Paramedic to RN bridge….. options?

[FiremanMike]

Again, where did I say that "nurses shouldn't do anything before the doc sees the patient"?

I have been very clear and very particular with the claims I have made in this thread. Your "oversimplification" is wrong. I never commented on anything beyond what should happen with a critically unstable patient in an ER.

I never compared nurses' ability to think independently vs. paramedics', because they are not directly comparable in my opinion. They work in very different environments.

You entered this thread to quote an experienced ER nurse sharing their experiences working and sharing a story of some of the things they had accomplished before the doc could get to a critical patient.

You said it was a hill you would die on because that was completely inappropriate.

If you're now insisting that this isn't what you meant, then fine. I'm done bickering over this with you..

 

[akflightmedic]

Monkey...did you used to work for me?

I lose who is who with the screen names, however you remind me of one of my former employees as I had several here at one time or another on this site. As this conversation evolves, you sure are ringing some bells.

And just an observation, but your word choice and usage, are interesting. And you sure as heck love using peri-arrest.

 

[MonkeyArrow]

Monkey...did you used to work for me?

I lose who is who with the screen names, however you remind me of one of my former employees as I had several here at one time or another on this site. As this conversation evolves, you sure are ringing some bells.

And just an observation, but your word choice and usage, are interesting. And you sure as heck love using peri-arrest.

No, I did not (nor do I currently) work for you.

I do like the word peri-arrest. I keep using it here because it nicely encapsulates the precise clinical scenario that I am referring to and that is at the crux of this scenario.

 

[akflightmedic]

Good old morbid curiosity strikes, I scrolled through all of your posts. Just an observation, tangential one of course, since that is where we are now. However, post after post, you bring in articles, links, journals, etc. All fine teaching points. And it is always great to learn and be exposed to new information. With the exception of a few one offs in the random discussion thread (and even those are devoid), nearly every single one of your posts is constructed in a way where there is absolutely no personal experience related, no examples to break it down, no making it human so one may understand better.

Your replies often acknowledge what someone says, and then the way your words are laid out, there is absolutely no claim to any of the above. And often, after your one hit, there is little to no participation beyond that. Occasionally yes, but more exception than the rule.

I have meet quite a few here over the years who often wrote in similar format or style.

Meh, not drawing any conclusions, but just found the observation rather fascinating. Could be wrong, could be tired, or simply could be dumb...who knows, right?

 

[MonkeyArrow]

Good old morbid curiosity strikes, I scrolled through all of your posts. Just an observation, tangential one of course, since that is where we are now. However, post after post, you bring in articles, links, journals, etc. All fine teaching points. And it is always great to learn and be exposed to new information. With the exception of a few one offs in the random discussion thread (and even those are devoid), nearly every single one of your posts is constructed in a way where there is absolutely no personal experience related, no examples to break it down, no making it human so one may understand better.

Your replies often acknowledge what someone says, and then the way your words are laid out, there is absolutely no claim to any of the above. And often, after your one hit, there is little to no participation beyond that. Occasionally yes, but more exception than the rule.

I have meet quite a few here over the years who often wrote in similar format or style.

Meh, not drawing any conclusions, but just found the observation rather fascinating. Could be wrong, could be tired, or simply could be dumb...who knows, right?

I am unsure how this relates to the points I've raised in this thread, but against my better judgement, I'll take the bait.

Good. That is exactly how I wish to come across. I interpret your description of my posting as a complement. I try to learn and practice based on the best science and evidence that is available, and I think the field should too. Therefore, I come on here and post said things that I think may be useful for others. We should be practicing based on evidence, not anecdote. I don't think my posting of war stories is all that helpful to anyone.

If your claim is that this is not an effective form of teaching...ok. I am not getting paid to teach. I come to this forum volitionally and specifically for the clinical discussions. If someone cares enough about what I posted, they should try to read the primary source and engage in a discussion if they have questions/disagree/have a different experience.

 

[CCCSD]

Then stop posting as if your “opinions” are the only thing that is truth. And please, get ride of the $20 words. They don’t make you sound educated, they come across as a pontifical horses rear end.

 

[silver]

Well this thread evolved interestingly.

To provide a different perspective, I would say I find myself frequently asking a RN "what do you want to do?" or "what orders do you want?" to which he/she may reply "Well I already did XXXX, so can I have an order for it?" Majority of time it's a reasonable start to get things going for an initial eval or resuscitation. I would never discredit a nurse's assessment skills. Sometimes I don't agree with it or the things they did without me, but end up taking it into account with developing my own assessment.

In regards to how tough RN/NP/PA/MD/DO school is: it's like training to be an athlete. You won't excel in nursing or medicine unless you put in the reps first. I remember helping teach a skills day for an EMT class while I was in college and one of the more senior instructors was a ED RN who was in scrubs coming directly from an overnight shift to teach. She was a 4th year medical student who during her BSN worked as a paramedic and then during medical school was working as a RN. As a college student, I thought she was out of her mind for working that much. Now I'm wondering if she is giving life and retirement advice.

 

[akflightmedic]

Meh, I will take the bait of your intentional disregard for my subtle/no so subtle implication (was chum really, bait is next).

First, I did not state war stories need to be shared. There is a HUGE difference between war stories and stories of experiences or relevance which teach/educate, or reinforce valuable lessons.

Second, I was calling out the fact that darn near every single post of yours, anyone could do (and has previously), because it lacks substance. It lacks relevance in the sense that if your only contributions are links to other sources and then you vanish from the thread, it then begs the question of who are you and what your intent is. One notable character was Mr. Brown and other aliases, much of the same flair if you will.

So you will drop a source, stand firm it is the ONLY way, and then vanish. Anything contrary to your preconceived opinion is garbage because apparently the tower (ivory?) upon which you stand should be enough. And that unto itself is grossly dishonest, and unfair, to not only "your dear readers", but also to yourself. You seem to kill amazing learning opportunities by taking this method of delivery, and in my past experiences I often found this was due to lack of knowledge, lack of experience, or both.

So as amazing as you are standing upon this rock (tower, rock, meh) of only delivering factual, objective data, peer reviewed studies, preserving the sanctity of healthcare delivery by highlighting how often all are wrong, yet never ever once bringing an expansion of a topic from a personal lens (which indeed, DOES help) and/or display a modicum of humbleness, in all truthfulness despite my eagerness to read, and learn, I typically skip your posts. Now you can respond that is my loss, or state you are not here for me anyways, and if you do that, then again my intention will have been missed. Take this as constructive feedback to help you become a better beacon of light for all things EEMS, medical, or whatever. Change the delivery of your message so it can actually be heard. Engage and converse, show you actually understand what you are posting. Share a story of personal relevance and how that study or practice applied or does not apply. Share LESSONS LEARNED...one of the greatest teachers of all time. In short, drop the pompous arrogance, and just be human.

 

[ffemt8978]

Do I really need to make this thread the focus of my complete and undivided attention?

So far it hasn't broken any rules but it is headed that way unless several members take a deep breath and relax a bit.