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About Experience Prior To Flight For Rns (repost)


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#21 MedicNurse

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Posted 02 September 2007 - 04:53 AM

It amazes me EVERYDAY at just how much that I do not know.

I learn something everyday. I am always excited to learn new things!

And like you Medic Ed RN, I have limited "actual" critical care experience, but have held my own with many ED holdovers and all that "float" time to the ICU's. Heck, I even have enough "experience" to be able to detail the required hours and experiences that allowed me sit for (and pass) my CCRN. And although I never was "just" ICU - I've had a vast share of really sick folks. That being noted, I think the quality of your experience can often trump the quantity. If you are covering a busy ED's 5 trauma/resus rooms vs. a small ED that sees 25 patients a day - you come from different worlds. Either does not mean that you are not a great nurse - it just means that you are different. Likewise, a medic that is in a city where each unit averages 15-20 runs a day with a transport time of less than 10 minutes is DIFFERENT from the rural medic with 2 runs a day that averages an hour to the closest hospital. One is not the better medic - they just come from different worlds.

I, too, have seen the good, bad and sometimes ugly from both professions. Just because one has been a medic or nurse for XX years, does not alone make them ripe for HEMS work.

What is important? A firm, vast knowledge base. A rabid desire to keep learning. Great technical skills. But, I think the ability to critically think is the key. The ability to be able to control the chaos. Also, you have to be able to know your limits and then keep pushing yourself to expand these limits!

I have been in the field. I remember the experience well. I think I looked (yep, the look gave it away!) kinda scared at times for the first 6 months. When I look at nurses that will be new to field work, I sometimes wonder just what are they thinking? There does seems to be a larger turnover in the HEMS nurses compared to paramedics. I think some of that has to be due to the differences in field vs. hospital work. It is a different world.


I think that the best prepared nurses for flight will have:

At least 3 (preferably 5+) years of diverse acute care experience. Minimally, some high acuity ED - add some ICU/CCU/CVICU/SICU time too. If you could toss in acute care pedes and OB then all the better! No, I'm really not kidding. You need to be ready for a lot of things!

I think that an EMT-B should be required for any RN that will work in a program that does primary scene work. This alone can save YOUR life, even before you get close to a patient. With this spend some time in the field. It is different. You don't know what you don't know - this will help!

The Alphabet classes. Do 'em like you mean it! ACLS, PALS, NRP, PHTLS (different than ENPC/TNCC). Not that the ENPC/TNCC are not great - they are! They just have a focus on hospital driven care. Take 'em if you get the chance. But, for HEMS - I think the PHTLS or (BTLS/ITLS) gets you in a "field frame of mind."

Course work in 12 lead EKG's, hemodynamics and mechanical vent management

Speciality board certification. I am not suggesting that you get you CFRN prior to flight, but do consider acknowledgment of your speciality with the appropriate certification. CEN, CCRN, RN-C.

Be involved in the profession. Join professional associations. Attend meetings and educational offerings. Hit the state and national conferences. Never miss a great journal article. Share your knowledge. Mentor.

After flight, I think TNATC is a great course. Also, start working toward instructor ratings in the alphabet courses - some programs teach a number of these courses as outreach. And then start working on your preparation for CFRN. Stay involved. Set a professional example. Never stop learning. Make safety/teamwork Job #1.

Good luck.
Stay SAFE.
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#22 Mike Mims

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Posted 02 September 2007 - 11:47 AM

by Mike Mackinnon
The only way to know if you are interviewing a quality person is to test em. Plain and simple. Otherwise, they may well be blowing smoke up your backside.

ABSOLUTELY,
I myself thought; I've taken all the required classes and have the experience so, it should be an easy transition from fire based EMS to HEMS, that wasn't the case.
It was a tremendous learning experience.
Some of the things I can recall were:
- Having a partner with the same skill level or higher.
As a street PM, you might be the only PM available.
- Learning the aviation industry.
The differences and similarities of medicine and aviation.
-Every call, there's a strong possibility it's going to be a critical pt.
This isn't as common on the streets. Your ratio of emergent vs non-emergent on the street is maybe 5/100 at best.
-There is no "perfect" hospital.
Bigger is not always better.
-Realizing that certifications are just saying, "you passed the standards for that course."
Actually applying what you have learned, in a clinical setting, is somewhat different.
-The suit does make the person.
Some people will let this go to their heads, being humble isn't a bad thing. They should try it!!!

