A Slap in the Face to Paramedics Everywhere?

As some of you probably know, last weekend I went to the Fire Department Instructors’ Conference (FDIC) in Indianapolis, IN and I spent a great deal of time wandering the convention floor, looking at cool things and talking to cool people. There were plenty of great things to see and great new things to learn about and I immersed myself in doing just that. One of the things I’m always interested in is looking at the new trends in ambulance design and the manufacturers always have their coolest new vehicles on display to feed my interest. However, while walking the conference floor, I came across an ambulance that did more to tick me off than it did to promote their new vehicle design. Seriously, it was like someone slapped me in the face. Here’s the picture I took from my phone:

 Ambulance Staffed by RNs

Does anybody see anything wrong with that picture? I was immediately ticked off…  I’m talking a level 7 hissy fit. I was livid for quite a while and if you follow my twitter feed, you probably saw the three or four times I TwitPic’d it.

I mean really? They had to put “Staffed By Nurses” in six inch high script on three sides of this thing?

I blocked out the name of the service that runs the ambulance and in all fairness to the manufacturer, this truck is awesome. I would be quite happy to work in this truck although being that it has no bench seat, its usefulness as a 911 truck is hampered by its inability to carry more than one patient at a time. However, I would flatly refuse to work in this truck or for the ambulance service that puts it on the street. I happen to know the service that bought it and I’m trying to avoid naming them directly, but they serve a midsize city in Illinois.

Before you go all West Side Story, whip out your switch blade and zip gun, and prepare to have a dance fight with the nurses out there, realize that I’m not mad at them. Sure, mostly they’re well-paid and have climate controlled jobs inside of well-lit buildings, but they didn’t do this to us. My beef is with the management of this particular ambulance service.

So, let’s say that you’re the manager of this particular ambulance service. Obviously, sitting there in your office you must think that your paramedics and EMTs are contemptible morons who live simply to cause you problems. Furthering your view of the world, you probably think that the rest of the medical profession and the members of the general public in your area view them the same way and simply don’t trust them to provide medical care when it’s like *really* complicated and stuff. You probably feel that everyone would feel safer knowing that their patient or loved one is traveling via the companionship of “nurses” whom you must view as actually being like actually *Competent* and stuff.  

And that’s what this rolling billboard to your contempt of your employees and their profession says about you. It’s a slap in the face to the good men and women you have working for you and there is flatly no excuse for it.

Here’s a tip, anonymous ambulance manager person (AAMP). There isn’t a need to have your precious ambulance be “staffed by nurses” when you have sufficiently equipped and prepared paramedics working in it. Paramedics are acute care specialists. We’re also experts in mobile medicine. Our education, training, and experience prepare us for the unique environment that we create when we move patients from one place to another. Critical Care Paramedics have the intensive Care experience, training, and background needed to operate in a critical care ambulance environment, nurses do not. Sure, ICU and ER nurses are great at Critical Care. However you shouldn’t regularly staff a critical care nurse in the transport environment for the same reasons that you wouldn’t put a critical care paramedic inside of the ICU. The professions are like in a lot of ways, but they’re separate for a good reason.

And you, AAMP, don’t respect that. Perhaps it’s because you’re burnt out. Perhaps it’s because you’ve beaten the system you’ve created into such a pulp that nobody wanted to staff your new Critical Care Truck. Perhaps it’s because of a lot of reasons, but it’s certainly not because you wanted the best in patient care or to show that your employees are capable of operating your shiny new “special” ambulance. No, you wanted “nurses” to “staff” that truck… and not only did you want the medical people you’re contracting with to know this, you wanted everyone who saw the truck to know it as the 6 inch high letters stating that fact clearly show. Do you think that the public views your crews as incompetent? If so, do you think that furthering the notion by advertising that your “special” truck is “staffed by nurses” will help that situation?

If your protocols are so draconian that even critical care certified paramedics cannot be allowed to staff that truck, then your protocol system is in the Stone Age. If your educational system isn’t up to the challenge of preparing your most experienced medics to staff it, then fix that problem. I know that there are great medic/nurse combos out there and I know that flight nurses have garnered quite a bit of respect out there in the world… and heck, I’m not knocking them for doing it. However, this is the time for Paramedics to step up and claim our turf. This ambulance clinched it for me. AAMP, your shortsightedness has caused me to lead a revolution of sorts here. You’re contempt for your staff has indicated to me that now is the time for paramedics and EMTs, such as the ones that work for you, to stand up and start claiming what is rightfully ours. Frankly, AAMP, your ambulance and your attitude is ridiculous and thinking like that must be stamped out right now by the good medics among us.

