ERDoc Posted February 12, 2008 Share Posted February 12, 2008 I've come across situations like that. One was proudly stating she was a Nurses Aid student and that we should do as she said. :jerk: I've had a few Nurses Aides bring family members into the ER who had just enough knowledge to be dangerous. I had one bring in her father, "I was practicing taking his blood pressure at home. It was 142/86. I knew that it was dangerous and I should bring him right in." I also got into a debate on the benefits/risk and pathophysiology on coumadin with one who brought in her father with an ulnar artery occlusion. Link to comment Share on other sites More sharing options...
zippyRN Posted February 12, 2008 Share Posted February 12, 2008 I think this thread should be allowed to run because it raises a very important point that affects us all. You have still failed to answer my question though zippy. Your entire argument stems from the fact that nurses are registered but Technicians aren't. Do you therefore think that simply because a Physiotherapist or Chiropodist is registered that they are also more competent and appropriately qualified to deal with an emergency over a Technician? it depends on their competencies doesn't it ... the point that seems to be being missed repeatedly is ... that a registered practitioner of what ever profession's duty of care is notdischarged by the simple presence of another provider AND, IF the other provider is not registered, the registered practitioner may well beheld accountable until thepatient is delivered into the care of another registered practitioner A PGD is only valid in the workplace and only for a set group of circumstances, you cannot deviate from these. You cannot for example give morphine to lower blood pressure if the PGD is only for chest pain. A PGD is essentially a document signed by a doctor, pharmacist and senior nurse giving you permission to administer a drug in a set circumstance. This is called a protocol, it depends on how the PGD is written ... they can be as broad or as narrow as the professionals involved in drafting them wish them to be... e.g. the analgesia PGDs i use at work are extremely broad in their scope covering traumatic and non traumatic pain with few if any additional cautions and contra indicatiosn over and above those in the BNF something which you attack US Paramedics for having to follow. This is not autonomy! Autonomy is having freedom to administer a drug or perform a procedure when you and you alone deem it fit. NOT when a protocol says you can/must do something. so the choice of a range of analgesia ( and local anesthesia agents) given alone or in accepted combinations isn't autonomy? You are not a nurse prescriber, you do not have any prescribing rights therefore you have no right to administer any medication outside of your workplace. incorrect . If you take drugs from my ambulance or my bag and try to take over the care of my patient then you are committing a criminal offence. Those drugs are there for me and my crewmate, not some jumped up off duty nurse. You have no authority or legal power to use those drugs on anyone. correct but by virtue of the theft act rather than medicines legislation and incorrect if i acting on behalf of a mutally 'employing' trust... Pre hospitally, you are about as qualified as a first aider and have the same rights if not less. incorrect on both counts If you honestly believe that you can take drugs from your workplace and use them pre-hospitally then I hope you do so because when you die you will go to hell where you will be eternally spanked by the baby jesus. have i actually said that... except of course when required to do so as part of my role and with the full knowledge and consent of management... Failure to recognise limitations is the biggest cause of error in the health service and inability to recognise human limitiation is the biggest cause of aviation related accidents. You zippy, need to recognise your limitations and scope of practice. you need to recognise your limitations in not acknowledging the scope of practice of your professional peers. You are not allowed to administer or prescribe any drugs autonomously, you cannot simply give a paramedic (or even technician) level drug without direct reference to a doctor. incorrect vis PGDs and similar guidelines vis independent prescribing ... (alkthough i am not at present an independent prescriber) Technicians can give schedule 7 drugs as they are administering them in the course of their employment. if techs can anyone can , there is NO specific mention of Ambulance technicians in any legislation , altewrnatively if others can't techs can't... the primary problem being the lack of case law and wolly worded statements from the MHRA, which can appear to change the meaning of the Medicines Act. You cannot just walk into a pharmacy and demand a drug for a patient, a paramedic on the other hand can! only if it is on the statutory exemption list. Your authority to practice is through your employer which is why when you are in St Johns, you are no more than any other St Johns ambulance attendant. Incorrect A Technician's authority to practice is also through their employer via the medical director. incorrect , no prescriber can issue a direction to adminster a medication to a patient they have never met. A Paramedic however, is licensed to prescribe, Paramedics can NEVER prescribe , they can only adminster in line with the stat exemption and supply / adminster in line with a PGD. administer and supply medication through statute. They have the freedom to practice and make their own decisions, although they are accountable to a higher body who judge those decisions (sometimes unfairly). This is the difference, freedom to practice, make own decisions rather than having to seek permission or approval. the exact same statement can be made with reference to any registered health Professional. A written PGD or spoken direction from a doctor is NOT AUTONOMY! A legal staute empowering one to make decisions and administer drugs IS! Heck, even chiropodists can prescribe more drugs than you can! Chiropodists cannot prescribe they can adminster drugs under a medicines act exemption, this is not prescription. I have nothing further to say to you exacept go away and actually read the legislation in question as your knowledge of it appears to be extremely limited. Link to comment Share on other sites More sharing options...
Richard B the EMT Posted February 12, 2008 Share Posted February 12, 2008 ERDoc reports a nurse's aide presented a family member, saying I was practicing taking his blood pressure at home. It was 142/86. I knew that it was dangerous and I should bring him right in I wonder if that Nurse's aide is aware that there's only 2 things that affect a blood pressure: anything and everything. Hell, I probably have that BP climbing the stairs out of the #2 line subway station at Hoyt Street, heading to FDNY Headquarters. Link to comment Share on other sites More sharing options...
disco77 Posted February 12, 2008 Share Posted February 12, 2008 Hey zippy, as i see you've not ran away hiding your head in shame, may i ask, if you have had any success in finding another fellow UK nurse who actually shares you view of your role yet, given the number of EMS forums you frequent, i would have thought that you would be as active on the nursing ones & IF you were correct, would have no trouble finding someone to back your claims. Link to comment Share on other sites More sharing options...
scott33 Posted February 13, 2008 Share Posted February 13, 2008 Perhaps these guys can help. Link to comment Share on other sites More sharing options...
brentoli Posted February 13, 2008 Share Posted February 13, 2008 So I was sitting in my cubicle today, and I realized, ever since I started working, every single day of my life has been worse than the day before it. So that means that every single day that you see me, that's on the worst day of my life. Link to comment Share on other sites More sharing options...
JPINFV Posted February 13, 2008 Share Posted February 13, 2008 Wow, that's messed up. Link to comment Share on other sites More sharing options...
Stoker Posted February 13, 2008 Share Posted February 13, 2008 Wow. It's well after midnight here and this little Aussie is still up reading and wondering how the original subject turned into a "Zippy UK St John He Said She Said"series. Careful now, remember to keep your words soft and sweet just in case you have to eat them... oh, and the horse was a nice touch.. :wink: Link to comment Share on other sites More sharing options...
ccmedoc Posted February 13, 2008 Share Posted February 13, 2008 So I was sitting in my cubicle today, and I realized, ever since I started working, every single day of my life has been worse than the day before it. So that means that every single day that you see me, that's on the worst day of my life. On the upside...today isn't the worst day ever.....Just the worst so far. Ya got something to look forward to.. :wink: Link to comment Share on other sites More sharing options...
chbare Posted February 13, 2008 Share Posted February 13, 2008 So I was sitting in my cubicle today, and I realized, ever since I started working, every single day of my life has been worse than the day before it. So that means that every single day that you see me, that's on the worst day of my life. That is messed up. At least I feel better about my life. Take care, chbare. Link to comment Share on other sites More sharing options...
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