RN to Paramedic...

[CriticalCareIFT]

As an ICU/ER Nurse how many patients do you RSI/intubate a month?

As an ICU/ER Nurse how many codes/traumatic codes do you run as a team leader a month (ACLS/PALS/NRP and call the times and push the meds, interpret rhythms and difib)?

As an ICU/ER nurse how many Mass Casualty Incidents that you respond to, triage, and render care?

As an ICU/ER Nurse how many cath lab activations that you determine from a 12 lead that you yourself perform and read and call do you do a month?

As an ICU/ER Nurse how many medications based on your standing orders without notifying the MD, only based on your physical exam and patients complains did you administer a month?

As an ICU/ER Nurse how many patients have you carried or a stair chair down the stairs a month?

As an ICU/ER Nurse how many patients did you use KED, Longboard, Scoop a month?

As an ICU/ER Nurse how often did you drive the ambulance with lights and sirens on an emergency call last month?

etc. etc. etc.

I would image all of these would get "0" from an experienced ICU/ER Nurse, yet in 2 weeks time from a course she will be fully competent to do all of them.

Authority? It's called not suffering from delusions of grandeur.

 

[Akulahawk]

Oh, you just had to go there...

I'm going to comment, inline, in red...

As an ICU/ER Nurse how many patients do you RSI/intubate a month?
How many patients did CFRNs intubate/RSI per month before they joined a flight program?
As an ICU/ER Nurse how many codes/traumatic codes do you run as a team leader a month (ACLS/PALS/NRP and call the times and push the meds, interpret rhythms and difib)?
ICU/ER nurses probably do that a lot more than you think... especially since they're often on an RRT or Code Blue team within the hospital and have to initiate care prior to an MD arriving from somewhere else in the hospital.
As an ICU/ER nurse how many Mass Casualty Incidents that you respond to, triage, and render care?
How many MCI's did you run before you became a Paramedic?
As an ICU/ER Nurse how many cath lab activations that you determine from a 12 lead that you yourself perform and read and call do you do a month?
I would suspect that the ICU/ER nurse probably reads 12-leads and calls the cath lab to expect a patient rather often and calls the physician... "I have a patient that needs to go to the cath lab, here's why..."
As an ICU/ER Nurse how many medications based on your standing orders without notifying the MD, only based on your physical exam and patients complains did you administer a month?
Probably more than you do...
As an ICU/ER Nurse how many patients have you carried or a stair chair down the stairs a month?
EMT level stuff, and psychomotor. Easily learned OJT.
As an ICU/ER Nurse how many patients did you use KED, Longboard, Scoop a month?
EMT level stuff, easily learned OJT.
As an ICU/ER Nurse how often did you drive the ambulance with lights and sirens on an emergency call last month?
EMT stuff.
etc. etc. etc.

I would image all of these would get "0" from an experienced ICU/ER Nurse, yet in 2 weeks time from a course she will be fully competent to do all of them.

Authority? It's called not suffering from delusions of grandeur.

 

[STXmedic]

*disclaimer: I'm not a nurse; I'm a paramedic. My wife is, however, an RN in the STICU.

CriticalCareIFT, I mean no disrespect, but you seem to have a very poor idea of what an ED/ICU nurse does; and a very inflated sense of what a paramedic does and how difficult it is to learn.

An ICU nurse certainly does push meds, often (and I mean multiple times per shift), based on their own decision-making.

An ICU nurse certainly does run codes. Maybe not through the entirety, but they are certainly able. Especially if they're on the hospital's RRT/Code team.

RSI is not the best argument, either. While nurses other than CFRNs do not perform RSI, neither do the vast majority of paramedics. Many are never even taught; many more are never in a system that allows it. And for the systems that allow it, most will put the medics through RSI training and clearing. What makes a nurse incapable of sitting through the same training once they're in a system utilizing RSI.

MCIs? Seriously?

All of the operational stuff you pointed out is mute as well. How hard is it to learn how to bring somebody down in a stair chair? (Hint: not hard at all.)