And I should also say this to the nurses in the audience before you start skewering me for knocking you: Have you looked at the debates in your circles concerning the use of paramedics in the ER and in other hospital units? Have you ever seen the term “Unlicensed Assistive Personnel”? Well I have, and it’s what the upper nursing echelon calls me and my professional colleagues.  It’s offensive, but hey… our jobs are different. You have the hospitals and the fixed facilities. That’s what you do. We have the field. It’s what we do. There’s a line, respect it. If you want to do EMS, go through a real paramedic program. If we want to do nursing, we should go to nursing school. Really, it’s that simple. The transport environment is difficult and requires the use of specialized personnel… which we have, they’re called paramedics. The medical care we provide is close to the care that you provide, except we have autonomy that you do not and we are use to working independently in the environment in which we operate. Your focus is different than mine.  You may be the best transport nurse out there, but even though you personally may be awesome, my profession needs to have people as awesome as you working on our side. That’s what this is about, not to knock your transport nursing skills, but to kick us paramedics in the shorts and get us to step up and maintain ownership of what we should own.

The responses I got back on Twitter show me that there are a lot of like minded individuals out there. Perhaps some of them might work for you, AAMP. You better take that into consideration because if I have my way the paramedics are going to get the notion that we’re not just a bunch of contemptible morons and we’re soon going to take control of our own profession. On that day, managers like you will be obsolete. Perhaps you can get a job managing nurses.

Here is my personal ‘thumbs down’ for the graffiti against my profession that you had someone slather on your shiny new truck, AAMP. My advice? Take it off and reconsider your staffing patterns. What you’re doing is bad for my profession. It affects me negatively, it affects my profession negatively, and it shall not go unanswered.

What do you think?

—————————————————————

Be sure to check out the follow-up to this post “A Slap in the Face? How about a Wake-Up Call?”

Also, for more of my thoughts on the state of EMS in the State of Illinois, check out “Dear Illinois EMS”

  • Jill

    This is a great post. You are a good writer. You are quite emotional and there are some grammar errors and/or typos.

  • Jill

    This is a great post. You are a good writer. You are quite emotional and there are some grammar errors and/or typos.

  • Pingback: Around the Fire Web | Firegeezer

  • Pingback: uberVU - social comments

  • http://twitter.com/rescue_monkey Rescue Monkey

    Chris, I understand where you are coming from. We have a “Baby Buggy” in my town that is staffed by PICU nurses (but they do not advertise this on the side of the ambulance), but this doesn't seem to bother me to the extent that it bothers you. I cannot change the system that AAMP is running, I can only try to advance public perception of our profession (which we know is not that great). I still get called Ambulance Driver by the nursing homes, ER nurses etc. but I cannot blame them, we haven't done anything to change that stereotype.
    Nurses have been working on air transport services for a long time does that bother you also? Or is it just the blatant advertising that that ambulance is staffed by nurses?

  • http://twitter.com/in_the_city Angelo

    Im with you Chris. Sound the call. Lead the revolt. Death to our enemies… Oh sorry got off track there for a minute.

    It's “Staffed by Nurses” for two reasons. The first being people love nurses. Kind, caring, compassionate nurses. With paper hats. And animal print scrubs. Or naughty night time tendencies. The nursing profession is one of those things that people just admire. Mean while Im sure most of the population is watching my paramedic backside so as to ensure I dont steal the good silver while bringing there loved one back from the loving embrace of the hereafter.

    They've got better marketing than we do. Johny and Roy was a long time ago. But everyone's seen that Nurse Jackie what not.

    Also you've got to look at the EMS system in which that… place…. which I may or may not have once looked into employment with …. operates in. Critical Care standing orders have to be approved by first the local system and then the state here in IL. Again its marketing. Some medical director who thinks we're all knuckle dragging CHUDS decides that he's not comfortable with the “ambulance” guys doing something and the immediate response is put nurses in cargo pants and get'em out on the street. Its system failure.

