Move to ER or stay on a Truck ???

[BaylorHopeful]

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Hey Guys-

So I've run into a spot. I've just about hit a year on the road (Started in January). Last week, two of the Level I trauma centers in town started another round of hiring ER Techs. Being an ER Tech would pay me more and give me more experience (I work for a private company that has a few municipal contracts, but I still nonetheless do more transports aka The Renal Roundup)

My only hangup is that over the summer I started teaching at the EMT-B program that I went through, and I feel as though my moving off the truck would lead to a decline in my instructor capabilities (since I teach people to work ON A TRUCK)

Would moving to the ER be a poor decision as far as my teaching goes ??? Or am I just paranoid about it and moving to the ER would not only help that but my premed issues (sorry I had to throw that in there)

Thanks for your help

 

[Jambi]

Would moving to the ER be a poor decision as far as my teaching goes ???

No it would not, I would do it.

Or am I just paranoid about it and moving to the ED would not only help that but my premed issues (sorry I had to throw that in there)

yes you are. Working on an ambulance does give you a different perspective than that of an ED Tech but both are valuable. I would say that as an ER Tech your work schedule would be much more stable and since you would be making more you would need to work less therefor giving you more time to devote to your pre-med studies. In the ED you will have more of an opportunity to see outcomes of patients that are brought in from the field, you will also have the chance to build relationships with docs that could lead to a LOR, shadowing experiences, and most importantly, knowledge.

If you're worried about your "street cred" while teaching just keep a part-time job working the bone box. 🙂

 

[msmertka]

Hello,

I had to undergo the same dilema about a year ago. I have made the jump from the street to the hospital. Of course I am fortunate that in our level 1 T center, medics are medics in the ED, not IV techs. I would say it has been a positive move. Though my respect for the nursing profession has declined considerably. (a different story) I don't get to perform some skills as often as I like, but I have aquired new ones. Like reading radiology films, advanced proceedures, volumes of knowledge, and a few really great perks. (like working around MDs and DOs who have made helping medics become docs their project.) The greatest benefit so far has been the opportunity to sit in all the classes the physicians have. I also get invited to the dinners from drug reps, and goodies from marketing gurus. Here at least the Medic is highly valued by the Physician staff, and consequently despised by the nursing staff. (something about us stealing their jobs.) I would highly reccomend the hospital.

As for teaching I do that too. Though I have been barred from teaching EMT-Bs, because I like to treat everyone like my peer and not my underling. I tend to run out of class time before I am done with what I want to teach. My medic junior peers (students) seem to appreciate me more, and the rest of the staff does as well. The FT instructors favorite phase is often "ask Smertka", and they listen as intently as anyone when I am teaching how to read a CXR. Now if you are in a place that thinks prehospital care is driving somebody to the hospital as fast as possible and if you are lucky starting an IV or a ET tube, it may damage your "street cred" But at that point who cares? If you are planning on med school my advice, look out for #1, and take the money and the opportunities the hospital offers.

Hey Guys-

So I've run into a spot. I've just about hit a year on the road (Started in January). Last week, two of the Level I trauma centers in town started another round of hiring ER Techs. Being an ER Tech would pay me more and give me more experience (I work for a private company that has a few municipal contracts, but I still nonetheless do more transports aka The Renal Roundup)

My only hangup is that over the summer I started teaching at the EMT-B program that I went through, and I feel as though my moving off the truck would lead to a decline in my instructor capabilities (since I teach people to work ON A TRUCK)

Would moving to the ER be a poor decision as far as my teaching goes ??? Or am I just paranoid about it and moving to the ER would not only help that but my premed issues (sorry I had to throw that in there)

Thanks for your help

 

[jonb12997]

if you want to go to medical school? get yourself into the ER... it's going to be a lot more like what you're going to be doing once you finish school. Being in a truck is fun, but unless you're doing critical transports or such, you're not going to get the level of medicine of a rig that you'd get while working in the ER. Also, be nice to the nurses, some of them can really teach you a lot.

 

[BeakerEMT]

I would definitely support working in the ED. I worked on a ambo for 6 months then in the ED for 2.5yrs before starting med school. I learned a hell of alot more in the ED than in the field for mutliple reasons.
1. You learn more from those whom know more (to an extent), docs very interested in teaching and involving me in cases knowing I was going to med school.
2. Many of the skills I learned in the ED are skills med students/residency do; like foleys, wound preps, ortho-glass splints.
3. An emergency in the ED is much different than in the field. I learned significant amount triage and treatments in the ED. Also, very helpful when you see emergencies on the floor as a med student.