Your view of what we do as paramedics is definitely a bit falsely elevated. Is our job a cake-walk? No. It certainly takes education to be proficient at what we do. Can any nurse jump in an accelerated program and be successful as a paramedic? Of course not. Can an ED/ICU nurse with several years of experience? I have no doubt. Especially an ICU nurse, and especially if they were an EMT beforehand.

Go shadow some nurses on these floors and see what it is they actually do. Many will run circles around you.

 

[CriticalCareIFT]

*disclaimer: I'm not a nurse; I'm a paramedic. My wife is, however, an RN in the STICU.

CriticalCareIFT, I mean no disrespect, but you seem to have a very poor idea of what an ED/ICU nurse does; and a very inflated sense of what a paramedic does and how difficult it is to learn.

An ICU nurse certainly does push meds, often (and I mean multiple times per shift), based on their own decision-making.

An ICU nurse certainly does run codes. Maybe not through the entirety, but they are certainly able. Especially if they're on the hospital's RRT/Code team.

RSI is not the best argument, either. While nurses other than CFRNs do not perform RSI, neither do the vast majority of paramedics. Many are never even taught; many more are never in a system that allows it. And for the systems that allow it, most will put the medics through RSI training and clearing. What makes a nurse incapable of sitting through the same training once they're in a system utilizing RSI.

MCIs? Seriously?

All of the operational stuff you pointed out is mute as well. How hard is it to learn how to bring somebody down in a stair chair? (Hint: not hard at all.)

Your view of what we do as paramedics is definitely a bit falsely elevated. Is our job a cake-walk? No. It certainly takes education to be proficient at what we do. Can any nurse jump in an accelerated program and be successful as a paramedic? Of course not. Can an ED/ICU nurse with several years of experience? I have no doubt. Especially an ICU nurse, and especially if they were an EMT beforehand.

Go shadow some nurses on these floors and see what it is they actually do. Many will run circles around you.

We are talking 2 week program to learn all these competencies, that after 2 weeks the nurse can jump side by side with you in your truck and perform as an equal because of her extensive ICU/ER experience.

 

[TransportJockey]

We are talking 2 week program to learn all these competencies, that after 2 weeks the nurse can jump side by side with you in your truck and perform as an equal because of her extensive ICU/ER experience.

Most of the things they are learning are stuff that we expect brand new baby basics to do (stair chair, LSB, scoop, gurney ops, EVO, etc) even if they come from a bootcamp 1 week EMT-B course...
And they most likely will have to go through FTO and mentorship time if they want to work as a medic on a truck... if they're already operating as a flight nurse then a lot of this they have been doing. Same if they are ground transport nurses on a CCT truck.

 

[Akulahawk]

We are talking 2 week program to learn all these competencies, that after 2 weeks the nurse can jump side by side with you in your truck and perform as an equal because of her extensive ICU/ER experience.

Given that we're talking about an experienced ICU/ED nurse, I'd have to say that I would expect that after the 2 week course, that nurse would be as competent as a new grad medic, which is what they'd be considered, and probably could run circles around many medics...

 

[CriticalCareIFT]

I am just curious, what do doctors do in those hospitals where RN's run codes, make all the medication decisions, and push the drugs? Man what a sweet gig those places must be for a doctor.

 

[STXmedic]

I am just curious, what do doctors do in those hospitals where RN's run codes, make all the medication decisions, and push the drugs? Man what a sweet gig those places must be for a doctor.

Go shadow an ICU. Seriously. You seem to have no clue how an ICU works.

 

[VFlutter]

I am just curious, what do doctors do in those hospitals where RN's run codes, make all the medication decisions, and push the drugs? Man what a sweet gig those places must be for a doctor.

During the days most doctors have 30+ patients they have to see besides procedures they do. They can not be on every floor all the time. At night most hospitals only have a few doctors in house, the CCP and the ER docs.

 

[STXmedic]

During the days most doctors have 30+ patients they have to see besides procedures they do. They can not be on every floor all the time. At night most hospitals only have a few doctors in house, the CCP and the ER docs.

And that's if they're lucky enough to have a CCP. Many times its just a hospitalist.

 

[CriticalCareIFT]

Go shadow an ICU. Seriously. You seem to have no clue how an ICU works.

