re:nurses vs. medics

["Patrick Cobb" <pcobb@wilcoems.org>]

This has been an interesting discussion over the obvious discrepancies.However, one topic has not surfaced that I attribute to the problem; TIME.The first nursing journal was published in 1886.Obviously, nursing has been around for many years before the invention of formally trained pre-hospital providers.I believe Paramedicine is still fighting a big demon; TRADITION.In the beginning of Paramedicine, we were taught the basics.Just enough to provide minimal care to patients and hope they get to the hospital alive.That is the way some of the nursing profession still views our role in patient care.Obviously, this is a very general statement.But consider this, how many Paramedics go thru hospital clinicals as part of their training process versus the number of nurses who go thru field clinicals with us.We all know the answer-not very many.If we as a profession took more time to educate the nursing students, we would have a much easier time in helping the nursing field understand just exactly what it is to do the job we do.To this day, I still go to ICU's and pick up critically ill patients and transport them to a higher level of care.Funny thing is, I get all the paperwork handed to me in a sealed envelope that says "Give to Doctor" and my verbal report consists of "Here is your face sheet".I know I am not the only one this happens to.I really believe the nurses who do this think that if something bad happens enroute there is nothing I can do about it;or, they think we are going to call a doctor to tell us what to do.The reason this occurs is simple;no effort on our part to educate them on what our capabilities really are.How do you fix it?To me it seems the easiest way is start from the top.Organizations like the National Registry could play a key role in helping educate nursing schools on what we do.Form partnerships with your local schools so that training for both sides of the house are equal.I cannot believe this would not make a positive impact on our profession.As far as the pay is concerned, I do not know many pre-hospital agencies who have the funds to pay us what hospital based nurses make.Especially with the political game this would cause.However, I do not believe it is fair and equitable for a flight team to have unequal pay.Yes, the two professionals compliment each other when on calls.However, when nurse/medic combo's were first devised, there was one clear intention why-the medic handles the scene calls and the nurse handles the inter-facility transfers.This was logical in the beginning because of the vast difference in training.But, in this day of CCT Paramedics holding a plethora of certifications and at least a 2-yr degree versus a nurse with a 2-yr degree and the same certifications, what really is the difference?Add to the fact that at least in Texas, a helicopter cannot transport a patient without a Paramedic.It seems clear to me that the Paramedic should have the same pay,privileges,and authority as a flight nurse.I do not want to open pandora's box regarding EMT-P's working with full privileges in critical care hospital areas such as ER's and ICU's.To me that is the nurse's world, not ours.Just like we as medics train for the field, not the nurses.

Patrick N. Cobb, EMT-P, EMD

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