Flightmed archive for April-2002
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Flightmed archive for April-2002



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Re: Turf battles



Eric, et al
 
Well said in it's context. If I may let's change the bounds for a minute to one a little more narrow.
 
In some areas of the states there is a shortage of Paramedics, so the Advanced EMT ( EMT -I) is being used to supplement and or replace the Paramedic. Most medics aren't really keen on that . You'd may say "can't blame them as they are being replaced with providers of less education / experience ".  Will the outcome this action be detrimental to patient care? etc. My point here is not to belabor that issue but to illustrate that RNs may feel the same way when you see Paramedics in the hospital setting.  The same arguments are advanced there also. Ah but here is where it gets to be apples and oranges for many reasons, a few of which I may touch on. Maybe time for a little parallelism.
 
(Let's assume for a moment the variable X is the number of years that you the reader would like it be.)
 
X years ago, while this occupation was new,  our work and contribution to medicine was minimalized. In the view of the other medical occupation(s) we were good to move patients around, cleaning equipment, doing other assigned tasks. We received our training ( education) mostly in the hospitals (as they were) of this time. As time progressed  our education moved from the clinical environs to the academic arena, where college degrees in our chosen  occupation came about. This was in part to recognize we developed a body of knowledge that was our own, we also recognized that this was keystone to a profession and desired to be acknowledged as such by the other member(s) of the medical profession.
 
As the reader I'm sure that you find that this thesis is familiar. If not, this is a synopsis of the earlier years of nursing * and the mature paramedics will see it as their own also.  * ( At least this is the interpretation I made from Professional Strategies in Nursing class, "I passed")
 
A interesting aside to this issue can be found at http://www.ncems.org/pdf/Joint_Position_Paper.pdf . I am sure that it wasn't easy getting the BON and the EMS folks together on this one. Being a student of outhouse law, I believe this can be considered a precedent.
 
Bottom line - Two different professions, one not so old and one relatively new, having sibling agruements.
 
Jim Kendrick 
Flight Crew Person
----- Original Message -----
Sent: Tuesday, April 02, 2002 2:39 PM
Subject: Turf battles

>>In addition, I have never seen a paramedic or EMT
take an NICU assignment in a hospital.<<
 
Well, you will probably never see an EMT-B taking a NICU assignment, I am fairly certain.
 
Although the debate has changed somewhat, allow me to stir the hornet's nest a little more.
 
In my opinion, there is a fair amount of turf protection/defense by nurses, particularly at hospitals.  For example, in my city there are several hospitals that have fought tooth and nail to keep EMT-Paramedics out of their Emergency Department as employees.  If they are employed they are delegated to orderly duties and if they are lucky will be allowed to do 12 lead ECGs for the nursing staff, but they are not allowed to act up to their scope of practice.   When I lived in Portland, Oregon, however, paramedics were utilized in the ED triage or in the ED itself acting as a skills position on the trauma team , doing everything, if not more than an RN.  In my facility I can insert chest tubes, intubate, push all the meds etc.  Can all of the non-flight nurses do the same?  No.
 
No, I am not raising the who's-better debate again.  My point is, the reason you may not see a paramedic in the NICU or any other unit in a hospital may be in part to turf protection.  I am fairly certain a motivated paramedic could retain NICU theory as well as another provider. 
 
But, I could be wrong.
 
Eric E. Kincaid, CCEMT-P
Boise, ID USA
 
PS-I have the utmost respect for NICU staff and nurses in general, so please save your attacks...

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