EMT-Practitioner

Discussion in 'Topics in Healthcare' started by Mr. Hat, May 27, 2008.

  1. Mr. Hat

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    As we all know, there is a major nursing shortage which is expected to get much worse over the next several years. I have come up with an idea that will help alleviate this problem, especially benefitting underserved areas. I would love to collect your support and send a petition to congress and various medical organizations - please "sign" via your positive reply to my post.

    My idea is the creation of the EMT-Practitioner program. Many of you are already aware that many EMTs function as Techs at Emergency Departments around the country. EMTs are already allowed to do many "nursing functions" including but not limited to: wound care, EKGs, IVs and lab draws, foley catheter insertions and removals, splinting, BLS, providing patient care and comfort, and so on. Techs are not allowed to administer medications, give shots, or do nursing assessments. They also do not have ACLS/PALS etc. However, I think with a little additional training, EMTs could do most of these things in 99.9999% of cases within the primary care setting.

    Following is my proposed 1 semester, 15 credit hour program allowing EMT-Basics to become EMT-Practitioners and work as "nurses" - with all nursing privileges - in any primary care setting.

    EMT-Prac 100: Basics of Chemistry (2 credits)
    EMT-Prac 102: Administering Meds as Ordered (2 credits)
    EMT-Prac 103: Knowing if a Med Order Looks Wrong (1 credit)
    EMT-Prac 105: Fundamentals of Nursing Assessment for Primary Care
    (3 credits)
    EMT-Prac 110: ACLS/PALS Certification (2 credits)
    EMT-Prac 200: EMT-Practitioner Clinical (5 credits - 225 hours of experience
    in a primary care clinical setting)


    Please show your support! This may be the answer we're looking for in terms of solving the primary care nursing shortage. I've worked with many, many good EMTs and I know they could probably do just as well as primary care nurses in 99.999% of cases with just a little bit of additional training. Plus they'll probably cost a couple bucks an hour less than an RN, saving money for practices and for patients! Everyone wins!!!!
     
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  3. cpants

    cpants Member

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    Excellent.
     
  4. Mr. Hat

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    Check out this concurrent thread I started at allnurses.com:

    http://allnurses.com/forums/f8/emt-practitioner-305996.html

    Just a sample:

    "I am totally against this idea. If an EMT wants to be a nurse, they need to attend nursing school. The few classes you suggest does not make one a nurse."

    Yet the classes an NP/DNP takes makes one an MD/DO? I'm seeing a double standard in thinking here! Nurses are saying NP/DNP can solve the MD/DO primary care shortage because most primary care stuff is bread and butter.... so why can't EMT-Practitioners fix the RN shortage in primary care stuff which is pretty much bread and butter.....?
     
  5. Mr. Hat

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    And here's another sample reply:

    "perhaps you should do some research on the differences in EMT basics as opposed to Paramedics. They are quite vast in their knowledge and certification requirements. I have been an EMT-B for ten years and having just completed nursing school and started working as a nurse I can tell you that the foundation of knowledge needed to work as a "nurse" doesn't exist in that EMT-B curriculum. Even as a paramedic there is a major difference in how we are taught to do skills and the critical thinking involved, not that paramedics can't do what nursed do, but its a different way of thinking and responding to situations.

    Oh yeah and with your idea not everybody wins... us nurses would be out of work if they could send an EMT to school for a semester to be a "practitioner". Who in the world would want to hire us when, just like you said, they could get the job done for less money? A petition like that would just be shooting ourselves in the foot, not to mention devaluing our education and the job we do on a daily basis."

    So two major points from this RN.....

    1) EMT's can't fuction as nurses because THEY DON'T EVEN HAVE THE FOUNDATION OF KNOWLEDGE NEEDED OR CRITICAL THINKING SKILLS NECESSARY

    2) Nurses would lose their jobs because we EMTs would be doing the jobs for less money, therefore no way would nurses support this (forget what's good for patients)

    HMMMMMMM...... These arguments seem vaguely familiar to me but I can't seem to think where else I might have heard them....
     
  6. Miami_med

    Miami_med Moving Far Away
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    poppycock, that semester seems far too practical. In order to obtain a "practicioner degree," we all know that you must take courses that don't actually help you learn how to practice.
     
  7. Taurus

    Taurus Paul Revere of Medicine

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    Great job, dude. :thumbup:

    The thread exposes the ugly hypocrisy of nursing.

    It should sicken any physician when a nurse says that they're practicing "advanced" nursing and not medicine. It's all the same lies. The only back they're looking out for are themselves.

