Turf Wars

["kathie price" <kprice@usa.com>]

Ouch!
This is a touchy one for me, since I ware both hats.
After graduating nursing in the early 70's, I took it a few steps further and took extended training at OHSU Portland Oregon for NICU. That was in the early days, when NICU was just really starting to get off the ground. After 6 months of intensive training in that area, we were then put out there for all transports of neonates be it ground or air.
When Paramedics really started coming out in our area in numbers, many of us had questioned the Head Doc of the NICU, as to why the medics never did our transports,  her answer really blew us away. It was her opinion that the Paramedics had big hands and no experience with infants that small, if put in a code situation, those hands would be causing injuries due to lack of experience. It seemed to me that the answer to that was simple, lets get them into the units and get them some experience with the little ones. The Doc's shot that one right out of the water. The did not want untrained personnel running around the unit with critical infants, quote "trying to learn." Which I thought was ridicules, since it had not been that long ago, that several of us had been running around those very same units trying to learn ! Their answer to that was that Nurses had a totally different type of training and approach to pt. care, then the medics did. I found the big block there, to be th!
e Doc's not the nurses.
In the 7 years that I worked in that unit, I did two transports with Paramedics, on both transports, the Paramedic drove the ambulance.
Later when I became involved in Trauma, and part of an air transport unit full time, it was then that we were just seeing Paramedics starting to man the bird, and occasionally in the Trauma unit itself.  Off and on for several years, we did have Paramedics in and out of the ED, it usually depended on the weather we were being affected by the Nursing shortage in our area. I have seen Docs walk right past a Paramedic in search of a nurse to give orders to, which if they are not going to utilize the medics, then why have them there??????
In a bad situation, I personally do not care which hat you happen to be warring, a set of train hands, is a set of hands. But it has been my experience that a lot of the problem lies with the Docs, and not nursing personnel. I have personally seen Doctors pull nurses from the Regular newborn nursery to do a Neonatal transport, rather then utilize a Paramedic. And of course when questioned as to why, 
the Doc's always say it is their lack of training in the newborn area. But I have yet to see any Doc allow a Paramedic or EMT to come into the units to get the training they need. If Doctors and hospital continue to with hold the necessary training for medics, that will allow them to function at a level that they want for their pts. 
This problem will continue to be what it always has, a circle jerk.
Kathie Price


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Kathie Price

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