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Prehospital Care

Ashton Treadway napthene at gmail.com
Sun Apr 9 07:44:09 BST 2006


As a paramedic student watching this discussion with intense interest,
I'd like to humbly request that everyone involved try extra hard to
keep this from degenerating into a slanging match. I realize this is a
contentious subject, but it's been incredibly informative thus far for
me, at least, and it seems to be getting a little...personal in here.



On 4/8/06, Mike MacKinnon <mmackinnon at cox.net> wrote:
> Steve
> 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

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