State Bill allows Nurses to Staff Ambulances

In an interesting twist the state legislature in Texas is considering staffing ambulances with nurses.

And I'm for it.

Let me explain:

There is a place for nursing pre-hospital but we're going to need a complete retraining for the nursing staff.  Focusing on decision making without physician approval as well as adapting to adverse conditions will be needed and we in EMS are more than willing to help them prepare for this change in role and responsibility.

We need more specialized help in the field and nursing can help fill that void.

See Texas ENA, that wasn't hard now was it?

For those of you not in the know, head over to Unwired Medic's post for details about the Texas nursing group spreading lies to prevent medics from practicing in the hospital.

Before you grab a pitch fork to tear apart their hilarious claims, let's turn the tables for a minute.

Could a nurse staff an ambulance?

The short answer is no.  The nurse has no extrication training, no patient movement training and no idea how to react to standing orders.

But if I needed their expertise in the field I'll be the first in line to help them get trained up.  I certainly wouldn't be the first to write a letter about how placing a nurse in the field would be unsafe and endanger patients.

That's exactly what the Texas ENA did without thinking about, or researching, the capabilities of modern Paramedics.

We aren't simply techs wandering the halls performing IV sticks and other random tasks.  If the Texas EDs need practitioners with experience giving medications, performing intubations and other advanced procedures and reassessing complex patients, why not choose a Paramedic?

We do those things in low light with little rest and no back up as it is.

Texas ENA seems to think that giving us comfortable shoes, bright light and a room that doesn't move will somehow endanger patients.

Adorable.

Texas ENA is worried a technician with an associates degree can outperform their Nursing degree when the cards are down in a time sensitive situation.

You played your hand too early Texas ENA and are drawing for the inside straight.

We're holding the Royal Flush.

We're all in.

Do you call or raise?

PS - You should fold.

Comments

Shilah said…
huh..... i dunno, Happy --- seems to me the "doctor-helpers" would be unable to function without a doctor, and unwilling to take orders from a mere "ambulance driver" (paramedic). How would this help the patients ???
Antoine Hakim said…
I am RN and also advanced paramedic, in my opinion the job of nurse is very far than EMT but they can be paramedic faster than others but they Surely they should do training and hands On.
Suzanne Barrett said…
I can see where a RN could be very beneficial to working on ambulance, however why don't we offer additional sections to the Paramedic program to include the are in portion that they can provide in and return increase a paramedic salary to where a Paramedic could only work one job?
gillian cox said…
As both ER nurse and advanced EMT, my opinion is that I would much rather have a trained medic in my ER, than a single experienced nurse in my box. The two jobs are NOT the same, nor are they mutually exclusive. Good, reliable, nurses are harder and harder to find. Much of the nursing job is assessing, charting, and teaching. Paramedics can offer valuable hands on, time consuming, skills in the ER. What ever happened to doing what is best for patients?
ER's are only getting busier, more overwhelemed, with sicker patients waiting longer for care. Let's use every tool we have!
Lee said…
I am an ICU/ED RN and personally have been enraged by the further limitations placed on paramedics in the ED. I certainly think that paramedics should be allowed to practice to their fullest potential in the ED setting.

However, I disagree with your statement on RN's not being able to follow standing orders. We do it every day. The ED may not be one of the places they are most plentiful as there are physicians readily available to receive orders from rather than following SDMO's. In the ICU we follow SDMO's and protocol's all the time. I am actually on the rapid response team and we often have no physician in house during cardiac and respiratory arrests, and we follow ACLS as well as post-resuscitative protocols.

Further training on extrication and operating in adverse pre-hospital conditions would be necessary. I am pro-paramedic in general, but be careful about generalizations you make such as the SDMO issue. I support the ENA, ANA, and TNA in general, but if they are making efforts to limit paramedics practice potential in the ED, I do not support that.
Jeremy said…
Well said