    This is why physicians need to stand up and do something about this blatant encroachment on our profession. Nurses not only want to control nursing but they want to now control medicine as well. Are we gonna let them?
     
  8. nebrfan

    nebrfan Rx Beer

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    I agree. You should include classes like:

    "Practice Epistemology: Expanding Ways of Knowing for Reflective Practice. Ways of knowing about the human experience of health and illness and the nature and scope of knowledge will be explored. A narrative approach is used to uncover, describe and interpret the meaning of health, illness, and nursing practice.

    Designing Theory-Guided Models of Care. This course builds on an overview course on nursing philosophy and theory, and focuses on the application of theories in nursing and other disciplines to guide practice and design transformative models of health care. Grand, middle-range and practice level theories will be analyzed for their application potential, and students will develop models for practice in their specialty area based on these theories.

    Cultural Competence for Advanced Practice. Addresses cultural perspectives on clinical care, including the frameworks and methods used successfully by advanced practice nurses to assess cultural preferences, express expectations, negotiate treatment plans, and modify care to accommodate provider-patient differences and patient and family expectations."​

    Oh - wait. Those are some of the DNP courses offered at the University of Colorado. It's a good thing one doesn't need a solid foundation in pathophysiology when practicing from a cookbook...
     
  9. AwesomO

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    +pity+
    :lol::lol::lol::lol::lol::lol::lol::lol:
    But wait a minute what about putting the patient first? Surely these nurses did not go into nursing for the money. They should be thrilled with this new TEAM approach that would save countless health care dollars. Although EMT-practitioner is oddball especially if they will not all be in the ER. Lets call them Advanced Nursing Medical Technicians. They can introduce themselves as Nurse or even advanced medical nurse. After all they earned it!
     
  10. Mr. Hat

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    Yeah, I like that name better too. Maybe I'll email Ms. Mundinger and see what she thinks....
     
  11. Josh L.Ac.

    Josh L.Ac. MSA/LAc & BSN/RN --> AA-S

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    My first [and last] semester in a FNP program consisted of two classes: Graduate Research and Advanced Nursing Theory. The former required weekly quizzes and finished with a literature review, the goal of which was not to get published but to display on a poster board at Nursing Research day. The latter culminated with the development of my own nursing practice theory.


    I owe how much for that?
     
  12. oldpro

    oldpro MS IV

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    And How does this prepare one for Medical Practice?
     
  13. Josh L.Ac.

    Josh L.Ac. MSA/LAc & BSN/RN --> AA-S

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    Not very well, thus the [and last] comment.


    It was a great experience, though, because it helped me decide on going to AA school instead.
     
  14. zenman

    zenman Senior Member

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    There is not a nursing shortage; there is a shortage of nurses willing to deal with the crap any longer. Any type of "replacements" will suffer the same fate.
     
  15. zenman

    zenman Senior Member

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    Well, it looks like your poorly thought out plan didn't fly. Now your thread over at allnurses is closed.
     
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  17. Mr. Hat

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    And I can't tell you how devestated this makes me. My every life's happiness depended on it.... :rolleyes:
     
  18. brianmartin

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    The nurses jumped all over your plan at the same time they are advocating essentially the same thing! Ingenious.
     
  19. AwesomO

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    It's called looking out for your profession. Nothing wrong with it but when Doctors try and do it people throw a fit.
     
  20. Taurus

    Taurus Paul Revere of Medicine

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    The thread was nevertheless useful and enlightening. It shows that nurses are just interested in protecting their own turf and deceptively trying to invade others.
     
  21. Taurus

    Taurus Paul Revere of Medicine

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    We should sticky this thread.
     
  22. AwesomO

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    I'm sure a group from allnurses will come here and complain to admin resulting in this thread being closed as well. :rolleyes: Or they'll just flat out delete that thread. Someone should copy that thread.
     
  23. Tired

    Tired Fading away

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    You all misunderstand the relationship between RNs who want to be DNPs/CRNAs and RNs in general. When you actually talk to most nurses, there is quite a bit of hostility towards NPs in general, and total disgust at the ones who try to appropriate the "Doctor" title.

    Similarly, the whole DNP concept was not put forth by some grass-roots movement of floor nurses looking to screw us. Far from it. The truth is that most nurses, though they may personally dislike physicians, still have a lot of professional respect for what they do, and do not believe that NPs are equivalent to us.

