Guest guest Posted October 5, 2000 Report Share Posted October 5, 2000 Good points all, Gene. Once again, thank you for getting right to the heart of the matter. Until we work together: paid/volunteer, municipal/private, fire service/third-service we will NEVER get the political clout we need, we will NEVER get the recognition we deserve AND need. We must stop the infighting and work together. We must work toward PROFESSIONAL staus, get away from TECHNICIAN status. We need to improve education, and we need to make it clearer just what Paramedic means. The idea of being classified in the same category as a pipefitter, and getting paid less than a 15 year-old asst manager at Micky-D's is rather distasteful. Realizing that I am part of the reason this occurs is even more so. As Earl Pitts would say: " Wake Up, Amuricuh!! " Barry E. McClung, Paramedic/Crew Chief North Blanco County EMS City, Texas [texasems-L] Re: Right to Practice Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2000 Report Share Posted October 5, 2000 Mr. Gandy has made some very interesting points. Now may I pose a question to the E.R., flight, street, and I.C.U. Nurses on the server? As nurses, what can we do to help bridge this gap in the professionalism of nursing? The ANA recognizes respiratory therapy, radiology, and physical therapy as professions, so why not EMS? Perhaps the teeming masses of nurses in EDNA could develop a policy of “professional recognition” or what ever important sounding title they feel they need to use to impress the public with and recognize the paramedic profession for what it is; a profession. Stay safe Easley [texasems-L] Re: Right to Practice Paramedics in Texas have NO right to practice except under the delegated practice of a physician medical director. The Medical Practice Act allows physicians to delegate certain practices to anyone; thus the office " nurse " who has no training except OJT who is allowed to give injections, draw blood, and do various other procedures as delegated by the physician s/he works for. The Nursing Practice Act states that there are certain functions that a nurse cannot delegate to " non-licensed personnel " . One of them is patient assessment. A nurse cannot legally delegate certain actions that a physician can. So herein lies the rub. Nurse administrators have to make sure that the nurses do not violate the law, and they tend to adhere to narrow interpretations of the Nursing Practice Act. Many nursing administrators do not even know that there are Licensed Paramedics in the State of Texas, and, unfortunately, many of them would not greet that news with any enthusiasm. Not only that, they are reinforced by the fact that there's no scope of practice legislation in place for Paramedics, whether Licensed or Certificated, in Texas. Since THEIR Nursing Practice Act doesn't mention Paramedics, they take the position that Paramedics don't exist according to them. If they can't find a law or regulation that specifically grants to a Paramedic the privilege of doing a certain procedure, then they're going to take the position of comfort and deny that Paramedic the privilege of doing anything other than what a janitor could do. (Of course, hospitals can let janitors do anything they want: give meds, take vitals, start IVs, put in Foleys, you name it.) And don't ever think for ONE SECOND that this is not an economic issue. Nurses are going to protect their turf to the death, as well they should. Who can blame them? Abandon any notions that you might have of altruistic motivation. All protect their own interests when push comes to shove. Money talks. It all boils down to the fact that, as I have stated ad nauseum, we in EMS have totally and completely failed to form any sort of politically powerful organization that could work for us to correct these problems. There is such an organization available, but it costs a little bit of money to join. EMS people have never supported such an organization in any sort of numbers. There are 42, 000 + of us, but we have no voice. Getting physicians to buy into delegation of practice to Paramedics is very problematical. Physicians who have a knowledge and background with EMS are very receptive to our abilities, but often they are put down by the nurses and administrators. Often the ER physicians are not on staff and are hired hands and treated like step-children by the hospital administration and medical staff. Many of them don't have any stomach for engaging in internecine battles with administration. Why should they? They are usually stressed to the limit by the administration and have little or no time to engage in turf battles, especially those they don't have an immediate economic interest in. There are a very few who recognize patient care issues and will go to bat for the patients. It's easier for them to say, " Hey, that's not my problem. I doctor, they decide who helps me and I can't control that. " Who's to blame? Well, " We have met the enemy and they is us! " We're to blame. Not the nurses, not the doctors, not the administrators. We're to blame because we have failed and refused to develop a united front and to increase our level of education and training to a unified professional level. We continue to foster an image of " technician " rather than professional. Now I know some of y'all are going to roast me because of that and say that I'm elitist and don't appreciate experience and skills. Not so. I do. But as others on here have so adroitly stated, nobody outside our own circles recognizes the " skilled technician " as being anything more than a minimum wage earner. Even plumber's helpers and carpenter's helpers make more than we do. We have nobody to blame but ourselves. If we want the right to practice in hospitals and in other forums outside pure EMS, then we need to get some laws to protect us. As has been stated, we must be very vigilant or we'll have done to us what the nurses did to the PAs and EMTs in Mississippi. There they got amendments to the laws that were introduced that protected their turf and decimated the very people the PA and EMT laws were designed to protect. Although we all have friends