Re: Denigration of Paramedics by UTMB Galveston

October 3, 2000

YOU GO GENE !!!!!!!!!!!!!!!!

October 3, 2000

Some things to keep in mind if the paramedical profession cosiders legislation

to define its scope of practice. EMS and the PA profession are both young. PAs

started out as medics and corpsmen out of the Vietnam war who were trained with

a minimum of educational investment to do mainly routine skills and minor

diagnostics that ate up alot of doctors time. For over a decade, the majority

of PA programs only offered certificates upon completion. Then some began to

offer Associate's degrees, then onto bachaelor's degrees,and now the profession

is moving towards all master's degree programs. This has only helped our

profession, and I'll tell you why: Education = Respect and the ability to fight

off attacks by would be competitor professions...namely the nurses. I could

give you story after story, but instead I'll tell you what happened in

Mississippi to PAs because of nurses. PAs were practicing in Mississippi

several years ago and decided to add some legislation defining!

scope of practice. Once the bi

ll is introduced, anything can be added or changed/taken away before it's

passed. The Mississippi nurse's lobby had a ludicrous addition made to the bill

under our noses and had it passed in order to keep us from practicing there.

Basically, the new act said that only master's level PA's would be able to

practice in that state. At the time, only a handful of PAs in the country were

master's level trained. It has taken years to get the legislation changed and

we are now able to practice in that state. Let this be a warning! Be very

careful about what you want. The nursing lobby will be watching and WILL try to

screw with EMS. Take my word, our move towards higher education levels has kept

us in the fight with the massive nursing lobby, and has affirmed and secured our

place in the medical community. PLEASE, if you value your own place in the

medical continuum and want to move into non-traditional roles as caregivers,

increase your educational requirements as soon as po!

ssible.

Blaine Rourke

October 4, 2000

Well said.

JBurgan LP

October 4, 2000

No flames from me, Gene.

I agree with you that SOME nurses mistreat the members of the pre-hospital

career path, and do their best to see we don't go anywhere. I have even

witnessed a unit RN talk down to a member of a flight crew because she was

apparently unworthy of performing care in the clinical setting, or at least

at this particular facility. Just one problem, though: the " flight medic "

was, in addition to being an LP, an MSN, CEN, CCRN, CFRN, etc... ad nauseum.

How do I know this? The flight crew member is a friend of mine, and was

brought from the airport to the community hospital on MY ambulance. Just

the fact that her flightsuit had a paramedic patch automatically made her a

lower lifeform in the eyes of the " unit queen " .

Yes, SOME nurses feel threatened by paramedics. Yes, some nurses mistreat

field personnel. But I also believe that it can, and MUST get better, in

order for the ENTIRE medical profession as a whole to survive in this new

age of Medicare cuts and facility/service closures/cutbacks.

Everybody in the healthcare field MUST work together, or we will ALL hang

together.

Barry E. McClung, Paramedic

October 4, 2000

As usual I applaud Mr. Gandy’s thoughts and single-minded intent to raise

the level of EMS to a professional level. However, I am beginning to think

Mr. Gandy is a lone voice crying in the wilderness. It will be interesting

to see the volume of e-mails both pro and con regarding his latest e-mail.

Mr. Gandy, would you be so kind as to keep a running total of pros and cons

in regards to this most lucid of concepts you have put forth. It might wake

up a few people as to what the EMS Professionals such as you, Mr. , Dr.

Bledsoe, Mr. Haussecker, Mr. Barber, and many others whose names escape me

at the moment, are up against.

I will formulate my response and post it later for public ridicule.

Stay safe

Easley

[texasems-L] Denigration of Paramedics by UTMB Galveston

I have a friend who works for the University of Texas Medical Branch

Hospital in Galveston who has just told me that the UTMB-Galveston has

stripped the Paramedics working for them in places like Telemetry and the ER

of their privileges to do any sort of skills. The paramedics have received

NO SUPPORT from either the medical staff, the nursing staff, nor the

administrative staff.

There appears to be widespread ignorance among hospital managers there of

the education and skills possessed by Paramedics. The nursing service there

has apparently taken the position that Paramedics are inferior to even nurse

aids. The nurses have taken an adverse position to the Paramedics and are

apparently hostile to the idea of Paramedics performing any sort of

functions

equal to their education, training, and skills.

I'm currently asked by the services affiliated with my programs why more of

my paramedic students don't apply for employment with them. Three answers:

Salary, respect, and benefits. Who in her/his right mind would put in the

time and sweat to become a great paramedic when the profession provides such

a dearth of respect, pay, and status?

