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MICN/Radio Nurse: Why do we need them?


SDMedic

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I work as a medic in San Diego and for every call we run we have to give a full report to an MICN en route. I'm not aware of any other system that uses the MICN to the extent that we do, so I'm wondering if anyone could tell me if they work(ed) in a system that also utilizes MICNs and is in the process of eliminating them, or already has, and what it took to do so. There is a movement going on here to try and eliminate them since they're seen as little more than an unnecessary middle-man(woman), but the problem is that they rule the system, and basically developed it, so the goal is to prove how the system can be just as successful without them.

in short, i'm looking for any similar experience out there. likewise, i'd be more than willing to hear from anyone who thinks their system could benefit from them. thanks!

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What is a MICN?

Mobile Intensive Care Nurse

This is interesting from San Diego. I don't mean to sidetrack the thread but it appears there is some credibility to MICNs in California. The areas I am familiar with use them instead of Paramedics for CCT.

http://apps.sandiego.gov/pjaol8/bulletins/3630.pdf

It is a job announcement for EMERGENCY MEDICAL SERVICES MEDICAL EDUCATION MANAGER.

The Position:The EMS Medical Education Manager reports directly to the Emergency Medical Services Battalion Chief.

The position works with other managers and staff within the EMS Division, Training Division and San Diego

Medical Services Enterprise partnership, a joint venture which provides medical transportation services to the City of San Diego.

The position is responsible for managing and developing the content of pre-hospital continuing education.

Duties comprise oversight of programs including field training, job-related orientations, paramedic internship and other specialized pre-hospital training programs. This position will also be responsible for the

maintenance and administration of paper based records and electronic learning systems used to facilitate

educational experiences.

Qualifications:

The ideal candidate will possess the following qualifications:

• Demonstrated teaching experience in the pre-hospital setting;

*************************

Any combination of education and experience that demonstrates these qualifications may be qualifying. A

typical way to qualify would be possession of a Bachelor’s Degree in nursing (BSN), a minimum of five years

experience as a Registered Nurse (RN) and five years of progressively responsible experience in pre-hospital education. Practical experience as a Mobile Intensive Care Nurse (MICN) is desirable.

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MICN - Mobile Intensive Care Nurse (Radio Nurse): takes incoming reports from units on-scene/en route, issues orders (if required by local protocols), informs as to availability of hospitals (bypass)

Sounds good. Only problem I can see is I only take verbal orders from a Dr., so it may not help on that part.

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There is a movement going on here to try and eliminate them since they're seen as little more than an unnecessary middle-man(woman), but the problem is that they rule the system, and basically developed it, so the goal is to prove how the system can be just as successful without them.

What or who do you propose as an alternative?

Who is trying to eliminate them?

Obviously not the FD since their EMS Education Manager employment notice was pretty specific in wanting an RN/MICN.

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Sounds good. Only problem I can see is I only take verbal orders from a Dr., so it may not help on that part.

Exactley. this is why when we call a report to whoever picks up the phone, the last thing i say is "Do you have any questions?", not 'orders'. i dont take orders from nurses. our calling the nurses is a courtesy and may expedite a bed for the patient. if i have a serious case i call report to the doc and he can tell the nurses.

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But wait....if the nurse if fully trained in your service/area protocols and this is how your system operates, then I guess you would have to take orders from the nurse. I am sure the nurse has verbal or prewritten instructions from the med control and has some leeway in asking or ordering further questions or interventions.

I mean if this is how they do it there and this is what you signed up for, then I guess you would take orders from a nurse or find another job. Seems to me that ethics would dictate you do the best for your patient and if that order came from a nurse, then I would be inclined to follow it...I certainly would not pick and choose which patients I was going to help because of my feelings for the licensure level of the person on the phone. I mean if they were of lower licensure level, that would be weird and most unlikely to ever occur. But since they are a higher level of care and that is the way the system is set up and you agreed to it by working in that area, then I guess you are stuck.

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