What Do You Say?

[dropdeded]

New EMT here. Just wondering, what do you say to a patient when you leave them? Be it in the ER, a residence, a facility, whatever? Taking them home or hospice, after minor or major tauma? I mostly hear "Good Luck",hmm. What do YOU say when you leave a patient?

Ed

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[beanbean]

I usually shake their hand and tell them 'it was nice to meet you'; 'best of luck to you' or 'Take care' depending on the patient and the circumstances.

Deirdre

 

[12R34Y]

i think "take care" and a handshake sum up the majority of my encounters.

 

[southerndoc]

Like the others, I also say "take care."

 

[HNS]

Normally I give report and ask if there is anything else I can do, directing to staff@ ER and pt. That is really it, no more needed.

 

[raDiOnut]

I usually go with some version of "take care," "take it easy" or "hope I don't see you anytime soon..."

raDiOnut

 

[niko327]

I usually say either:
feel better (sick patients)
be well (for less sick patients).

 

[OSUdoc08]

It depends on the level of care. If I am transferring care to an RN (which I consider my equal as far as care is concerned), I simply tell them what I did to the patient procedurewise. If it is a physician, I tell them what I think the problem might be and what the history is in addition to procedures. If it is to an LVN or hospice care, I say "sign here" and leave. Of course they all get the pink copy before I leave.

 

[southerndoc]

It depends on the level of care. If I am transferring care to an RN (which I consider my equal as far as care is concerned), I simply tell them what I did to the patient procedurewise. If it is a physician, I tell them what I think the problem might be and what the history is in addition to procedures. If it is to an LVN or hospice care, I say "sign here" and leave. Of course they all get the pink copy before I leave.

You don't give a patient report to an LVN? Imagine if you went to do an interfacility transfer and the RN didn't give you a patient report.

 

[Mavrick]

Same as most here in the UK too. "Take care"
Generally whatever seems appropriate and might make the patient feel better about things.

 

[OSUdoc08]

No, I don't give a patient report to an LVN. This is for 3 reasons:

1. it's never in the ER---it's usually to a nursing home and little care was provided anyway

2. it is a reduction in level of care, and they wouldn't know what I'm talking about anyway

3. i just don't care


(and for the record---RN's general don't even talk to me much less give me a patient report----they just point to the packet with the patient info)

 

[southerndoc]

2. it is a reduction in level of care, and they wouldn't know what I'm talking about anyway

(and for the record---RN's general don't even talk to me much less give me a patient report----they just point to the packet with the patient info)

Looks like the RN's have the same philosophy as you with regard to not telling anyone because it's a reduction in level of care.

I was fortunate to work for a hospital-based service where we knew the RN's, rotated in the ICU (as primary care providers, not as techs), etc. When we did interfacility transports, the nurses always gave us patient reports in addition to the paperwork (unless the doc gave us the patient report... if that was the case (about 25% of the time), the RN usually just gave us the paperwork).

 

[Apollyon]

I would always take the patient's hand, look them in the eye (if they weren't gorked), and say, "Best of luck". I even did this with the gorked, giving them the benefit of the doubt.

What's different now, is that, in the ED, I take the patient's hand, and tell them that me and the police are the only two groups that "I hope I never see you ever again!" (with a laugh); if they need more, I tell them except walking on the street. I also say I wish I didn't have any work, and they could lay me off. This leaves the patients on a happy note.

 

[OSUdoc08]

RN to paramedic isn't a reduction in level of care----they are equivalent.

Just FYI

 

[southerndoc]

RN to paramedic isn't a reduction in level of care----they are equivalent.

Just FYI

RN to paramedic is a reduction of care too, especially from critical care nurse to paramedic.

Sorry to burst your bubble... I used to be naive and think the very same thing until I got into medical school and start working with the nurses.

 

[12R34Y]

yes NURSES are absolutely above paramedics in the heirarchy regardless of what you would like to think..

you can't argue that. they have licenses, we have certification.

later

 

[blotto geltaco]

Yep the good critical care nurses are pretty doggone smart. The EMT-P vs RN argument is an old one. Let it rest.