    Here's an example. The critical care medic idea here where I live in Chicago is basically only about 2 years old. At first we had very very basic standing orders, dopamine infusions, KCL, dobutamine, Heparin, blah blah blah. We wanted more, but no one was willing to bet that we weren't going to kill people left and right. A year went by and then some more stuff got added; Drug assisted Intubation, IO guns, some more drips and some extra meds. But here's the kicker… we still need nurses from time to time. Hell I needed one last night. The system is uncomfortable with the idea of 2 highly educate CCT trained medics watching a Propofol drip so enter the nurse. She is a very nice lady and I have no doubt a good ICU nurse. But she has no place in an ambulance. Who did all the work? Who set and operated the vent? Who programed all the IV pumps? Who ensured proper monitoring of the pt? Who maintained the integrity of the ET tube throughout the transfer? Who got a good report from the sending hospital and wrote a meticulous chart? Yeah the “unlicensed assistive personnel” Who came along for the ride, did very little, and made more in an hour than I made in the entire 24 hr shift?

    Yeah see, she's got better marketing than I do.

    Anyway… if you're thinking about taking a road trip down ….. to that unnamed city to throw some eggs at the ambulance I'm in, but I want to go fishing after.

  • http://twitter.com/in_the_city Angelo

    Oh and I doubt like hell that that thing's gonna be answering 911 calls. With that paint job, and if it's fancy on the inside that reeks of big headed SCT to me

  • Ambulance_Driver

    It's an IFT bus, so yeah, not surprising that it's staffed by nurses.

    But like you, I think the statement on the side carries an implicit message: “Not staffed by those lowly paramedics.”

    I wouldn't get so torqued about it, though. I mean, they need somebody to wield the Foleys and bedpans, right? ;)

  • http://www.lifeunderthelights.com Ckemtp

    As asked by one random medic at FDIC:

    “If there's a bunch of nurses on the truck, where are they going to put the doctor to tell them what to do?”

  • Steve

    AMEN BROTHER!!! I can assure you that is NOT a problem that is limited to IL, I have the same issue here in NJ. I moved here from the MD/DC area about 10 years ago, and after doing CCT in DC, where I was monitoring A-lines, Balloon Pumps etc, I showed up to find I had to have a NURSE for a walkie, talkie pt with a monitor. It's ridiculous. Some of the nurses I've seen climb into ambulances from the hospital are ones that I taught ACLS to, and should perhaps reconsider the idea of street medicine. This is a problem that will persist until we stand and shout in one loud voice “We will not go quietly into the night! This is our passion, our profession, and our professional arena”. Lets make this a national campaign for Paramedic Unity!!! Say it Once, Say it Loud! I'm a MEDIC and I'm PROUD!!!

  • dave

    well, you have to realize that this information is for the general public. and general public thinks we paramedics are just ambulance drivers. There is such a great demand for RN's and Iam sure the public thinks that the level of training that RN's have is greatly above that of a paramedic. Which probably is. However, as a paramedic, we dont use care plans, or nuturi nutritional needs or wound care. You cant deny that TV plays a significant role in what the public thinks of pre-hosptial personnel. That being said, can you think of any TV show that gives you the impression that Paramedics are highly trained emergency personnel?

    So it is my thought that the person behind this artwork on the side of the unit, is just taking advantage of what the public thinks.

    And you also have to admit, that until the paramedic course entertains the possibility of including the critical care program into the regular course of study within the paramedic course, that the addition of a person with that training..ie..a RN with ICU and ER time, does help with patient care as well as outcome.
    It would be my hope that Paramedic training would one day include all of the” extra stuff” that we would need to provide the same care with or without RNs on board. I agree that RN's on board now, dont really add to street EMS, however, I will debate that the addition of a RN with ICU and ER tenure, does provide ample training to better provide for transfer of critical care patients. That being said…Flight programs still include a RN as part of the crew on most flight programs. That being said, most of them eventually cross train to at least a basic EMT adn then continue to paramedic. and also the vise versa…most paramedics that work on such programs such as a flight team also consider cross training into a RN role.

  • Former medic

    As a person who has done both jobs (and still currently working as a nurse), I am nothing short of appalled. Paramedics in the city where I worked were trained in a great program, and were very knowledgeable. Saying that however, in the city where I currently reside, paramedics are bound by very restrictive protocols, and therefore their training programs reflect this, and teach only what a medic needs to know in this system.
    Don't get me wrong, I think this service has insulted, and undermined the knowledge and abilities of their medics, and medics everywhere. I work with nurses who wouldn't know how to use a BVM if their life depended on it, and frankly speaking, that scares me. There are great nurses out there, but in a hospital setting, nurses can't use the skills that medics are taught, and use on a regular basis. Nurses are bound by their state's nurse practice act, and if working on a rig, these require a special skills clause by their state.
    In an emergency situation, I would much rather have a well trained medic by my side who knows what to do, and knows how to use the equipment in their truck.
    The second aspect of this article that bothers me is, as the author put it, the anonymous ambulance manager person (AAMP). The upper management of this service should be fired, or have retirement forced upon him or her. If management wants the staff to be proud of who they are, what they do, who they work for, and to come to work with a good attitude, then management should encourage and advocate for them not undermine their abilities and suggest that there is someone else out there who can do their job better than their current employees.