Sorry, I have not been to the ICU's where Noctors are in charge.

 

[STXmedic]

Sorry, I have not been to the ICU's where Noctors are in charge.

Nor have I. I don't think I ever stated that was the case, either.

 

[Handsome Robb]

You realize that we follow orders just like a nurse does, right? Who do you think wrote/approved the protocols you follow?

You really think that a nurse has to go and ask a doctor anytime they titrate a pressor or a paralytic or sedative? Of administer analgesia? You think a patient goes into VF the nurse isn't going to start CPR and immediately defibrillate the patient as soon as the code cart gets there? How efficient would that be?

No one said they run the entire code but they do start it off until a physician gets to the bedside. Sometimes that can be one or two rounds, sometimes more until the ERP makes it there. Another floor doc might get there sooner but how many codes has that physician run this year? Answer me that.

The majority of what nurses are going to have to learn are skills, which don't take that long to learn, operations which again don't take long to learn and they're going to have to learn scene control, which is hard to learn for those that to through a formal medic program as well. Also, how many skills do we do that a nurse hasn't already learned? There aren't many.

No one here is advocating any nurse in the world can take a bridge course and operate as a medic but there are those out there that can. Just like there are medics out there that could operate in a nursing roll with some training. It's a two way street.

You're taking everything everyone says and responding to it or quoting it as the extreme of what they said. Respond to what's said, don't twist things to make it look like you're right because the people in this thread aren't dumb enough to fall for it.

 

[Summit]

I am just curious, what do doctors do in those hospitals where RN's run codes, make all the medication decisions, and push the drugs? Man what a sweet gig those places must be for a doctor.

Not counting ED, whose one night doc is not a deployable resource, we have 225 beds, 25 of those are ICU, covered typically by one hospitalist and one intern. What do you think happens when there's a bedside procedure a code going at the same time?

 

[CriticalCareIFT]

Not counting ED, whose one night doc is not a deployable resource, we have 225 beds, 25 of those are ICU, covered typically by one hospitalist and one intern. What do you think happens when there's a bedside procedure a code going at the same time?

Patient will receive noctor care, due to the misfortune of ending up in a hospital where there is no doctors?

 

[Carlos Danger]

Patient will receive noctor care, due to the misfortune of ending up in a hospital where there is no doctors?

You again display your ignorance of critical care units and how they work.

This has actually become humorous.

 

[CriticalCareIFT]

You again display your ignorance of critical care units and how they work.

This has actually become humorous.

Are you actually claiming that in critical care units nurses practice medicine due to doctor shortage?

 

[VFlutter]

Are you actually claiming that in critical care units nurses practice medicine due to doctor shortage?

No one claimed that nurses practice medicine. We have standing orders and "online medical control" exactly like medics.

Patient will receive noctor care, due to the misfortune of ending up in a hospital where there is no doctors?

Pretty much every non-academic hospital is run that way.

You claim to be a CCEMTP and do Critical Care IFT yet you seem to know absolutely nothing about how critical care units function or what ICU nurses do. Who do you think set up that balloon pump, titrated the pressors, and managed the vent?

 

[CriticalCareIFT]

No one claimed that nurses practice medicine. We have standing orders and "online medical control" exactly like medics.



Pretty much every non-academic hospital is run that way.

You claim to be a CCEMTP and do Critical Care IFT yet you seem to know absolutely nothing about how critical care units function or what ICU nurses do. Who do you think set up that balloon pump, titrated the pressors, and managed the vent?

Perfusionist/IR Cardiologist, nurse titrated pressors after calling the doctor, respiratory therapist... wait wait sorry I meant omnipotent ICU RN.

I will repent for all my transgressions at the alter of Florence Nightingale.

 

[VFlutter]

Perfusionist/IR Cardiologist, nurse titrated pressors after calling the doctor, respiratory therapist... wait wait sorry I meant omnipotent ICU RN.

The Cardiologist places the IABP but once the patient is in the unit it is my responsibility. I adjust settings as needed. I titrate and wean pressors to maintain MAP, I do not call the doctor. I adjust vent settings based off ABGs.

Omnipotent? No. Competent? Yes.