who are nurses, THE NURSES (as in the TNA) are NOT our friends. Their political organization will do anything and everything that they possibly can to keep us from gaining a legal foothold from which to practice our education and skills outside their control. And they will NEVER willingly allow us to practice along side of them. Trust me. Gene Gandy, LP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2000 Report Share Posted October 5, 2000 Gene, I have to agree with you, but there is away (I believe) to have our voices heard. This way is by getting MORE EDUCATED. By this means it would provide a more open mine field that could be used to defend " our " turf. Eventually also leading to an expansion of " our " turf. Nurses really don't care about experience, take for example a medic who has worked in EMS for 20yrs +. All they know is that a so called nurse, is one who is has taken a ADN, BSN, MS, or higher education. Now think of the advantages when you have a RN,LEMT-P, w/ a Master's in Science. Now you are able to compare... which one will get more respect? what do you think? A.A.S. EMT-P/LVN [texasems-L] Re: Right to Practice > Paramedics in Texas have NO right to practice except under the delegated > practice of a physician medical director. The Medical Practice Act allows > physicians to delegate certain practices to anyone; thus the office " nurse " > who has no training except OJT who is allowed to give injections, draw blood, > and do various other procedures as delegated by the physician s/he works for. > > The Nursing Practice Act states that there are certain functions that a nurse > cannot delegate to " non-licensed personnel " . One of them is patient > assessment. A nurse cannot legally delegate certain actions that a physician > can. So herein lies the rub. Nurse administrators have to make sure that > the nurses do not violate the law, and they tend to adhere to narrow > interpretations of the Nursing Practice Act. Many nursing administrators do > not even know that there are Licensed Paramedics in the State of Texas, and, > unfortunately, many of them would not greet that news with any enthusiasm. > Not only that, they are reinforced by the fact that there's no scope of > practice legislation in place for Paramedics, whether Licensed or > Certificated, in Texas. Since THEIR Nursing Practice Act doesn't mention > Paramedics, they take the position that Paramedics don't exist according to > them. If they can't find a law or regulation that specifically grants to a > Paramedic the privilege of doing a certain procedure, then they're going to > take the position of comfort and deny that Paramedic the privilege of doing > anything other than what a janitor could do. (Of course, hospitals can let > janitors do anything they want: give meds, take vitals, start IVs, put in > Foleys, you name it.) And don't ever think for ONE SECOND that this is not > an economic issue. Nurses are going to protect their turf to the death, as > well they should. Who can blame them? Abandon any notions that you might > have of altruistic motivation. All protect their own interests when push > comes to shove. Money talks. > > It all boils down to the fact that, as I have stated ad nauseum, we in EMS > have totally and completely failed to form any sort of politically powerful > organization that could work for us to correct these problems. There is such > an organization available, but it costs a little bit of money to join. EMS > people have never supported such an organization in any sort of numbers. > There are 42, 000 + of us, but we have no voice. > > Getting physicians to buy into delegation of practice to Paramedics is very > problematical. Physicians who have a knowledge and background with EMS are > very receptive to our abilities, but often they are put down by the nurses > and administrators. Often the ER physicians are not on staff and are hired > hands and treated like step-children by the hospital administration and > medical staff. Many of them don't have any stomach for engaging in > internecine battles with administration. Why should they? They are usually > stressed to the limit by the administration and have little or no time to > engage in turf battles, especially those they don't have an immediate > economic interest in. There are a very few who recognize patient care issues > and will go to bat for the patients. It's easier for them to say, " Hey, > that's not my problem. I doctor, they decide who helps me and I can't > control that. " > > Who's to blame? Well, " We have met the enemy and they is us! " We're to > blame. Not the nurses, not the doctors, not the administrators. We're to > blame because we have failed and refused to develop a united front and to > increase our level of education and training to a unified professional level. > We continue to foster an image of " technician " rather than professional. > Now I know some of y'all are going to roast me because of that and say that > I'm elitist and don't appreciate experience and skills. Not so. I do. But > as others on here have so adroitly stated, nobody outside our own circles > recognizes the " skilled technician " as being anything more than a minimum > wage earner. Even plumber's helpers and carpenter's helpers make more than > we do. We have nobody to blame but ourselves. > > If we want the right to practice in hospitals and in other forums outside > pure EMS, then we need to get some laws to protect us. As has been stated, > we must be very vigilant or we'll have done to us what the nurses did to the > PAs and EMTs in Mississippi. There they got amendments to the laws that were > introduced that protected their turf and decimated the very people the PA and > EMT laws were designed to protect. Although we all have friends who are > nurses, THE NURSES (as in the TNA) are NOT our friends. Their political > organization will do anything and everything that they possibly can to keep > us from gaining a legal foothold from which to practice our education and > skills outside their control. And they will NEVER willingly allow us to > practice along side of them. Trust me. > > Gene Gandy, LP > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2000 Report Share Posted October 5, 2000 Jim and all, I work in an ER as most of you know, and I see who the nurses have respect for and who they don't. I've been watching closely and it really boils down to how the EMS personnel present themselves. It's kinda like a mirror and your attitude gets shot right back to you! If you present a cocky, egotistical attitude, then you receive that back, etc. But, I've noticed a few things that really tick the nurses off and they are listed below. I know you asked the nurses on the list, and I'm not trying to act like a nurse, but I'm not 100% right and no one else can be either, so if we take everyone's opinions and roll them together, maybe we can learn how to gain the respect of nurses throughout Texas! To gain nurses' respect means that you have to: (1) treat them with respect; (2) act professionally; and (3) give a clear, concise and proficient verbal report and written report which is complete. Ok, that sounds pretty simple, well, let me explain some incidents where I've seen the nurses' reactions both to the EMS employees' faces and before and after they leave. Don't be lazy. Take your pt. to the appropriate hospital. I don't care if they " look " ok to you, if the car rolled, if the any occupant died, if the pt was not restrained - all these need to go to a trauma center if one is available. AND, there are 2 available in FW. I don't care if you were in the middle of eating or watching football, and even if SW is closer than JPS or Downtown, treat the pt. appropriately. AND, don't leave something off the radio report because you think " I don't want them to divert me and if I tell them _____ they will send me to another hospital " - you are doing no one any favors! Can you believe this really happened! When the pt. arrived and the EMT was giving the nurse a verbal report, the EMT said something about the pt having just been released from the hospital from having brain surgery. The nurse asked why that wasn't included in the radio report and the medic stated " my partner told me not to say that because ya'll would send us downtown " ! Yeah, can you believe it? If you state something in your report, make sure you really did it. Medic reporting " pupils PERL " and doc, standing at head of pt reaches down and pulls open eyelids to reveal that pt has only one eye! Don't leave your paperwork laying around. Almost every ER has a place designated for paperwork, etc. for each room in the ER, so if you don't know where that is so you can place the copy of your report there, then ask! Sooooo often, I come into the ER in the morning and start cleaning the counter and find ambulance reports stuck in boxes for forms, laid behind a computer, holding a place in a magazine! These are left by the EMS personnel just laying whereever they happened to be when they finished them. To show professionalism, place them with the pts.' other information in the designated place for that room. And, lastly, it is not always the pts' call as to what hospital they go to. There are times, as we are all taught, that the pt needs to go to a certain facility and that is where you should take them - I don't care where they request to go! We are taught this in school and taught what hospitals in our areas are appropriate for what emergencies; then when we get out on the ambulance, it all goes out the window! Remember that your job is to care for the pt. to the best of your ability AND remember that your job is not done until the paperwork is properly and correctly filled out and filed appropriately. Enough of my rant, but acting with professionalism will gain your being treated as a professional. Take care, stay safe, and practice mercy, ya'll!! Jana, EMT, (EMTP student), and ER tech [texasems-L] Re: Right to Practice Paramedics in Texas have NO right to practice except under the delegated practice of a physician medical director. The Medical Practice Act allows physicians to delegate certain practices to anyone; thus the office " nurse " who has no training except OJT who is allowed to give injections, draw blood, and do various other procedures as delegated by the physician s/he works for. The Nursing Practice Act states that there are certain functions that a nurse cannot delegate to " non-licensed personnel " . One of them is patient assessment. A nurse cannot legally delegate certain actions that a physician can. So herein lies the rub. Nurse administrators have to make sure that the nurses do not violate the law, and they tend to adhere to narrow interpretations of the Nursing Practice Act. Many nursing administrators do not even know that there are Licensed Paramedics in the State of Texas, and, unfortunately, many of them would not greet that news with any enthusiasm. Not only that, they are reinforced by the fact that there's no scope of practice legislation in place for Paramedics, whether Licensed or Certificated, in Texas. Since THEIR Nursing Practice Act doesn't mention Paramedics, they take the position that Paramedics don't exist according to them. If they can't find a law or regulation that specifically grants to a Paramedic the privilege of doing a certain procedure, then they're going to take the position of comfort and deny that Paramedic the privilege of doing anything other than what a janitor could do. (Of course, hospitals can let janitors do anything they want: give meds, take vitals, start IVs, put in Foleys, you name it.) And don't ever think for ONE SECOND that this is not an economic issue. Nurses are going to protect their turf to the death, as well they should. Who can blame them? Abandon any notions that you might have of altruistic motivation. All protect their own interests when push comes to shove. Money talks. It all boils down to the fact that, as I have stated ad nauseum, we in EMS have totally and completely failed to form any sort of politically powerful organization that could work for us to correct these problems. There is such an organization available, but it costs a little bit of money to join. EMS people have never supported such an organization in any sort of numbers. There are 42, 