  • Theresa Jones

    Fantastic post. As a parmedic first, nurse second, I too, find it a slap in the face. I do not have a problem with transfers being done by nurses,in-as-much, as I know they can and do, handle it. However, I do have a problem with them putting nurses above medics, then advertising it, as though medics were vermin or something. That's just plain wrong. If anything were to go wrong, which sometimes it does, paramedics are far better apt to caring for the emergency than most nurses. I think that they need to explain their thinking/marketing reasons a bit better. However, now nurses can be called abulance drivers too! HA HA HA ;-)

  • skydoc

    As a Respiratory Therapist and a Paramedic involved in critical care transport I would like to say I understand where you are coming from but the reality is that when it comes to interfacility CCT's paramedics alone do not cut it. I don't care how good of a medic you are or how many years of experience you have on the streets, you just can't replace actual bedside experience in an ICU! If it was my loved one or myself for that matter I would say give me a CCT transport team with a nurse and a RRT! They are the ones with the actual day in and day out bedside experience! This especially applies for pediatrics and neonatal transports. You can't teach years of day in and day out experience no matter how much you try. Now I completely disagree with advertising on the side of a CCT vehicle who staffs it. It degrades the profession in general when you put professional against professional. But the bottom line is still what is best for the patients and in the critical care world that is experience!

  • TINA

    Love the article, very valid points throughout. I have nothing against Nurses, currently going to Nursing school after 15 yeears in EMS. Here's the thing, it's not they don't have critical thinking skills, it's they don't really take the initative towards patient care. They don't have the same skill set that Medic's have. When was the last time you saw a nurse dropping an ET tube, doing a needle cric, needle decompression? We can tell you drug dosages and drip rates in our sleep, they are usually looking for the doctor to write it on a chart or they are looking it up in a book. I had someone ask if we could shock a patient in PEA the other day! Again, I have worked with some very skilled nurses that I would happily work with in the field, they just have a different mindset than that of a Medic. We will call up and (ask, not wait) for orders for our patient is the standing orders are not working to create a positive pt outcome.

  • Roger

    i can see your point, and could easily argue for the exact same thing. The only problem is I dont mind them doing it… its a transfer service. STAT TRANSFER. Let em do all the transfers they want. Hell let em do it all… The reality is that I would rather have a 911 trauma or even medical call before i have to do a transfer. The other side is, its a probably the dumbest idea they have come up with in a while. Why take a higher paid less skilled (in mobile emergency medicine) either way, give em a fresh roll of toilet paper and let em do what they have been trained to do. Monitor the patient while the medics are saving lives

  • http://davidkonig.com Dave Konig

    This actually doesn't bother me as much as the “non-emergency stretcher transportation” vehicle I saw at EMS Today.

    Of course, it would be nice if they advertised correctly by adding, “And Costs 900% More!”

  • http://twitter.com/shell1972 Shelly Wilcoxson

    I to get your point and am appealed at the advertising so in your face but it is a transfer unit and there are many states that now offer pre hospital RN programs , specifically for such rigs as this, and though it is far from a good paramedic program it does involve many of the same classes and such as medics are required to take. I DO NOT ever want a RN staffed rig to answer my 911 call but if they wanna run granny from NH to Hospital for Dialysis then by all means and leave the REAL Medic's free to save lives

  • 911Medic

    I agree with many of the posts as too the need for an image overhaul for our profession. I am very proud to be a Paramedic (always spelled with a capital P, RN is always capitalized) and I am also proud to be a critical care Paramedic! My experience with taking RN's with me on transfers is this “I could not do this job, how do you do this stuff in this moving ambulance?” as they seatbelt themselves in and reach for the nearest grab bar! I would say 90%+ RN's know that we are pre-hospital medicine and they are just fine with that! Then there is the other 10% that cringe every time they hear Paramedic or EMT mentioned in the same sentence as they are, these are our foes! We are just as much to blame as anything else for allowing this pre-conceived stereotype of pre-hospital medicine (propagated by poorly conceived T.V. shows and movies). We need to reach out to our communities and do more to educate the public as to who and what we are; most that have used our services are fans. However the average person will need EMS only once in their lifetime if that, we can't wait around for everyone to have their emergency to make an impression. More time needs to be spent doing wellness fairs, job fairs and geriatric teaching! These are the opportunities that will allow us to grow our image, our brand if you will. I am very proud to be a Paramedic and will continue to fight for the status and recognition that we all deserve!

