becksdad Posted October 25, 2006 Share Posted October 25, 2006 In another post, AK stated that an emergency in an ER is different than one in the field. Could anyone discuss these differences, what a field provider could expect working in an ER, adaptations a field provider may expect to be necessary, etc? I know this is a pretty generalized question, but any wisdom you all could impart would be really appreciated. Link to comment Share on other sites More sharing options...
somedic Posted October 25, 2006 Share Posted October 25, 2006 Well Lets see what a field provider can expect: How about being made into a unglorified orderly ready to insert foleys, change colostomy bags and diapers, give bed baths, change out suction cannisters perform janitorial work, and be a nurse's gopher for 12 hours straight. What adaptions a field provider should make? Adapt to making no decisions of your own. Adapt to being told what ,when, and where to do everything. Adapt to not actually doing any EMS skills because of "hospital policy". Adapt to staying in one place for 12hours straight. Adapt to cleaning up your nurse in charge of you's mess. Adapt to getting proficient at urinal placement and operations failing that ,certification as a foley cath technician, solid waste removal and mitigation, running stat blood samples to the lab, lifting patients, performing rectal temps, emesis basin application and contents analysis, NG tube placements. Adapt to frequent personality changes from the nurses regardless of the time of month. Physicians yelling out orders like Dr.Mark Green on that stupid tv show"ER". Back stabbing. Gossip. Being written up for trying to be an EMS person in a non EMS world. Constantly being asked when you are moving UP to nursing. Try it you will see what I mean. SOMEDIC Link to comment Share on other sites More sharing options...
becksdad Posted October 25, 2006 Author Share Posted October 25, 2006 Oh boy. Does this post belong in the one entitled "Paramedics version of hell"? Link to comment Share on other sites More sharing options...
somedic Posted October 25, 2006 Share Posted October 25, 2006 A paramedic's version of hell? For me yes. There are some hospitals where EMS types integrate and work well with ER staff but I bet they are the exception and not the rule. The argument for or against EMTs/Paramedics working in a hospital ER is an old one. SOMEDIC Link to comment Share on other sites More sharing options...
Ridryder 911 Posted October 25, 2006 Share Posted October 25, 2006 What I have found is it is usually the attitude of the Paramedic of what they get to do and how much they get allowed to do... and with certain attitudes as posted, one can see why. So you want to what.. ? Be above anyone else..or be excluded? Guess what I have 3 college degrees, and I still do those functions if needed.. it's part of the job! I have worked as a Paramedic in the ER setting and as well with Paramedics as being the charge nurse.. some good .. some bad .. just like the RN's. Most that was treated like crap, was because they thought their crap did not stink.. that they though they were above and beyond any menial tasks and expected only to do the "glory" procedures.. guess what this is true medicine. Yes, it can be a bear.. and yes, it is actually hard work.. standing on your feet, getting frowned upon because physicians lagging behind, and answering to some stupid physicians orders, and taking care of more than one patientand one medication at a time.. However many Paramedics come in with a "holier than thou" attitude and only having a <1 yr "training" and a certification and patch and thinking this should impress most staff members?.. I don't care how many people you have "tubed" or how many "14g's" you have started.. (probably have you beat, anyway).. If you have that attitude, get over yourself and attitude, you are only impressing yourself. ER can be a great learning tool and it is a shame we do not require EMS to be in hospital base and to work occasionally so most medics can really be exposed to medicine.(Especially since that is what EMS is really about). Better understanding of all professions and their roles would be better understood.. treatment and stabilization would be better understood as well from more than what was taught in the one text book that most Paramedics are taught from... R/r 911 Link to comment Share on other sites More sharing options...