10 year medic/MS4

 

[Krazed_Medic]

(and for the record---RN's general don't even talk to me much less give me a patient report----they just point to the packet with the patient info)

That makes me so ticked off! They make sure and ask us what is going on, but never do the same for us. GRRRRR!

 

[OSUdoc08]

yes NURSES are absolutely above paramedics in the heirarchy regardless of what you would like to think..

you can't argue that. they have licenses, we have certification.

later

In Texas, Paramedics can be licensed, and are considered equivalent as far as what skills are possessed.

In the hospital, they aren't considered the equivalent, but they are in the field, especially when RN's are found on a helicopter alongside medics.

Later,

Justin, Licensed Paramedic

 

[12R34Y]

like i said. RN's are above paramedics in the hospital setting. the ED is what i'm referring to.

if i didn't make that clear i'm sorry.

i think nurses no WAY more about a whole lot than paramedics in many areas. Likewise, paramedics are good at handling critical patients and doing some pretty cool procedures that nurses usually don't perform on a regular basis.

get off your high horse and play on the team. I really think it says alot when you don't think the nurse at a hospital deserves to hear your findings. However, if it is a physician then you tell them your assessment and thoughts.

I think you'll find out who really runs the place (including you) in your third and fourth year when the nurses own you.

this isn't made to be mean. just saying that the attitude of paramedic superiority because we can do cool procedures and handle stressful situations does NOT make you the end all be all of medical care.

Nurses know tons more about stuff paramedics never ever learn.

you'll soon see.

later

 

[HNS]

Talk about being high on the horse....

 

[12R34Y]

hey HNS,

i'm a paramedic. been one for 8 years now and also have the advantage of also being a medical student.

deal with it.

you've been called a paragod on multiple forums now.

i'd think about how you look and worry about yourself

 

[blotto geltaco]

like i said. RN's are above paramedics in the hospital setting. the ED is what i'm referring to.

if i didn't make that clear i'm sorry.

i think nurses no WAY more about a whole lot than paramedics in many areas. Likewise, paramedics are good at handling critical patients and doing some pretty cool procedures that nurses usually don't perform on a regular basis.

get off your high horse and play on the team. I really think it says alot when you don't think the nurse at a hospital deserves to hear your findings. However, if it is a physician then you tell them your assessment and thoughts.

I think you'll find out who really runs the place (including you) in your third and fourth year when the nurses own you.

this isn't made to be mean. just saying that the attitude of paramedic superiority because we can do cool procedures and handle stressful situations does NOT make you the end all be all of medical care.

Nurses know tons more about stuff paramedics never ever learn.

you'll soon see.

later

That is very well put.

Yaaaay team!

 

[niko327]

like i said. RN's are above paramedics in the hospital setting. the ED is what i'm referring to.

if i didn't make that clear i'm sorry.

i think nurses no WAY more about a whole lot than paramedics in many areas. Likewise, paramedics are good at handling critical patients and doing some pretty cool procedures that nurses usually don't perform on a regular basis.

get off your high horse and play on the team. I really think it says alot when you don't think the nurse at a hospital deserves to hear your findings. However, if it is a physician then you tell them your assessment and thoughts.

I think you'll find out who really runs the place (including you) in your third and fourth year when the nurses own you.

this isn't made to be mean. just saying that the attitude of paramedic superiority because we can do cool procedures and handle stressful situations does NOT make you the end all be all of medical care.