  • podmedic

    Looks like this particular unit is for transfers and not emergency response. Inter-facility transfers are (usually) stable patients being moved to a larger or specialty hospital for a specific procedure. Even high risk cardiac patients have to be stabilized by the transferring facility before they are released to the transfer unit. Not too many emergency situations there for a paramedic to be needed.

    The big problem most seem to have with this including Chris here at “Life Under the Lights” is that the nursing profession has a higher respect factor among the public. This is because we are operating under so many different models that no one knows who we are. Are we firefighters, sheriff's deputies, third service, private ambulance? No one knows from district to district.

    We have no industry unity. We have no standard of training recognized nationwide by every state and jurisdiction. We can't all get behind the same national organization to represent us.

    You know who does? Nurses – that's who!

    If you want EMS to have more respect among your communities, you need to earn it and build a standard for the profession. Learn the lesson nurses learned a hundred years ago when they began to nationalize the standards for nursing – then you can have what nurses have.

  • Adam_Thompson

    Excellent post CK. I think you are right in your initial response. Imagine an ER door signed “staffed by paramedics”…. hahaha, I have revealed my ultimate goal.

  • Pingback: Paramedics Upset About Nurse Staffed Ambulance

  • Pingback: Behind the Seams: Doggy Heroism, EMTs vs. Nurses and More | Tactical Pants Blog

  • Jason Whaley PA-C/FF

    As a former medic (now PA in emergency medicine), I can see both sides of this argument. I think you may be taking it the wrong way….although that's easy to do considering how the rig is stenciled (bad taste IMO). I dont think this is intended as a slap to paramedics, I think it's intended as a marketing ideal.

    Sometimes it's just a legal issue that it comes down to. Nurses have a broader opportunity for various treatment options than medics do, partially from education, partially from legal definition. Medics do not have the legal authority to diagnose…..nor do nurses, per se, although they have a “nursing diagnosis” template they can work from. And nurses are hardly “unlicensed personnel”.

    Also notice that this agency does Transfers – I seriously doubt they are going to participate in a 911 rotation for their city. These are for insurance or level-of-care necessitated critical care transfers, not 911 service. When I was a medic we used to do it all the time with CCRNs from my agency. Never a problem….but we also had highly qualified and skilled nurses who ran vents, pumps, everything in the rig short of drive it. They were totally qualified to be there. Some are…some aren't. That's true everywhere. A skilled CCRN is worth their weight in salt at times – I've had patients in a learjet decompensate with an hour to our destination airfield, and another 30 minutes to the receiving hospital. When they're using their ICU skills to keep that patient alive with me, it makes a difference. Isn't the care of the patient ultimately what we're here for? ICU skills – that medics dont have – may make the difference. How often is ALS really needed? not as often as people think….but when it is, it makes a difference. Same with CCRN/ICU skills.

    Anyone else been around since the days of verapamil and not adenosine? Since EOAs? When the LP5 was as good as it got? before pacing? When it was still called EMD? I have been. I've seen EMS progress in ways that we could never have dreamed 20 years ago, and just look at where we've come since Johnny and Roy. I also see it as an educational and legal issue. If you want more scope, you have to go get more education. I see this argument with NPs who want to function without any physician supervision….want to do that, go to med school. Want the option to exceed your protocols and scope? go to more school and get more education, it really is that simple. Not that preferred, but that simple. If diprivan is out of your scope, if ANYTHING is out of your scope, you'll need a nurse. Also that simple. The knowledge will be trumped by education and legal authority, plain and simple. I will say that most nurses I've known who crossgrade to MICP are not good medics, since they dont have the street smarts that most of us have earned the hard way (some have been really good). I've also seen some nurses attempt the crossgrade and fail miserably (“what do you mean you dont have IV pumps on the street?”). EMS is not for everyone, but we all know this already.

    I was a medic. I am a PA. I am a firefighter/engineer. I teach at a paramedic program. I sat on the National EMS Education Standards Committee. I'm not down on medics in any way – just offering up some observation and perspective having seen it from both sides.

  • lordbalsac

    I ran into this article via JEMS on facebook and almost fell out of my chair! I will hold back my REAL THOUGHTS as I work for the company that runs this truck on a daily basis. There are 2 of these trucks actually. Brand New!

