Nurses are way better than paramedics

[Journey]

I'd like to join the pissing contest. Can someone please tell me where the line we measure from is? I've been drinking all morning!

Start with education first if you want to measure something. The U.S. Paramedic relies on a few skills with very little education and then wants to be recognized as just like a doctor or a nurse. In other countries they would be lucky to get a job driving the ambulance with minimumal patient contact.

Medicine does not stop once the cool skills are finished which is why RNs need a broader education to cover the many needs of the patient for continued resuscitation and extended care. Prehospital medicine is a specialty but has not advanced in the U.S. past the tech level.

The drinking part in your post is a nice touch to give credit to the U.S. Paramedic. Maybe you are trying to be funny but unfortunately the only joke here is the U.S. EMS education and some Paramedics being allowed to do advanced skills and administer medications with so little training and education.

 

[MrBrown]

Brown drinks almost a gallon of water a day, so much so his nephrons are suing him for breaching labour laws.

Does that mean Brown wins?

 

[Cohn]

Brown drinks almost a gallon of water a day, so much so his nephrons are suing him for breaching labour laws.

Does that mean Brown wins?

Brown always wins.

 

[MrBrown]

Brown always wins.

Not true

 

[Cohn]

Not true

It's not what other people think Brown, it's what I think of you that matters :wub:

lol


j/k

 

[Chimpie]

Keep it on topic please.

 

[rook901]

It took 15 years to get the changes together that will be going into place shortly and they are not major changes by any means.

The question is how long do you want each Paramedic to spend with a patient in the field? Can the EMS agencies afford to have all the diagnostic tools on each ambulance? What about CXRs? Are you just going to write an antibiotic script for pneumonia without knowing if it is pneumonia or CHF or what type of pneumonia to determine the correct antibiotic? Medicine is attempting to be more precise to prevent more resistant strains of bacteria. Medicine is also trying to be very, very careful with all procedures done to prevent more infections or avoid patients needing dialysis for either the short or long term.

You're absolutely right. There will never be enough time or equipment available in the field to make the kinds of differential diagnoses that you need to make to start writing prescriptions on the street. The best that you'll be able to do is write a broad spectrum antibiotic for the sniffles, and hope that that knocks it out. If not, they can follow up with the ED next week, since they obviously have no PCP if they're calling 911 for the sniffles.

But really, the kind of scripts I would see medics writing are the same that a primary care MD would write for a general case of the crappy lung, where the MD isn't going to do a CXR or sputum culture anyway. Beyond that, you're moving far away from street medicine.

I think that a good starting point for Paramedics wanting progress for the profession would be to stop comparing medics to RN's in the first place.

 

[Journey]

But really, the kind of scripts I would see medics writing are the same that a primary care MD would write for a general case of the crappy lung, where the MD isn't going to do a CXR or sputum culture anyway. Beyond that, you're moving far away from street medicine.

Define crappy lung. What type of treatment is done for crappy lung? A primary care MD will usually refer a person with a pulmonary problem to a Pulmonologist for more testing. What if that crappy lung is cancer or COPD or any of the many disease processes associated with COPD? Will just an inhaler be adequate? There is also another big difference between your private PCP and a Paramedic besides what I have already mentioned in previous posts. The PCP will have your medical records. This may not be your first meeting with physician. If this was your first meeting, the PCP will probably send you to get many lab tests done. If this was in a clinic or ED, the physicians in either will have to establish a baseline for you which is done through additional testing. Or, they may also have access to your medical records from previous visits.

People do call 911 for many reasons and right now many people are without PCPs and insurance. That includes some EMTs and Paramedics who have lost their jobs due to the economic times or those who are still unemployed after finishing school.

I think that a good starting point for Paramedics wanting progress for the profession would be to stop comparing medics to RN's in the first place.

Agreed. Right now all is being done is skill comparison. If you want to work in the same capacity as an RN why sign up to be a Paramedic? A medical assistant or LVN can say they do many of the same skills that an RN does but they are still not an RN by either education or licensure. An EMT can also say the same when comparing a Paramedic to his level but that still does not make the EMT a Paramedic.

 

[JPINFV]

But really, the kind of scripts I would see medics writing are the same that a primary care MD would write for a general case of the crappy lung, where the MD isn't going to do a CXR or sputum culture anyway. Beyond that, you're moving far away from street medicine.

Here's the problem. How good is the average paramedic going to be at deciding if it's a generic pneumonia which gets a macrolide and one that needs further work up? Who are you going to refer to for follow up if it doesn't get better? In which cases do you need to hospitalize the patient? Even diseases that can be diagnosed and treated clinically isn't always as simple as a script and a door because you need something in place in case that doesn't work.

 

[Level1pedstech]

ya gotta think, now if you were to put a standard nurse in the field they would freeze up because they dont have a doc there to tell them what they can and can not do. as if you would put a medic in the er they would excell. its all about Adapting and overcomming.

