Nurses vs EMT/Paramedics in EMS

MrBrown

Forum Deputy Chief
3,957
23
38
I'm still waiting for my questioned I asked you a few weeks ago: What is with your recent obsessions with TEEX?

Because in all honesty it would be an understatement to say I am horrendously disgusted and at a loss to understand how anybody from instructor to regulator to student to medical director can think 12 weeks of instruction is acceptable to learn advanced life support?

We had one of these wonder people who had been to some quick and dirty patch factory come down here. Thier level of knowledge was so inadequate it wasn't funny.

I guess if we require four years of education and internship for Paramedic (somewhere between I and P) and six or seven years for Intensive Care Paramedic (ALS) we are doing something wrong because obviously 12 weeks plus a couple hundred hours of skills experience is adequate?

The minority may not be representative of the majority but honestly which do you think stands out; the guy who went to a decent two year program or somebody who rocked down to the couple month zero-to-hero school?

In the 1970s it took two years to become a Qualified Ambulance Officer (who couldn't really do much except dish out oxygen and one or two meds) and yet somehow, forty years later, the American system cannot mandate such a requirement at even the top level, let alone the bottom.

While it is easy to point fingers at other people I should say we've taken a huge backward step here in New Zealand. Gone are the days when it took a year or more to become a qualified Ambulance Officer and one was required to do a large number of pre-block course assignments around anatomy and phys because that is "not relevant when crewing an ambulance" so 24 weeks part-time is now acceptable it seems. Never mind the mandatory Bachelors Degree or higher for Paramedic and above and in mandating such a qualification a huge disparity is created between what is now styled "Ambulance Technician" (I sure as hell wouldn't call them a 'clinician') and higher levels.
 
Last edited by a moderator:

JPINFV

Gadfly
12,681
197
63
Another patronizing post

wqww81.jpg
 

VentMedic

Forum Chief
5,923
1
0
Quote:
Originally Posted by VentMedic
Another patronizing post

wqww81.jpg

__________________


Now isn't that so much easier than trying to talk about something you have not yet obtained any experience with.
 

dudemanguy

Forum Lieutenant
112
0
16
You are admittedly not in the medical field but somehow know that nurses will save a Doctors butt? Or that nurses are vastly superior to Paramedics in knowledge? How is it that a nurse, with less education than a doctor, can be viewed in such a high regard by you, but when you say a medic has less then a nurse, that the medic is inferior? Double standard much?

I said I'm neither a paramedic or a nurse, never said I wasnt in the medical field. I'm an EMT-B and a CNA.

I also never said paramedics are inferior to nurses. I was simply trying to address the assertion that paramedics should be able to test out as RNs. I can maybe understand an RN testing out to be a Paramedic, although I agree with mycrofft that the two jobs require different mindsets, and that a good nurse wouldnt necessarily make a good paramedic. I dont see how a paramedic could test out to be an RN, at least not without substantially more education than the minimum paramedic requirements.

I was not trying to dismiss paramedics, or imply that their training standards are insufficient for the job they perform. Ill leave that to people who would know better than me.
 

Veneficus

Forum Chief
7,301
16
0
I also find it amusing that the medical students in here already seem to have a poor view of nurses. When they are interns they will likely quickly learn that its the nurses that are gonna repeatedly save their butt.

I think you watch way too much tv or listen to way too much nursing propaganda.

But I would love to hear how a nurse is going to save me repeatedly and from what exactly?

But fair warning before you post some nonsense about not knowing a medication, a dose, cutting off the wrong limb, being afraid to order a test, touch a patient, or fill out a form, keep in mind I am educated in a far different system than the one that produces interns who stand around and watch people work their first year.

I also didn't come to medical school right out of high school or college. I have considerable experience in healthcare.

As of my schooling to date I can do anything a nurse can do, I am positively sure she cannot say the same statement about me.
 

JPINFV

Gadfly
12,681
197
63
I also find it amusing that the medical students in here already seem to have a poor view of nurses. When they are interns they will likely quickly learn that its the nurses that are gonna repeatedly save their butt.

Who has a poor view of nurses unless a poor view is not seeing nurses as all knowing gods of health care? I don't want a med surge nurse intubating me any more than a dermatologist. Does that mean I have a poor view of dermatologists?
 

VentMedic

Forum Chief
5,923
1
0
As of my schooling to date I can do anything a nurse can do, I am positively sure she cannot say the same statement about me.

You assume all nurses are women and they probably wear short white dresses ready to "service" all male doctors in your fantansies as well. Get over the dated thinking. I don't know what country you are from but I doubt if nurses are all women in every country just like they are not in the U.S. Not all Paramedics are men either. Welcome to the year 2010.

If you can do everything that a nurse can, why are you envious of Smash and wanting to work for his/her system?

From the Dilaudid thread:

Originally Posted by Smash
I think ems should carry as many options for pain relief as possible. That said, I don't know how much added benefit there would be from a third opioid agent if morphine and fentanyl are carried. I'd go for ketamine or a hypnotic instead.
can I come and work for you guys?