    I make no secret of my tortured relationship with nurses. But if we're going to address the DNP issue as a community, we need to understand the political playing field. "Nurses" did not come up with the DNP idea, and "nurses" are not advancing it. Small groups of politically-savvy nursing school faculty are responsible for this. Truthfully, for a variety of reason, everyday-RNs are much more our natural allies in this fight than their's.

    Try it sometime (I have): when the issue of NPs comes up, explain calmly to an RN your concerns about allowing NPs parity with physicians. You'll be suprised how many of them agree with you 100%.
     
  24. cpants

    cpants Member

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    Tired, you make a great point. Who will resent calling a DNP "doctor" more than a masters-level NP who knows the title is total BS?
     
  25. Taurus

    Taurus Paul Revere of Medicine

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    I agree. I respect RN's and NP's who want to work as a team.

    I have a problem with Mundinger et al. Since I can't separate the DNP's who want to really work as a team vs those hell bent on pretending to be doctors, I support PA's and AA's.
     
  26. zenman

    zenman Senior Member

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    True. NPs are not equal to physicians and most RNs and NPs know that. It's easy to see that the education is different. Nursing education at all levels is messed up...period. I've taught in both ADN and BSN programs and I know that first hand. I also got my masters as an advanced practice nurse (psych clinical nurse specialist) back in 1983. I happened to have a nursing professor
    department head who was not a great expert in her field, but I searched out smart people for my preceptors, including a year of personal therapy and supervision. I do have my own ideas about how NP education should be and it doesn't include the DNP.

    I personally haven't seen much hostility from nurses towards NPs. My parents both see NPs and they have multiple complex health problems, including AVR, cardiac arrest and pacemaker insertion. I'm sure the NPs supervising physician likes this arrangement, otherwise he'd spend too much time trying to talk to my mom who is deaf as a post. My wife also sees an OB-GYN NP. I haven't had a primary doc or NP since Hawaii where my Chinese physician and I used to sit and BS about health care.

    I toy with the idea of doing a psych NP just for the additional knowledge and the need for psych providers, especially with the increase in PTSD among the military. If I go that route, it certainly will not be to play one-up with any psychiatrist. (I can do that with my shaman role...sorry, couldn't resist!).

    I don't know any DNP students so I have no clue why they went for it. It is similar to an MPH. Personally, I'd rather go for London University Master of international primary health care instead. In international health care you find many examples of what they left out of medical textbooks, plus it's just more interesting.:D
     
  27. fab4fan

    fab4fan TiredRetiredRN
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    I think I'd better back off on the cough syrup I've been taking for this persistent bronchitis I have. It's making me see things I don't believe. :scared:
     
  28. oldpro

    oldpro MS IV

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    Hello MS IV here also an RN

    While you are right mostly here, it is not RN's and LPN's but the PHD nurses and the NP's who want this, I have known NP's who think that after a year or so they are "Doctors" and there are PHD Nurse educators that think this is true and want to Put weight behind this thought by making the DNP the "Doctorate level" for NP. In this way they are "Doctors" Technically but not in reality, so in my opinion this is a way to Cheat the system to give the NP "Doctor" status and therefore Nursing has a Doctor role in the direct care of the Patient, PHD's in Nursing do not usually have a direct patient care role.

    You have to take this step in understanding, also understand there is an invisible wall between Doctors and Nurses (Us and Them ) :cool:
     
  29. shahalam

    shahalam brownmedstudent

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    They deleted the thread :(

    That was quite amusing and genius...loved it!
     
  30. oldpro

    oldpro MS IV

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    Deleted? WOW thats really bold of them, most sites to keep integrity just lock the threads not delete (Censor the site) :eek:
     
  31. Tired

    Tired Fading away

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    Allnurses routinely deletes threads and posts. They will even close down threads and delete select posts in order to "clean them up", then reopen them like nothing ever happened.
     
  32. Taurus

    Taurus Paul Revere of Medicine

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    The funniest thing about allnurses is that they won't show your post until a nurse has reviewed it. :laugh:

    What are they afraid of? They're all about censorship over there.
     
  33. Tired

    Tired Fading away

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    Not quite. In the general forums it does not require review. But if you want to post a new thread in the "News" section, they require moderator review before they will put it up.
     
  34. shahalam

    shahalam brownmedstudent

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    I'm sorry for my poor choice of words. I meant that they locked the thread...sorry for the confusion
     
  35. oldpro

    oldpro MS IV

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    Thats Cool then, Locking is form of censorship but really not as bad.
     

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