Don't anyone faint...I suggested a paramedic take my slot.

[mycrofft]

What I do is something a trained and indoctrinated paramedic could do, follow standardized procedures, refer to the MD as needed, and respond all over a pretty big campus. The difference in pay would be a significant savings to my employer.

My superiors say they would have to write a whole new set of standardized procedures and hire five parameds (three full time, two on call) and create a new job class.

Don't say I didn't try to share. Best job here, for my money!

 

[VentMedic]

What I do is something a trained and indoctrinated paramedic could do, follow standardized procedures, refer to the MD as needed, and respond all over a pretty big campus. The difference in pay would be a significant savings to my employer.

My superiors say they would have to write a whole new set of standardized procedures and hire five parameds (three full time, two on call) and create a new job class.

Don't say I didn't try to share. Best job here, for my money!

You're kidding, right? This sounds more like exploiting the Paramedic as cheap labor for the State of California. Also, with the many recent headlines from Prison Health problems,what is the expectation for level of care and education of the providers as per the contract with the State?

The hospitals could hire 3 LVNs for the price of one RN also but that does not satisfy the requirements for the job.

Rewriting a job classification for "cheaper labor" when it concerns healthcare that is already under the mircroscope may not the be wisest move.

Paramedics may be able to do many of the skills that you perform but are there other details and paperwork for accreditation that requires an RN's signature?

What I do is something a trained and indoctrinated paramedic could do, follow standardized procedures,refer to the MD as needed

This comment is rather bothersome.
This job is ideal for a Paramedic because it is a cook book with just recipes to follow?

 

[mycrofft]

Yo, slow down.

I don't work for the State. Almost did but they are really, really jacked up, whole system needs a D&C and rehire. I work for a County.

As they are probably going to meld my job with another soon, someone's gonna get some unemployment time. I've been with the system the longest, so unless I go postal or retire, my chair's reserved for the musical-chairs budget contest going on.

In my humble opinion, Paramedics have a different mindset than nurses, more decisive and rational in my experience. Since all the "standardized procedures" (protocols) I follow require an MD review and countersignature, I'm not out there doing much more than following a cookbook in most (routine) instances. In fact, over the years, the action I have been allowed exhibits less and less autonomy due to the revisions of protocols. One of my saving graces at work is that, despite that, (being ex-street and military FF), I step in, make the call, and act, even if it's going to get me chewed, because it meets community standards and the pt needs it. The average para has much more experience than I have over the last twenty years starting difficult IV's, giving parenteral drugs, and doing fancy airways, so could offer the pt even more benefit if the protocols were not too tight.

I am not sure a para would get paid much less if any less than we do. Probably would not put up with the micromanagement and backstabbing endemic in much of the nursing subculture.

 

[downunderwunda]

The simple reality is too many Medical Directors dont want to give Paramedics the recognition they deserve.

I am lucky, here we work completely autonomously, no need to call for medical control. I am also able to vary my protocol, based on sound training.

That is how it should be, with the Protocol as a guide for those anal retentives who are incapable of proper, rational thought.

 

[VentMedic]

In my humble opinion, Paramedics have a different mindset than nurses, more decisive and rational in my experience. Since all the "standardized procedures" (protocols) I follow require an MD review and countersignature, I'm not out there doing much more than following a cookbook in most (routine) instances.

But isn't the majority of inmate care maintenance? I know there is now a large dialysis patient population within both the county jails and prison systems. The same patients that many in EMS complain about are housed within those walls. The difference now is you must maintain their failing bodies due to years of drugs, alcohol and gang fight results. Bowel programs probably were not what some Paramedics may consider as something they wanted to do when they decided on EMS as a career. In California I am most familiar with one large jail that is near the SF Bay area. They have had some issues but again much of it stems from an inmate population that has more health issues. The challenges and costs for the system to maintain the inmates on their HIV meds and dialysis are staggering. But, it is still important to have people highly trained/educated for long term care issues as well as emergencies in these facilities. If you are becoming burnt out as a nurse, imagine what a Paramedic would be from the street would be like after a few months taking care of the day to day routine needs of the patients they didn't like treating on the ambulance.

The simple reality is too many Medical Directors dont want to give Paramedics the recognition they deserve.

I am lucky, here we work completely autonomously, no need to call for medical control. I am also able to vary my protocol, based on sound training.

That is how it should be, with the Protocol as a guide for those anal retentives who are incapable of proper, rational thought.

Working in a jail or prison system is a little different than your street medicine. You may be expected to follow certain channels as there are many watchdogs and jail house lawyers looking out for the inmates. If you fail to contact the doctor for an inmate with a serious illness or injury, you may have some questions to answer. Doctors and prison/jail officials don't like to be blind-sided by calls from the receiving hospital and the media if it is newsworthy.

 

[mycrofft]

It's different here.

Vent, sound like the CDC medical reception center at Vacaville. County jail is less maintenance, and serioously ill inmates are sometimes released. My day is poeple wanting to citcumvebnt sick call's waiting and copay (a few bucks) by announcing theyhave a medical emergency. Occasionally I have a real one, but I am required to assess each one, find their chart, and document.
Yeah, we overtreat many cases rather than take a chance they are not really sick or hurt.
A para could do it, but adrenaline junkies we definitely do not need.

 

[VentMedic]

Vent, sound like the CDC medical reception center at Vacaville. County jail is less maintenance, and serioously ill inmates are sometimes released. My day is poeple wanting to citcumvebnt sick call's waiting and copay (a few bucks) by announcing theyhave a medical emergency. Occasionally I have a real one, but I am required to assess each one, find their chart, and document.
Yeah, we overtreat many cases rather than take a chance they are not really sick or hurt.
A para could do it, but adrenaline junkies we definitely do not need.

I know a little about Vacaville but the patients I am familiar with are from Alameda County.