Nurses know tons more about stuff paramedics never ever learn.

you'll soon see.

later

Hello 12R34Y,

You made a generalized statement about nurses knowing "tons more stuff paramedics never learn", how do you figure this is so?
This is not meant to be a mean post or anything, but I don't think it's fair to make that comments about all medics. You probably know all this stuff already being a medic and all, so I will address my comments to those that may be reading this post as an outside observer. Though it may seem that medic training (which is taught with the medical model) is all about 911 emergency prehospital care, I'd like to also point out that many medics receive additional training to assume other varied roles. An example of this is the transport medic, these guys receive training in critical care medicine, and critical care monitoring. Balloon pumps, A-lines, vents, multi drips etc were par for the course where I worked. General knowledge about various medical disciplines are also attained with time and experience. Some medics get specialized training in pediatrics and do transfers using a variety of monitoring and supportive equipment that is far beyond the scope of the core curriculum taught in paramedic school initially. There are medics that over the course of training became very knowledgeable about many subjects in healthcare. On a similar note, nurses if I'm not mistaken are also taught a core curriculum (taught using the nursing model), that once completed allows them to go on and receive additional training and endorsements to work in a variety of settings (emergency, peds, ICU). Which core curriculum lends itself to greater utility is debatable. I think time and experience have a lot more to do with the attainment of knowledge than the core curriculum taught in either school. Comparing a rookie paramedic to a 25 year ICU nurse is not very fair. But you must agree that comparing a 25 year Paramedic to a 1st year nursing grad isn't fair either.
The roles of Paramedics are changing rapidly, what they will be able to do in the future depends on a variety of factors, not the least of which is Political.
Fortunately for nurses, their roles in healthcare are already well defined by virtue of their long history, utility and Political power. The heirarchy that you make reference to seems more to do with money and political power, than knowledge and training. There are dollars at stake here, Medics will never be able to work as equals with nurses in a hospital setting mainly beacause the powerful nurse lobby would never allow medics to move into their domain. It's really unfortunate for those of us on the EMS side of things that many opportunities for continued advancement of our profession will be slow-coming. In the meantime I do agree that we must continue to work as a team in order to take care of our pts and our communities.

 

[southerndoc]

Niko, I agree with your post.

Many nurses simply have more experience than most paramedics. The majority of EMS in this country is rural EMS, and one can safely say the majority of a paramedic's time is spent watching TV, reading, or sleeping at the station. Yes, some paramedics work their tails off, but in rural settings (which comprise the majority of America), paramedics are not this busy.

Some paramedics attend critical care transport courses, but again, your experience comment is valid. Who has more knowledge of IABP's and Swan-Ganz catheters? A paramedic who attended a 2-week CCEMT-P course or a critical care nurse who is in her fifth year of nursing?

The majority of paramedics simply do not get the experience that most nurses get as far as IN-HOSPITAL critical care is concerned.

It is with that in mind that I made my comment that a transfer from nurse to paramedic is a decrease in care. Most, but not all, nurses are in the hospital. My original comment was directed at interfacility transports, which I view as an extension of the hospital setting and NOT a "pre-hospital" setting (although it is outside the hospital). Transferring care from nurse to paramedic in this regard is a decrease in care. This is NOT meant to be offending or derogatory toward paramedics.

Alternatively, transferring care from a paramedic to an RN on the scene of a motor vehicle collision is also a decrease in level of care. Paramedics are masters of pre-hospital care, whereas RN's are not. RN's are masters of in-hospital care, which in my opinion includes the domain of inter-facility transports (which are now out-of-hospital care as opposed to pre-hospital care).

 

[niko327]

Niko, I agree with your post.

Many nurses simply have more experience than most paramedics. The majority of EMS in this country is rural EMS, and one can safely say the majority of a paramedic's time is spent watching TV, reading, or sleeping at the station. Yes, some paramedics work their tails off, but in rural settings (which comprise the majority of America), paramedics are not this busy.

Some paramedics attend critical care transport courses, but again, your experience comment is valid. Who has more knowledge of IABP's and Swan-Ganz catheters? A paramedic who attended a 2-week CCEMT-P course or a critical care nurse who is in her fifth year of nursing?

The majority of paramedics simply do not get the experience that most nurses get as far as IN-HOSPITAL critical care is concerned.

