Any one an ER Tech? EMT-P as RN Nurses?

[speedygodzilla]

Hello,

I just recently got a job as an ER Tech at one of the local hospitals. This my first healtcare job and I am very excited about it. I am an EMT-B just passing the EMT Test back in February. I looked for jobs for a good month to a half till I finally got my first interview for ER Tech. I really want to work on an ambulance but I couldn't pass up the great chance to get some real experience.

I was wondering if any other EMT are ER Techs, and what are your responsibilities in the ER?

For me, I triage, get vitals, basic life care when needed, clean the rooms, draw blood (which is totally something I was never taught), do labs (also has to be taught here at the ER), & etc. There is also charts which I have to file. Today, Easter Sunday is my 3rd day on the job and I love it. Even if I have I work on a holiday. Welcome to healthcare, it is part of our responsibility.

My fiance is a CNA and is interested in becoming a ER Nurse and has heard that EMT-P can work at ERs and play the same basic role as RN Nurses. Has anyone found this to be true? Anyone do this? What is the difference on if you are an RN or an EMT-P in the ED?

Thanks

Nate

[AZCEP]

Whoa there speedy. Let's not get the nursing crowd wound up just yet, okay?

Congratulations on the job. You will gather a significantly different view of how to manage a patient in an ER than you will get in the street. Not better/worse, just different. You are closer to the end points of treatment, so your exposure will be geared more to the eventuality that the patient will experience. The labs/blood draws and any other procedure that you are allowed to help with will also help you down the road.

The ability of paramedics to work in hospitals, and other facilities is based on the willingness of the facility to allow them. The different things that they are allowed to do will be monitored by RN's/MD's/RT's, and they are all going to be a bit different in each facility. Some will follow state regulations to the letter, while some will be a bit more lax in their interpretation of the rules. For the most part, they can and do function in a similar capacity to RN's, but they generally are not given the ultimate responsibility for the care a patient receives.

[chbare]

As AZCEP stated, much will depend on the facility and the job description for the medic. Currently, I would recommend nursing school if you want to work within the hospital. You will be able to easily transfer into other units and have many career advancement options avaliable. I have no problem working with a medic or having medics provide care at their level of education, however, employment opportunities within the hospital can be quite limited for the paramedic. I know several medics who work in the ER on the side for extra money, but they all still work on the ground and have much more autonomy in the field.

Take care,

chbare.

[VentMedic]

You'll find working in the ER an excellent experience and a chance to get a broader picture of patient care.

The philosophy and direction of each ER will vary with the Medical Director of the ER. Also, every different healthcare professional(Lab, Radiology, Respiratory, ICU staff, etc) have their own Medical Director to establish their protocols. Medical Directors have meetings to keep the protocols and job duties of each professional in check so the SYSTEM flows. Learning the SYSTEM offers you the knowledge to make a decision about your future goals or education plans. The hospital setting will give you the opportunity to ask questions and explore your future options.

You as an EMT and as many EMT-Ps do, are working under another job title with another set of rules and regulations that are recognized by the hospital and State that you are in. Since education and experience varies so much for EMTs and Paramedics, this is a way for the hospital to establish a minimum of skills that they want their employees to have and train accordingly with some flexibility within State guidelines. This may give you the opportunity to do some things that you can not do as an EMT-B such a phlebotomy. You will also find many ER techs that do not have EMT certifications or Paramedic licenses but have been trained internally by the hospital. However, YOU may also gain additional certifications to compliment your EMT making you more employable in many different healthcare settings (OR or Ortho tech). The hospital will also assist you in your education. Many systems are now set up where you can go to school during your scheduled days and get paid. Some hospitals have their own affiliation/schools for training as nurses, Radiology, Nuclear med techs, etc. Many EMTs just starting out just see two career options, nursing and paramedic. There are many great careers out there in the medical profession.

As an ER Tech, you will learn a wide range of skills. Going back to school for additional college courses will give you the knowledge to compliment these skills. This is where Paramedics and RNs appear similiar but are different. The RNs, whether it is in the class room or on the job, have learned different protocols and "prep work" to get the pt moving along into the next level of care in the hospital. They are constantly checking labs prior to different tests. Ex. BUN is necessary before CT with contrast. The Rad. Technologist will be quite upset if an opening is made in a busy CT scan room and the pt has not been cleared. The pt and doc will not be happy either if the test is delayed because of a nursing "oversight". All will be upset and pt possibly harmed if contrast is given to a pt with a very high BUN or history of lupus. This is just one of many examples that nurses are checking and "responsible" for although the doctor is ultimately responsible but depends on everyone to keep him/her informed. When the system doesn't flow due to a medical error or lack of training; big traffic jam and lots of unhappy people.

Respiratory Therapists start thinking about VAP (vent associated PNA) and ARDSnet before the pt is intubated. If the pt was intubated in the field, they have another set of concerns and protocols. Many RT departments are involved in a nationwide data gathering for research for both VAP and ARDS. All healthcare professionals' (including yours) skills are closely monitored in the hospital settings. Different accrediting agencies require proficiency data to be constantly updated. Various re-embursement agencies will be monitoring that procedures are done within their guidelines. Many underlying factors are occurring behind the scenes constantly that are not always obvious to a causal observer.