000 + of us, but we have no voice. Getting physicians to buy into delegation of practice to Paramedics is very problematical. Physicians who have a knowledge and background with EMS are very receptive to our abilities, but often they are put down by the nurses and administrators. Often the ER physicians are not on staff and are hired hands and treated like step-children by the hospital administration and medical staff. Many of them don't have any stomach for engaging in internecine battles with administration. Why should they? They are usually stressed to the limit by the administration and have little or no time to engage in turf battles, especially those they don't have an immediate economic interest in. There are a very few who recognize patient care issues and will go to bat for the patients. It's easier for them to say, " Hey, that's not my problem. I doctor, they decide who helps me and I can't control that. " Who's to blame? Well, " We have met the enemy and they is us! " We're to blame. Not the nurses, not the doctors, not the administrators. We're to blame because we have failed and refused to develop a united front and to increase our level of education and training to a unified professional level. We continue to foster an image of " technician " rather than professional. Now I know some of y'all are going to roast me because of that and say that I'm elitist and don't appreciate experience and skills. Not so. I do. But as others on here have so adroitly stated, nobody outside our own circles recognizes the " skilled technician " as being anything more than a minimum wage earner. Even plumber's helpers and carpenter's helpers make more than we do. We have nobody to blame but ourselves. If we want the right to practice in hospitals and in other forums outside pure EMS, then we need to get some laws to protect us. As has been stated, we must be very vigilant or we'll have done to us what the nurses did to the PAs and EMTs in Mississippi. There they got amendments to the laws that were introduced that protected their turf and decimated the very people the PA and EMT laws were designed to protect. Although we all have friends who are nurses, THE NURSES (as in the TNA) are NOT our friends. Their political organization will do anything and everything that they possibly can to keep us from gaining a legal foothold from which to practice our education and skills outside their control. And they will NEVER willingly allow us to practice along side of them. Trust me. Gene Gandy, LP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2000 Report Share Posted October 5, 2000 Jana, very well said, and the question is not intended to exclude paramedics. It just seems to me the ER nurses should get concerned with the professional recognition of paramedics (I am including all levels of the paramedicine community). I have been an E.R. nurse since 1978 and a paramedic for 7 years before that, and as a rule, the overall pre-hospital care of the patients I have received from various EMS systems has been good, and dependant upon the EMS system, outstanding. Obviously, there are less than optimal care being given on an anecdotal basis, but that is true of every profession. Stay safe Easley Re: [texasems-L] Re: Right to Practice Jim and all, I work in an ER as most of you know, and I see who the nurses have respect for and who they don't. I've been watching closely and it really boils down to how the EMS personnel present themselves. It's kinda like a mirror and your attitude gets shot right back to you! If you present a cocky, egotistical attitude, then you receive that back, etc. But, I've noticed a few things that really tick the nurses off and they are listed below. I know you asked the nurses on the list, and I'm not trying to act like a nurse, but I'm not 100% right and no one else can be either, so if we take everyone's opinions and roll them together, maybe we can learn how to gain the respect of nurses throughout Texas! To gain nurses' respect means that you have to: (1) treat them with respect; (2) act professionally; and (3) give a clear, concise and proficient verbal report and written report which is complete. Ok, that sounds pretty simple, well, let me explain some incidents where I've seen the nurses' reactions both to the EMS employees' faces and before and after they leave. Don't be lazy. Take your pt. to the appropriate hospital. I don't care if they " look " ok to you, if the car rolled, if the any occupant died, if the pt was not restrained - all these need to go to a trauma center if one is available. AND, there are 2 available in FW. I don't care if you were in the middle of eating or watching football, and even if SW is closer than JPS or Downtown, treat the pt. appropriately. AND, don't leave something off the radio report because you think " I don't want them to divert me and if I tell them _____ they will send me to another hospital " - you are doing no one any favors! Can you believe this really happened! When the pt. arrived and the EMT was giving the nurse a verbal report, the EMT said something about the pt having just been released from the hospital from having brain surgery. The nurse asked why that wasn't included in the radio report and the medic stated " my partner told me not to say that because ya'll would send us downtown " ! Yeah, can you believe it? If you state something in your report, make sure you really did it. Medic reporting " pupils PERL " and doc, standing at head of pt reaches down and pulls open eyelids to reveal that pt has only one eye! Don't leave your paperwork laying around. Almost every ER has a place designated for paperwork, etc. for each room in the ER, so if you don't know where that is so you can place the copy of your report there, then ask! Sooooo often, I come into the ER in the morning and start cleaning the counter and find ambulance reports stuck in boxes for forms, laid behind a computer, holding a place in a magazine! These are left by the EMS personnel just laying whereever they happened to be when they finished them. To show professionalism, place them with the pts.' other information in the designated place for that