Again, this "I can start an IV and you can't so I must be just like a doctor...nan nan nah nah!" mentality has been the downfall of EMS in the U.S.

But I would love to hear how a nurse is going to save me repeatedly and from what exactly?
If you ever make it to doing a residency, you'll find out. There probably isn't a doctor that has completed their residency that hasn't been thankful to have a nurse around to prevent them from looking really stupid in front of the attending at some point. If you screw up writing an order, you'll find out how well educated the RNs are. They are the patient's line of defense to keep you (if you even become a doctor) from doing more harm when you make a mistake.
 

VentMedic

Forum Chief
5,923
1
0
Who has a poor view of nurses unless a poor view is not seeing nurses as all knowing gods of health care? I don't want a med surge nurse intubating me any more than a dermatologist. Does that mean I have a poor view of dermatologists?

And he continues to use those examples....

Nobody here said anything about a med surg nurse intubating. However, there have been several threads on the EMS forums about EMT-Bs intubating after just a couple hours of extra training and few saw any problem with that. Afterall, it is "just a skill" and some believe no eduation is required.

You might also be surprised to know that dermatologists are MDs who may have intubated in their internship before specializing in skin disorders.
 

8jimi8

CFRN
1,792
9
38
But I would love to hear how a nurse is going to save me repeatedly and from what exactly?



from being human. Just last night a 3rd year ordered ativan on a patient who was ALLERGIC to ativan.

another example? Ordered D5W on a diabetic teenager with IICP.

It's not about Nurses saving Drs. It's about the HC TEAM saving lives.

Doctors treat diseases.

Nurses treat patients.

This thread isn't about a pissing match between HCPs.

The tangent that it has taken, is "Why can RN's challenge the NREMT-P and not vice versa."

And i'll reiterate for anyone who still wants to ask that question. Because RN's have the foundational education to adapt to the specialization of pre-hospital care. Paramedics cannot because it is not possible to extrapolate pre-hospital care and generalize it to non-emergent situations.
 

Veneficus

Forum Chief
7,301
16
0
It's not about Nurses saving Drs. It's about the HC TEAM saving lives.

That is my impression on it, but if somebody tries to take a shot at me, i usually fire back.


Doctors treat diseases.

Nurses treat patients..

I respectfully disagree with this statement.

From my perspective the whole purpose of medicine is helping the patient. sometimes it requires medical knowledge, sometimes social help, and now and again something as simple answering a question regarding how much it will cost or disrupt their life.

I would agree there are many "scientists" in medicine who have no people skills and focus on pathology. There are also a fair number who of providers just doing a job.


The tangent that it has taken, is "Why can RN's challenge the NREMT-P and not vice versa.".

Because their advanced education buys them that privilege.

And i'll reiterate for anyone who still wants to ask that question. Because RN's have the foundational education to adapt to the specialization of pre-hospital care. Paramedics cannot because it is not possible to extrapolate pre-hospital care and generalize it to non-emergent situations.

Well said.
 

Hal9000

Forum Captain
405
3
18
That is my impression on it, but if somebody tries to take a shot at me, i usually fire back.




I respectfully disagree with this statement.

From my perspective the whole purpose of medicine is helping the patient. sometimes it requires medical knowledge, sometimes social help, and now and again something as simple answering a question regarding how much it will cost or disrupt their life.

I would agree there are many "scientists" in medicine who have no people skills and focus on pathology. There are also a fair number who of providers just doing a job.




Because their advanced education buys them that privilege.



Well said.


I won't add anything useful, but I agree with this post.
 

MrBrown

Forum Deputy Chief
3,957
23
38
From my perspective the whole purpose of medicine is helping the patient. sometimes it ... [is] as simple answering a question regarding how much it will cost

Hmm you mean healthcare costs money?

*Checks last hospital bill mmm $0.00 ..... fascinating, what is this concept you speak of :p:p:p:p:p
 

Shishkabob

Forum Chief
8,264
32
48
And i'll reiterate for anyone who still wants to ask that question. Because RN's have the foundational education to adapt to the specialization of pre-hospital care. Paramedics cannot because it is not possible to extrapolate pre-hospital care and generalize it to non-emergent situations.

As opposed to vene, I'd disagree.


Correct, we typically arent taught the non-emergent side of medicine as much as hospital based providers... but more often than not, the vast majority of calls we go on are NOT emergent, and it seems we do somewhat fine. (Exceptions not included)


And on the same token, I've seen nurses in CPR, ACLS and PALS classes utterly fail at just practicing fake emergent situations. So the lack of doing something does not just rest on one subset of providers, and does not pay much attention to education, and this is where experience helps a little bit.


As Vent said before, Paramedicine is a specialty of emergency medicine, but that's not our limit.