I guess the biggest transition by far would be
-Being treated differently, both good and bad.
The suit doesn't make the person.
I'm the same person you knew before, just with a little more training, experience and a great opportunity.

I'm sure there are alot more but, these are the ones off-the-top-of-my-head...
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Mike Mims

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#23 MedicNurse

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Posted 02 September 2007 - 05:15 PM

Hey there Mike Mims -

You are so right! Thank you! I am so glad that I was not the only one that felt that way! :D :D

I thought it would be a fairly straightforward (okay, an EASY) "transition" to a flight role. Wow, was I ever wrong. I had solid nursing experience, all of the necessary classes, a couple of board certifications, high acuity field paramedic experience and had never missed a chance to improve my clinical practice. I consider my critical thinking ability very well developed. So, I thought I was READY and would be able to "hit the ground running". Looking back, I was frustrated that "it" did not come as easy as some other things have come.

Well, although many of the clinical practice elements do come naturally - in some ways, I feel like I've taken a journey to the dark side of the moon.

My biggest "challenges" were very much like yours Mike:

Understanding the aviation issues. I have so much to learn. I am so grateful to my pilots - they are amazing! They have been patient, professional and phenomenal teachers!

Also, big kudos to the mechanics! They will answer any questions and really do want you to feel as good about that ship as they do!

Working with a partner that is as good (or better) than you. Together we are so much stronger that either of us are as individuals. SYNERGY! is awesome. But, it does take some getting used to!

You are the expert - so you better be bringing it everyday! There is awesome responsibility with comes with that flight suit - you gotta be clinically brilliant, but be able to remain humble and grateful. You are called because things are not going well for the patient - often, despite your best efforts patients still die. I guess that I do deal more with death in the flight world than I ever did on the ground/or in the hospital.

Physically this is a job that is so much more demanding than others. It is essential that you be in a great shape and make self care a priority. (Translate: It kicked my bum at first!)

And yes, you are treated differently because of the "suit". As long as you keep some perspective it can make this job so rewarding! But ALWAYS remember to be professional, kind and gracious to those that request your help.I remember being the one that called (HEMS) for help. And I remember how wonderful it felt to have a flight crew compliment me on my work - it was the best feeling! I was acknowledged for being good at my job, by those that were the best in the business! I pass that feeling on whenever possible!

:rolleyes:

Stay SAFE!
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#24 Medic Ed RN

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Posted 03 September 2007 - 04:37 AM

Now that I agree with whole heartedly Mike. When I started, I had a written test, oral board, practical simulation, and an interview with some upper managment. I truly felt like I had gone through the ringer. But I will say that it is completely justified. We are given a HUGE responsibility. Out here, we are practicing medicine. We dont ask, we do. Still makes me nervous sometimes. Just makes me keep studying and learning. Thanks Mike and take care.
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#25 jbflightnurse

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Posted 04 September 2007 - 01:01 PM

Mike
MedicNurse


AMEN
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Jan B.

#26 Dunkle

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Posted 07 September 2007 - 11:52 AM

Medic RN--

I have to agree with your recent post. My theory is-- It is not how many years of experience you have, but rather the amount of experience packed in those years. I too have worked with ICU Rn's with 15-20 years of experience and could not manage a moderately sick patient, and more worriesome, could not foresee the need to intervene in a crisis situation. Please don't get me wrong, I believe an adequate amount of experience is expected, but one can not stop asking questions--- and when they do stop asking questions and assume knowledge about everything people become dangerous. Thank you--- I am off of my soap box.
So, another course question--- Have any of you taken the TNATC course? Advantages, disadvantages? Highlights? Mike I have looked in ATCN course, and unfortunately there are not many-- if at all-- offered in the Northwest. I have, although registered to audit a ATLS course and am looking forward to this. Thanks you all for the inspiration.
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#27 Mike Mims