room. And, lastly, it is not always the pts' call as to what hospital they go to. There are times, as we are all taught, that the pt needs to go to a certain facility and that is where you should take them - I don't care where they request to go! We are taught this in school and taught what hospitals in our areas are appropriate for what emergencies; then when we get out on the ambulance, it all goes out the window! Remember that your job is to care for the pt. to the best of your ability AND remember that your job is not done until the paperwork is properly and correctly filled out and filed appropriately. Enough of my rant, but acting with professionalism will gain your being treated as a professional. Take care, stay safe, and practice mercy, ya'll!! Jana, EMT, (EMTP student), and ER tech [texasems-L] Re: Right to Practice Paramedics in Texas have NO right to practice except under the delegated practice of a physician medical director. The Medical Practice Act allows physicians to delegate certain practices to anyone; thus the office " nurse " who has no training except OJT who is allowed to give injections, draw blood, and do various other procedures as delegated by the physician s/he works for. The Nursing Practice Act states that there are certain functions that a nurse cannot delegate to " non-licensed personnel " . One of them is patient assessment. A nurse cannot legally delegate certain actions that a physician can. So herein lies the rub. Nurse administrators have to make sure that the nurses do not violate the law, and they tend to adhere to narrow interpretations of the Nursing Practice Act. Many nursing administrators do not even know that there are Licensed Paramedics in the State of Texas, and, unfortunately, many of them would not greet that news with any enthusiasm. Not only that, they are reinforced by the fact that there's no scope of practice legislation in place for Paramedics, whether Licensed or Certificated, in Texas. Since THEIR Nursing Practice Act doesn't mention Paramedics, they take the position that Paramedics don't exist according to them. If they can't find a law or regulation that specifically grants to a Paramedic the privilege of doing a certain procedure, then they're going to take the position of comfort and deny that Paramedic the privilege of doing anything other than what a janitor could do. (Of course, hospitals can let janitors do anything they want: give meds, take vitals, start IVs, put in Foleys, you name it.) And don't ever think for ONE SECOND that this is not an economic issue. Nurses are going to protect their turf to the death, as well they should. Who can blame them? Abandon any notions that you might have of altruistic motivation. All protect their own interests when push comes to shove. Money talks. It all boils down to the fact that, as I have stated ad nauseum, we in EMS have totally and completely failed to form any sort of politically powerful organization that could work for us to correct these problems. There is such an organization available, but it costs a little bit of money to join. EMS people have never supported such an organization in any sort of numbers. There are 42, 000 + of us, but we have no voice. Getting physicians to buy into delegation of practice to Paramedics is very problematical. Physicians who have a knowledge and background with EMS are very receptive to our abilities, but often they are put down by the nurses and administrators. Often the ER physicians are not on staff and are hired hands and treated like step-children by the hospital administration and medical staff. Many of them don't have any stomach for engaging in internecine battles with administration. Why should they? They are usually stressed to the limit by the administration and have little or no time to engage in turf battles, especially those they don't have an immediate economic interest in. There are a very few who recognize patient care issues and will go to bat for the patients. It's easier for them to say, " Hey, that's not my problem. I doctor, they decide who helps me and I can't control that. " Who's to blame? Well, " We have met the enemy and they is us! " We're to blame. Not the nurses, not the doctors, not the administrators. We're to blame because we have failed and refused to develop a united front and to increase our level of education and training to a unified professional level. We continue to foster an image of " technician " rather than professional. Now I know some of y'all are going to roast me because of that and say that I'm elitist and don't appreciate experience and skills. Not so. I do. But as others on here have so adroitly stated, nobody outside our own circles recognizes the " skilled technician " as being anything more than a minimum wage earner. Even plumber's helpers and carpenter's helpers make more than we do. We have nobody to blame but ourselves. If we want the right to practice in hospitals and in other forums outside pure EMS, then we need to get some laws to protect us. As has been stated, we must be very vigilant or we'll have done to us what the nurses did to the PAs and EMTs in Mississippi. There they got amendments to the laws that were introduced that protected their turf and decimated the very people the PA and EMT laws were designed to protect. Although we all have friends who are nurses, THE NURSES (as in the TNA) are NOT our friends. Their political organization will do anything and everything that they possibly can to keep us from gaining a legal foothold from which to practice our education and skills outside their control. And they will NEVER willingly allow us to practice along side of them. Trust me. Gene Gandy, LP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2000 Report Share Posted October 5, 2000 , The typical response I'm used to getting from ER's that don't usually treat homeless people is " What's this? Is closed? " , and yes it's always in front of the patient. They call, we haul... Ken [texasems-L] Re: Right to Practice Paramedics in Texas have NO right to practice except under the delegated practice of a physician medical director. The Medical Practice Act allows physicians