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.
I doubt if the standard Paramedic could function in the same areas as the RN or even in some EMS or IFT situations without some time to adapt and overcome. I do agree the Paramedic in the ED can excel but as a tech. They are generally supervised by the RNs and restricted even if they use their field protocols because blood products and many of the meds used in the hospital are not part of their scope of practice.
The next time you are in a hospital, ask to see their protocol book which may be online on their intranet or somewhere in the unit or ED. Even for med-surg you will find it is a much thicker manual than what a Paramedic has. It is just in a different set of protocols to cover many, many needs of a patient and not just the emergent ones. There are also specialty teams (Rapid Response and Code Teams) within the hospital who take care of emergencies usually consisting of an RN and an RT which also have many protocols which are similar to a Paramedic but with a broader scope since their operate off Critical Care protocols. This means they also order, do and incorporate lab values into their treatments which a Paramedic does not have the ability to do or the education for unless they are on a flight team and then there is generally an RN with them to provide that part of critical care decision making. But that doesn't mean a Paramedic can't get a degree and learn these things. They however are at a disadvantage because they lack the years of ICU experience working with lab values and all the different meds on a daily basis. Med surg RNs also often run their protocols off lab values. Considering a med-surg or ED RN will have 5 - 12 patients at any given time for the entire shift, they have to do a lot of adapting and overcoming. In the nursing home they may have over 30 patients and 300 medications and therapies to do. A Paramedic usually has only one patient for a short time who may be the only patient for the entire 24 hour shift in some areas. A Paramedic also does not have the education and training to work in an ICU, OR or most areas of the hospital including an ED without an orientation and extra training. Even CCT Paramedics may need RNs to set up all the medications and equipment for them so they can then drive quickly to the next hospital. There are also many medications and equipment that a Paramedic is not qualified for and an RN may have to accompany. You may also not see all the different very INTENSIVE care patients because a specialty team will transport them which will usually consist of RNs.
Some Paramedics who enter nursing programs are also overwhelmed when they hit the clinical situation inside the hospital. They didn't realize how many patients and things the RNs have to be responsible for at one time. They also realize how meticulous the charting must be and that there is little room to make a med error but it is easily made with all the distractions going on in a nursing unit. Correct spelling is important in charting and they usually don't have access to spell check.
There is absolutely nothing wrong with taking physician orders either since many medications required to treat one illness may cause another by damaging another organ. Ever wonder why there are so many dialysis patients?
Nurses IVs are generally completely by the book, very structured, from cleaning the site to securing the catheter. This is in line with the nursing mindset, which is to do them according to policy and like they are trained to do. There is ABSOLUTELY NOTHING WRONG with this (and they may often have little choice). Paramedics are trained in skills, but are expected to adapt to whatever needs to be done at the moment.
This sums up why field sticks should be changed out as soon as possible. RNs are trained and educated to prevent more infections. CMS will no longer pay for a patient getting an infection once inside the hospital. Some Paramedics are told all patients will be given an antibiotic which covers everything and field technique doesn't matter. That again just goes to some relying on street medicine rather than actual education.
When the U.S. Paramedic requires a minimum of an Associates degree across the board for entry, then you can talk about respect as a professional. Right now 6 months of training is a tech. Surgical Techs may require 1 year of training which is longer than many Paramedic programs but they are still techs and very specialized which a Paramedic is not qualified for nor can an RN just jump right into without extra training.
A few impressive life saving skills and protocols in the field are of great value but in no way do the protocols and knowledge of a Paramedic begin to cover all the possible emergencies present even after field treatment that still require identifying and correcting the problem or many problems which caused the emergent situation. Treatment does not stop with what is done in the field. It is very rare a patient will have only one straight forward medical problem. Even the MI which seems to some to be pretty straight forward will have other issues which may have caused a clot which must be corrected. A breathing problem may need much more than an albuterol treatment and a diabetic may need more than just a little glucose.
Regardless of how much education you get right now as a Paramedic, you will still be held to the lowest denominator. However, just having an A.S. or B.S. degree will not make you the same as an RN. Many other professionals such as PT, OT and ST require Masters and Doctorates but they do not claim to be RNs. The professions of OT and PT also have assistants that require a minimum of an Associates degree. They are in no way equal to the OT or PT with higher education and even with a two year degree, they may be viewed much like the CNA is to the RN in the hierarchy of the professional world. The PT and OT assistants also know their two year degree is not equal to RNs or their higher educated professionals but they still serve a valuable purpose. They can be happy and secure with that or they can get more education with another credential. The OR Tech can be happy with their title or they can take the steps to become an OR RN.