*Checks last hospital bill mmm $0.00 ..... fascinating, what is this concept you speak of :p:p:p:p:p



The correct way :ph34r:
 
Last edited by a moderator:

ExpatMedic0

MS, NRP
2,237
269
83
What about the thosands of Paramedics in Oregon with the exact same foundtional education requirments? Please see below

https://www.pcc.edu/about/catalog/emt.pdf
http://www.pcc.edu/about/catalog/nur.pdf

What about the tens of thosands of Paramedics with degree's in science and health care? Why is it that you think these Paramedics specificly are incabable of being ED nurses?

from being human. Just last night a 3rd year ordered ativan on a patient who was ALLERGIC to ativan.

another example? Ordered D5W on a diabetic teenager with IICP.

It's not about Nurses saving Drs. It's about the HC TEAM saving lives.

Doctors treat diseases.

Nurses treat patients.

This thread isn't about a pissing match between HCPs.

The tangent that it has taken, is "Why can RN's challenge the NREMT-P and not vice versa."

And i'll reiterate for anyone who still wants to ask that question. Because RN's have the foundational education to adapt to the specialization of pre-hospital care. Paramedics cannot because it is not possible to extrapolate pre-hospital care and generalize it to non-emergent situations.
 

8jimi8

CFRN
1,792
9
38
What about the thosands of Paramedics in Oregon with the exact same foundtional education requirments? Please see below

https://www.pcc.edu/about/catalog/emt.pdf
http://www.pcc.edu/about/catalog/nur.pdf

What about the tens of thosands of Paramedics with degree's in science and health care? Why is it that you think these Paramedics specificly are incabable of being ED nurses?

Not without training.

The pre-reqs may be the same, but the education is not.

Without searching on the internet...

please explain the insulin curve to me and list a common combination of 3 types of insulin that will closest mimic the average normal insulin levels.

Regarding an insulin sliding scale what lab values my be taken into account when administering insulin?

What is the significance of creatinine of 1.8 and how would you modify your therapeautic insulin sliding scale?


Just an example of a small piece of the difference between what paramedics study and what nurses study.

Not trying to antagonize anyone, just clearly illustrate my point.
 

8jimi8

CFRN
1,792
9
38

VentMedic

Forum Chief
5,923
1
0
What about the tens of thosands of Paramedics with degree's in science and health care? Why is it that you think these Paramedics specificly are incabable of being ED nurses?

Every licensed health care professional has taken those same sciences and then go on to advanced degrees such as Bachelors, Masters and Doctorate in their chosen fields. None of them hold themselves out to be nurses even though much of even their focus education overlaps with nurses. By your logic, RTs, RRTs, SLPs, OTs and PTs should also be working in the ED as nurses. Actually some of these professions would be better qualified than the Paramedic since they do contain some of the nursing core elements in their education.

It essentially comes down to the Paramedic being unhappy with the limitations of their profession and trying to take shortcuts into a profession they believe is superior to theirs. That should be a compliment to nurses but in the process nursing should not have to lower their standards or dilute their profession with people who do not have the same education or possess the same skills and knowledge that makes their profession different from others.

EMS has also become accustomed to the quick patch and believe that everything should come to them as easily as their own patches and "skills". EMS providers also base their worth on "skills" and not education. The argument presented here is also "I can do exactly what skills I have seen nurses do" but have no clue what nurses actually know.
 
Last edited by a moderator:

ExpatMedic0

MS, NRP
2,237
269
83
OHSU is our primary state burn and trauma center. They choose to use a Paramedic in the trauma bay instead of an RN... and not as an ED tech... he/she works there full scope including intubation amongst many other things. OHSU is not the only hospital doing this either, other hospital have followed.

This is one clear example of how a Paramedic can not only fill the roll of a nurse in the ED but is a better choice in some areas.
 
Last edited by a moderator:

VentMedic

Forum Chief
5,923
1
0
OHSU is our primary state burn and trauma center. They choose to use a Paramedic in the trauma bay instead of an RN... and not as an ED tech... he/she works there full scope including intubation amongst many other things.

And again you are just listing "skills". You are not a nurse. You are working with some "skills" in the scope of being a Paramedic. Does that Paramedic wear the "title" RN on their name tag? I also can do exactly the same things as a RN as an RRT in the specialty units. I am not a nurse and have no desire to become a nurse since the rest of my scope of practice is very focused. RRTs can also do exactly the same things as a Paramedic and much more on transport but do not hold themselves out to be Paramedics. RNs can also do the exact same things as Paramedics but do not hold themselves out to be Paramedics. PAs can do the exact same things as Paramedics but do not hold themselves out to be Paramedics.

The Paramedic should stop trying to be what they are not and attempt to see what their profession actually is. This identity crisis is just further compounding the issues in EMS.

BTW, isn't OHSU a teaching hospital? Are you saying they have no doctors or residents that intubate so they must rely totally on the Paramedic to intubate? That doesn't speak well for that trauma unit or for them as a teaching facility.

Our patients also don't spend much time in the trauma bay. They get what needs to be done initially and moved either to the OR, another section of the ED or to the ICU. Other aspects of care are then initiated which the Paramedic would not be qualified for and the RN is the best choice.
 
Last edited by a moderator:
Top