1) The nursing lobby continues to push for advanced practice nurses to have more privileges, but continues to oppose EMS providers being able to practice community paramedicine or function as EMS providers in the emergency room. Why? Because that’s supposedly unsafe for the patient to be seen and treated by someone with less education than a nurse. Funny. That’s the same argument that physicians use to say that advanced practice nurses still need limitations on their scope of practice and for physician oversight.
2) You know the people in EMS who claim that EMS providers are legally prohibited from providing a diagnosis because only a physician can? Funny, aren’t they providing legal advice without the benefit of passing the bar exam? And by the way, their legal opinion also happens to be wrong.
Critical thinking. It’s contagious. Here’s hoping you catch it.
“……but continues to oppose EMS providers being able to practice community paramedicine or function as EMS providers in the emergency room.”
I her medics talk about this, but I rarely see it happen. I believe that the President of the Minnesota Nurses Association testified in support of their Community Paramedicine bill.
Is this just another example of urban legend, and EMS folks not knowing how to work within the political process?
I frequently see it happen, especially in California. NP’s want complete autonomy for themselves, but not for PA’s (incidentally, they go through the SAME schools in some California PA/NP programs). You cannot work as an EMT in the ER. You have to be relabeled as a “Patient Care Tech” or something where you aren’t allowed to work to a scope higher than a CNA, regardless if you are an EMT or a Paramedic. That, I believe, is due especially to the California Nurses Association, who constantly complains about the “nursing shortage”.
I have seen it go both ways in Missouri Skip. I am glad Minnesota appears to be getting along.
And being told I am to honest to work well in Politics is a good thing, isn’t it?
Of course, there was a lot of work (and nursing opposition) for years before support was offered in MN. Add that there is still a lot of potential opposition as CP programs are getting boots on the ground. Fortunately, people have cultivated relationships with nursing before going live.
Working in a paramedic capacity in the ED remains strongly opposed; by the ENA nationally, an MN Nurses Association at the local union level.
Skip and I are paramedics AND lawyers 🙂
And Skip, paramedics once worked in EDs in NYC (at St Clare’s, in particular, they were the triage officer) but the nursing unions objected and that ended that. I don’t know a single ED in the NYC metro area which has medics EXCEPT for Norwalk Hospital where they 911 medics work for the hospital and sometimes in the ED….
The Trauma Coordinator for one of the hospitals in El Paso is an RN and former Medic, as well as still being a part time flight nurse, she has a very high view of Medics and pushed for a team care approach in the hospital using an RN, Paramedic and EMT/CNA to run a group of patients. The local nursing union fought it as well as recruiting outside nursing organizations to fight the idea. One of the issues that I have seen is that RN’s are under the belief that they hold the monopoly on liability, i.e. they fight the team approach because in their mind their license is responsible for the actions of the Paramedic and EMT/CNA (sorry in the plan the two were interchangable). RN’s, from my experience, seem to think that their license carries more legal weight than a Paramedic and so any Medic in the hospital puts liability on to them. I’ll be honest that is above my legal paygrade on the truth of it and I’m sure varies from state to state, but it shows a specific example of the situation occuring. We have a couple hospitals in my region where Paramedics are hired as Paramedics and actually carry a patient load, but they face opposition from the nursing side of the house on a regular basis, luckily we have a shortage of experienced RN’s here ( the value of limited training programs is worthy of its own blog and thread, but it is evident here) which keeps Medics employed in jobs that would otherwise be filled by RNs.
And why says you can’t be effective in the political arena while talking out of both sides of your mouth?
Everybody but EMS folks, who are rarely politically effective anywhere!
And what does this have to do with the article? Politics wasn’t even mentioned.
But the issue is totally political – THAT is why politics was mentioned!
Interesting article on an Earthlink page of all places, about Paramedics in the ER… http://home.earthlink.net/~douglaspage/id77.html
Nurses’ associations rationalize their opposition to EMS personnel practicing in any role other than the prehospital realm using educational standards, but their true opposition is purely financial. They want any and all career expansion to go exclusively to nurses. They also know that increasing nursing opportunities stretches a already thin employee base. Fewer available applicants for more positions equals potentially higher wages.
Part of Murphy’s Law states, “When confronted with a situation that you cannot understand, look for the financial interest.”