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Steve,
I agree that the problem in this situation
is a scope of practice issue. The problem seems to be that there is no
system in place to allow Paramedics to function to their full skill level in the
hospital enviornment. I also concur that some of these problems could be
eliminated if the Paramedic was also an RN, but for many, myself included
returning to school to license as a nurse is not a viable option. The large
majority of Paramedics who work for flight services that are based in hospital
have many years expierence and are well qualified to treat most of
the patients seen in the ED. I believe you pretty much hit the nail on the
head when you stated that some of the problems stem from personalities getting
involved.
----- Original Message -----
Sent: Thursday, November 15, 2001 4:16
PM
Subject: Re: working in ER
Mark,
What may be occuring is scope of practice issues. Paramedics
are trained and registered as prehospital caregivers. Paramedics operate
under established protocol and from medical direction from physcians from the
receiving hospital via radio. Another sticking point may concern
department of nursing which may feel you are displacing an RN, while you may
do alot of nursing duties on transport, the license of an RN gives them
greater scope of practice and lattitude.
Another obstacle may come from physcians especially
in teaching institutions. On transport, the team does their assessment
and interventions as they deem necessary but in house in the ER it is the
physican who is in charge and makes the decisions as to what inteventions need
to be completed when and by whom. So the poltics of who is in charge and
who can complete what is very challenging one to tranport staff who are used
to autonomy in the field. So even personalities may play a
role. One way around it is for paramedics to also become RN's,
then scope of practice issues would not be an issues. Not to mention
more latitude in pay advances and oppotunities to work in other areas
within the medical field. No easy answers as Paul stated.
Sincerely,
Steve Sittig
>From: "Mark Lewis"
>Reply-To: flightmed@flightweb.com
>To:
>Subject: Re: working in ER
>Date: Thu, 15 Nov 2001 07:06:08 -0600
>
> This is an interesting topic, which seems to have as many
different methods
>of staff utilization as there are programs. I really don't feel
qualified to
>comment as to the best answer but do have a question I would
like to
>interject into the discussion. For those programs that utilize
Paramedics
>on their flight crews and also require the transport crew to
assist in the
>sponsoring hospital how are the Paramedics used In-Hospital? I
have heard
>some real horror stories about how in the in-hospital
enviornment in some
>areas Paramedics are very limited, to the extent of being
basically and ER
>Tech. Just curious how other programs are handling this.
>
>Sincerly,
>
>Mark Lewis NREMT-P
>----- Original Message -----
>From: "Paul M. Wright, Jr."
>To:
>Sent: Wednesday, November 14, 2001 6:24 PM
>Subject: RE: working in ER
>
>
> > I think Rollie has hit the nail on the head with his
comment about the
>Holy
> > Grail for transport staffing. I would phrase it as the
search for
> > "efficient cost shifting by finding meaningful work
capable of being
> > instantly interrupted".
> >
> > However difficult that quest for the Grail appears, I am
impressed by the
> > number of times that I have heard of programs that have
similar job
> > profiles with respect to non-transport
> > duties but the perceptions of how it's working differ
dramatically.
> >
> > Two of the factors that might be involved in this
difference are the
>nature
> > of the underlying relationship between the transport
program and the
> > sponsoring hospital and the attitudes of the transport
team members
> > themselves.
> >
> > I am aware of one hospital-based transport program that
was a significant
> > drain on the resources of the sponsoring hospital so the
hospital
> > administration's idea of getting everyone on board was to
tie the lack of
> > raises for hospital staff that year to the flight
program's need for
> > funding. Kind of along the lines of "you can help save
our flight program
> > by being good-natured about the lack of a raise".
Needless to say, this
>did
> > not make for warm and fuzzy relations between the
hospital core staff and
> > the flight program staff.
> >
> > And I could write many chapters of a very long book about
the damage done
>by
> > arrogance and pride on the part of transport team members
and I could
>write
> > passionately and at length on the profound embarassment I
have felt when
> > being professionally associated with some of my
colleagues who routinely
> > left anger and ill-will in every situation they touched.
Even in this
>forum
> > quite recently, statements have been made suggesting that
cockiness and
> > arrogance are a good thing for a flight nurse. I disagree
and I wonder
>how
> > often it is that otherwise workable solutions fail solely
due to the
> > personality and/or attitudes of the transport members.
> >
> > There are policies and practices that fail because they
are bad policies
>and
> > practices but there are also good policies and practices
that fail because
> > the underlying relationships are terminally flawed. So
part of the search
> > for the Holy Grail of staffing must also include a search
for useful
> > relationships between institutions as well a search for
useful values at
>the
> > individual level.
> >
> >
> > regards!
> >
> > paul
> >
> >
> >
> >
> >
> > _______________________________________________
> > Flightmed mailing list
> >
>
>
>_______________________________________________
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