Paramedics have extensive skills but many lack the knowledge for long term maintenance and care of the pt. This comes through more education and learning the things that some paramedics perceive as "BS" or "who cares about that" extra knowledge. ERs are also many times acting med-surg wards or extended ICUs when placement is in a holding pattern waiting for a bed. If "service" has been transferred to another physician like the Intensivist, the ER RN must assume the responsibilites now of the ICU protocols as well as the ER protocols. Lots of orders come with the ICU protocols and even the med-surg pt. New orders and new set of responsibilities to be followed. The ER physician will no longer be involved in the care of that patient unless they code.

On the ambulance, it's you, your partner and the pt. In the hospital, you will learn to coordinate your knowledge and skills with many, many healthcare professionals. Teamwork is tops. Flow with the system to get all the training and knowledge possible. Take advantage of every opportunity offered if you enjoy the medical profession.

[Spock]

Looks like you've gotten a lot of good advice especially the part on furthering your education. If your hospital has a nursing program they will help you get through nursing school while you work in the ER in order to get another RN which every hospital needs. That is why the ER tech concept was originally developed. Most of the hospitals in our area use ER techs. I was a patient once for a kidney stone and the ER tech started my IV. He did a great job even though he was nervous because he knew me as a CRNA and a medic. My hospital lets the ER techs (they are paramedics) do any skill allowed as a medic except intubation. They restrict that because the ER has emergency medicine residents who need the tubes. Smaller hospitals may not have that restriction.

It's great that you love your job so much and I would only suggest that you gain more experience before you start talking about nursing school. You may change your mind after six months. Most of the ER techs I know like working in the ER better than on the trucks because they have better pay, benefits and hours. They do give up autonomy but they feel it is a good trade off.

Live long and prosper.

Spock

[Wild-atheart]

I have found that the term "Emergency Room(or Department)" seems to scare a lot of nurses away from that part of the hospital. so If your making good money and happy there I would say Kudos to you. But your girlfriend should decide what area of medicine she would like to work in. Nursing is a whole different world than EMT. so if she wants to be in a hospital she might as well go for the RN because shell make way more money and be able to get a job pretty much anywhere in the country she wants to. Since you like your job now, you should also look into increasing you nursing education. The hospital you work for might even have a tuition reimbursement program for you complete you education.

Good luck

[speedygodzilla]

Looks like you've gotten a lot of good advice especially the part on furthering your education. If your hospital has a nursing program they will help you get through nursing school while you work in the ER in order to get another RN which every hospital needs. That is why the ER tech concept was originally developed. Most of the hospitals in our area use ER techs. I was a patient once for a kidney stone and the ER tech started my IV. He did a great job even though he was nervous because he knew me as a CRNA and a medic. My hospital lets the ER techs (they are paramedics) do any skill allowed as a medic except intubation. They restrict that because the ER has emergency medicine residents who need the tubes. Smaller hospitals may not have that restriction.

It's great that you love your job so much and I would only suggest that you gain more experience before you start talking about nursing school. You may change your mind after six months. Most of the ER techs I know like working in the ER better than on the trucks because they have better pay, benefits and hours. They do give up autonomy but they feel it is a good trade off.

Live long and prosper.

Spock

I didn't try to give off that I have or don't have an interest in nursing. I am in Fire Academy and plan on getting my paramedic after that. I know what I want for my future for the most part. I like the hospital here but I have a strong desire to be out in the field someday. My fiance is still deciding, and I am leaning more on RN nurse for here.

Thanks Everyone

[Rescue0ne]

I worked in the Emergency Department of a Level I Trauma Center for over a year after attaining my EMT-I...over a decade ago.

My job entailed assisting the Docs & Nurses with triage, bloodwork, assisting in stabilizing patients until they could be moved to the Operating Theatre. I was rotated to patient transport (read TRANSPORT) after awhile. It was involuntary, and I soon thereafter returned to EMS.

Back then, and now, I might add...it would be impossible (unless you really know someone, and I mean really) for a Basic EMT to be hired on (around here) as an ER Technician. The Level I does hire EMT-B's for the transport aspect of the ED, however. Usually as drivers, though. There's only 4 that I know of.

I know I say "around here" alot in my posts...but this is only due to feeling the need to qualify my remarks, because I have no clue how they do things in other places, having no first hand knowledge.

[bassnmedic]

I work in the ER and Cath Lab here. In the ER my title is Paramedic and the hospital basically has us function as RNs, I have assigned rooms and can utilize all skill sets that the state allows me to use. However, in the Cath lab, I am pretty much a tech that preps the patients and does V/S etc... nothing invasive. Working in these atmospheres has given me a whole new outlook on what happens to the patients after we as street medics drop them off at the ER. Over the last several months I have developed a new found respect for the RNs that work in the ER. It has been an excellent experience for me.

[Parapup]

Hey, I work hosital based ems and in the er we have medics. Besides crna and md's the emt-p is the only person in the hospital allowed to intubate. The emt-p has their own rooms in the ed just as an r.n. I believe the only pt an emt-p cannot be primary on is class1 traumas. That requires an r.n. So we have emt-p inhouse 24/7 for all hospital codes in the ed and on any floor. Medics still get paid like 5bucks less an hr than nurses though :evil:

pup nremt-p