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Posted 07 September 2007 - 04:59 PM

Medic RN--


So, another course question--- Have any of you taken the TNATC course? Advantages, disadvantages? Highlights? Mike I have looked in ATCN course, and unfortunately there are not many-- if at all-- offered in the Northwest. I have, although registered to audit a ATLS course and am looking forward to this. Thanks you all for the inspiration.

Dunkle,
I've taken both ATLS (which i actually audit) and TNATC.
Both are based on the same standards of advanced trauma care and pretty much mirror each other.
The difference is if you have to audit the ATLS there's no option. The ATLS is more for physicians.
Now, there have been people on this forum that have stated they have taken the FULL class that included both didatic and pratical skills. This is VERY rare as you probably know because I see you are auditing the ATLS yourself. You may get lucky and experience the whole class including the skills.

Back to your question, I don't know if you are trying to compare the ATLS vs TNATC vs ATNC is why you're wanting the Advantages, disadvantages? Highlights?
But, here's my opinions
I'm not sure where you are located but, I took mine at Vanderbilt and had a wonderful time and will go back again.
Matter of fact we had a flight nurse from Alaska.

Advantages:
-You can audit this class.
(you just won't perform the practical skills and final test) it's a choice. Unlike the ATLS whedidacticre you don't have a choice.
-Starting last year, you can "re-verify" the certification by taking a one day course.
This is a geart option if you are limited on time.
-It's a 3 day course
Spreads it out so, you're not "over whelmed with information".
-It's a four year certification.
A little better than a 2 year.
-The books are included.
You don't have to worry about finding the material before class.
-Classes are limited to around 20-24.
Makes the insructor/student ratio better suited for learning
-Invasive skills
You'll peform the skills either on cadavers or sedated/intubated animals. So, be sure to check with the coordinator. I don't know about the simulators though.....
-The needed topics covered.
There is additional information, other that what's in the text.
-The TNATC is givegreatinstructorperformn quite often
You can host a TNATC at your site, if you meet the requirements.
-The certification it's self.
If you are trying to get into HEMS, this certification is required at hire or within a time frame, in some programs.

Disadvantage
None I can think of.

Highlights
-Invasive skills
It's a big difference between performing them on cadavers vs animals.
-Meeting people.
We had a mixture of states in the class, FW and RW etc.... You find out the similarities and difference in programs. Information that can improve your current operations.
-Vanderbilt's program
Our instructors are CM's with Life flight so, we got to take a tour of the program.
-The instructors
They perform the skills taught themselves in the clinical setting. That's a HUGE difference than just knowing the printed information.
-Tennessee
Never been to Nashville.


Recommendations
*For anyone, HEMS or not, I'd strongly recommend this class as one of the top 3 you should attend.
*Don't audit the class; get the whole experience.
*Any questions go to http://www.astna.org/TNATC.html
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Mike Mims

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#28 Dunkle

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Posted 08 September 2007 - 01:05 PM

MikeMims,

I was told by the class organizer that I would have to audit d/t me being a nurse... i want to learn the skills---as well as the didatic. The cost of the class' are coming out of my pocket, so that's why I am asking which one is more hands on. As I work in a busy ER, I get to be in on quite a few CT and CL, but usually it is rushed and not much teaching time from the docs. I understand the basic mechanics, but would like to become proficient. Thanks again.
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#29 Mike Mims

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Posted 08 September 2007 - 02:03 PM

MikeMims,

I was told by the class organizer that I would have to audit d/t me being a nurse... i want to learn the skills---as well as the didatic. The cost of the class' are coming out of my pocket, so that's why I am asking which one is more hands on. As I work in a busy ER, I get to be in on quite a few CT and CL, but usually it is rushed and not much teaching time from the docs. I understand the basic mechanics, but would like to become proficient. Thanks again.