When I rant on here about educational standards for Paramedics and

educational recognition, that's what I'm talking about. Y'all who are

satisfied with your positions as low-paid Paramedics or volunteers need to

understand how your opposition to increased education and Licensure affect

those who are working in other than EMS and Volunteer situations.

How can we get any respect unless we DEMAND it and back it up with law? We

are dependent upon the whims of the nursing and medical professions for our

employment, and we get very little respect from either. It makes my blood

boil when I hear that Paramedics are told by nurses that they can't start

IVs, give meds, read ECGs, participate in codes or anything else because

they're only Paramedics and not LICENSED MEDICAL PERSONNEL. With due

respect

to the many RNs on here who are competent in emergency medicine, I would

like

to point out that most RNs employed by hospitals in managerial positions

haven't a clue about what Paramedics are educated and trained to do and what

their level of experience is. Yet they determine the scope of practice of

Paramedics who work in their hospitals. I have opposed legislation defining

a scope of practice for Paramedics, but I'm now re-evaluating that position.

I think we need legislation that firmly and finally establishes our rights

to

perform the skills we're educated and trained to perform and allows us to do

these skills without nursing supervision. We need to have legal basis for

our practice, which we do not currently have. We need LEGAL STATUS FOR OUR

PRACTICE!

Nurses will inevitably see us as a threat to their territory and fight us to

the death for control over us. Trust me. This is correct. The worst

thing

that can happen to EMS is for nurses to gain control of it. If nurses were

the best emergency caregivers then they would be staffing all the

ambulances.

Since they are not, the profession of Paramedicine has been created, and

Paramedics are the best emergency caregivers.

The nurses are firmly in control of us in the hospital setting and that's

why

we can't fill needed positions in Emergency Departments and other areas of

the hospital without their approval, which they're not going to freely give.

We need to establish ourselves as legally independent of nurse control and

on equal ground.

But we can't do that when we have members of our own profession constantly

arguing for less educational standards than the nurses have. PEOPLE, WAKE

UP!

This doesn't have anything to do with experience, skills proficiency, who's

a

great paramedic because of umpteen years experience and practice nor

anything

else except credentialing. I'm as proud of my blue-collar background as

anybody, but for God's sake, let's move on.

Some of you here who are nurses are going to jump right on top of me for

saying these things, and if you're also a Paramedic or if you're a nurse

with

emergency experience of any sort, then I welcome your replies and input.

Otherwise, you need to get some emergency credentials before replying.

Nursing education programs typically don't even include ACLS as a

requirement, not to mention BTLS nor PHTLS or PALS or PEPP. I'll bet that

99% of the Directors of Nursing Programs in the community colleges and

universities of Texas would not be able to tell you what BTLS, PHTLS, or

PEPP

stand for. What a travesty of intellectual dishonesty.

OK, Flame Away!

Gene Gandy

October 4, 2000

Greetings to all,

I am currently studying the development of

Continuing Education in the Professions. As part

of that study, I have looked at the development of

pre-professional education. It is very

informative. 100 years ago doctors did not have to

complete college training to get into medical

school. During the early years of the last century

that changed. Today, no one would even consider

getting into medical school without it. The same

can be said of most other 'professions'. I realize

that I am speaking from the position of a vested

interest, at least from perception. However, these

things are historical. Education beyond high

school is considered by the public at large to be

one of the marks of a profession. Currently,

approximately 25 percent of the American workforce

claims membership in a profession. Nearly everyone

of those professions require college training

which includes a rigorous skills development

process and mandatory continuing education. If we

want to be part of that Sisterhood/Brotherhood, we

will have to meet the entrance requirements.

I can come up with all kinds of reasons to not do

something, but that does not negate the impact of

the lack of performance. In 1979, with a wife and

two children, I came to the realization that I

needed an advanced college degree to accomplish my

goals. It was not that I was ignorant or

ill-informed, but those were the requirements

imposed by the system. At the time I was working

as a mental health counselor in private practice.

I could not be recognized as a professional

without at least a Master's degree. I started back

to school. I worked multiple jobs to make ends

meet. We qualified for food stamps, free lunches

for our children and were rated at below the

poverty level by the then current standards. I

paid the price. It took me until 1984 to complete

my Master's. At that time my goals had changed and

I began my work to my Doctorate, which I didn't

complete until 1995. That was a long and difficult

16 year journey. Many times, I was frustrated and

seemingly defeated, but I made it. I didn't see my

income dramatically increase until I came to my

current position 7 years ago. I did it because I

had a goal, not because I wanted to make mega

bucks.

