Paramedic Vs Nurse

May 7, 2007

Bob Ball on the Pramedicine list works at Hennepin County Medical Center EMS,

the primary EMS provider for Minneapolis. His agency took just such an action -

they offered educational programs to the nursing homes about appropriate

utilization of 911 services and emergency stabilization of patients.

From what I understand, the nursing home nurses were very receptive to the

training, and the program really helped cut down on unnecessary 911 calls.

I'll not address the rest of your post, but suffice it to say that the only part

I totally agree with is that the most useful staff at nursing homes are CNAs.

Re: Re: Paramedic Vs Nurse

I beg to differ Wes. Everytime I have walked into a nursing home I have dealt

with RNs and LVNs. It's a damn shame they get paid more than we do. They have

no idea what they are doing in the nursing home. The only ones who have

somewhat of a clue are the CNAs. The reason they have not done alot of

interventions is that they can't get their head out of their ass. It seems once

they stepped into the nursing home setting they forgot all their training and

shooling. Are you serious, paramedics training nurses for emergencies? They

need to be decertified or sent packing back to their country of origin. What

would happen to us if we forgot and needed retraining in emergencies? Better

luck teaching monkeys. I am sure nurses are just itching to get trained by

paramedics.

Sal Capuchino

EMT-Paramedic

Re: Paramedic Vs Nurse

I agree with SOME of the comments of this post. I believe that we

(Paramedics) should alway strive for higher education and

professionalism which will one day lead to higher pay and respect.

But, My views of the hospital setting is a little different. I have

worked in the ICU of our local hospital for almost 8 years, and have

worked closely with RN's, MD's, and other levels of the healthcare

team. I understand how the hospital chain of command works.

I have the greatest respect for nurses that I have worked with. And

my comments are in no way to belittle or ridicule the job they

perform. But, they (Nurses) are used to working in a CONTROLLED

environment. Even with the S*** is hitting the fan, whether it is

during a code or some other type of Sentinel event. There is

control. There is a Dr. who gives every order, even to the Liters of

O2 applied. A nurse can not give ASA unless it is okayed by the

physician whether it is by Verbal/Telephone Orders and in some ER's

there are Standing orders. But most floor nurses do not have that

privledge. They have to call for each order, each medication, etc.

Now, lets address the resources. Such as Respiratory Therapist, Code

Teams, Charge Nurse/Nursing Supervisors, EKG Technicians,

Phelobotomists, even down to Nursing Assistants that can help with

retrieving supplies. I have been a part of countless Code Blue

Situations and there is always at least 10 people that respond NOT TO

INCLUDE the Doctor. Sure the Nurse may be delivering the Drugs and at

times Defibrillating but it is directly under the Dr that has

responded to the Code Blue Situation. Each group of individuals are

respondsible for their own area of expertise. For the most part,

these critical situations flow together, the outcome may not alway be

positive, but the process is usually seamless.

For years, I believed that the two professions were similar. And

after working both sides of the fence I have realized that there are

more differences than most people realize.

On the Ambulance there are only Medics. And depending on the area you

serve, there may only be two crews that would respond to a major

medical incident, such as Cardiac Arrest. This equals 4 medics.

We have to " assess " and " diagnose " as a Doctor, Treat and Medicate as

a Nurse, We provide O2, breathing treatments, and Intubate as RT's,

We obtain EKG's as the Tech. We are kind, and provide blood draws as

the Phlebotomist. And we have less people, resources and most

importantly the ever changing and at times uncontrolled environments

in which we have to remain calm and work. There is not always the

perfect light or the perfect working surface such as a pt wedged in

between the toilet and a wall or the car the is overturned in a

ditch. Yes my examples are a bit extreme, but we have all been there.

Please do not take what I am saying in a negative way. The hospital

staff are wonderful, and I am in NO WAY saying that Paramedics are

Super Heroes, or that we are BETTER, but the situations are not the

same. I feel like it is comparing Apples to Oranges. They are both

fruit. Just like our ultimate goal is the same, which is to provide

the highest level of patient care, whether it is prehospital or not.

I know wonderful Nurses that would not make a shift in an ambulance.

Just like there are Wonderful Paramedics that would not make a shift

having to deal the attitudes of cranky patients and cranky Dr's for a

constant 12 hour shift.

We are what we are. But we are not the same.

Enjoy the differences.

April F. McElroy NREMT-P

City of Clute EMS

> Is it possible that one of the reasons that paramedic pay is so low

> (comparably to nurses, for example) is because that so many medics

volunteer

> their

> time? If the demand goes up, so does the pay in other industries.

>

> EMT-B

>

> ************ ********* ********* ******** See what's free at

> http://www.aol. com.

>

May 7, 2007

Believe it or not--- to start CPR--YEP! It scares the C#$% out of me when I

walk in and see no CPR and a BVM with no oxygen attached being performed by an

LVN with help from a CNA standing at the door of the room yelling " over here " !

salvador capuchino wrote: I'm suspecting that there's

something in the facility SOPs that prohibit

independent actions such as starting emergency oxygen without a practitioner's

order, despite the clear legal guidelines from the FDA permitting that. Bean

counters, no doubt...

I do not think any physician in his right mind would prohibit basic care, after

all aren't RNS, LVNs better educated or trained than we are? I am sure they are

taught in nsg school about emergencies. I am sorry if I sound negative, but I

have encountered way too many nurses that did not provide any care even for a

full arrest without a DNR. I guess they need a Doc to tell them to start CPR

too.

