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EMT working in ER: Does anyone know process and rules?


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Wow - I wish that I had seen this thread earlier! I don't know anything about Washington state, but can tell you of my experience in a hospital E.D. in Florida.

First, you will not be stripped of your certification in this environment, although your scope of practice may be different than in the field. You will see and use many types of equipment and materials never seen out on the road. You will learn many techniques of wound care not seen in the pre-hospital environment. You may or may not be able to initiate peripheral I.V.'s, but you will certainly perform lots of phlebotomy. You will become proficient at Foley placement (no ones favorite, but sometimes a necessity). If you choose, you will be assessing lots of patients, communicating your findings and impressions, and assisting with interventions. You will work codes, but be limited to compressions and ventilation. You will be watched closely and double checked initially, until Docs and Nurses feel they can trust you. Do not percieve this negatively, because it is the same as you would be in the reverse situation.

More importantly, it is not really about what you can and cannot do, but what you can learn. As stated earlier in the thread, you will have access to Nurses, Radiologists, Respiratory Therapists, Physicians, etc. You will not only be intimately involved with patient care, but have opportunity to observe, ask questions, discuss. Most practitioners are very willing to teach and help you. The free Continuing Education available in the hospital environment is plentiful and varied. After one year of employment, the hospital I work in provides full tuition reimbursment towards any discipline that attracts you.

Earlier, I made a statement that began: "If you choose...". Like anything else, you will recieve from a hospital experience as much as you put in to it. An E.R. Tech can probably meet minimum requirements and keep their position by just stocking, cleaning, transporting, recording vital signs, and performing basic procedures that fall within the scope of practice. If you just want the paycheck, there are easier and more lucrative ways to do that. But if you are assertive, you will be able to practice alongside other medical providers and become a valuable team member. And learn a lot in the process.

I truly love working the trucks, and have had loads of fun and learned a lot on the street. But I can say the same for my own hospital experience, too. So good luck to you! If you do go the hospital route, I hope it is a good experience for you, too.

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One of the services I worked for allowed us to work in the ER while on call. We responded from the hospital. Our medical director was the emerg doc so we worked under him while in hospital. Great experience and would love to get the opportunity to do it again.

If you get the chance and you have your basis covered I would strongly recommend doing it.

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I currently work in an ED (EMT-:D, everyone is correct the docs and nurses will watch you like a hawk at first then after you have proven you know your stuff they'll start teaching you other procedures. I've become EKG, ALS, IV, Cath, and Phlebotomy trained and certified under our states education guidelines.

The hospital I work for will also pay for paramedic, nurse or medical school. Not only will they pay for school they'll pay my salary during school and intern/externships too.

As the docs and nurses get to know you and are comfortable with your skill level, they'll seek you out to assist (educate you) on procedures. The director of the ED has the final say on what you can and can't do. Best advice I can give is if you don't know something or have forgotten a procedure because you haven't used it in a while, ask for help. If you try to BS your way through it they'll catch on and basically shut you down. We have an ED Tech who has been on the job 16 years who is nothing more than a ED Gopher. I've been at this particular hospital 6 months and have been accepted as part of the team.

Its all attitude and demonstrating a willingness to learn and be part of the team.

The upside to the ED is they typically pay more than the EMS corporations. I currently earn 4x that of an EMT-B for our area.

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There is a hospital near here that hires EMTs in the ED, OB, and surgical. They report to the charge RN. The pay isn't bad but the hours suck. They do get to do a vareity of things though. If it were closer I would apply.

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I work in a ER herein Florida and I was hired becuase I was an EMT but not to be an EMT. In the ER I was just a tech.. I started Foleys, took vital signs, transported patients, cleaned wounds, splinted ortho injuries, cleaned rooms. That sucks and the only time you really get any "EMT" work in is when there is a cardiac arrest pt that comes in.

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I am intimately familiar with the Alaska EMS regulations, but as has been previously mentioned, there are huge differences from state to state. An Alaska EMT certification is a pre-hospital credential. Hospitals are free to require that someone be an EMT if they desire, but EMTs working in a clinical setting are not authorized to perform any skills merely because they are EMTs.

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Not only do these regulations vary from state to state, but also from hospital to hospital, and unit to unit within a hospital. At my hospital, being an EMT-I, and with additional skill training and constant refreshing, we can do IV's, blood draws, splinting, suturing, foleys, ng/og, etc. the only thing we don't do is give medications (with the exception of NS, LR, and O2). However if you walk down the hall to an inpatient unit...all you can do is vitals. and if you look at the other hospitals in the area, each one is different as far as your scope goes.

The weird thing is that here I can work at a hospital and ER, but wouldn't get a job at a nursing home or skilled nursing unit because I don't have my CNA, which most require. Go figure.

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I just interviewed for a per dium ER tech job at out local hospital . The nursing supervisor told me my responsibilities would vary from paperwork tracking and afterhours pt. registration , to arranging interfacility transfers , taking radio reports of incoming medic rigs , splinting , being part of the code team ( compressions and bagging ) , and other pt. care as needed . She talked about cross training me for telemetry also . I also have a phlebotomy background though I haven't used it in years and she's talking about getting me recertified and possibly using me in different parts of the hospital . If this works out , it may become a full time gig instead of a way of keeping my skills up .

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I am an NREMT-B with my ACLS and PALS. I also work in an ER here in Florida. I am allowed limited patient care, along with taking vital signs, draw labs, run ECG, transport patients, clean wounds, splint ortho injuries and clean rooms. My shift is from 19:00 to 07:00. I am tight with the doc’s and they have me assist on a lot of the interesting procedures.

I love it!

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