Nurses working in EMS system?

[VentMedic]

In the US, you'll find nurses on:

Helicopter EMS crews

Mobile Intensive Care Units

Critical Care Transport Teams (inter-facility), ground and air

Specialty Transport Teams (NICU/PICU/Heart) air and/or ground

Air Ambulances, domestic and international

International Medical Accompany/Assistance Services

[Just Plain Ruff]

don't forget that there are some hospital based ambulance services that allow their RN's to run on the ambulance as back up crew members.

[Ridryder 911]

I know of a RN/Paramedic that is the fleet maintenance (mechanic) for a large EMS. It appears, he makes more money and less hours... were taking over...hee..hee..lol

R/r 911

[zippyRN]

don't forget i nthe scandinavain, /dutch systems the RN as paramedic is considered an advanced practitioner in his /her own right and from what i've seen have more options that UK / Aus types who are paramedic as health professional

[kitkat]

I have several co-workers that have their BN, when they are working as paramedics on the ambulance, they stay in the scope of practice that they are in at their level of paramedic training. I have never noted that they have "lorded" their education as better, or tried to advance themselves due to their nursing degree.

[Dustdevil]

Why dont you keep the nurses in the hospital where they belong and begin educating a new type of health care professional for over there called a PARAMEDIC?

Maybe if the United States ever does that successfully, they can show the rest of the world it is possible. Unfortunately, for now the US is the laughing stock of the EMS world with their pitifully inadequately educated "Paramedics" who are, for the most part, hobbyists and firemonkeys. For the life of me, I can't imagine why anybody who has seen the US EMS system first hand would even consider utilising "paramedics" instead of nurses for EMS. Yes, there are countries who have done so very successfully, but they did so by starting from scratch and eliminating the fatal pitfalls of US systems. And even countries like Canada, who have done quite well, still have some serious problems in their "paramedic" based EMS systems.

I don't know where this whole "six years" thing came from. Two to four years of nursing school, followed by 9 to 12 months of specialisation doesn't add up to six years in my math. But there is no doubt that the US would be much better served by a system staffed with those with a professional nursing education before moving into a specialisation in paramedicine than by the hodge-podge of tech school losers and firemonkeys we currently have. Anybody who disputes that is either ignorant, stupid, or simply selfishly protecting their turf with no regard for the good of the community or the profession.

[zippyRN]

<snip>

I don't know where this whole "six years" thing came from. Two to four years of nursing school, followed by 9 to 12 months of specialisation doesn't add up to six years in my math. But there is no doubt that the US would be much better served by a system staffed with those with a professional nursing education before moving into a specialisation in paramedicine than by the hodge-podge of tech school losers and firemonkeys we currently have. Anybody who disputes that is either ignorant, stupid, or simply selfishly protecting their turf with no regard for the good of the community or the profession.

the six years is the minimum zero -to -hero in the dutch / scandinavian system

an EU directive compliant 4600 hours in 3 years (2300 practice hours) general / adult Nursing pre-reg programme, some past basic consolidation in emergency and critical care areas and then a Masters degree to get the advanced practitioner status forthe 'paramedic role'

[zippyRN]

Thanks for your answers!

The education to become a ambulance nurse is 40 weeks in Sweden. If I compere it to education program to become a Paramedic I will say it´s the same we study. We also have another system in operation. When I work as an anhestesian nurse I have full responsibillity for the patient. We have one anhestesiologist that have 5-10 ongoing operation at the same time. We can call for him if we having problem. His/her job is to assess patients, spinal and ED anaesthesia. When we have children they are with us as support. I will say that my knowledge and skills are good for the patients. Anhestesia nurses are by tradition often working prehospital in Sweden.

Novisen//

40 weeks on top of the 3 year / 4600 hr RN adult pre-reg as per the EU directive IIRC

[Novisen]

40 weeks on top of the 3 year / 4600 hr RN adult pre-reg as per the EU directive IIRC

Or 4 years. To get a Master and Graduate Diploma i Prehospital nursing. In ECTS points it´s 240 points.

[WelshMedic]

We need to keep the six years of education concept in context to the situation. We are not talking about the United States and I dare not condemn another countries system without first hand knowledge of how that system works. The original poster simply seems curious as to how a similar approach is applied (if at all) in other countries.

CH,

I wholeheartedly agree that one shouldn't be too critical without first-hand knowledge of a particular system. Let me give you some perpective on the Dutch system:

The degree nursing program takes 4 years and encompasses Adult, Pediatric, Mental Health and Learning Difficulties nursing. Once you have completed the degree program you then specialize in one of the 4 main branches.

Should you wish to then become a pre-hospital practitioner (the translation of paramedic in dutch terms) you would then have to specialize in one of three critical care areas - ICU, anaesthetics or ER (another 18 months). Once you have completed this post-graduate program then you would be eligible for enrollment into the pre-hospital program. This, again, takes another year to complete and teaches the student to think outside the hospital environment and to prepare them for being an independent practitioner. It also includes the cornerstones such as PHTLS and Scene Management.

It is true that we are independent practitioners, Medical Command is a completely alien concept to us. We also have the option to refuse transport to someone who doesn't require it. This mainly works because we have a good primary care system - we can always refer the pt to a family physician. However, it's not all a garden of roses - we are, despite protests, still not alllowed to using muscle relaxants in RSI. Although this will hopefully change in the not-too-distant future.

I also have a reasonable understanding of the US system - I organize a yearly visit to the Pennsylvania/Delaware area for interested colleagues. Both systems have their good and bad. We win the autonomy hand, but you guys win in terms of investment and sheer volume of providers, making for a very fine network of responders to any particular incident. The legal norm for the Netherlands is 15 minutes between the call and arrival. How many SCA's are you going to save after a quarter of an hour?

Vive la difference!

WM (who's driving to Italy tomorrow for three weeks to enjoy the sunshine, good food and fine wine - there are some advantages to living in Europe).

PS- I did a Powerpoint presentation on Dutch EMS for colleagues in the US. Does anyone know of a way of posting it somewhere here? (If anyone's interested, of course)