It is with that in mind that I made my comment that a transfer from nurse to paramedic is a decrease in care. Most, but not all, nurses are in the hospital. My original comment was directed at interfacility transports, which I view as an extension of the hospital setting and NOT a "pre-hospital" setting (although it is outside the hospital). Transferring care from nurse to paramedic in this regard is a decrease in care. This is NOT meant to be offending or derogatory toward paramedics.

Alternatively, transferring care from a paramedic to an RN on the scene of a motor vehicle collision is also a decrease in level of care. Paramedics are masters of pre-hospital care, whereas RN's are not. RN's are masters of in-hospital care, which in my opinion includes the domain of inter-facility transports (which are now out-of-hospital care as opposed to pre-hospital care).

Hello Southerndoc,
First off I'd like to say that I like your posts very much. I think that you raise some valid and interesting points. My previous message was aimed at a generalized statement made for all paramedics. I am pleased to see that you don't feel that all transfer of care to paramedics is a decrease in care. You also talked about the CC-EMT-P course and compared it to a nurse whose been in ICU practice for five years. This is not a fair comparson. You should have compared the initial training curriculum RNs receive about critical monitoring/medicine (either formal or informal) to the CC training medics receive in the CCEMTP course. You should consider that at some point the medic will finish the CCEMTP program and begin to gather time and experience in practice of his own.
Rural EMS providers spending time sleeping at station made me think about another point. What is the concentration of Paramedics in these areas as compared to cities like New York, LA, Miami, Houston etc. Do the majority of paramedics in this country work in these rural settings (I really don't know the answer to this question). For those of us that work in busy systems that do critical care/high risk transfers I think your "sleeping point" becomes less valid. The rural vs urban vs critical care numbers question is an interesting one. I will concede that not all medics work in busy systems that do critical care transport and thus don't interact with ICU nurses (the experience disparity is much greater).
As for the medics that work only in 911 emergency care, and interact with CEN RNs, I'll ask you this; Do RNs know a "tons more stuff that medics never learn"? Don't you think that medics can learn just as much as nurses do by spending time in emergency care. RNs do not enter the ED knowing all there is to know about emergency medicine, they too must learn through experience.
Finally imagine if Paramedics could work in the in-hospital setting utilizing their full potential and training. Where do you think the profession would end up in 30 years, what roles (administrative or clinical) could you imagine paramedics assuming? Only after this happens will debates such as these be finally put to rest. I want to thank you again for engaging in this very interesting discussion and am look forward to your learned response. -Nick

 

[southerndoc]

You also talked about the CC-EMT-P course and compared it to a nurse whose been in ICU practice for five years. This is not a fair comparson. You should have compared the initial training curriculum RNs receive about critical monitoring/medicine (either formal or informal) to the CC training medics receive in the CCEMTP course. You should consider that at some point the medic will finish the CCEMTP program and begin to gather time and experience in practice of his own.

Yes, the paramedic will gain experience of his own. However, after a year of doing critical care transports, I can guarantee you that the critical care nurse has more critical care experience than a critical care transport paramedic (unless the paramedic is also working in a critical care unit). The critical care experience of a transport paramedic is periodic, whereas it is constant the entire shift of a CCRN (provided the census isn't low, at which point usually the CCRN is sent home, or at least that's what happens where I am).

Rural EMS providers spending time sleeping at station made me think about another point. What is the concentration of Paramedics in these areas as compared to cities like New York, LA, Miami, Houston etc. Do the majority of paramedics in this country work in these rural settings (I really don't know the answer to this question). For those of us that work in busy systems that do critical care/high risk transfers I think your "sleeping point" becomes less valid. The rural vs urban vs critical care numbers question is an interesting one. I will concede that not all medics work in busy systems that do critical care transport and thus don't interact with ICU nurses (the experience disparity is much greater).

My statement was that the majority of EMS in this country is rural (as the majority of the land is rural). There is probably a large disproportionate amount of EMS calls in urban settings. This does not, however, apply to the majority of the US.

