Paramedic Alternative To Trauma Nurse Shortage

Trauma centers are unable to fill nursing shortages, while highly-trained paramedics continue to leave the EMS field in large numbers. Paramedics face poor pay and limited opportunity. When hired by trauma centers, paramedics are limited to non-technical tasks. Few hospital administrators are aware of the training capabilities of paramedics and the role they could play in providing trauma center care.

Jim Becka has been a Houston area paramedic for 27 years and a journalist since 1973. His stories have appeared on the Mutual Radio Network, KTRH (Houston) and KLIF (Dallas). He is also the former public relations chairman of the American Trauma Society - Texas Division. This commentary was produced in 2004 and appeared in a video devoted to the shortage of trauma care in the Houston area.

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[CyanoticFuture]

And yet in many areas,paramedics make little over STNAs that may go through 1 month of school if that who cant even give oxygen.Maybe us medics really are stupid for doing what we do,hmmmm.Hell,2 years of school, months of training to practice skills and learn theory and medicine,More CE hours per year than what some health professionals need to be certified period,stress beyond believe at times,all to be called ambulance driver and make less than Mcdonalds managers.

[science98]

We need to start thinking outside the loop when addressing health care issues. We cannot keep doing the same thing that is not working. If paramedics are capable of working in trauma centers, their valuable skills should be utilized. We need to change the thinking of regulatory agencies.

[dingdong911us]

The Nurses union would never let Paramedics do in-hospital care, because that would mean cutting of nursing jobs. ER doctors and nurses still look at medics as ambulance drivers, and have no idea of the nature of work we do and neither do they care to know. EMS still remains the stepchild of Hospitals and Fire Departments all over the country.

[Joel1206]

The US needs to get with the times. In Canada the Paramedic plays a huge roll in ER's, especially those in rural areas! Paramedics are used in the acute care setting and Nurses fill the definitive roll, which works great!

[gwailo27]

Most of the things I state RNs can do in Canada are by directive, and are with in the RN's scope of practice if the RN has the knowledge, critical thinking and skill set to do so. Many skills are ,as you state, for remote areas but RN skills none the less. I think the EMS that come to our ER are fantastic and deserve a ton of credit for their skill set. however I think you will find that an RN in the role of basic RN, NP, CCRN, CNA can do anything with in EMS or advanced EMS scope of practice

[CyanoticFuture]

,which requires a few months of additional paramedic type training,and only if theyare operating on critical care type mobile ground units in prehospital setting swith either a doctor,paramedic or respiratory therapist alsoon board.Pacing cardioversion,EKGS,giving atropine,nitro,epi,cardizem,ad­enosine,andeven some fibrolyniticsfor occlusive cvas depending on what med control they are under(such asCleveland Heights&Shaker Heights FDs under University) w/o a docs verbal OK are routine for a medic

[CyanoticFuture]

Also gwalio,if you can do some oftheskills you say you can and have that much free discretion in your parctice, youre not an RN then,least not in America or east of the mississippi.Only nurses that can order anythingw/o a docs consent,especially x rays,or do sutures would be a Nurse Practicioner,which is usuallya Masters degree,or a PA,which isnt a nurseat all.And the only RNs I know about that can doneedle decompressions,breathing treatments,surgical airways,intubate,etc,would be a CCRN

[CyanoticFuture]

Paramedicas can do central lines in areas of very little medical coverage both hospitaland prehopital wise,such as remote places like in Alaska,N& S Dakota,Wyoming,etc. and as well as critical care transport units such as Akron Childrens hospital Mobile units,Medevac s helicopters .,cleveland clinics mobile units etc.

[gwailo27]

as an ER RN and can do all of the above. I have directives that allow me to give a huge array of drugs at my discretion Plus I also order X-rays do sutures, interpret blood work, Access central lines, set up & initiate & maintain drips including dope, nitro, insulin cardizem amiodarone ect, Cariovert, administer adenosine, atropine, TNK, Pace, telemetery & EKGs, Curious, Where the heck are paramedics starting central lines & placing chest tubes in)

+ I can challenge the EMS exam as a ER RN

[wangdangboombong]

You are 100% correct, & the level of respect we get is ridiculous. It seems we are always the first ones to get blamed for the things others screw up, & yet we are told to just sit back & take it, because we have to maintain a "professional relationship" with the ones blessing us out. But if we try to call them out on their screw up, we are on our way to getting fired.

[CyanoticFuture]

This disturbs me to the core to say this people,but it holds true and I mstarting to see this general attitude permeate and creep into many of my fellow EMS workers psyche,but as the old adage goes, "you eventually get what you pay for".Rememberthese points next time you hear someone bitch about how medics(especially firemedics who are also crosstrained in fire skillsthat also require yearly CEs now in themselves) make"too much for doing too little".Someday the EMS field may just abide by that