Should EMS be controlled so much by nurses?

[NUEMT]

Disclaimer....I Love nurses.

But, in a profession arguably taught in the medical model under protocols and procedures taught by and overseen by physicians, why so many nurse managers.

Here in Chicago you can expect your local EmS coordinator to be a nurse, paramedic educators, nurses, ecrns of course, paramedic clinical directors, individual hospital ems coordinators and preceptors during ER nclinicals .....all nurses.
While not a bad thing in every single sense..the nursing profession has done very well to insert themselves into every facet of EMS.

So the question is, to what end?

What interactions or scenarios have played out in your area that form your opinion.

For me, its high time EMS movrs forward with the education specific to our profession and cuts out some space at the table.

 

[ERDoc]

I'm not sure how long you have been doing this, but the nursing profession is very good at lobbying and inserting themselves. This isn't just limited to EMS but to the hospital also. I think it comes down to cost an desire. Most physicians want to see pts, it's the reason we went to medical school. I'm not saying nurses don't but there is a unique cohort in the nursing field that has their eyes set on admin. It also cost the system a lot less to put nurses into these roles that it does a physician.

 

[NomadicMedic]

Your view is a bit narrow and certainly situational. In many other parts of the country, nursing has zero input in EMS education or hospital coordination.

When you're limited to a single camera view, your bias is unintentional. Research on EMS across the country would be a great place to start.

In short, there's more to the world than your own backyard.

 

[Carlos Danger]

No place where I've ever worked as a paramedic ever had nurses involved in any way at all. Aside from HEMS, which is sometimes nurse-heavy and sometimes paramedic-heavy as far as which discipline has more influence.

 

[Summit]

Apart from RNs precepting ER clinicals or a medic who is also a RN instructing or a RN guest lecturer, I don't think I saw a lot of RNs in EMS education.

That said, I'm at a teaching hospital and it is an RN who teaches and runs the code blue simulations and ACLS classes for everyone, MDs, RNs, the experienced medics from the ED. They do an amazing job at it too. And nobody cares that the person is a RN because they do a professional job at it.

It isn't the only thing RNs teach for other disciplines.

And the RNs get taught by MDs. And there is PT, OT, psych techs, radiology techs, echo, lab, informatics, NPs, DOs, PAs, MDs, RNs, CRNAs, EMTs, RRTs, LSW, etc etc etc.

It is easy to lose perspective from outside the hospital. And it is easy to forget that EMS is one of the most recent disciplines at the healthcare table.

Most of healthcare world believes in interdisciplinary education and collaboration. Everyone teaches and learns from each other. I'm not saying EMTs should be lecturing in medical school, but you get my point.

 

[mgr22]

NUEMT, I don't see nurses "insert(ing) themselves into every facet of EMS." What would they gain by being more involved in a lower-paying, less respected field? Also, I disagree with your suggesting about "cut(ting) out some space at the table." In my opinion, the last thing we need to do is seem even more mysterious and parochial to other medical practitioners.

I'd rather see us take the opposite approach; that is, adopt some of the professional aspects of nursing -- e.g., higher education requirements, more lucrative career paths, even better grooming

 

[nightmoves123]

NUEMT I fail to see what your issue is from your post? I get the impression that you believe nurses are somehow overly involved in EMS? If so, you haven't given a reason why this would be a negative thing?

Having an ADN/BSN/RN makes one a very versatile healthcare provider, they can bridge across to various disciplines ranging from social work, CRNA to HEMS to remote medics on oil rigs etc. As said by other posters 1- just because it seems nurses are prevalant within EMS in your area does not make it so for the rest of the nation. 2-healthcare is a team effort and distancing one from another would have negative consequences for EMS.

 

[gotbeerz001]

Possibly you think you are closer to a doctor than you are… Even as a paramedic, nurses provide a higher level of care.


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[Flying]

What's wrong with having people who are likely better educated manage things?