to delegate certain practices to anyone; thus the office " nurse " who has no training except OJT who is allowed to give injections, draw blood, and do various other procedures as delegated by the physician s/he works for. The Nursing Practice Act states that there are certain functions that a nurse cannot delegate to " non-licensed personnel " . One of them is patient assessment. A nurse cannot legally delegate certain actions that a physician can. So herein lies the rub. Nurse administrators have to make sure that the nurses do not violate the law, and they tend to adhere to narrow interpretations of the Nursing Practice Act. Many nursing administrators do not even know that there are Licensed Paramedics in the State of Texas, and, unfortunately, many of them would not greet that news with any enthusiasm. Not only that, they are reinforced by the fact that there's no scope of practice legislation in place for Paramedics, whether Licensed or Certificated, in Texas. Since THEIR Nursing Practice Act doesn't mention Paramedics, they take the position that Paramedics don't exist according to them. If they can't find a law or regulation that specifically grants to a Paramedic the privilege of doing a certain procedure, then they're going to take the position of comfort and deny that Paramedic the privilege of doing anything other than what a janitor could do. (Of course, hospitals can let janitors do anything they want: give meds, take vitals, start IVs, put in Foleys, you name it.) And don't ever think for ONE SECOND that this is not an economic issue. Nurses are going to protect their turf to the death, as well they should. Who can blame them? Abandon any notions that you might have of altruistic motivation. All protect their own interests when push comes to shove. Money talks. It all boils down to the fact that, as I have stated ad nauseum, we in EMS have totally and completely failed to form any sort of politically powerful organization that could work for us to correct these problems. There is such an organization available, but it costs a little bit of money to join. EMS people have never supported such an organization in any sort of numbers. There are 42, 000 + of us, but we have no voice. Getting physicians to buy into delegation of practice to Paramedics is very problematical. Physicians who have a knowledge and background with EMS are very receptive to our abilities, but often they are put down by the nurses and administrators. Often the ER physicians are not on staff and are hired hands and treated like step-children by the hospital administration and medical staff. Many of them don't have any stomach for engaging in internecine battles with administration. Why should they? They are usually stressed to the limit by the administration and have little or no time to engage in turf battles, especially those they don't have an immediate economic interest in. There are a very few who recognize patient care issues and will go to bat for the patients. It's easier for them to say, " Hey, that's not my problem. I doctor, they decide who helps me and I can't control that. " Who's to blame? Well, " We have met the enemy and they is us! " We're to blame. Not the nurses, not the doctors, not the administrators. We're to blame because we have failed and refused to develop a united front and to increase our level of education and training to a unified professional level. We continue to foster an image of " technician " rather than professional. Now I know some of y'all are going to roast me because of that and say that I'm elitist and don't appreciate experience and skills. Not so. I do. But as others on here have so adroitly stated, nobody outside our own circles recognizes the " skilled technician " as being anything more than a minimum wage earner. Even plumber's helpers and carpenter's helpers make more than we do. We have nobody to blame but ourselves. If we want the right to practice in hospitals and in other forums outside pure EMS, then we need to get some laws to protect us. As has been stated, we must be very vigilant or we'll have done to us what the nurses did to the PAs and EMTs in Mississippi. There they got amendments to the laws that were introduced that protected their turf and decimated the very people the PA and EMT laws were designed to protect. Although we all have friends who are nurses, THE NURSES (as in the TNA) are NOT our friends. Their political organization will do anything and everything that they possibly can to keep us from gaining a legal foothold from which to practice our education and skills outside their control. And they will NEVER willingly allow us to practice along side of them. Trust me. Gene Gandy, LP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2000 Report Share Posted October 5, 2000 Jana, I don’t know which ER you work in, but as I read your post I couldn’t help but chuckle a bit at an interesting facet of the nursing staff of one of the downtown hospitals. They will of course remain nameless, but needless to say, we were on hospital divert earlier this week. We ran on a homeless person who was in the dining room at one of the local soup kitchens. When we approached him and asked him what was wrong, he said that his foot hurt. He was CA & O x 2, he couldn’t tell us the date or year, because he had been homeless for so long. He proceeded to take off his shoe to let us see. Sure enough, the foot was completely swollen and red. Looked like an infection. The next up hospital was not one accustomed to seeing these kinds of patients. When we wheeled him into the hospital doors, one of the nurses was bringing around a wheelchair to the triage desk and looked up to see this man with dirty tattered clothes, mangy hair, and a smell to go along with that appearance. Right in front of the patient, she looked me dead in the eye and yelled, “You ‘ought to be shot for bringing him here!” After I picked up my jaw off the floor, we put him in his room, and not before that same nurse snarled once again at us and wanted him put in the room furthest away from the nurses desk. Before we left, we exposed both feet for the convenience of the nurse to clearly