EMS working in small hospitals, long term care

[Happiness]

Oh RumFiend, you know. I assume (yeah, I'm an ass) that he would be referring to our standing orders and capabilities. RN's cannot intubate, etc and need physician approval for pretty much everything. We can intubate, give narcs, suture, so on and so forth without having to see if Simon Says ...

The first time I brought in a pt with a very nasty fractured ankle (it was pretty gross to say the least) I was surprised that the nurse could NOT give entonox. I just went got mine and carried on with my protocol until the Dr. came in and had a look, there is no reason ever that a patient should have to wait with a 10/10 pain scale.

[zippyRN]

zippy RN

Canada vs UK .. 2 completely different sets of rules of engagement .

cheers

squint I've had these kind of discussions around 'Nurses can't do X, Y or Z' on a nursing based site with a wide international readership and oddly enough even with reference to statute law and the requirements of BONs often these statements can't be substantiated

[tniuqs]

ZippyRN:

Feel free to attempt to convince the REMT-P's registered in Alberta or BC that RNs are anywhere near the same scope of independent practice and I wish you good luck with your argument.

cheers

[rock_shoes]

squint I've had these kind of discussions around 'Nurses can't do X, Y or Z' on a nursing based site with a wide international readership and oddly enough even with reference to statute law and the requirements of BONs often these statements can't be substantiated

Sorry mate but different scopes of practice between RN's and EMT-P's are a fact of life in Canada. Can RN's have skills added to the SOP? Sure, but once they've completed the required training they're not simply RN's any more. At the base level comparing say a new grad RN to a new grad EMT-P, the EMT-P does have a more expansive SOP.

It's all about operating environment. Is it valuable for an EMT-P taking a medivac patient out of Resolute to be able to perform an ABG? Absolutely. Does a ward nurse at Foothills (Trauma centre in Calgary) need to be able to perform an ABG? Absolutely not. The RT's available are more than happy to do it.

[Richard B the EMT]

Directed at MattMatt...

First off, welcome aboard the city!

Second, just know that "local" protocols can differ by town, county, parrish, state, provence, and nation. Some of what I can do in NYC as an EMT-B, I'd be in trouble for doing in Inwood, Nassau County, just over the county line from me, and the reverse is also true of an EMT-A from Inwood VFD's EMS.

[tniuqs]

squint I've had these kind of discussions around 'Nurses can't do X, Y or Z' on a nursing based site with a wide international readership and oddly enough even with reference to statute law and the requirements of BONs often these statements can't be substantiated

I took the time to look back at the original post, it has zero to di with the RN scope of practice (suggest you zippyRN should too) .. the "root problem" stems from the very serious fact that the RN union is resistant to work in collaboration with EMS in hospital setting.

We presently have a Government that may in fact dictate that .. but an election is coming up and I seriously doubt anything will transpire until that is over.

In closing I would refer you to the Alberta College regulations under Health Disciplines Act an RN cannot be directly employed by an ambulance operation unless registered under the Act as an EMR, EMT or EMT -P.

I was always frustrated when working in ER as an RRT and was permitted to do arterial access but not venous could not pick up paddles.. even though in the ER garage I was "legally permitted" (but not across) the invisible territorial RN Union Line.

[Siffaliss]

oh dear oh dear oh dear ...

it'd would be funny if it wasn't showing the ignorance of individuals

from a UK perspective there is only one thing an 'ordinary' RN cannot DO that a paramedic can do and that is give IV morphine without an existing prescription. Every other Paramedic intervention requires either a small piece of administrative work ( e.g. Patient group directives for medications) or simply proof of competency - e.g. peripheral IV cannulation

Similarly for a Paramedic to do everything an RN does again requires proof of competency and various small pieces of administrative work, however there are a substantially larger list of things a paramedic would have to demonstrate to be able to do everything an RN can.

perhaps if those who are fond of saying 'Nurses can't do X, Y or Z' were to do a little bit of research they might find that aside from legislation surrounding medication , most of these prohibitions are nothing more than organisational policy or 'widely held truths' without a basis in regualtion or legislatiion.

As squint said, there are completely different rules of engagement. But thanks for your your ignorant comment regarding assumption of "everything is the same everywhere"

ZippyRN:

Feel free to attempt to convince the REMT-P's registered in Alberta or BC that RNs are anywhere near the same scope of independent practice and I wish you good luck with your argument.

cheers

Yup.

Sorry mate but different scopes of practice between RN's and EMT-P's are a fact of life in Canada. Can RN's have skills added to the SOP? Sure, but once they've completed the required training they're not simply RN's any more. At the base level comparing say a new grad RN to a new grad EMT-P, the EMT-P does have a more expansive SOP.

Absolutely. Zippy, if you ever feel so inclined, take a read:

http://www.collegeofparamedics.org/Content_Files/Files/aocp_emtP.pdf

It's all about operating environment. Is it valuable for an EMT-P taking a medivac patient out of Resolute to be able to perform an ABG? Absolutely. Does a ward nurse at Foothills (Trauma centre in Calgary) need to be able to perform an ABG? Absolutely not. The RT's available are more than happy to do it.

Or, at a smaller rural hospital, you certainly wouldn't need to ask twice of the paramedic who brought the patient in to do such procedures.

The first time I brought in a pt with a very nasty fractured ankle (it was pretty gross to say the least) I was surprised that the nurse could NOT give entonox. I just went got mine and carried on with my protocol until the Dr. came in and had a look, there is no reason ever that a patient should have to wait with a 10/10 pain scale.

Good on ya! You did the best thing for the patient, especially if the nurse wasn't able to or did not request and administer pain meds as per verbal orders by the doc.