Each one of us decides what we want in life and

then goes for it. My roots are in blue collar,

white trash. My family knows the law from both

sides. I have relatives who abuse and distribute

drugs. That's where I would be if I hadn't made a

choice to go elswhere. I follow the discussions on

this list very closely because I care very much

about EMS and where we are going as a profession

(we are one, even when we don't always act like

it). The world is full of people who will rub most

anything in someone else's face, but that doesn't

make them better. Education is not an end-all, it

is simply a means to an end. Formal education is

the development of experience through someone

else. It is vicarious. I have education that I got

in the classroom (good and bad) and I have a

wealth of education that I gained in the school of

hard knocks (good and bad); one is not better than

the other, they were just gained differently. The

world, however, recognizes the classroom (Formal

Education) more readily than hard knocks.

We all need to attempt to move toward promoting

the cause of the profession rather than excusing

our individual shortcomings. I am not directing

this at any specific individual or group. I have

many at the University, who possess Doctorates,

who present themselves as ignorant. Education

won't change that automatically. It does give

their ignorance more respect in the world. That

may not be right, but it is a fact. There are some

things we can't change, we just need to look past

it. One thing we can all change is our education

level. I still study, go to class, and generally

seek to improve my education level. I simply

follow the example of many more intelligent people

I know.

I do not want to put my self up as someone

superior, but rather to say that if this dumb old

coot can do it, you yougnsters ought to find it

easy. We generally can accomplish what we set our

mind to do.

Bob

--

Dr. Bob Folden

Division of Continuing Education

Texas A & M University-Commerce

" Learning is the Breath of Life "

October 4, 2000

An old partner of mine, who was always receiving a rather ill form of

professional criticism from nurses, once explained to me why they were

like that. :

The reason why some of these nurses are so sinical towards EMS personnel

was due to the fact that they take the Same form of tasteless

" bullying " by the Doctors they work with at their departments.(I have

seen it) He went on by saying that these " nurses " take out their

frustrations and treat us like " the bottom of the food chain " so they

can receive that Dominant feeling of command. At most hospitals, Nurses

are not even allowed to administer medication much less start an IV of

Saline with out a Doctor's approval first. IMAGINE THAT!...

a registered nurse that makes 20+ an hour can't treat a patient unless

told so by a Doctor, but this underpaid " Ambulance driver " can provide

VARIOUS forms of treatment / patient care ranging from Basic skills to,

and beyond, ACLS standards. WOW, No wonder they are so moody!

A Nurse who is competent and Confident on his/her position WILL NOT

behave in such a childish manner. These Nurse I Applaud! ... AND for

the others who have their noses in the air, I think these are just

people who are unhappy with themselves.

Peace,

JD Carstetter, EMT-P

October 4, 2000

On Wed, 4 Oct 2000 09:49:56 -0500 " Barry E. McClung "

writes:

>

> the fact that her flightsuit had a paramedic patch automatically

> made her a lower lifeform in the eyes of the " unit queen " .

Barry and friends -

I have several of the " alphabits " you described. The volunteer service I

ride with issues shirts with whatever our state cert or license is, and I

have noted the same reaction. They do the " better than you " BS until they

see my name tag. Then their eyes get BIG!

Half of them then treat me like a peer, and a few ask about prehospital

practice.

Unfortunately, the other half act like I am a pariah (as in- 'how could

you stoop to working the streets, as a VOLUNTEER, when you should be

where the rest of us are?')

On the other hand, I have seen a fair number of prima donna flight nurses

(none locally, or lately, thank goodness) that really give a bad

impression of flight nursing. I equate it to the arrogance seen in more

than a few pilots or surgeons.

I'd like to know where a RN working the ED in a non-trauma certified, or

level 4 or 3 TC can come off with such a superior attitude? JD probably

has it right; it's either inferiority or food chain superiority.

" Leadership is action, not position "

Larry RN CFRN NREMTP

....and some other stuff

________________________________________________________________

YOU'RE PAYING TOO MUCH FOR THE INTERNET!

Juno now offers FREE Internet Access!

Try it today - there's no risk! For your FREE software, visit:

http://dl.www.juno.com/get/tagj.

October 4, 2000

Ever tried to get RNs to ride out to see what goes on in the field? You

offer them regular hourly pay and a 3 free meals, and most will still not.