MedicRN Posted October 25, 2006 Share Posted October 25, 2006 After a rather traumatic EMS call, I got out of the field for a while (about 3 years total). I eventually got a job in an ER, but quickly found out how frustrating it can be for a pre-hospital provider. While I could still use my 'head-knowledge,' I couldn't 'do' anything with it - I couldn't even DC the IV I had started an hour earlier while sitting on the ER apron of the facility in a different uniform!! Yes, I did get quite proficient at placing foleys, cleaning up rooms for the next pt, taking VS with a machine and applied more plaster than Paris has available!!. I also wore a rut in the hallway tile between the ER and CT scanner (averaging 25 trips a shift). I did get the occasions to assist with the repair of severe lacerations and learned more about the human body then I thought possible. Would I change it if I could do it all over again? Not on your life!! PS.... I did get back into part time EMS for a rural service (600 calls/year). But also during that time, I returned to school to complete my nursing degree (started some 18 years earlier). Link to comment Share on other sites More sharing options...
becksdad Posted October 25, 2006 Author Share Posted October 25, 2006 Thank you, Ridryder! That sounds much more like what I was hoping and expecting to hear! I've always found that in most things, attitude is the key, and that you get out what you put in. What I want to do is try to be as prepared as I can be to become a valued team member. I am certainly not above ANY task, nor above ANYONE. In fact, I would hope to enter a more clinical (or should I say "continuing") care setting with the expectation of learning from everyone there. See, here's the deal - I had a seizure at the end of a shift a couple weeks ago, and EEG confirms the diagnosis of seizure disorder. The short form of the story is that while all the serious stuff has been ruled out, I cannot by law here work on an ambulance for a period of 5 years seizure free. Horse kicks in the gut probably hurt less than that news! But I've had time to explore options and there are many. I can go to dispatch, but I'm not thrilled about that. I can go to our Logistics Dept. No thanks. Or I can stay in medicine which is what I really want to do. So I plan on going into the Hospital system, and I'm looking for some advance info. From what I see there are actually advantages here - diversity of experience, unlimited educational opportunities, great benefits. Anyone else with any wisdom to offer, please do! I would like as much input as I can get, Thanks! Link to comment Share on other sites More sharing options...
becksdad Posted October 25, 2006 Author Share Posted October 25, 2006 Thanks to you also, MedicRN! I was posting while you posted yours! Link to comment Share on other sites More sharing options...
Dustdevil Posted October 26, 2006 Share Posted October 26, 2006 SOMEDIC's assessment was not an exaggeration. That is indeed about the bottom line in a large percentage of the ER jobs for EMTs. But Rid is of course right. Your attitude sets the tone for their attitudes in many cases. I don't expect that you would have a problem with that. But beware that some nurses simply are going to give you $hit no matter how good your attitude, personality, work ethic, knowledge, and skills are. But there is usually that one nurse who is not that way and even understands and/or appreciates you and takes you under their wing, so to speak. That person can be a great help in assisting you to adjust, as well as taking some of the heat from other nurses off of you. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted October 27, 2006 Share Posted October 27, 2006 Let me chime in on this. My first job was hospital based EMS. We had at least two nurses and two paramedics working in the ER and when an EMS Call came out both paramedics went out on the call. We many many times had more staffing than that but at night that was pretty much the extent of it. When calls were not coming in we were expected to take care of patient from start to finish. That meant exam's, evaluations and treatments. We worked as medics under the RN then the Physicians licence but we were autonomous members of the ER staff. There was only one thing in the ER that I could not do - spike a bag of blood and since 1999 we have been able to do that. We all did the scut work, taking specimans to lab, changing foleys, changing linens and such. It's part of the job and you just do it. I would put my skills up against the skills of any RN out there. Not to say I'm better than every RN out there ok. RN's are taught a different assessment process than I was so I understood that. Our relationship's between the medics and RN were collaborative and not offsetting. We all knew that we could learn from each other and that is what made the teamwork facet of the hospital Based EMS so incredibly good in my opinion When the ER supervisor hires anyone she asks them if they have a problem working with medics if they are RN's and vice versa if they are a medic and if that person says yes they do then they are just plainly not hired. Simple as that. I've worked in 3 different EMS hospital based systems and they must have been the exception to the rules as they were as good a working environment that I have ever worked in. So in short I'd say go for it. If you can get over (not saying you have this attitude) the attitude that you are not a scut worker and you are part of the team then you will be happy and like what you do. You can always just try it and see how it is. Link to comment Share on other sites More sharing options...
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