The organizer is correct, which doesn't make this an appealing class.
If it were me, I would not waste my time or money with the ATLS class you'll be disappointed with just learning the didactic and not performing the skills.
Talk with the ATLS class coordinator and see if you can get a refund if not, at least a partial refund.
They should have a alternate waiting list for this class so, filling your spot won't be a problem but, in the mean time I'd ask around if anyone you know would want to go in your place.
Even if you loose a little money and have to wait for a TNATC class, it would be worth it.

I'm not knocking ATLS, it's an excellent class................for physicians.
If you want the hands on then TNATC is the way to go.
Also, when looking for an TNATC class find out what will be available for the invasive skills part of the class.
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#30 Owen Wall

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Posted 07 October 2007 - 11:58 PM

Just another thought. I came to PA from NY with 2.5 years experience in Medical ICU, a year or so as a NYS EMT and fresh out of medic school. When I got down here I recieved reciprocity for my PHRN. Pre-Hospital RN programs or something similar might be available in your state and you may not even know it. Most of the nurses I know who are thinking about getting into pre-hosptial care have never even heard of a PHRN and coming from out of state neither had I. I'm kind of on the fence about recommending it since I came from previous pre-hospital experience but it is another option if someone wants to dive into EMS without sitting through a full medic course. Their is classwork involved, its not as simple as handing in paperwork but it would be shorter then going through EMT and medic school. Personally I think a little time as an EMT would be ideal first but Im sure someone could argue with me or against me on that. To each their own.
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#31 sern

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Posted 05 November 2007 - 08:04 PM

Hello. Newbie here. Just wondering what sort of things to except on for a pre-employment hands on skills test. Thanks!! This message forum is so helpful!
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#32 fltnrs

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Posted 06 November 2007 - 10:33 PM

I would have to agree with everything you said in your post except for the part about working in a hospital that is a teaching hospital. In this type of hospital you are going to get the sickest medical patients you would every dream of taking care of. Usually when these pt's hit the door they pretty much have one foot in the grave and another on a bannana peel, (pardon the pun). In this type of a hospital you are going to get the gunshot and stabbing victims and the serious automobile accidents. Now you have a bunch of interns and residents who for the most part are way in over their head when it comes to treating these patients. Now in the ER I would have to agree that at least there is an ER attending or two running around making sure that everything is being done, until the trauma surgeons arrive, that needs to be done until the pt either goes to surgery or up to the ICU. But once they are up there it is up to the nurses to make sure that the right treatments are being done and that the procedures are being done correctly. Teaching hospitals give nurses a great deal of automomy and when you work in one with new green doctors you really need to be on top of your game because you are pretty much the teacher for the doctors. You will see procedures done over and over so many times that you can pretty much do it with your eyes closed, but these docs may have only seen it once or twice before and are standing there with a scalpel or a long needle in their hand shaking you had better be able to guide them along correctly. As one knows d/t hospital policies RN's are not allowed to do all of the fun things that EMT-P's are allowed to do out on the street but if you have worked in a teaching hospital especially in both the ER and then in the units you should have no problems transitioning into a flight nurse role. Granted they may not be the best in getting pt's on a backboard with CID but when it comes to a really sick medical or trauma pt on multiple gtts a nurse that worked in a teaching hospital has probably seen it before, several times. Yeah, some may lack in the intubation role but it's not because we don't want to, it's because they won't let us. I think that's why they put both an RN and a Medic on the helicopter, so that one can compliment the other. I think they may have another word for it.....teamwork. Any good medic would be willing to help an RN with their deficits just as any good nurse would be willing to help out the medic.
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#33 Mike MacKinnon

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Posted 06 November 2007 - 10:59 PM

Hey there

Well I think it depends on the hospital.