First of all what is a standard nurse? From what I have seen in the ER I think the docs are more dependant on the RN's for routine day to day care of patients especially in the pediatric emergency setting where I spend most of my time. I have seen docs butts more than once covered by a quick thinking RN. Not to diminish the PA and MD's roles but really I think alot of PA's and MD's would freeze up without the help of their RN's. PA and MD's may have higher education but that in no way makes them better care givers. Quality givers of patient care get that way by having a combination of god given ability and by having taken the time to obtain a higher education. I have seen my share of providers at all levels that have a great education but absolutely no ability to interact with patients.

As far as medics excelling in the ER that's a stretch at best and one of those things that is never a given. Medics in the ER face challenges and depending on their scope of practice must constantly be aware of stepping over the line. Many just can not help themselves and end up in trouble. On the other hand I have a fellow tech that is a full time FF/PM and functions just fine in his limited tech role. He knows and respects his boundaries and is happy providing care at more of an EMT-B level. I have heard of medics becoming quite disillusioned with their sometimes limited role in caring for patients in the ER setting and going back to the streets after a very short time.

 

[JPINFV]

First of all what is a standard nurse? From what I have seen in the ER I think the docs are more dependant on the RN's for routine day to day care of patients especially in the pediatric emergency setting where I spend most of my time. I have seen docs butts more than once covered by a quick thinking RN. Not to diminish the PA and MD's roles but really I think alot of PA's and MD's would freeze up without the help of their RN's. PA and MD's may have higher education but that in no way makes them better care givers. Quality givers of patient care get that way by having a combination of god given ability and by having taken the time to obtain a higher education. I have seen my share of providers at all levels that have a great education but absolutely no ability to interact with patients.

You know, I'm starting to find these stories funnier and funnier.

Do people understand what a "team" is anymore? Especially a team made up of different types of providers who have different roles (no, comparing a paramedic to an EMT is not similar to comparing a nurse to a physician)?

Ok, so the nurse caught something that the physician missed. So what, that's part of being a contributing member to the team. How many RNs would be able to step up and make the same judgment calls that physicians are making with the same patient load that the physicians are carrying (which is more than the number of patients that the RN is caring for)? It's easier for RNs to spend more time with patients when the RNs are caring for half the number of patients than the physician.

Similarly, when did it ever become wrong to simply be good at the field you (generic "you") choose to enter. Why is it that everyone has to cherry pick the one time they one-uped a provider in another field. Why is it that paramedics feel that they have to prove that they are better than nurses, even though paramedics practice prehospital emergency care and nurses practice nursing, and nurses feel that they have to prove that they are better than physicians, even though nurses practice nursing and physicians practice medicine. If a paramedic wants to prove that they can be better at nursing than a nurse, then go to nursing school. If a nurse wants to prove that they are better at medicine than a physician, then go to medical school.

Until you (generic you) can step into the shoes of the other provider and take on all roles under the same conditions as the other provider, any comparison and back slapping about how 'you are so much smarter than [paramedic, nurse, or doctor] Smith because you caught something they didn't' is just being petty.


Oh, and for the record, if I catch a nursing error when I start rotations in June, do I get to claim that I'd be a better nurse than the actual nurse?

 

[Level1pedstech]

You know, I'm starting to find these stories funnier and funnier.

Do people understand what a "team" is anymore? Especially a team made up of different types of providers who have different roles (no, comparing a paramedic to an EMT is not similar to comparing a nurse to a physician)?

Ok, so the nurse caught something that the physician missed. So what, that's part of being a contributing member to the team. How many RNs would be able to step up and make the same judgment calls that physicians are making with the same patient load that the physicians are carrying (which is more than the number of patients that the RN is caring for)? It's easier for RNs to spend more time with patients when the RNs are caring for half the number of patients than the physician.

Similarly, when did it ever become wrong to simply be good at the field you (generic "you") choose to enter. Why is it that everyone has to cherry pick the one time they one-uped a provider in another field. Why is it that paramedics feel that they have to prove that they are better than nurses, even though paramedics practice prehospital emergency care and nurses practice nursing, and nurses feel that they have to prove that they are better than physicians, even though nurses practice nursing and physicians practice medicine. If a paramedic wants to prove that they can be better at nursing than a nurse, then go to nursing school. If a nurse wants to prove that they are better at medicine than a physician, then go to medical school.

Until you (generic you) can step into the shoes of the other provider and take on all roles under the same conditions as the other provider, any comparison and back slapping about how 'you are so much smarter than [paramedic, nurse, or doctor] Smith because you caught something they didn't' is just being petty.

I think we in the ER are the quintessential example of how people of all levels work together with the common goal of a positive outcome for all the patients we see. One of the reasons I stay on the inside is that we set aside personalities and differences and regardless of education level always work as a team. Professional respect is a given at least where I work.

 

[WTEngel]

I wasn't going to jump into this thread because I really didn't have any way of putting what I want to say nicely, but I am going to jump in anyway, against my better judgement...