    INFORMATION: It is an inter-facility hospital transfer truck with a “PHRN” and one EMT driver on board. The unit parks off a … See Morehighway exit and waits all day for a “nurse transfer” to come into dispatch. It has a built in flat screen TV and XBOX in the back for occasional pediatrics going across the state. It does not run any 911 although some of the nurses get paid big $$$ OT to work the streets. Apparently if a patient is in hospital A and going to hospital B with more than a just a saline lock it is beyond the paramedic's scope. How funny. A facilty nurse or now these so-called PHRN's in this truck do the transfer and the company can bill big. The nurses that work here are treated like gold.

    Thats all I will say. /END

  • http://www.firedaily.com Fire Daily

    Wow.

  • http://www.firedaily.com Fire Daily

    Wow.

  • Pingback: A Slap in the Face for Medics? How about a Wake-up call | Life Under the Lights

  • francisbaker

    So are you a certified School Teacher with a Masters in English also?

  • http://www.lifeunderthelights.com Ckemtp

    Francis,

    Don't mind Jill. She's family and a fellow blogger.. And actually, yes.. She has all of those credentials. Thanks for jumping to my aid though ;)

  • francisbaker

    Like the last comment – BRAVO Theresa!

  • francisbaker

    Another big question here is if the is a 'TRANSPORT” only vehicle, what the hell is it doing with all the bells and whistles that make it LOOK like a REAL AMBULANCE. I am sure that the multi $ inside could be outfitted just as well without all the OUTSIDE I WANT TO LOOK LIKE A REAL AMBULANCE. If this is just a truck to take a patient from A to B facility with ICU types on board, then there should be no need for radios, lights, sirens or ambulance markings of any kind. The name of the originating hospital or service name with the rest of the LOGO would suffice. Does your State not have ANY rules and regulations for defining an AMBULANCE, how it will be marked, how it will be staffed, what equipment it will carry to be LICENSED as an ambulance? If not, then someone there should start looking at the liability of the empty return trip and stop/no stop for an MVC or other incident. Is this or has this been addressed there? Most States I am aware of require BY LAW these things and you BETTER STOP on your way back empty from a trip and make contact and render aid if you are out of your jurisdiction! What is it about nurses who are not EMT trained believing they can handle the street? All due to them and their 'profession' but really, when was the last time you saw a nurse be successful with a stick at 80 MPH or down in a ditch at 0300 hours in the dark, in the mud, in the rain, you get the idea! Two seperate professions, two seperate sets of training and I firmly believe that if EMS has one glaring fault, WE RESIST THE 'GET A DEGREE' program. Other 'professions' are considered professions because of a piece of paper. That doesn't mean the holder is worth a damn, it just means in the eyes of the public, they have a degree, they must be professional, they must know what they are doing. Perception is more than 75% of the battle ladies and gents. Until we look professional, have the piece of paper with our names on it, then we will still only be 'technicians' with a whole lot of medical training and experience. PERCEPTION = PROFESSIONALISM! (In the eyes of the public). I am not disagreeing here, just trying to make my point. (Oh yes, please look through this for the mispelled words and grammatical errors please, My college professor would like to hear from you.)

  • francisbaker

    Totally agree with the Nationalization and Stanards in each State being the same along with the education. As I have said before in other posts, the Degree (piece of papeer) is what catches the eye of the public and other professionals. When I first went into law enforcement, the local I worked for had NO real standards for being an officer, except the County Acadamy (which by the way was NATIONALLY recognized). Myself and several other officers went on to earn AS & BS Degrees and had our accomplishments printed in the local newspapers. Our personal face-to-face with members of the public changed because they started “seeing” us as educated, knowledgable, even cultured individuals who weren't just out there weilding our badge and gun power to be a 'gestapo' type outfit. As I said before PERCEPTION = PROFESSIONALISM Get some National Standards that ALL States have to follow, more education from the ground up (EMT – EMT-A, EMT-I, EMT-P, EMT-PA) so that our pre-hospital medicine enriches the treatment of patients.

  • EMSJunkie

    Just to add my two cents to the discussion….In IL, In order for a vehicle to be licensed as an Ambulance The state requires that it be staffed by 2 EMT's. The fact is this vehicle is most likely also staffed by 2 EMT's or Paramedics or Paramedic/RN's or 1 Paramedics and 1 Paramedic/RN. The company is using the staffed by nurses as a marketing tool and also only for Inter-Facility transfers. It also comes down to money, Since the patient is “Critically ill” there is a higher payment from the Insurance company. They found it easier and cheaper to hire RN's rather than train their Paramedics to become Critical Care Paramedics.

