Alot of the smaller hospitals around here use Paramedics in the ed. Not as techs, but as substitutes to RN's. They cannot find enough RN's, so they fill the gaps. Smaller ED's may have 1-RN,2-LPN's,2- MEDICs and 1-EMT.
Being a substitute can have its drawbacks. They are not permanent.
http://www.heraldtribune.com/article/20070706/BUSINESS/707060338/0/COLUMNIST06
Sarasota hospital lays off 7, shifting nurses into the jobsBy DAVID GULLIVER
SARASOTA -- Sarasota Memorial Hospital is laying off seven people from its emergency room as it restructures to find more work for nurses.
Seven employees -- two paramedics, four technicians and a materials specialist -- will lose their jobs.
Hospital officials said the moves will not hurt patient care, as nurses are shifting into those roles.
The layoffs are part of a larger effort to staff units primarily with nurses.
When the expanded emergency care center opened in late 2005, it had 19 nursing vacancies. The paramedic and tech positions covered that shortage.
Quote by BossyCow:
If an EMT or Paramedic wants to work in an ER they have to have additional licensure, either CNA, LPN or RN. If nurses wish to work in an ambulance they have to obtain additional EMS certification.
Bingo! For an RN or RRT to work in Florida on a scene response vehicle, ground or air, they must have a paramedic certificate. Specialty teams that do not do scene response are exempt. But, that is exactly how the extra training is viewed. It is another certificate. There is not degree involved, just a few months of extra training. Considering how long it takes to get on a Specialty transport team or hospital helicopter and the additional training for it, paramedic school can be a walk in the park.
If they take the certificate through the college, they are given credit for the college level A&P classes they have completed so the Survey of A&P for the Paramedic is not necessary. Both professions should be familiar with EKGs, IVs and medications if they have been accepted for a transport team. The EMT-B skills of extrication might be more noteworthy. They also already have the ACLS, PALS, NRP, ATLS, TNCC, etc in their alphabet. Intubation may have already been taught to both the RN and RRT and is being performed regularly in the hospital.
The interesting part is the clinicals. In the hospital ED, the RRT and RN paramedic students are only allowed to do the scope set by the school's program. If this is their home hospital, this may be the easiest shifts they will ever pull. They are assigned to the ED for 2 shifts/week and they will be paid out of an education orientation budget since the helicopter is hospital based. They draw labs, start IVs, and give a few meds while being "observed" by people they may have trained as new grad RNs. They must also do the intubation rotation even though they may already intubate independently. This time a doctor must sign them off. However, the paramedic sign off sheet usually consists of "tube in or not". For RT school, each student has an indepth checkoff sheet.
The RRT and RN paramedic students can not draw ABGs, insert A-lines, draw blood from A-lines or central lines, touch any access ports other than a peripheral IV, touch ventilators, secure ETTs the hospital way, administer blood or thrombolytics or manage Levophed. Even suctioning either NT, ETT or trach must be observed. This would all be part of their regular day in the ED if they were not a paramedic student.
These rules are mandated by the Paramedic schools.
When on the ambulance, RNs and RRTs must abide by the fact that they are now very limited in the number of protocols available to them and must stick to the "field diagnosis". Inside the hospital, even in the ED, they may skip plan A and start thinking about B, C and D for the long term. If they know it will be a sepsis protocol, that may change their choice of vasopressors. The same goes for a hospital based CCT. They already know what their facility is going to want in terms of special ETTs and medications.
Quote by Medic8388:
The only things I am not allowed to do (per my job description) is administer blood products and take phone orders from a physician.
Not being able to take orders is a big draw back. I hate being responsible for someone else's orders. I don't know your patient. I don't know what you told the doctor. And, you hand me the phone and want me to take the order, in my writing, with my signature? You had best not ever screw up giving the right information on the right patient to the right doctor and burn the person taking that telephone order for you. If they are cautious and smart, they will review everything themselves. But, that takes them away from their patients and responsibilities.
Hospitals also like the RNs to be able to work in at least one other area of the hospital. Many ED RNs came from other areas so floating is rarely a problem if it is necessary. PCTs that have been trained as an ER Tech can also float with not problems. A paramedic is limited in where they can work by certification and training.
Medic8388
On one hand its a good opportunity for the medics ( I know I've learned quite a bit), on the other hand hasn't nursing taken enough good paramedics?
As I mentioned before, it is still a great learning experience for the paramedic. You may also get the opportunity to do some things that you wouldn't in the field. Not everyone has a high tech, progressive EMS system in their neighborhood. And, not everyone wants to be a firefighter. You may also see other other alternatives in medicine that you might want to explore.
There is a thread on another forum about EMTs and Paramedics aged 50+. You don't have to be that old to have an injury that may prevent you from doing your job. It is always nice to have an option that you care about doing and not because it's the only thing you can do. I chose being an RRT because I don't have to do as much lifting as a nurse. I assist, but it is not my primary responsibility. Of course, I also chose it for the technology and the freedom.
I see many paramedics going through their nursing clinicals. I am very supportive of them because they are not doing their nursing through a mail order program. There are some that we can all see will not make it because of their attitudes of entitlement. But, yes, nursing will get the good paramedics that do want to expand their knowledge and education.
