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Prehospital Care

Mike MacKinnon mmackinnon at cox.net
Sun Apr 9 07:29:03 BST 2006

Get real.
I was a medic in Canada (P3) and a Nurse. Now an RN/Medic in the USA. I
never did anything as a medic near what I do as an RN, ever. Paramedic
education is highly specific to a very narrow scope of practice while RN
education (4 years science degree in Canada) is intentionally general
coverage of everything allowing the individual to specialize with a strong
science background. In the pre hospital setting I do much more than the
medics. Everything a medic can do is in the scope of practice of an RN while
the reverse is not true.
If there was a logical choice for a midrange person in hospital (when there
are no PAs or NPs available) it would clearly be an RN not a paramedic. RNs
would be used to the inner workings as well as the ER presentations,
treatments and knowledge base to make decisions. 
A wise man once told my when I was an EMT (P1) planning to be a medic
shooting off my mouth how easy it looked "Son, you don't know what you don't
know.". Steve, your a paramedic looking in and making judgements without the
education or experience of a critical care RN.     
Mike M
-------Original Message-------
From: Steve Urszenyi
Date: 04/08/06 22:57:02
To: 'Trauma &, Critical Care mailing list'
Subject: RE: Prehospital Care
Snippet from Andrew Bowman's post:
<< An added benefit would be the occasional procedure (ETT, central line,
etc) under the tutelage of an ED doc to give tips and tricks. >>
I few years back I was hired with about 3 or 4 other medics by a local
community hospital here in Toronto that wanted to create an ER Paramedic
position. The goal was to augment the physician staff with ALS paramedics to
assist in the Fast Track part of the ER. The very progressive-minded ER
director (an ER MD) envisioned us performing a pseudo Physician's Assistant
role. But guess what the biggest stumbling block was? The nurses' union.
They screamed blue murder that medics in the ER should not be able to do
anything above the skill set of the RNs. Never mind the fact that I do just
that every day out on the road where my skill set far exceeds anything they
are trained or permitted to perform. The program lasted around 8 months and
was then canceled. Oh well.
Steve Urszenyi
trauma-list : TRAUMA.ORG
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