On the other hand, you offer a medic regular hourly pay and a free meal just

to hang out in the ED, ICU, or floor, and most of the time you have to beat

them back with a stick. The issue boils down to nursing leadership, as I

have seen. The DON, ADON, or CNO sets the frame of mind in how the RNs

respond to the other allied health professions. Nursing leadership can

either relate that everyone is a pier, or can relate the attitude that the

nursing department is abused by the other departments, and must be

defensive. I guarantee that if in your venue the RNs have a negative

attitude with EMS personnel, the same attitude is related to RT, PT, Lab,

Radiology, Engineering, and Housekeeping or whoever.

-mike

jdc911@... wrote:

> An old partner of mine, who was always receiving a rather ill form of

> professional criticism from nurses, once explained to me why they were

> like that. :

>

> The reason why some of these nurses are so sinical towards EMS personnel

> was due to the fact that they take the Same form of tasteless

> " bullying " by the Doctors they work with at their departments.(I have

> seen it) He went on by saying that these " nurses " take out their

> frustrations and treat us like " the bottom of the food chain " so they

> can receive that Dominant feeling of command. At most hospitals, Nurses

> are not even allowed to administer medication much less start an IV of

> Saline with out a Doctor's approval first. IMAGINE THAT!...

> a registered nurse that makes 20+ an hour can't treat a patient unless

> told so by a Doctor, but this underpaid " Ambulance driver " can provide

> VARIOUS forms of treatment / patient care ranging from Basic skills to,

> and beyond, ACLS standards. WOW, No wonder they are so moody!

>

> A Nurse who is competent and Confident on his/her position WILL NOT

> behave in such a childish manner. These Nurse I Applaud! ... AND for

> the others who have their noses in the air, I think these are just

> people who are unhappy with themselves.

>

> Peace,

>

> JD Carstetter, EMT-P

>

October 4, 2000

Even though this is not at all a funny situation - I have to read

these posts with some amusement because your assessments of nurses

are, for the most part, so painfully accurate! I am an RN, have been

for many years, and ER has always been my chosen field. I am also a

Paramedic and have been an EMS educator full time for the last 15

years. I will spare you the details of how old that makes me. Through

the years I have worked with many fine nurses who did their best to

develop both younger nurses and Paramedics in the ER setting.

Unfortunately, I have worked with just as many who, to quote an

article in the Dallas Morning News about a month ago, " eat their

young " . Nurses cannot, per our nurse practice act, delegate the

dispensing of medications to a paramedic or anyone else. Yet,

through hospital credentialing procedures, we frequently delegate

that practice to LVN's. Why not paramedics? There are so many

things that need to be accomplished on both sides before this

situation changes for the better. Nurses need to know their own

practice act, and more importantly, they need to teach physicians

about it. I have seen physicians put nurses and paramedics at risk

over things, simply because no one knew what their practice

guidelines were. I tend to be in favor of a scope of practice for

paramedics, because without it, we are not able to take a firm

stand on what we will and won't do - can and can't do. Credentialing

is a very real possibility for paramedics working in the ER; it

is difficult for me to understand that, with the nursing shortage

that we currently face, DON's would not be grabbing every resource

that they can and making the best use of them possible. One of the

reasons cited for the nursing shortage is physician abuse. If that

is true now, (it wasn't too bad back when) then we are in a sorry

state. Administration has to support its nurses, nurses have to

support technicians if we are to survive as a true profession.

It is going to take increased educational standards, probably a

scope of practice, and community EMS leaders beating down hospital

doors singing the praises of this largely untapped gold mine, our

Texas EMS men and women. The paramedics of this state are going to

find themselves involved in such things as home care, clinic

referrals, etc., in the not too distant future. Will there still

be a place for RN's, absolutely, but we need to all work together,

not separately, as we go. Reimbursement factors are going to be a

big issue, so it is time to climb out of the clouds, ladies, and

work with us, not against us! My last word, a disclaimer, to my

many nurse colleagues who have spent most of their lives and all

of their careers trying to further the cause of Texas EMS people -

thanks for all you do - we wouldn't be where we are today without you. Debbi

Cason, Jan Auerbach, Carol Ferguson,

Ann Hudgins, Lucy DeTamble, to name a few.PS, Call me Mike, I will

ride out with you anytime, and I'do it for the three squares, not

money! .

Re: [texasems-L] Denigration of Paramedics by UTMB Galveston