Not all teaching hospitals get all the "sickest" patients nor do all hospitals which are not "teaching" hospitals get the "easy" patients. In most teaching hospitals learners are literally tripping over each other. be they physicians, nurses, RTs etc etc. That means there are alot of people who need "experience" doing things which in a non teaching hosptial, the nurse would do. I have seen it over and over and over again. I would totally disagree that teaching hospitals are where you will get the best experience and get to do everything. Its just not true the majority of the time.

While you mention the residents who are over their head, well in the non teaching hospital that takes care of pts as sick as seen at any teaching hospital, guess who does all that stuff the resident does? The Nurse & the attending.

I understand what you are trying to say but I would bet the farm you have never worked at a hospital which had seriously high acuity but was not a massive teaching institution. At those places all RNs have an expanded role and often are the "goto" people for just about everything. In a teaching hospital it is rare there isnt some med student, some resident or some other learner who will "do it" for the experience.

Having worked in both types of hospitals I would say that you might see some of the "newest things" at the teaching hospital but otherwise Id say a good non-teaching hospital will give everything else to you and allow you to do more than most teaching hospitals. Now the podunk hospital (teaching or not) isnt going to give you much experience with anything major, those are not the ones im really talking about.

As for autonomy, well a resident who is clueless and afraid to call an attending isnt autonomy, thats just dangerous practice. As nurses we are a great resource to both attendings and learners but we should never be directing care within the walls of the hospital. The education is simply not there for that role. Take a look around at most of these teaching hospitals, alot of new grads in the ICU and ER. These are the people helping the resident? That is just scary to me.

Remember, RNs NEVER have autonomy in the hospital. While it happens all the time that RNs "do things" and have someone sign in the AM it is not autonomy (and its illegal). Autonomy is the ability to make unilateral decisions for which you are ultimately responsible. There is some degree of that in flight but not at all within the walls of any hospital.

Im not trying to be argumentative (tho i am eh?), I just believe that the worst place for someone to learn the most is where there are a shitload of other learners. Teaching hospitals often are exactly that, maybe not all, but most. Keep an open mind to other places, you might be surprised at the difference.


I would have to agree with everything you said in your post except for the part about working in a hospital that is a teaching hospital. In this type of hospital you are going to get the sickest medical patients you would every dream of taking care of. Usually when these pt's hit the door they pretty much have one foot in the grave and another on a bannana peel, (pardon the pun). In this type of a hospital you are going to get the gunshot and stabbing victims and the serious automobile accidents. Now you have a bunch of interns and residents who for the most part are way in over their head when it comes to treating these patients. Now in the ER I would have to agree that at least there is an ER attending or two running around making sure that everything is being done, until the trauma surgeons arrive, that needs to be done until the pt either goes to surgery or up to the ICU. But once they are up there it is up to the nurses to make sure that the right treatments are being done and that the procedures are being done correctly. Teaching hospitals give nurses a great deal of automomy and when you work in one with new green doctors you really need to be on top of your game because you are pretty much the teacher for the doctors. You will see procedures done over and over so many times that you can pretty much do it with your eyes closed, but these docs may have only seen it once or twice before and are standing there with a scalpel or a long needle in their hand shaking you had better be able to guide them along correctly. As one knows d/t hospital policies RN's are not allowed to do all of the fun things that EMT-P's are allowed to do out on the street but if you have worked in a teaching hospital especially in both the ER and then in the units you should have no problems transitioning into a flight nurse role. Granted they may not be the best in getting pt's on a backboard with CID but when it comes to a really sick medical or trauma pt on multiple gtts a nurse that worked in a teaching hospital has probably seen it before, several times. Yeah, some may lack in the intubation role but it's not because we don't want to, it's because they won't let us. I think that's why they put both an RN and a Medic on the helicopter, so that one can compliment the other. I think they may have another word for it.....teamwork. Any good medic would be willing to help an RN with their deficits just as any good nurse would be willing to help out the medic.


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Mike MacKinnon MSN CRNA
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"What gets us into trouble is not what we don't know
It's what we know for sure that just ain't so" - Mark Twain

#34 justlookin

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Posted 07 November 2007 - 04:57 AM

Well I think it depends on the hospital.


