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Paramedic vs Nurse
Ok, I have been thinking and asking alot of people about this. I figured why not ask my peeps on FFN. When there is an accident on the interstate and a off duty nurse arrives and assists in medical aid, and the local firefighting/ ems response arrives to transport. If the EMS has a paramedic on board can they take the patient without the nurse going along or does the medics have to take the nurse along as well? I know that if a Doctor is assisting, then the Doc. has to go for being higher but does a Nurse? Who is higher a nurse or a paramedic?
Replies to This Discussion
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Permalink Reply by Paul Montpetit on
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Ralph...you were speaking to a Dinosaur not a current up to date informed Nurse....should have offered to give her the cannula as she asked and then tied it firmly around her neck and suspended it about 3 feet above her head......would have gotten her attention....for a couple of minutes anyways....Paul
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Permalink Reply by Korrey on
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In most systems the paramedic has the last say in any emergency situation. If a nurse/Dr. render care that's above the medics scope, that's when the nurse/Dr. should ride along. Some nurses have to get a Dr. permission to give drugs unless their a flight medic or trained in the ems system. If all else fails call medical control and put it on them.
Always CYA
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Permalink Reply by Mike Schlags (Captain Busy) Retd on
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Someone who has graduated as an accredited EMT-B, does not necessarily make them an incident commander unless they are on scene in the capacity as a supervisor, which in my world would be inititally a fire captain and if the incident warrants it, a pass off to the battalion chief, making the captain in charge of operations.
If you are a single resource, thinking in terms of an ambulance responding solo, then ICS would not apply because we are not talking a complex incident that requires a scene commander. Now if the incident grows past more than you can handle as one single resource, say you need help with landing a helicopter, another group to handle extrication, another to handle the triage of many victims and so on, then the IC is a real deal. No resources, single resources committed... there's nothing to manage except patient care.
Regardless whether you are the IC or an EMT-B providing patient care, read both mine and Ralph's comments about REAL emergency room nurses. These are definite lead, follow or get out of the way individuals that really do save lives...
I've worked tons of calls with these ladies, and let me tell you that until you witness a 250-lb combative head injury patient (football player) go from OMG to nada... RSI I think it's called where they basically paralize the patient (rapid sequence intubation? help me here Ralph). Anyway, these RN's have to go through nursing school (x2-4 years), work in a hospital in med/surg or some place within the hospital to learn the job, and 5-7 years critical care experience in the ICU, CCU and/or ER prior to even putting on a flight suit.
Like they say, a picture says a thousand words...
http://www.silcom.com/~pordecon/calstar.htm
TCSS,
CBz
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I could not agree more Korrey. The good news is that for the most part, I believe that we all can turn on our BS detector and figure out whether the nurse in question is an asset or a liability. From there the first responder can decide whether to invite them to the party or not... and yes, it needed to be said, Always CYA...
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Permalink Reply by Michael J Burke on
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The Paramedic or EMT has authority over the pt unless the Doctor or Nurse is willing to ride with the pt and assume responsibilties for care. Alot of times someone may show up on scene and claim they are a "Doctor" but they fail to tell you that they are a Veterinarian or a Chiropractor. I politely say we have control of the scene and ask them to leave and if they don't I have the Police remove them from the scene as I believe(but don't quote me on this) interfering with pt care may be against the law in Massachusetts.
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and everywhere else for that matter...
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Permalink Reply by blair4630 on
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If the EMS response unit is on scene, and the nurse is an off-duty nurse, yes, there's no question they can transport without taking the nurse. In fact, at least in my state, they can't take the nurse if they wanted to...unless the nurse is a PHRN. Even an off duty MD doesn't have to go with the pt. just because he stops to render aid. If the doctor is an emergency medicince MD and wishes to take command and/or perform higher level procedures, then that is a different story that involves getting authorization from the EMS services' command facility, and also accompanying the pt. Other than that, people don't have and obligation, or in most cases even a right, to go along with the pt. to the hospital just because they stop to help.
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Permalink Reply by Padre Pete on
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Justin, A Dr. friend of mine (may he rest in peace) used to come out to observe, from a safe distance, when there were wrecks on the turn he lived on. He once said "Pete, this is crazy. This patient should be on his way to the hospital. Instead you guys are pretending to be doctors and wasting valuable time." I explained it this way. "The same state that licenses you as a phycian (radiologist) licenses these emergency medical technicians for what they do. Like you, they are required to follow protocol dictated by that same state. That is exactly what they are doing. And, like you, departure from that protocol could reult in catastrophic liablility." I guess you pretty well got the point that nurses fall in there too. You've had some great feedback here. Good post.
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Permalink Reply by Reg Mathis on
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Sorta reminds me of the time, several years back when we were toned to a 3-car MVA. The driver of one of the vehicles had a pretty severe head lac. and it was a GUSHER! I was working on extrication on the passenger and this young man runs up and says "I'm a physical therapist, can I help?" Well the Para working on the driver looks at him for a second, then slaps a handful of 4x4's in his hand a presses his hand onto the pt.s scalp. This kid got a look on his face like the Para had handed him a bowl of cat sh*t!
He turned the color of a set of scrubs! But he was a trooper, he stuck in there and didn't hurl until he was relieved!
Ahhhh...memories!
TCSS
Reg
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