Urgent Care Paramedic

[SpecialK]

Makes sense in the context of the system. The thing for our urgent cares is, I don't believe they have the same obligations as an emergency department (subject to a couple of conditions - e.g. if they're part of a hospital that accepts Medicaid like most do and has an ED, etc.) to treat anybody and everybody. As far as RNs, I guess the market for medics in the UK is probably more analogous to our RN market - insofar as that the supply is a bit tighter?

I missed your point on the first part about treating everybody?

As for the British market for RNs I wouldn't know, I am not an RN, nor do I like in England.

In New Zealand many Nurses love working at the A&M clinics, it's easy, good hours and the pay is not bad (little bit higher than working in the hospital because the A&Ms are run by a private, for-profit company so the NZNO has gouged them for a bit more)

 

[EpiEMS]

I missed your point on the first part about treating everybody?

As for the British market for RNs I wouldn't know, I am not an RN, nor do I like in England.

Whoops! Sorry - I thought you were in the UK, my mistake. NZ, ok, cool.

My first point is that it doesn't hit your bottom line if you can turn people who can't pay away at the door (not that people are that cruel) or if such folks don't show up at all. Hospitals have to eat the cost of treating the uninsured/can't pay/etc., while not all urgent cares have to.

 

[SpecialK]

My first point is that it doesn't hit your bottom line if you can turn people who can't pay away at the door (not that people are that cruel) or if such folks don't show up at all. Hospitals have to eat the cost of treating the uninsured/can't pay/etc., while not all urgent cares have to.

Ick ... our public hospitals are funded by the Government (via the Ministry of Health) and each of the 21 District Health Boards decides how it will be spent, but unlike Medicare in US we operate via global budgeting. Nobody is ever not seen because of money as is simply not part of the equation, all decisions are based solely on clinical need. It's not perfect, but it's the only system I have ever known and I've never wanted for anything, the public system has always taken care of me and my family and those I know splendidly and it hasn't cost us a cent.

Anyway .... this might work in the US or somewhere else, and it's an interesting concept regarding expanding roles which many people have been keen to do and the Nurses have been doing for decades. I don't expect it here anytime soon. I am sure some ambulance personnel would love it; set hours, reasonable pay, easy workload ... I like the idea of those, but I'd probably get a bit crazy being stuck in a clinic all day.

 

[Generic]

Actually, you are not exactly entirely correct. The last time I looked at the regulations for California paramedics it appeared that paramedics could work outside of the prehospital environment as an ALS provider in very limited circumstances. Most notably this is within the ER, using their entire scope of practice, facilities that are essentially remote/very rural. In that situation the paramedic is directly supervised by the physician. Most of the time, however, you are correct.

I did address that but I did not know the outcome of the legislation that would allow paramedics to work as an ALS provider in a rural hospital.

 

[Akulahawk]

I did address that but I did not know the outcome of the legislation that would allow paramedics to work as an ALS provider in a rural hospital.

Paramedics can function with their full pre-hospital scope ONLY in the ED of those rural hospitals. They cannot do full-up ALS on the inpatient side of things at those hospitals. The ED is considered an outpatient care area, not inpatient.

 

[NomadicMedic]

@SpecialK, The US healthcare system is totally different. While I agree, in theory, that healthcare should be a universal free service… That's just not the way it is here, and probably never will be. So, comparing what you do in NZ to what we do here is interesting strictly from an academic perspective. It's like comparing apples to… kiwi?

The urgent care clinic is certainly a great way to take the pressure off the hospital emergency departments, if people know to use it. We are in network for just about every insurance provider in the area, and the cash price is significantly less than an emergency department visit. It certainly makes sense for minor injuries and illness, occupational health issues, drug tests, x-rays, lab work… The marketing and education portion of that issue is one of the big reasons I was hired. Another part of my job is to develop and implement advertising and marketing campaigns to let people know what's appropriate for an urgent care visit and what's not. (And yes, that is an entirely separate compensation package then the clinical work.)

There are some urgent care clinics that are simply in it for the money, and while the owners of the practice where I work are certainly looking to make a profit, they aren't out to gouge the patients. (They could, quite easily.) We dispense about 50 different meds for an extremely low price and we found the patients pay for that convenience. It may not be only four bucks like you would pay at Walmart, but most of the standard meds are $10 or $15 per prescription.

As for the job, I can only equate it to working as a combo of unit tech/RN/MA at an emergency department. The paramedic does the initial assessment and triage, charts the findings, sets up the room for the mid-level, assists with procedures or performs them if they're in our scope, administers medications, draws and orders labs, handles most of the administrative paperwork aside from the actual discharge, does all follow up calls and of course the never ending stocking and cleaning.

As I mentioned before, it's a very different patient care experience from working as a street paramedic, but it's very similar as well. I've always felt that my strong point as a medic has been the development of my rapport and connection with patients. Any monkey can do the skills, but actually talking to people is what many medics struggle with. Having an authentic positive attitude, staying busy and working to move patients through the system in under 60 minutes is a fun challenge.

This may certainly not be the job for everyone, but, if you're ready to get off the ambulance, get out of the rain or snow or heat, not have your sleep interrupted at 3 o'clock in the morning for a stubbed toe and never, ever have to carry someone down a flight of stairs again, yet still use all of your assessment skills and practice at your level, this is a pretty good compromise.

i like it so far.

 

[RocketMedic]

I think it's an interesting part-time gig myself.

 

[Summit]

This may be the thing that drives me to nursing.

Working in a clinic is what lead me to nursing.

 

[NomadicMedic]

Working in a clinic is what lead me to nursing.

It's definitely piqued my interest. Or becoming a PA.

 

[VentMonkey]

@pamedic, sorry couldn't resist. Seriously though, it sounds pretty cool, and perhaps another option later on down the road, particularly if we do move out of state, so thanks for sharing @DEmedic.

 

[NomadicMedic]

No physician around usually? By the by, do they have any radiography other than X-ray?

I missed this one earlier. There's a physician always on call if we ever need to consult. We have two medical directors and they both see patients in the clinics, although not every day. We also have specialists that use one half of the office various days a weeks, so at any given time we may have an OB, ortho, plastics or maxofacial doc in the building.

 

[scotty vidrine]

Cool that you can get that kind of a job. I have mixed feelings about this type of situation But everything isn't black & white

 

[NomadicMedic]

Why do you have mixed feeling about this kind of job? Do you not feel that this is a role paramedics shoukd function in?

 

[SandpitMedic]

It's definitely piqued my interest. Or becoming a PA.

PA is tough for most of us EMS "schlubs" because most have no Bachelors degree. Afraid a lot of us missed that boat.

Good luck in your new role! Enjoy!

 

[Summit]

Cool that you can get that kind of a job. I have mixed feelings about this type of situation But everything isn't black & white

In the other thread you were uncomfortable that RNs were on Paramedic "turf" because Paramedics don't have enough opportunity in your view... but here is opportunity and you are uncomfortable?

 

[scotty vidrine]

Why do you have mixed feeling about this kind of job? Do you not feel that this is a role paramedics shoukd function in?

i have seen medics get used as less than what they are i guess. I know this doesn't happen in every situation

 

[NomadicMedic]

i have seen medics get used as less than what they are i guess. I know this doesn't happen in every situation

What does that mean? A medic working as a Medical Assistant is a different skill set, but not "less than what they are". In many cases it pays more than an ambulance job, it's inside and there's significantly less risk of coming home injured. Who cares if a paramedic is doing TC Swabs and giving IM Decadron instead of backboarding car accidents and doing IFT. It's just different skills. The place where paramedics excel is in assessment and managing the emergent patients that present in the UC.