to. It has also been brought up that as soon as an EMT-B up to an EMT-P sets foot in a hospital, they are stripped of there ability to do pt care. It's a little confusing to me and I would like to have some unbiased opinions and answers.

1. Do you have to have a special certification or training to work in an ER at your scope?

2. Is it true that you are stripped of your cert once you are inside of a hospital?

Thank all of you in Advance

Nick

depends what state you live in .I know in pa you can be a emt but yr not working as a emt yr considered a er tech

[fireflymedic]

Just really depends on the hospital and what your capabilities/motivation is. If you have CNA training as well I know it's a benefit in this area, but I don't know if that's acros the board. The biggest reason for this is they have had a problem with straight EMS workers being lazy. Of course that doesn't apply to all, but to a good portion kind of giving EMS in the ER a bad name. This has been especially true with medics in the ER to supplement nurses. However, if you jump in and work hard you'll get to see and do quite a bit once they learn your comfort level and motivation. The skill set there is entirely different as it's more like a mass casualty of butt wiping and bed changing sometimes compared to one or two patients on the street. However, depending on where you are, you may draw labs, run the labs, double as a clerk, transport, and any other variation of things. That pretty much covers it. Keep your eyes and ears open and mouth shut and have fun.

[OLDTIMER]

The ambulance service I work for is trying to have me work in the ER. We are a critical access hospital (less than 15 pts a day on average). I have heard conflicting stories that I have to get what Washington calls a Health Care Provider. Other people have told me that I don't have to. It has also been brought up that as soon as an EMT-B up to an EMT-P sets foot in a hospital, they are stripped of there ability to do pt care. It's a little confusing to me and I would like to have some unbiased opinions and answers.

1. Do you have to have a special certification or training to work in an ER at your scope?

2. Is it true that you are stripped of your cert once you are inside of a hospital?

Thank all of you in Advance

Nick

EMT certifications generally allow you to work on an ambulance. Special training/licensure /certification allows you to work in a hospital. many hospitals & doctors mistakenly believe they can train anyone to do anything under their hospital and/or MD license. In some states this might be true, in other states it is not permitted under state laws. Some hospitals/MD's find this out too late (in court) where "unlicensed practioner" is on trial for practrcing medicne or nursing without a license & employer is a co-defendant.

Check with state hospital licensing board & get written opinion on whether or not you can perform each skill/intervention the hospital expects you to do. Also check with hospital malpractice insurance company to see if you are individually covered for these practices/skills.