Yep! This should be taken into careful consideration when hiring decisions are made for flight/ground CCT teams.

Mike is totally correct that many large, teaching hospitals are crawling with a bunch of nurses,docs, etc but they don't have much experience (ie: ICUs full of new grads). Nurses coming from these facilities might have more exposure to really sick patients, but might lack true experience managing them.
On the other hand, nurses from non-teaching facilities might not be as familiar with the "super-sick ICU trainwreck", but they are often much more competent in patient management because they have much more responsibility for the patient's care.

Personally, I have worked at huge teaching hospitals (>1000 beds), non-teaching level 2 centers both small and large, and occasionally in the little "podunk" band-aid boxes found in rural areas. There is much to be gained from each type of facility, but experience at just one type is not nearly as good as experience at many types.
For example, one of the huge teaching facilities was packed full of the "super sick ICU trainwrecks" on 15 drips, nitric, IABP/VAD/ECMO so the nurses got exposure to this, but they needed permission for pretty much everything from one of the hundreds of baby docs running all over the place. Just on the other side of town was a large non-teaching Level II facility where the really sick patients weren't encountered as often, but the nurses had very liberal standing orders and policies to follow (a sort of pseudo-autonomy) and were responsible for MANAGING patients because there weren't docs all over the place.
While working in the little podunk facilities might not look all that appealing on a resume, remember that these places might not even have a doc in house and the nurses/medics must MANAGE patients until one arrives (or the flight team gets there).
If you want to seek out a strong nurse, find one with experience at many types of hospitals and who has ICU/ER float experience. These nurses often have a variety of experience which they can draw upon regardless of their location.

Also keep in mind that nurses who are accustomed to blindly following orders is the same as a medic who only knows how to follow protocols.
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#35 JBERGENRN

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Posted 07 November 2007 - 04:25 PM

I can only echo what has been stated, I just wanted to mention if no one else has already that working night shift helped me practice independently both in and out of the hospital without additional resources that may or may not be helpful. Also as stated CTICU (CVICU) with extensive standing orders gave me great autonomy, again at night, as does working with my medic colleagues who work so well autonomously. I have since come over to the "light" and the sun feels good! but I believe my night time experience was a help to me. If only to be 4 or 5 people and work different areas to be very well rounded. (the Night will always be my friend) Be safe.
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#36 baseflight

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Posted 08 November 2007 - 02:56 PM

MikeMims,

I was told by the class organizer that I would have to audit d/t me being a nurse... i want to learn the skills---as well as the didatic. The cost of the class' are coming out of my pocket, so that's why I am asking which one is more hands on. As I work in a busy ER, I get to be in on quite a few CT and CL, but usually it is rushed and not much teaching time from the docs. I understand the basic mechanics, but would like to become proficient. Thanks again.



Dunkle,

There is a TNATC offered in Spokane in April 2008. You can register by going to ASTNA's website. The majority of attendees will be the local flight crew since this is the first time it has been offered in our region.

They will be using SIM man, not an animal lab.
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#37 jwCCRN

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Posted 10 June 2016 - 01:59 AM

Hi guys

An excellent question was brought up in the recent 2 threads on experience which I thought I might elaborate on a bit (from my perspective).

Everyone knows you are supposed to have 3-5 years of experience in either ER or ICU. You should have the basic alphabet classes like ACLS and PALS. However in life we rarely want 'bare minimum' for anything why should this be different?

First lets look at the deficiencies all RNs have if they have no previous EMS experience. When i say "EMS" I mean as an intermediate or a paramedic. EMTs rarely get experience in large city systems except to drive and EMTs who have only worked in hospital have no experience.

So here is what many RNs are missing for scene calls:

- Ability to c-spine a patient effectively
- Ability to BVM a pt effectively (often not done correctly due to lack of good teaching and experience)
- Working without hospital resources
- Working in organized chaos (people spinning)
- Working in random and difficult environments
- New skills such as Intubation, Chest tubes, Central lines
- Working as a Co-Leader with your partner not in a large team with a physician calling the shots.
- Fast assessment, prioritizing and transporting from scene

Some of these will be easier for people with ER experience but the ICU only RN will be totally out of their element.