As for the medics that work only in 911 emergency care, and interact with CEN RNs, I'll ask you this; Do RNs know a "tons more stuff that medics never learn"? Don't you think that medics can learn just as much as nurses do by spending time in emergency care. RNs do not enter the ED knowing all there is to know about emergency medicine, they too must learn through experience.

"Tons" more stuff? No. Familiarization of critical care events and having more hands-on experience, yes. Any person who works in a hospital critical care unit or emergency department is going to see more than a person sees on an ambulance. It doesn't matter if it's a paramedic or an RN. If an RN who did pre-hospital work only was compared to a paramedic who worked full-time in a critical care unit, then the paramedic would have more experience than the RN. Transferring care to the RN on an inter-facility transport would be a decrease in level of care in this case.

 

[niko327]

Hello Southerndoc,
Interesting response and good points, but I'm still unconvinced about a couple of things.....

"The critical care experience of a transport paramedic is periodic, whereas it is constant the entire shift of a CCRN (provided the census isn't low, at which point usually the CCRN is sent home, or at least that's what happens where I am)."

That is a very good point and you are probably right, but I'll also argue that the periodic critical care encounters medics get are "high quality". Periodic encounters that Critical Care transport medics have are often with patients who are very ill (transferring hospital can not handle) and need constant careful and very close attention, especially because they are being taken out of a quiet, stable, and non-moving environment. Doing things like titration of drips optimizing vent settings even IABP are not uncommon. I'm not saying that RNs are not doing these same things but I doubt they are running around all shift doing these things to every patient in the ICU (how much is really supportive care). Whoever is doing more for any given period of time is not really the issue, I just want to say that I don't really think that RNs "know tons more stuff that medics never learn".

"My statement was that the majority of EMS in this country is rural (as the majority of the land is rural). There is probably a large disproportionate amount of EMS calls in urban settings. This does not, however, apply to the majority of the US."

Yeah, I agree, but I want to know if the majority of certified EMT-Paramedics as opposed to BLS providers work in the rural setting. Do you know the answer ?(I know I don't know)


"Familiarization of critical care events and having more hands-on experience, yes. Any person who works in a hospital critical care unit or emergency department is going to see more than a person sees on an ambulance."

What sort of hands-on experience do you mean? Nothing against nurses (I mean it, I really have nothing against them), but the hands on experience is the carrying out the doctor's orders, and most anything that is really a critical procedure is handled by somebody with an MD, or DO after their last name.

What secret events are occuring in the ER that medics never heard of? Familiarization with critical care events is not the same as doing them. I don't know every critical care event that goes on in a hospital, but I think that medics are probably "familiar" with many, and if given the opportunity could probably become "familiar" with most of them. Once again I am not trying to say that medics are better, I just want to say that I don't think "nurses know tons more stuff medics never learn". Are we really as unsophisticated as some would like us to believe?

Sorry by the way, I don't know how to do several quotes and respond to them within a post so I copy and pasted from your previous response. I admit they didn't teach me that in paramedic school. Take care.

 

[southerndoc]

Niko, to put it in perspective:

The paramedic is equivalent to the general surgeon practicing in a rural community. Occasionally he sees trauma, and occasionally he operates on that trauma.

The dedicated trauma surgeon practices in a dedicated trauma unit. He sees more trauma and operates more.

Who do you want operating on you if you are in a severe accident and you got to choose whether you were located near the trauma surgeon or near the general surgeon?

That 1 hour occasional transport with the IABP doesn't substitute for the experience a CCRN can get managing the IABP for 8-12 hours during a shift.

I'm not sure what your critical care experience is, but when I was a paramedic, I thought I had all the critical care experience that I could need and that I was equal to CCRN's. How naive and arrogant. I realized just how much CCRN's know after doing my critical care rotations in medical school.

 

[niko327]

Niko, to put it in perspective:

The paramedic is equivalent to the general surgeon practicing in a rural community. Occasionally he sees trauma, and occasionally he operates on that trauma.

The dedicated trauma surgeon practices in a dedicated trauma unit. He sees more trauma and operates more.