    No one (here anyway) disagrees with the fact that Paramedics are vital to the EMS system and while there are nurses that look down on Paramedics, There are many that appreciate the jobs they do every day, and as with any profession there are good people and bad people, both in Para-medicine and in Nursing.

  • CHITOWNMEDIC

    I wonder what Andy Rand's employees think of their rig out there on the Peoria River (hint)? I bet that's one reason why all of a sudden they had a slu of open positions for Paramedics last month .

  • CHITOWNMEDIC

    Oh, I did forget to ask, you do know what STAT means ? Should've Taken A Taxi !!

  • firebird108

    As a paramedic with 25 yrs experience, I worked for 8 years with a hospital based service. This hosptial did heart transplants, and last resort procedures. Our team transported only critical care patients, transfers with very ill / dying patients. I worked with many talented RN's, Resp therapists and Docs & other HCP's. But when we had cardiac arrests in the back of the unit, 2 times, the RN freaked out, could barely follow orders to bag patient and after the arrest one quit, said too much stress. It took team work to bring our patients to the hospital alive and I treasure the memories of those years, However there was never a sign on the ambulance indicating that one profession was better than another. We all did our job and as a result the patients we trnsported, mostly from rural hospitals with no ability to treat them, lived, or were given a chance at life. Also on another note, one of the executives of a major company ( unlimited resources)has a paramedic with him 24/7….not a nurse.

  • mlroberts

    I know how you feel I worked as a critical care Paramedic in the Largest Hospital in New York City for over 20yrs. I was dispatched one night to a small community hospital in New Jersey for a cardiac patient and when we arrived on the floor a nurse told us that she couldn't let us take the patient because we didn't have a nurse with us. We called the receiving Physician who told her that he was taking over the care of the patient and we were more than qualified to transport the and if she didn't like it she could keep the patient and answer for it in the morning. So we took the patient when we got to the Cardiac floor at our hospital the receiving Nurse handed me a note that was in a sealed envelope that asked her to call the nurse at the referring hospital and let her know the patient made it with out a problem. The Nurse asked me if I would like to make the call which I did. The nurse asked me how I got the note I told her the receiving Nurse gave it to me, I also told her that at my Hospital we work as a Team.

  • http://twitter.com/wtrachim Walt Trachim

    This is thought-provoking stuff, Chris. As usual, in fact – your observations are spot-on.

    Out this way the critical care model is most visible in the HEMS community: it consists of a Paramedic and an RN. Depending on which organization, the medic either does or doesn't have to be an FP-C and/or a CCEMT-P. One of the services requires all personnel working on aircraft to have taken FCCS at the very least plus have all of the other alphabet certs we all have.

    Regarding nurses on ambulances, I think people that make the argument that they don't belong on the street are some of the same folks who would say that Paramedics don't belong in the Emergency Department. Does that mean having either is a bad thing? Not necessarily. I've worked on CCT trucks with nurses myself who I thought were quite good at what they do. On the other hand, like anything else, I've seen some who behaved like idiots. And the same could be said about those Paramedics who work in-hospital: some of them are really top-grade where others simply don't belong there.

    I think much of this, as has already been said, is based on perception. It is simply what you see and which opinion you hold. And what Jason Whalley said in his comments is true no matter where you are. If you want to do more, you need to learn more. That's the way it should be, shouldn't it?

  • No Name Necessary…………

    As a former employee of this company I seen a link to this article with the picture of the rig and instantly knew it was in regards to my former employer. I've heard how hiring RN's was now a big marketing plan they were using. In the company RN's can do no wrong, and the medics are the bastard children doing the grunt of the work. Anyone who sits in one of there CE's for 5 minutes can easily get the hint. Not only is it a slap in the face that the nurses are making at least 10 more dollars an hour than the companies most experienced medics, it is adding salt in the wounds when you see how there nurses walk around our local hospitals like their shit don't stink. I don't know these nurses personally and have never ran an emergency call with them, but I've heard stories, and they aren't very impressive. Although I've never seen the actual rig, I've heard that it has an XBOX 360 along with a LCD TV built in back. I've also heard how over all it is so much nicer than the ambulances there medics are sitting in on a street corner for 12 hours. I know this ambulance wasn't designed to run 911 calls, but this company does put RN's on the street. And if you ask anyone they will tell you they would much rather see a medic show up. When i heard it was going to be at FDIC I am not surprised that it got this kind of response. In regards to lordbalsac, I will not hold back my true feelings. This company pays there medics shit and wastes all kinds of money on technology that doesn't work. They focus more on how to make a buck, than taking into consideration they employee human beings. And most medics i know take pride in being a paramedic. They way they advertise this service they have is just plain disrespectful. Open your eyes! Your nurse transfer program is a joke, you arent they first company to offer this and real EMS providers really couldn't care less. Next year keep it parked in your garage.