 

[RocketMedic]

Possibly you think you are closer to a doctor than you are… Even as a paramedic, nurses provide a higher level of care.


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Not necessarily

 

[NUEMT]

Your view is a bit narrow and certainly situational. In many other parts of the country, nursing has zero input in EMS education or hospital coordination.

When you're limited to a single camera view, your bias is unintentional. Research on EMS across the country would be a great place to start.

In short, there's more to the world than your own backyard.

Precisely why I asked for other points of view. Thanks.

 

[NUEMT]

No place where I've ever worked as a paramedic ever had nurses involved in any way at all. Aside from HEMS, which is sometimes nurse-heavy and sometimes paramedic-heavy as far as which discipline has more influence.

Thanks for the perspective. Are hospital level EMS coordinators even a thing where you are?

 

[NUEMT]

NUEMT, I don't see nurses "insert(ing) themselves into every facet of EMS." What would they gain by being more involved in a lower-paying, less respected field? Also, I disagree with your suggesting about "cut(ting) out some space at the table." In my opinion, the last thing we need to do is seem even more mysterious and parochial to other medical practitioners.

I'd rather see us take the opposite approach; that is, adopt some of the professional aspects of nursing -- e.g., higher education requirements, more lucrative career paths, even better grooming

I should clarify... Not insert into so mu h as in front of..at least here.

As for space at the table.. I mean to say in healthcare and I totally agree the way forward is through education. Well said.

 

[Carlos Danger]

Thanks for the perspective. Are hospital level EMS coordinators even a thing where you are?

Yeah, kind of. They exist at the larger hospitals, but they don't "control" anything. They primarily act as a liaison between the trauma service and the EMS agencies. Most of the ones I've known were nurses who were also paramedics or at least who had an EMS background, and got into the job using their connections in the ED. The most recent one I knew was a flight RRT who had been a paramedic for years. I think he got hired into the role primarily on his paramedic certification and HEMS background.

 

[NUEMT]

Possibly you think you are closer to a doctor than you are… Even as a paramedic, nurses provide a higher level of care.


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Maybe a higher level of nursing care. But nurses in the facilities here do little without a direct order.

 

[NUEMT]

What's wrong with having people who are likely better educated manage things?

My point is why not Be the bettet educated person.?

 

[gotbeerz001]

My point is why not Be the bettet educated person.?

Spelling + punctuation would make this a better argument.


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[gotbeerz001]

Maybe a higher level of nursing care. But nurses in the facilities here do little without a direct order.

I think may favorite quote of yours was something to the tune of:

"I have had many great conversations with doctors because I read what they read"

While I applaud your apparent excitement for the field, your efforts will be best rewarded when applied to a current and realistic end. EMS in the US is largely customer service and logistics; an idealistic EMT is not going to change that. While there may be advances in requirements to become licensed which lead to higher trained NEW people (the existing will be grandfathered) which may lead to more demand and higher wages, you still have not solved the reality that in most areas 50% of those who call do not need attention, 30% are best served at urgent care, 15% warrant an ED evaluation, 3% are true emergencies and 2% will die regardless of your efforts.

Most of is have been in your position at some point; we are not "burnt out" for deciding that pushing back against the current is largely wasted effort. The job is what it is; if you want the job to be something different, go to school and become a PA. There are enough EMTs who think they are MDs walking around.


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[gotbeerz001]

*Most of us


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[Carlos Danger]

There are plenty of similarities between nursing and paramedicine, but they are too different to say that one is "higher" or "lower" than the other.

Nurses receive a very broad and general education and then most go on to specialize and develop expertise in a specific area of nursing, such as critical care. Paramedics receive a very narrow and focused education and then go on to care for every type of patient in existence. Kind of backwards, in a way.

The whole thing about "nurses need orders and paramedics do not" is a myth perpetrated by those who have no idea what most acute care nurses actually do.

I wish that myth would die and be buried alongside "if we were licensed instead of certified, we'd be better off as a profession".