Who do you want operating on you if you are in a severe accident and you got to choose whether you were located near the trauma surgeon or near the general surgeon?

That 1 hour occasional transport with the IABP doesn't substitute for the experience a CCRN can get managing the IABP for 8-12 hours during a shift.

I'm not sure what your critical care experience is, but when I was a paramedic, I thought I had all the critical care experience that I could need and that I was equal to CCRN's. How naive and arrogant. I realized just how much CCRN's know after doing my critical care rotations in medical school.

Hello Southerndoc,
I understand what you are trying to say. What I am saying though is that a medic with many years experience doing these 2 hour IABP calls just may be more experienced than a nurse in her first month in critical care (wouldn't you think?) And you're right in that I really don't know what your experiences were like as a medic. In fact, I guess it just goes back to my an original point that one should not make any generalized statements about any particular group of people outside or even inside your own profession (I'm probably guilty of this too.). I can only really reference my own experiences and perhaps I feel the way I do mainly because I was surrounded by very well trained and very, very strong medics, (people I'd trust to manage my IABP God forbid I ever need one). And in my own experiences I've come to the conclusion that so long as we maintain a healthy intellectual curiosity, open ears, and a desire to do the right thing there is very little we can't learn/know ICU, ER, or otherwise. Don't think for a second that I deny there are very talented RNs out there, but by the same token there are some amazing medics out there as well. I guess that we can continue with this thread ad nauseum and I'd doubt I could get you to agree with me, but hey that's OK too. In the end all I'm trying to say is that I don't think nurses know tons more stuff medics never learn. I really haven't seen any evidence of that in doing 911 or critical care. What I have seen are two dedicated groups of individuals who are granted a "license to learn" the day they graduate their program, and must remember to tread a humble path (lest we later realize how naive or arrogant we were ) on their way to becoming competent providers. Take care.

 

[southerndoc]

I've never said that nurses know TONS more than medics. A nurse with one month of critical care experience probably has as much experience as a paramedic working on a critical care transport unit for a year. Let us not forget that fresh-out-of-school nurses rarely, if ever, gain employment in the critical care unit as their first nursing job.

Re: my paramedic experience. I worked full-time for a hospital-based 911 provider that was also responsible for critical care transports. The hospital I worked for was a member of a health alliance, and as such, would routinely transfer critical care patients to "sister" hospitals. We were required to complete a CCT course.

 

[niko327]

I've never said that nurses know TONS more than medics. A nurse with one month of critical care experience probably has as much experience as a paramedic working on a critical care transport unit for a year. Let us not forget that fresh-out-of-school nurses rarely, if ever, gain employment in the critical care unit as their first nursing job.

Re: my paramedic experience. I worked full-time for a hospital-based 911 provider that was also responsible for critical care transports. The hospital I worked for was a member of a health alliance, and as such, would routinely transfer critical care patients to "sister" hospitals. We were required to complete a CCT course.

Hello Southerndoc,
I am well aware you never said that....but you responded to my original post about that comment (said by someone else) and by the tone of your posts seemed to be taking a position defending it. I don't neccessarily agree with your 1 year=1 month analogy, by your estimates a nurse working for 1 1/2 years has equivalent experience to an 18 year medic, I find that pretty hard to swallow. But anyway, it sounds like you had good experience before med school. Take Care.

 

[Krazed_Medic]