While it would be optimal to be a former paramedic who has a year or 2 of experience, for most RNs this wont be the case. So what can you do to prepare yourself?

Classes like BTLS are helpful as they are targeted for prehospital professionals. However, nothing can replace experience and a 2 day class doesn't translate into skill. Even classes like ACLS, PALS, NRP and the like are only as helpful as the experience you have with putting them into practice. I cant even count how many RNs come through ACLS even from ICUs who cannot pass the recert as they never have codes in their ICU or have never BVM'd a pt.

While many think they are ready (and many companies will hire you) with the 3-5 years experience, you are only as ready as the QUALITY of experience you have gotten. There are ICUs where more time is spent cruising the Internet and grazing the potluck everyone brought in than doing critical care. There are ERs which are little more than family doctors offices rarely seeing 'sick' patients and when one comes in they cant call HEMS fast enough. No matter how many years of experience you have in these types of ER/ICU you are not prepared to fly.

If you want to be the best rounded you can be the 2 places to have experience are CVICU and ER. These should both be high volume and high acuity areas where complications and codes are expected not rare. You will find that the worst ER to work in is a teaching ER. Residents, interns etc will be involved and doing all the difficult cases and you will be a 'charter'. Both the ICU and ER in hospitals without residents or interns will provide you with a much better learning experience. Why? Well it has to do with resource allocation. In many teaching facilities RNs have little autonomy as there is always a resident to call and it is encouraged so they can learn. In a hospital without residents, RNs take on a much more autonomous role by necessity in both the ER and ICU.

If you come from an ICU without ER experience you will get in the paramedics way on a scene. If you come from the ER without ICU experience you will be absolutely lost on ICU - ICU transports with critical patients. While a high acuity ER is usually the same from one to the next, ICU is not. Neuro ICU experience, NICU, PICU etc will be useless to you on the majority of interfacility transports and all scene calls (unless they are the mission of your service).

90% of programs have a similar mission. Depending on the mission of your program and the subset of patients they fly you should have experience catered to that. Sufficed to say, I'm focusing on the vast majority of programs and pt transports not the specialty teams.

So my recommendations are:

- Have a mix of high acuity ER and CVICU experience.
- Go on rides with a local high volume paramedic rig.
- Do rides with the service your thinking of working for
- Find out the mission and pt subsets they fly most
- Take every alphabet class then become instructor in them all (people always learn more by teaching)
- Talk to the paramedics at the service you are looking into and ask them their expectations of their RNs
- Talk to the RNs at the service and ask them what they expect of the paramedics and what is expected of the nurses.

If i can think of more ill add to this post. Hope its helpful.

I have to disagree with much of this. CVICU is great experience. However, I sense a bias. A trauma/burn ICU is quality, as is a surgical ICU. Each gives something the other doesn't. As an ICU and ER nurse, I must say ER nursing is a poor experience for flight. It is order driven. Very minimal critical thinking etc. You do not manage patients. You say if you have ICU and no ER exp. you will get in a medics way? Im sorry but thats ridiculous! I was an EMT years before being an ICU nurse and I feel that I would be able to function alongside the medic! And PICU is highly desired. So to say it will not help on 90% of calls is insane! Ive never seen a flight program that only flies adults. And the worst yet is talking about no residents...I learned more by spending nights talking to residents, getting them to quiz me, building trust and letting them let me make the calls! I cannot imagine not having them throughout my career. They truly taught me so much. I am not replying to be rude, but much of what you posted is fully subjective and based on opinion. Much of what was said also just seems false. My background was EMS and 3 years of ICU with only a few months of ER because I felt like I was losing my skills. I now speak at conferences, teach college classes and fly full time. This goes to show that quality exp can be gained anywhere. Its what you put in that matters. I would hate someone to read this and decline a good local ICU, and drive 30+ miles because they now feel that CVICU is the place you need to be. 


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