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Permalink Reply by Mark David Rempe on June 24, 2009 at 11:18pm

No offense, but I have worked with people in the same situation as you in the past. It is easy for them to work the way ER works, but you can't always do that in the field. If they don't remember where they are and always focus on the ER way, thats where the distrust comes in. I personally don't have a problem with it as long as the nurse/doctor can remember where they are working at the time. Its not an easy thing to get respect, and its easier to lose it! Maybe try and remind them where you work and it might help to ease the trouble for them. It is also possible that they could just have a hard head and won't accept it, thats impossible to overcome.

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Permalink Reply by Dewayne and Diana Bean on June 24, 2009 at 11:44pm

There is only a few not many on my actual dept feel this way. Most are supportive.

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Permalink Reply by FF Nick on June 25, 2009 at 4:35am

I'd look at it from a liability issue. Should something happen on a scene, who is going to cover you? Our insurance covers only personnel of the fire department. I'm not one to turn down help at all when I need it, but I'm also not going to put my department in a liable position should things go south. Now with you being in an actual fire department or squad, I'd venture to say it's no big deal for you to help out on med calls and wrecks with the other medics, but when Jane Doe stops on the side of I-10 and says "Im a nurse what can I do to help?" I politely thank them and tell them we've got everything covered. You have to be careful operating out of your scope of practice, cause you also put yourself in position for a reprimand or even worse, losing your license.

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Permalink Reply by Jake Fireman on June 25, 2009 at 8:41am

I understand how you may not be able to perform the essential functions of your nursing career in the EMS "field". I understand all the liability issues, however, you should be respected for the knowledge base that you have. Most nurses that I know, especially those who work in the ER have knowledge far superior to Paramedics and a lot more then EMTs and First responders. There are of course things you CAN do while working on your squad. Taking vital signs, assisting in bandaging, bleeding control, splinting etc. You just can not work within your hospital "scope" in the field.

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Permalink Reply by Paul Everson on June 25, 2009 at 4:26pm

I am just going to reiterate what everybody seems to be stating. Paramedics and EMTs work under the license of the Medical Director, using standing oders that the EMS Office has put into place. We are given enough rope to do our job, but not enough to hang ourselves. When an EMT or Paramedic is hired they have to get the blessing from the Medical Director, either by an interview or a testing process.

We have contact with RNs on a daily basis, and I personnaly respect the job they perform and they respect the what we do. In an emergency situation I would welcome the help, but it would be very limited as to not put the department at risk or the safety of any and all at the scene in jeopardy.

This even holds true to doctors who are on the scene not affiliated with us. I have had that happen and stated to the doctor "If you are going to direct our care you will need to give me your MDH number (Minnesota Department of Health) and accompany us to the hospital". Some do, others have declined understanding the situation. We don't know who or what kind of doctor they are, or even if they are one.

I understand that you have a knowlegde and skill level above an EMT/ Paramedic but, like I have said before, our job duties, training and even performance are monitored by the Medical Director. If we perform outside the guidelines we have to explain why and recieve possible disapline.

As far as I am concern the respect is mutual.

Paul

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Permalink Reply by anne potter on June 25, 2009 at 4:50pm

Really??? thats too bad . She could hold the dressing you just put on.. may be hold the leg as you splint it... Not all the time you will have the help.. It would be the same of asking a stranger to help when you r first on scene.. Most professionals do not stop if it looks covered by fireman,or emt's....
So being from both of the playing fields.. Liability happens as soon as you put your feet on the gound..People r going to sue no matter what ,even you if you put the bandage on tooo tight....

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Permalink Reply by anne potter on June 25, 2009 at 4:51pm

You Are so right..

When it gets right down to it...
We are there to help the pt not lift our leg up to mark our territory

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Permalink Reply by Fireyladd - Retired Chief Sharp on June 25, 2009 at 5:18pm

sadly ignorance and shortsightedness on their part.

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Permalink Reply by Dewayne and Diana Bean on June 26, 2009 at 1:00am

Thanks for all the comments!

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Permalink Reply by Dewayne and Diana Bean on June 26, 2009 at 1:07am

lol

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Permalink Reply by Mick Shelley on June 26, 2009 at 2:16am

Your Welcome

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Permalink Reply by Mike Schlags (Captain Busy) Retd on June 26, 2009 at 3:50am

Out of all of these posts, I really feel qualified to address the topic, honestly...

First off, I was one of the original paramedics in my county in the early 1970's with a certification number of 006... God I feel old. Now, 36 years later, working both private ambulance, teaching paramedic school and as a career firefighter for the past 30 years, as well as helping my wife go through RN school... and oh yea, I have worked very closely with the Calstar Trauma RN's so with all of this being said, I know the issues and what the differences are between EMS and nurses.

I sort of feel disappointed by the way my fellow FF who are EMT's and Paramedics state that a nurse doesn't count...

Don't feel any disappointment unless it's for the folks that are just plain ignorant. EMT's or EMS folks are trained in the basics, and I mean the basics. Nurses, specifically RN's are educated as professionals, learning how the systems work and have a thorough understanding of how the body works, which enables them to provide patient assessment's on a far more complicated level than a typical emergency responder can ever dream of providing, myself included.

Bottom Line / Reality Check:

Where do EMT's take their victims? TO THE HOSPITAL WHERE AN RN WILL ASSESS THE PATIENT AND IN MANY CASES DICTATE THE COURSE OF ACTION WITHOUT THE IMMEDIATE PRESENCE OF AN EMERGENCY ROOM PHYSICIAN USING STANDING ORDERS.

When a paramedic makes base station contact, requesting orders, who tells them what to do? RN's...

I apologize for the fact that not all firefighters / EMT's don't have a clue sometimes. An RN has a lot less to learn about how to fit in and help out than the other way around. If your department has the ability to use folks trained to this higher standard of healthcare delivery, then everyone benefits. Work together, play nice and remember that it's the patient that counts first, not us. And if the issues are ego driven, then...

Where I work, when it's really a bad call where a life is truly in danger, we call RN's to bail us out with their shock trauma helicopter. The requirement to work for Calstar is a minimum of seven years experience. You are ACLS certified, work in an ER and ICU and have 20 years plus experience. This leads me to believe that your local EMS's and Paramedics are idiots.

This is my "honest" opinion... : )

TCSS, CB

PS: Here's a secret fellow firefighter's... When ever you meet an RN for the first time, you have to understand that they are performing a subconscious head to toe patient assessment. Just stand back and watch them look for signs and symptoms, many very subtle. I know this so well hanging with my wife and some of her nurse friends. It's what they do...

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