I know that this is way off topic from the OP, but I feel like I want to put my two cents worth in on this one. I have been in EMS now for 5 years, two of those years as a paramedic. I love my job. I love being a paramedic. Do I think that some nurses have a lot more knowledge that I do, you bet I do. DO I think that some nurses have much less knowledge than I do, well yeah! I think that a lot of the "argument" comes down to how much "patient contact time" does one acquire? In EMS, in many cases, how many actual patient contacts are you making? Just as an example, the service I work for right now has 16 hour shifts. The last shift I worked, we did a total of three calls, all transfers. Two of them were to another hospital, while the other was back home. All in all for the day, I had two and a half patient contact hours. Even on a busy day, there is usually no more than 12 hours of patient contact time, and that is a very busy day. I know that for some places it is much more. You have to take into account the time in between calls. It could range from just a few minutes, to several hours. Now, how often have you ever walked into an ER, and all the nurses were playing cards, or video games? It's not that often. When they show up for work, work starts, and usually does not end until their shift is over. In their 12 hour shift, they have all 12 hours in patient contact. Again, I know this isn't everywhere. I just know that when I go to work, it may be a couple of hours before I do anything. So, to me, it's not a matter of how many years one has been a paramedic or a nurse, but how much patient contact one has made that really counts as experience. Again, just my opinion. I'm definately pro-EMS, but I'm also pro-everyone as well. Even the oldest paramedic, nurse or doctor is never to old to learn something new.

 

[southerndoc]

Krazed Medic, that was basically my point in my posts. Critical care paramedics do not spend as much time with patients as critical care nurses do. It is ultimately experience that makes me say that there is a decrease in level of care when they transfer care to a paramedic. Decreased level of care is not always associated with decreased knowledge.

I agree with your statement that even the oldest paramedic, nurse, or doctor is never too old to learn something new. I've learned a lot from nurses, fellow paramedics, residents, attendings, and even fellow medical students. I've even learned stuff from techs -- some who have had no formal training at all.

 

[Rob77]

This discussion is strikingly similiar to the MD/DO/PA/NP posts. The bottom line is who the hell cares. It's pointless. Nurses know what nurses need to know and medics know what medics need to know. They both have important rolls in healthcare and they are both well trained for their respective positions.-----Rob

 

[southerndoc]

This discussion is strikingly similiar to the MD/DO/PA/NP posts. The bottom line is who the hell cares. It's pointless. Nurses know what nurses need to know and medics know what medics need to know. They both have important rolls in healthcare and they are both well trained for their respective positions.-----Rob

Actually it has some clinical application since some rare things may need a nurse to accompany the paramedic crew on a critical care transport, especially if the paramedics aren't trained in critical care transport, IABP pumps, etc.

 

[niko327]

Actually it has some clinical application since some rare things may need a nurse to accompany the paramedic crew on a critical care transport, especially if the paramedics aren't trained in critical care transport, IABP pumps, etc.

Hello Southerndoc,
Please recognize that this is not the case everywhere. Where I worked, nurses never accompanyed us on any critical care job, we were expected to know how to do our job. (I have had MD peds fellows on board if we were doing a bad peds job.) Anyway, it would stand to reason that if you're a medic not trained to do critical care work, you shouldn't be doing critical care transports. Deferring to nurses was not an appropriate option for us. Maybe we were held to a higher standard, but what you're describing is foreign to me. Take Care.

 

[niko327]

As a side note, I think this series of posts really needs it's own thread, since it has nothing to do with what you say to patients at the end of a call. My apologies to the OP since we inadvertantly hijacked his thread.

 

[southerndoc]

Hello Southerndoc,
Please recognize that this is not the case everywhere. Where I worked, nurses never accompanyed us on any critical care job, we were expected to know how to do our job. (I have had MD peds fellows on board if we were doing a bad peds job.) Anyway, it would stand to reason that if you're a medic not trained to do critical care work, you shouldn't be doing critical care transports. Deferring to nurses was not an appropriate option for us. Maybe we were held to a higher standard, but what you're describing is foreign to me. Take Care.

There was actually a recent discussion on EMED or EMS (not sure which listserv it was) about the need for nurses to accompany paramedics on critical care transfers.

I have mixed feelings about the issue.

 

[dropdeded]

As a side note, I think this series of posts really needs it's own thread, since it has nothing to do with what you say to patients at the end of a call. My apologies to the OP since we inadvertantly hijacked his thread.

No worries, just learning some things I didn't expect when I started it.

Ed

 

[edtheman]

Every one is trained in there own level of care ..... No one is above any one else