Who's in Charge

[Guest guest]

Why are we talking about who's in charge? Ever heard of teamwork? Who's in

charge of a football team? It's a matter of teamwork. Working with a

knowledgeable CCRN would be a pleasure and I can't conceive that there would

ever be

a situation when a battle over who's in charge ensued. Members of a team each

use their particular strengths, neither to the exclusion of the other.

Tater's example of an RN paired with a Paramedic is an excellent one. Each

has particular strengths that are brought into play. Neither is subservient to

the other, but each are equal in their own realm. Together they create a

team that is better than either of them alone.

Why is teamwork such a difficult concept for EMS? We work next door to a

clinic that has a physician, an LVN, and two NPs. We all work together, and

there has never been a conflict. We actually LIKE each other and respect each

other's strengths.

Best,

GG

[Guest guest]

In my humble opinion, I believe (1) EMS's infancy as a profession and

(2)it's ever expanding scope of practice are two variables that might

be involved in the teamwork equation.

Pre-hospital personnel have taken increased responsibility for the

welfare of a patient from the load, go, little if no treatment era to

the current practice of performing a comprehensive assessment,

utilizing diagnostics, and formuating a field impression/treatment

plan. Dr. Bledsoe wrote in his Paramedic Care: Principles & Practice

series that paramedics " are now stepping into non-traditional roles "

such as Critical Care Transport, Primary Care, Industrial Medicine,

and Sports Medicine. Question is, how much responsibility should

we/will we take in the future when our education/standard of care

starts to parallel other professions (ie RN, PA)?

The BNE I believe sees these ever-expanding roles as a threat and has

responded accordingly for the security of their profession, thus

creating animosity amongst EMTs/paramedics and nurses when we really

should be focusing on the common ground that we share.

Regards,

Alfonso R. Ochoa

> Why is teamwork such a difficult concept for EMS? We work next door

to a

> clinic that has a physician, an LVN, and two NPs. We all work

together, and

> there has never been a conflict. We actually LIKE each other and

respect each

> other's strengths.

>

> Best,

>

> GG

>

>

>

[Guest guest]

-- " Alfonso R. Ochoa " wrote:

The BNE I believe sees these ever-expanding roles as a threat and has

responded accordingly for the security of their profession, thus

creating animosity amongst EMTs/paramedics and nurses when we really

should be focusing on the common ground that we share.

Alphonso -

Did you ever hit it on the head! It is a turf war, no matter how you dress it

up.

Nursing, while a popular, trusted profession, still has to maintain position and

expand, because that translates into M-O-N-E-Y, if not just possibly finding

itself (eventually) priced out of the market. With the new mandatory staffing

rules (which really is a two edged sword) there may be at first an appearance of

good care, but that could fall off steeply when the well starts running dry,

both in terms of retiring nurses (for whatever reason) and declining health care

dollars.

It ain't gonna be pretty, whatever happens, unless some attitudes of the powers

that be in nursing change. First, they have to realize good care is not the

exclusive domain of nurses. Second, they have to think team themselves. They

don't really now; they talk about 'interdisciplinary team care', but unless a

nurse believes they are in charge, see how far THAT gets.

My fives cents worth (really revved up lately)-

Larry RN LP EMSI

[Guest guest]

-- " Alfonso R. Ochoa " wrote:

The BNE I believe sees these ever-expanding roles as a threat and has

responded accordingly for the security of their profession, thus

creating animosity amongst EMTs/paramedics and nurses when we really

should be focusing on the common ground that we share.

Alphonso -

Did you ever hit it on the head! It is a turf war, no matter how you dress it

up.

Nursing, while a popular, trusted profession, still has to maintain position and

expand, because that translates into M-O-N-E-Y, if not just possibly finding

itself (eventually) priced out of the market. With the new mandatory staffing

rules (which really is a two edged sword) there may be at first an appearance of

good care, but that could fall off steeply when the well starts running dry,

both in terms of retiring nurses (for whatever reason) and declining health care

dollars.

It ain't gonna be pretty, whatever happens, unless some attitudes of the powers

that be in nursing change. First, they have to realize good care is not the

exclusive domain of nurses. Second, they have to think team themselves. They

don't really now; they talk about 'interdisciplinary team care', but unless a

nurse believes they are in charge, see how far THAT gets.

My fives cents worth (really revved up lately)-

Larry RN LP EMSI

[Guest guest]

Gene has it right. Teamwork! The purpose behind the RN & Paramedic

teams has been both to appease the facilites, and to borrow

strengths from each profession to compliment the team as a whole.

In reality, how long do you go to school for EMT through Paramedic?

And how long does an associates level RN go to school? It equals

out to about the same amount of schooling. RN's receive a broad

range of schooling, with no specialization in any one area, or any

intense training in any one area. We receive a very focused

schooling with specialization in Emergency medicine and Critical

Care. We learn the rest of the stuff through CE and real life

experience in the field, as well as studying on our own and asking

questions. They learn it through real life experience once they get

into their clinical practice area.

No one has any more or any less training per-say than the

other......the training is just in different areas. Hence, if a

Paramedic is lacking in one area, the RN might be strong in that

area, and when the RN is lacking in an area, the Paramedic might be

strong in that area.

As far as the CEN, CCRN, etc.............well, the FP-C exam is

designed and validated by the same company that handles those

exams. It is written along the same core guidelines. The test is

not easy, and it takes a large amount of knowledge above and beyond

the norm for Paramedics or any RN for that matter, to pass it. The

NFPA and BCCPC developed the exam to set a national standard of

competence for paramedics practicing in the critical care arena.

I don't think an RN is any more competent to utilize Balloon pumps

or vents or drugs or special procedures than a properly educated

Paramedic is. It all boils down to education. In most flight

programs that I know of, the Paramedic and RN are considered

equals. They compliment each other on the team.

The CCEMT-P course I went to, was a month long. Some are shorter,

some are a semester or more long. The course preps you with the

basic knowledge. It is your job and duty to apply that knowledge,

and further your own education.

The FP-C exam has somewhere around a 60% pass rate, with only a

little over 350 people being certified so far. The passing score is

80% or greater. The exam questions are tricky, and difficult, and

are constantly being reviewed and revised to make them more

difficult and more applicable. You have to think your way through

the questions, not just regurgitate information back onto the

paper. It actually requires brains and an ability to reason.

The CCEMT-P course is a great prep for anyone entering the CCT

field, and the FP-C Exam is a great measure of knowledge and

understanding of the principles and methods of CCT.

This whole RN vs. Paramedic thing has to stop. We are on the same

team. I have been the subject of abuse from nurses, and have

likewise lashed back at nurses in the past. But, the fact is, we

all bring different knowledge and skills to the table that

compliment each other. The nurses need to chill out, and so do the

Paramedics. If they do, and everyone quits getting their feelings

hurt over petty BS, then we can learn to work together and provide

better care. I also know a few RN's who make better Paramedics than

they do nurses.

I guess I am done for now.............

Blum