observe the medical problem and so that she could compare the infected foot with the non-affected foot. You could cut the smell with a knife. As far as the whole treating them with respect, giving a complete concise report and acting professionally, I’m afraid you’re preaching to the choir. So, when I read your post about “things that tick the nurses off”; I had to give you one scenario in which they “ticked” the medics off. Fortunately for us, however, we didn’t have to work the rest of the night with that smell lingering in the air. I say what comes around goes around. They treat me with professional respect and they will receive likewise. :-) , B.S., L.P. Re: [texasems-L] Re: Right to Practice Jim and all, I work in an ER as most of you know, and I see who the nurses have respect for and who they don't. I've been watching closely and it really boils down to how the EMS personnel present themselves. It's kinda like a mirror and your attitude gets shot right back to you! If you present a cocky, egotistical attitude, then you receive that back, etc. But, I've noticed a few things that really tick the nurses off and they are listed below. I know you asked the nurses on the list, and I'm not trying to act like a nurse, but I'm not 100% right and no one else can be either, so if we take everyone's opinions and roll them together, maybe we can learn how to gain the respect of nurses throughout Texas! To gain nurses' respect means that you have to: (1) treat them with respect; (2) act professionally; and (3) give a clear, concise and proficient verbal report and written report which is complete. Ok, that sounds pretty simple, well, let me explain some incidents where I've seen the nurses' reactions both to the EMS employees' faces and before and after they leave. Don't be lazy. Take your pt. to the appropriate hospital. I don't care if they " look " ok to you, if the car rolled, if the any occupant died, if the pt was not restrained - all these need to go to a trauma center if one is available. AND, there are 2 available in FW. I don't care if you were in the middle of eating or watching football, and even if SW is closer than JPS or Downtown, treat the pt. appropriately. AND, don't leave something off the radio report because you think " I don't want them to divert me and if I tell them _____ they will send me to another hospital " - you are doing no one any favors! Can you believe this really happened! When the pt. arrived and the EMT was giving the nurse a verbal report, the EMT said something about the pt having just been released from the hospital from having brain surgery. The nurse asked why that wasn't included in the radio report and the medic stated " my partner told me not to say that because ya'll would send us downtown " ! Yeah, can you believe it? If you state something in your report, make sure you really did it. Medic reporting " pupils PERL " and doc, standing at head of pt reaches down and pulls open eyelids to reveal that pt has only one eye! Don't leave your paperwork laying around. Almost every ER has a place designated for paperwork, etc. for each room in the ER, so if you don't know where that is so you can place the copy of your report there, then ask! Sooooo often, I come into the ER in the morning and start cleaning the counter and find ambulance reports stuck in boxes for forms, laid behind a computer, holding a place in a magazine! These are left by the EMS personnel just laying whereever they happened to be when they finished them. To show professionalism, place them with the pts.' other information in the designated place for that room. And, lastly, it is not always the pts' call as to what hospital they go to. There are times, as we are all taught, that the pt needs to go to a certain facility and that is where you should take them - I don't care where they request to go! We are taught this in school and taught what hospitals in our areas are appropriate for what emergencies; then when we get out on the ambulance, it all goes out the window! Remember that your job is to care for the pt. to the best of your ability AND remember that your job is not done until the paperwork is properly and correctly filled out and filed appropriately. Enough of my rant, but acting with professionalism will gain your being treated as a professional. Take care, stay safe, and practice mercy, ya'll!! Jana, EMT, (EMTP student), and ER tech [texasems-L] Re: Right to Practice Paramedics in Texas have NO right to practice except under the delegated practice of a physician medical director. The Medical Practice Act allows physicians to delegate certain practices to anyone; thus the office " nurse " who has no training except OJT who is allowed to give injections, draw blood, and do various other procedures as delegated by the physician s/he works for. The Nursing Practice Act states that there are certain functions that a nurse cannot delegate to " non-licensed personnel " . One of them is patient assessment. A nurse cannot legally delegate certain actions that a physician can. So herein lies the rub. Nurse administrators have to make sure that the nurses do not violate the law, and they tend to adhere to narrow interpretations of the Nursing Practice Act. Many nursing administrators do not even know that there are Licensed Paramedics in the State of Texas, and, unfortunately, many of them would not greet that news with any enthusiasm. Not only that, they are reinforced by the fact that there's no scope of practice legislation in place for Paramedics, whether Licensed or Certificated, in Texas. Since THEIR Nursing Practice Act doesn't mention Paramedics, they take the position that Paramedics don't exist according to them. If they can't find a law or regulation that specifically grants to a Paramedic the privilege of doing a certain procedure, then they're going to take the position of comfort and deny that Paramedic the privilege of doing anything other than what a janitor could do. (Of course, hospitals can let janitors do anything they want: give meds, take vitals, start IVs, put in Foleys, you name it.) And don't ever think for ONE SECOND that this is not an economic