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thank you Jen....good information.
michele moore
>>>
jenharris@flightnursing.com 05/03/03 09:11AM >>>
In some rural areas of Texas EMS is provided
by volunteer agencies that may or may not have a medic on shift that day.
It may be two basic EMTs that you receive care from. Also, I have many
times beaten EMS to the scene, as the dispatcher immediately sent us out due to
mechanism of injury and distance of transport. We circle as the ground
units arrive and set up an LZ. So, no, the patient has not necessarily
been stabilized prior to the arrival of the flight crew.
Personally, I enjoy the nurse-medic crew
configuration. I was just trying to point out that Patrick's statement
that in Texas all helicopter transports require a paramedic was
inaccurate. All scene helicopter transports in Texas, however, do require
a paramedic. Interfacility helicopter transports can be staffed
by many various combinations, though.
Blue skies,
Jen
----- Original Message -----
Sent: Saturday, May 03, 2003 10:37
AM
Subject: Re: re:nurses vs. medics
Its interesting, since most scenes have an
abundance of excellant EMS personnel. Why would you need to fly one
in? Here in Oregon (at least surrounding the area that I live in), a
ground paramedic is perfectly capable of trauma care and scene
management. When we arrive everything has usually been done to ready the
patient for transport and we spend very little time on scene. The intent is to
get out of there and on the way to the surgeon. We would never try
to tell them how to run the scene, get involved in extracation. What is
the reasoning behind the law, seems like 2 RNs could do the job well or
? How did the law come into effect, due to problems or just
one group getting rules made to exclude others? michele moore emt-p
rrt
>>> jenharris@flightnursing.com 05/03/03 12:06AM
>>>
Actually, the Texas Administrative Code Title 25 Part 1
Chapter 157
Subchapter B Rule 157.12 states that for a
helicopter:
(1) when responding to an emergency scene, at least one of
the personnel
shall be a paramedic;
(2) when responding for an
inter-facility transfer, at least one of the
personnel performing patient
care duties shall be a certified or licensed
paramedic, registered nurse or
physician. The qualifications and numbers of
air medical personnel shall be
appropriate to patient care needs;
(3) when responding as in paragraphs
(1) and (2) of this subsection, the
second person may be a certified or
licensed paramedic, registered nurse, or
a physician; and
In other
words, interfacility helicopter transports can have quite a
combination of
staff - but does not always require a paramedic.
I had to clarify this
when I was working for a paramedic-owned helicopter
company that thought
the same thing - that all helicopter transports in
Texas require a
paramedic. Even after reading the rule the owner was
convinced that
somehow the state had ruled against 2 nurses carrying out an
interfacility
transport. I clarified with TDH. In reality, a paramedic
is
required for SCENE work.
Blue skies,
Jen Harris, RN, CEN,
CFRN
----- Original Message -----
From: "Patrick Cobb"
<pcobb@wilcoems.org>
To: <flightmed@flightweb.com>
Sent:
Friday, May 02, 2003 8:49 PM
Subject: re:nurses vs. medics
>
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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