Nurses Balking About Proposed Calif. Paramedicine Program

[JPINFV]

Sorry to hear that you have so little respect for your non-physician colleagues.

Recognizing that the education of one isn't equal to the other isn't having "so little respect" it's recognizing that there's a difference in education. Furthermore, I don't recognize "nursing experience" as a substitute for medical school, which is exemplified every time I get paged to authorize shoving a K-dur down a patient's neck for a potassium value of 3.4.

I have no desire to get dragged into a APN vs. MD debate, especially in a thread about an exciting horizon in paramedicine. I would refer anyone who IS interested in such to the many outcomes studies which have been done on the topic. Like every other area of healthcare, what the research reveals is often very different than what we assume to be true.

You mean like the studies that show they order more tests than even a physician in residency?
Or the fact that the exam developed for them as a watered down Step 3 had half of the applicants failing? There's value in having a general understanding of medicine and THEN specializing. There's a reason even orthopods have to have a general understanding in medicine, regardless of how much they get ragged on.

I was simply pointing out the errors in your description of Georgetown's NP programs.

How many medical schools are set up in a way to allow students to work part time while attending? There's a reason for that...

 

[Uclabruin103]

I'm confident now that I can successfully determine whether someone just released from the ER needs immediate transport back. That's what we do. Triage people and do physical assessments to determine our treatment. Now as far as long term treatment of chronic issues? I can't speak for everyone but I know my medic training didn't touch on that at all.

I don't see why a nurse wouldn't want to use us in this role together. We can have the flexibility to work under standing orders for immediate interventions while they could take care of the long term care.

I'm curious what everyone thinks would be enough education for medics to take this role, and what would we be learning. It's one thing saying we need education, but in what?

 

[Carlos Danger]

I'm confident now that I can successfully determine whether someone just released from the ER needs immediate transport back. That's what we do. Triage people and do physical assessments to determine our treatment. Now as far as long term treatment of chronic issues? I can't speak for everyone but I know my medic training didn't touch on that at all.

I don't see why a nurse wouldn't want to use us in this role together. We can have the flexibility to work under standing orders for immediate interventions while they could take care of the long term care.

I'm curious what everyone thinks would be enough education for medics to take this role, and what would we be learning. It's one thing saying we need education, but in what?

Anytime a labor union has a strong opinion on something, it's a very safe bet that their motivation is protectionist. That is to say, they don't like the idea of community paramedicine because they feel there is the potential for it to negatively affect employment opportunities for nurses.

Some nursing organizations and individual nurses, however, have very legitimate concerns about patient safety, given the fact that the current paramedic curriculum provides exactly ZERO preparation for community health activity. I assume there are plenty of physicians who feel similarly.

Remember that nurses are the largest group of healthcare professionals in the US and are therefore a major stakeholder in any major healthcare paradigm. Also remember that nurses have basically been the sole providers of community healthcare for decades.

A big part of the problem here is that it's difficult to talk about something that hasn't even been defined. What does "community paramedicine" even mean? Does it simply mean giving paramedics more power to refuse inappropriate transports and instead provide some very basic primary care and refer the patient to a clinic? Or are we talking about providing post-op wound care and rehab to patients who have no way to get to their doctor for follow-up? The former is the type of thing that should already be part of a paramedics training and scope, IMO. Concerning the latter, though, I think a really solid argument can be made that it makes much more sense to further invest in the community health nursing framework that already exists, rather than go to the trouble and expense of creating new educational programs for paramedics to do what nurses already do.

 

[SandpitMedic]

So it's like the 2 year part time online courses where half of the information is fluff (admin, "capstone project," "nursing theory"), calling them a nurse practitioner, and saying that they're equal to physicians?

I think the comeuppance are ready to come out of the oven.

+1


(We agree on something.)