I still work as "field medic" with two different groups for various community events and my time in the ED made me a much better field medic

 

[OSUdoc08]

Hey Guys-

So I've run into a spot. I've just about hit a year on the road (Started in January). Last week, two of the Level I trauma centers in town started another round of hiring ER Techs. Being an ER Tech would pay me more and give me more experience (I work for a private company that has a few municipal contracts, but I still nonetheless do more transports aka The Renal Roundup)

My only hangup is that over the summer I started teaching at the EMT-B program that I went through, and I feel as though my moving off the truck would lead to a decline in my instructor capabilities (since I teach people to work ON A TRUCK)

Would moving to the ER be a poor decision as far as my teaching goes ??? Or am I just paranoid about it and moving to the ER would not only help that but my premed issues (sorry I had to throw that in there)

Thanks for your help

The Bad:
ED: Nurse's little helper & very few procedures

Truck: Autonomy & you get to utilize all of your skills

The Good:
Higher Pay in the ED
Good Networking with ED staff & physicians
Get to watch procedures

 

[MedSchoolFool]

I'll be finished training as an EMT-B in December and have already received a couple of offers to work at two local ambulance companies. I've also been assured that there are plenty of other companies looking to hire. However, I do wonder if it is possible for an EMT-B to gain employment in an ED. There is a Level 1 trauma center nearby and I think it would be a goldmine of experience if I could work in it.

So, is it just not realistic for someone with an EMT-B certificate to work as an ED tech? Also, would I only be relegated to wiping butts if I were to work in an ED, or could I expect a more substantial patient care role than that? I know that I would be limited since EMT-B isn't allowed to do anything more invasive than an airway pretty much. Would anyone advise for or against an EMT-B in the ED?

 

[OSUdoc08]

I'll be finished training as an EMT-B in December and have already received a couple of offers to work at two local ambulance companies. I've also been assured that there are plenty of other companies looking to hire. However, I do wonder if it is possible for an EMT-B to gain employment in an ED. There is a Level 1 trauma center nearby and I think it would be a goldmine of experience if I could work in it.

So, is it just not realistic for someone with an EMT-B certificate to work as an ED tech? Also, would I only be relegated to wiping butts if I were to work in an ED, or could I expect a more substantial patient care role than that? I know that I would be limited since EMT-B isn't allowed to do anything more invasive than an airway pretty much. Would anyone advise for or against an EMT-B in the ED?

Most tech's in the ER are EMT-B's, unless you are at a trauma center. I know that some trauma centers require you to be a paramedic.

Either way, you have a limited scope of practice, and cannot administer meds, cardiovert, or intubate. You can start IV's, however. (Yes, even EMT-B's do.)

 

[MedSchoolFool]

Awesome. Glad to know that most ED techs are EMT-B and not paramedics. That's just gives me more options for getting clinical experience. Thanks for that info.

I would love it if I could get the chance to learn how to run an IV. But in Delaware, where I live, running an IV is outside the EMT-B scope of practice. Also, Delaware doesn't recognize the EMT-I level. So, basically the only EMS qualified to do a line in this state are the paramedics. According to Delaware protocol EMT-B can't even do a simple glucose test on diabetics (which is something the paramedics and medical directors are trying to get changed). Anyway, that's the first state for ya.

JJ

 

[nonlethal]

Also, would I only be relegated to wiping butts if I were to work in an ED, or could I expect a more substantial patient care role than that? I know that I would be limited since EMT-B isn't allowed to do anything more invasive than an airway pretty much. Would anyone advise for or against an EMT-B in the ED?

If you really want to perform "perineal care", get a CNA. They're trained to take vitals (pulse, temp, BP, and that's about it), change diapers, and give bed baths. And you don't have to speak English, or even have a GED.
Pretty scary that to work in most any other department in the hospital, they require a CNA?

 

[OSUdoc08]

Awesome. Glad to know that most ED techs are EMT-B and not paramedics. That's just gives me more options for getting clinical experience. Thanks for that info.

I would love it if I could get the chance to learn how to run an IV. But in Delaware, where I live, running an IV is outside the EMT-B scope of practice. Also, Delaware doesn't recognize the EMT-I level. So, basically the only EMS qualified to do a line in this state are the paramedics. According to Delaware protocol EMT-B can't even do a simple glucose test on diabetics (which is something the paramedics and medical directors are trying to get changed). Anyway, that's the first state for ya.

JJ

Hospitals don't have to adhere to state protocols, since you can recieve in-house training, and fuction under the hospital's license and not your own certification.

 

[CCEMTP2DOC]

Hospitals don't have to adhere to state protocols, since you can recieve in-house training, and fuction under the hospital's license and not your own certification.

This is true. I work part time at a Level II ER and we,as paramedics, do a lot. So it is dependent upon hospital protocol.

Rob

 

[southerndoc]

This is true. I work part time at a Level II ER and we,as paramedics, do a lot. So it is dependent upon hospital protocol.

Paramedic abilities within a hospital vary from tech to full ALS capabilities. Georgia law allows paramedics to essentially do everything a RN can do. However, JCAHO prevents paramedics from triaging patients.

 

[BeakerEMT]

Agreed, the hosptial I worked for liked to have EMT trained people but it was not requirement. And as stated above the hospital decides your level of skill as you are not working as EMT under you own license.

I would caution the thinking trauma center/med school hosptial = more skills for the tech. Many of the more advanced skills I did an ED tech in a private hospital are done by residents and med student at the hospital now am a med student at.

 

[12R34Y]

You have to be very careful about where you apply to work as an ED tech.

I worked in 2 trauma centers in two different states as an ER tech and NEITHER allowed me to start IV's. the only thing i could do was phlebotomy. NO foley...nothing else, but stocking, wound care, suture removals etc...

so you can't assume you'll be using your skills in all ER's ( or trauma centers for that matter). Just call and find out.

good luck,

later