issue. Nurses are going to protect their turf to the death, as well they should. Who can blame them? Abandon any notions that you might have of altruistic motivation. All protect their own interests when push comes to shove. Money talks. It all boils down to the fact that, as I have stated ad nauseum, we in EMS have totally and completely failed to form any sort of politically powerful organization that could work for us to correct these problems. There is such an organization available, but it costs a little bit of money to join. EMS people have never supported such an organization in any sort of numbers. There are 42, 000 + of us, but we have no voice. Getting physicians to buy into delegation of practice to Paramedics is very problematical. Physicians who have a knowledge and background with EMS are very receptive to our abilities, but often they are put down by the nurses and administrators. Often the ER physicians are not on staff and are hired hands and treated like step-children by the hospital administration and medical staff. Many of them don't have any stomach for engaging in internecine battles with administration. Why should they? They are usually stressed to the limit by the administration and have little or no time to engage in turf battles, especially those they don't have an immediate economic interest in. There are a very few who recognize patient care issues and will go to bat for the patients. It's easier for them to say, " Hey, that's not my problem. I doctor, they decide who helps me and I can't control that. " Who's to blame? Well, " We have met the enemy and they is us! " We're to blame. Not the nurses, not the doctors, not the administrators. We're to blame because we have failed and refused to develop a united front and to increase our level of education and training to a unified professional level. We continue to foster an image of " technician " rather than professional. Now I know some of y'all are going to roast me because of that and say that I'm elitist and don't appreciate experience and skills. Not so. I do. But as others on here have so adroitly stated, nobody outside our own circles recognizes the " skilled technician " as being anything more than a minimum wage earner. Even plumber's helpers and carpenter's helpers make more than we do. We have nobody to blame but ourselves. If we want the right to practice in hospitals and in other forums outside pure EMS, then we need to get some laws to protect us. As has been stated, we must be very vigilant or we'll have done to us what the nurses did to the PAs and EMTs in Mississippi. There they got amendments to the laws that were introduced that protected their turf and decimated the very people the PA and EMT laws were designed to protect. Although we all have friends who are nurses, THE NURSES (as in the TNA) are NOT our friends. Their political organization will do anything and everything that they possibly can to keep us from gaining a legal foothold from which to practice our education and skills outside their control. And they will NEVER willingly allow us to practice along side of them. Trust me. Gene Gandy, LP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 6, 2000 Report Share Posted October 6, 2000 : The case you present illustrates that nurses, too, are quite capable of unprofessional behavior. Methinks the gun that nurse advocated be used on you would have served better turned in the opposite direction. We should be intolerant of that kind of attitude on the part of nurses (or doctors for that matter) as surely as we should be of such coming from a paramedic. the kind of social elitism suggested by that nurse's reaction is incompatible with any medical profession. I think removing the guy's shoes to assist in the nursing assessment process was a master stroke. Always repay ill treatment with kindness (me tongue tucked firmly in me cheek). Dave RE: [texasems-L] Re: Right to Practice > Jana, > > I don't know which ER you work in, but as I read your post I couldn't help > but chuckle a bit at an interesting facet of the nursing staff of one of the > downtown hospitals. They will of course remain nameless, but needless to > say, we were on hospital divert earlier this week. We ran on a homeless > person who was in the dining room at one of the local soup kitchens. When we > approached him and asked him what was wrong, he said that his foot hurt. He > was CA & O x 2, he couldn't tell us the date or year, because he had been > homeless for so long. > > He proceeded to take off his shoe to let us see. Sure enough, the foot was > completely swollen and red. Looked like an infection. The next up hospital > was not one accustomed to seeing these kinds of patients. When we wheeled > him into the hospital doors, one of the nurses was bringing around a > wheelchair to the triage desk and looked up to see this man with dirty > tattered clothes, mangy hair, and a smell to go along with that appearance. > Right in front of the patient, she looked me dead in the eye and yelled, > " You 'ought to be shot for bringing him here! " > > After I picked up my jaw off the floor, we put him in his room, and not > before that same nurse snarled once again at us and wanted him put in the > room furthest away from the nurses desk. Before we left, we exposed both > feet for the convenience of the nurse to clearly observe the medical problem > and so that she could compare the infected foot with the non-affected foot. > You could cut the smell with a knife. > > As far as the whole treating them with respect, giving a complete concise > report and acting professionally, I'm afraid you're preaching to the choir. > So, when I read your post about " things that tick the nurses off " ; I had to > give you one scenario in which they " ticked " the medics off. Fortunately for > us, however, we didn't have to work the rest of the night with that smell > lingering in the air. I say what comes around goes around. They treat me > with professional respect and they will receive likewise. :-) > > , B.S., L.P. > Quote Link to comment Share on other sites More sharing options...
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