Sal Capuchino

EMT-Paramedic

Re: Re: Paramedic Vs Nurse

In a message dated 07-May-07 13:52:37 Central Daylight Time,

airmedic51@... writes:

True, but basics are basics and common sense is common sense.

LVNs should know how to apply BASIC CARE--- Especially O2 without doctor's

orders if the patient needs it ! But, alas, maybe that's wishful thinking.

part of the problem here is that many facilities interpret the various

nursing practice acts to mean 'anything not specifically permitted is

forbidden'...

for example...a decade or so ago, I had a number of LPNs who wanted to take

ACLS. They were willing to spend the time to learn the rhythms etc, but the

then Admin types were horrified...'LPNs can't push emergency medications!'...I

had to get a letter from the State Board of Nursing confirming that, while a

'plain' RN cannot delegate an LPN to push medications, that a physician can

legally direct an LPN to do so. This was later amended to allow MSN Nurse

Practs to supervise LPNs doing IV push meds as well.

I'm suspecting that there's something in the facility SOPs that prohibit

independent actions such as starting emergency oxygen without a practitioner's

order, despite the clear legal guidelines from the FDA permitting that. Bean

counters, no doubt...

ck

S. Krin, DO FAAFP

************************************** See what's free at http://www.aol.com.

May 7, 2007

And guys please understand where I am coming from. Here we are getting paid our

lowly wages and yet here are these nurses that are supposedly better educated

than we are, and yet they have no clue what or how to deal with an emergency.

IMHO nursing homes should hire paramedics and get a doctor to write protocols.

And while even our profession has a few medics that are the same way as these

nurses, if we failed to do our job, we get decertified. Why can't the same be

done for these nurses? And yet the majority of these nurses are filipinos, and

I have nothing against them. The only filipinos that I have actually seen doing

a damn good job are the ones that have been in nursing for like 15 years or

more. So now, is there anything in the nursing curriculum that is not being

done now that was being done then? And I understand that some things a nurse

has to wait for a doctor to give the order before she does it, but come on you

can't tell me a nurse needs and MD order

to start CPR, give oxygen, etc. I know most nsg homes need to call the

administrator to call for an ambulance sometimes too, why all the red tape? Let

me guess, it will raise TDSHS eyebrows or it will cut into their $ they recieve

from the patients? Alot of times if you question these nurses, they bite back.

How do you expect us to retrain them on emergencies?

Sal Capuchino

EMT-Paramedic

Re: Re: Paramedic Vs Nurse

In a message dated 07-May-07 13:52:37 Central Daylight Time,

airmedic51@... writes:

True, but basics are basics and common sense is common sense.

LVNs should know how to apply BASIC CARE--- Especially O2 without doctor's

orders if the patient needs it ! But, alas, maybe that's wishful thinking.

part of the problem here is that many facilities interpret the various

nursing practice acts to mean 'anything not specifically permitted is

forbidden'...

for example...a decade or so ago, I had a number of LPNs who wanted to take

ACLS. They were willing to spend the time to learn the rhythms etc, but the

then Admin types were horrified...'LPNs can't push emergency medications!'...I

had to get a letter from the State Board of Nursing confirming that, while a

'plain' RN cannot delegate an LPN to push medications, that a physician can

legally direct an LPN to do so. This was later amended to allow MSN Nurse

Practs to supervise LPNs doing IV push meds as well.

I'm suspecting that there's something in the facility SOPs that prohibit

independent actions such as starting emergency oxygen without a practitioner's

order, despite the clear legal guidelines from the FDA permitting that. Bean

counters, no doubt...

ck

S. Krin, DO FAAFP

************************************** See what's free at http://www.aol.com.

May 7, 2007

For what it is worth......

http://www.jems.com/columnists/bledsoe/articles/102848/

May 7, 2007

Excellent article, Dr. Bledsoe.

-Alfonso R. Ochoa

>

> For what it is worth......

>

> http://www.jems.com/columnists/bledsoe/articles/102848/

>

May 9, 2007

Well Hatfield,

You got what it was all about to begin with. Who cares about the difference

between a nurse and a medic. Its about the professionalism of medics. The

inadequacies of pay for paramedics, and the difficulties we face due to lower

pay.

Think about what it would be like to be apart of the medical community

team. Not the stretcher bearer and as wes said the gas station attendant. But

men and women who are knowledgeale, capable, and recognizeable as experts in the

field of prehospital medicine. My desire for paramedics is to be recognized as

medical professionals in the medical community.

Professionals stand out in their field. They are licensed, and dedicated to

furthering their education. They take the extra step to expand what little

knowledge they started with into expertise. Think about doctors. They are not

" generic Doctors. " They have specializations. Cardiology, Emergency, Intesive

care, etc. What have we done to expand our knowledge as a paramedics. There

are just now degrees being offered in EMS. When will we decide to to saddle up

the horses and make education, and professionalism very much apart of who we

are?

I agree with Kelley, Comparing of apples and oranges is much like comparing

Nursing and Paramedicine. Yet both grow on the Trees and both get the same

sunlight and same amount of water to grow. So why can't paramedicine have the

same education requirements, same levels of pay, and more growth opportunities?

And just be different medical professionals?

So what is the biggest difference between a nurse and paramedic?

Education.

Tom & Marsha LeNeveu

Paramedic, Future RN & RN

Fort Worth Texas

Email: TomMarshaLeNeveu@...

yahoo Group: Christian_Medic