EMTs, Paramedics, RNs, RTs, NPs, PAs, Physicians, Radiology Techs, Unit Secretaries, Access Specialists, etc. all have their place in the process of patient care. The job of taking care of the patient can't be accomplished if any one of these pieces of the puzzle is missing.

With that said, there are highly proficient providers in every discipline, and incompetent providers in every discipline.

Skills and education aside, any provider that chooses to step up and say their profession is "so much better" than another, or that there is no other type of provider that can do a better job than they can, is delusional and most likely a very questionable provider in their given discipline.

Until you can work with other disciplines and support the continuum of care for the patient, you are a crummy provider, I don't care what initials come after your name.

Last but not least, this argument of "this discipline always treats me like crap" or "this person did this, so from now on I am going to be disrespectful to that discipline" is the most immature and weak argument I have seen since 3rd grade...

End Rant...

 

[Frozennoodle]

Everyone here, being medical professionals, should know from the first 10 seconds of actual field work that team work is what wins the day. Grandstanding, cocky, I'm the one who did this look at me I'm so awesome, BS isn't going to help any patient you come in contact with. Period. If you want to pretend you're God's gift to medicine then live in that delusion but you'll never earn the respect of anyone in the field.

 

[Level1pedstech]

I wasn't going to jump into this thread because I really didn't have any way of putting what I want to say nicely, but I am going to jump in anyway, against my better judgement...

EMTs, Paramedics, RNs, RTs, NPs, PAs, Physicians, Radiology Techs, Unit Secretaries, Access Specialists, etc. all have their place in the process of patient care. The job of taking care of the patient can't be accomplished if any one of these pieces of the puzzle is missing.

With that said, there are highly proficient providers in every discipline, and incompetent providers in every discipline.

Skills and education aside, any provider that chooses to step up and say their profession is "so much better" than another, or that there is no other type of provider that can do a better job than they can, is delusional and most likely a very questionable provider in their given discipline.

Until you can work with other disciplines and support the continuum of care for the patient, you are a crummy provider, I don't care what initials come after your name.

Last but not least, this argument of "this discipline always treats me like crap" or "this person did this, so from now on I am going to be disrespectful to that discipline" is the most immature and weak argument I have seen since 3rd grade...

End Rant...

Spot on.

 

[uhbt420]

medics and nurses are two different professions. they have similar skill sets but work in differnet environments

it's like comparing police officers and sheriff's deputies

and yea we could use more education but whining on the internet isnt exactly going to fix that. it will take a few years for the military model to succumb to the general education model.

 

[TheyCallMeNasty]

I wasn't going to jump into this thread because I really didn't have any way of putting what I want to say nicely, but I am going to jump in anyway, against my better judgement...

EMTs, Paramedics, RNs, RTs, NPs, PAs, Physicians, Radiology Techs, Unit Secretaries, Access Specialists, etc. all have their place in the process of patient care. The job of taking care of the patient can't be accomplished if any one of these pieces of the puzzle is missing.

With that said, there are highly proficient providers in every discipline, and incompetent providers in every discipline.

Skills and education aside, any provider that chooses to step up and say their profession is "so much better" than another, or that there is no other type of provider that can do a better job than they can, is delusional and most likely a very questionable provider in their given discipline.

Until you can work with other disciplines and support the continuum of care for the patient, you are a crummy provider, I don't care what initials come after your name.

Last but not least, this argument of "this discipline always treats me like crap" or "this person did this, so from now on I am going to be disrespectful to that discipline" is the most immature and weak argument I have seen since 3rd grade...

End Rant...

quoted oh yea

 

[socalmedic]

it's like comparing police officers and sheriff's deputies

ummm, they do exactly the same job (especially here in So.Cal). only one works for the county and the other for a city. other than that they both conform to the standards of Peace Officer.

 

[JPINFV]

ummm, they do exactly the same job (especially here in So.Cal). only one works for the county and the other for a city. other than that they both conform to the standards of Peace Officer.

Not only that, but the sheriff is normally the primary law enforcement agency in unincorporated parts of the county (I say "normally" because my parents live in an unincorporated part of San Diego County and their primary agency is the highway patrol. In the incorporated city immediately across the street, the city has contracted with San Diego Sheriff Department for law enforcement. This makes it interesting when calling 911 for a drunk driver who crashed into a neighbor's yard) as well as in contract cities.

 

[MusicMedic]

medics and nurses are two different professions. they have similar skill sets but work in differnet environments

it's like comparing police officers and sheriff's deputies

and yea we could use more education but whining on the internet isnt exactly going to fix that. it will take a few years for the military model to succumb to the general education model.

uhh. Its Nothing Like comparing PD and SD...

even though we all know what you mean

how bout comparing an Architect and Construction workers? (i dunno its 6 am here ive been up all night!)

best metaphor would be Apples and Oranges!

WTEngel said it spot on! its all about team work, if you dont work well with your peers, then youll fall flat on your face!