  • http://twitter.com/wtrachim Walt Trachim

    This is thought-provoking stuff, Chris. As usual, in fact – your observations are spot-on.

    Out this way the critical care model is most visible in the HEMS community: it consists of a Paramedic and an RN. Depending on which organization, the medic either does or doesn't have to be an FP-C and/or a CCEMT-P. One of the services requires all personnel working on aircraft to have taken FCCS at the very least plus have all of the other alphabet certs we all have.

    Regarding nurses on ambulances, I think people that make the argument that they don't belong on the street are some of the same folks who would say that Paramedics don't belong in the Emergency Department. Does that mean having either is a bad thing? Not necessarily. I've worked on CCT trucks with nurses myself who I thought were quite good at what they do. On the other hand, like anything else, I've seen some who behaved like idiots. And the same could be said about those Paramedics who work in-hospital: some of them are really top-grade where others simply don't belong there.

    I think much of this, as has already been said, is based on perception. It is simply what you see and which opinion you hold. And what Jason Whalley said in his comments is true no matter where you are. If you want to do more, you need to learn more. That's the way it should be, shouldn't it?

  • No Name Necessary…………

    As a former employee of this company I seen a link to this article with the picture of the rig and instantly knew it was in regards to my former employer. I've heard how hiring RN's was now a big marketing plan they were using. In the company RN's can do no wrong, and the medics are the bastard children doing the grunt of the work. Anyone who sits in one of there CE's for 5 minutes can easily get the hint. Not only is it a slap in the face that the nurses are making at least 10 more dollars an hour than the companies most experienced medics, it is adding salt in the wounds when you see how there nurses walk around our local hospitals like their shit don't stink. I don't know these nurses personally and have never ran an emergency call with them, but I've heard stories, and they aren't very impressive. Although I've never seen the actual rig, I've heard that it has an XBOX 360 along with a LCD TV built in back. I've also heard how over all it is so much nicer than the ambulances there medics are sitting in on a street corner for 12 hours. I know this ambulance wasn't designed to run 911 calls, but this company does put RN's on the street. And if you ask anyone they will tell you they would much rather see a medic show up. When i heard it was going to be at FDIC I am not surprised that it got this kind of response. In regards to lordbalsac, I will not hold back my true feelings. This company pays there medics shit and wastes all kinds of money on technology that doesn't work. They focus more on how to make a buck, than taking into consideration they employee human beings. And most medics i know take pride in being a paramedic. They way they advertise this service they have is just plain disrespectful. Open your eyes! Your nurse transfer program is a joke, you arent they first company to offer this and real EMS providers really couldn't care less. Next year keep it parked in your garage.

  • M17

    Just a few more “facts” to add to this story.

    1) The company which designed the truck were responsible for it being at the show, not the ambulance company.

    2) While some nurses do run the streets as well, some are well seasoned in the medical field and perform just fine while others are less of an asset.

    3) I have been an employee for this company as well, left for a few reasons, one being I didn't agree with the direction the company was headed.

    4) Even with the “good” nurses on the streets from time to time, I agree, it does feel like a slap in the face.

    The system this company works under does not recognize a National Critical Care program, but does offer their own CC program for medics who are accepted. Why have mandated CE's and not offer higher education for the medics that show promise. All I can say is, enjoy flipping that payroll, at this rate you'll need more PHRNs to cover the medic spots that are opening on a weekly basis.

    • Andrew R

      Its Advanced Medical Transport of Central Illionis also know as AMT runs out of Peoria IL and is a huge joke!

  • Pingback: Swing Trading Tips For More Profits | DayTradingIssues.info

  • Pingback: Staffed by Nurses an insult to paramedics? That depends…

  • http://www.lifeunderthelights.com Ckemtp

    To the person who's comment I just deleted.. I'm sorry buddy.. I had to. I just can't have people writing bad stuff about the service itself. Come on, I'm not picking on the service by name and I can't have that bad of derogatory stuff said on this page. It's my perogative to delete that stuff as I see fit.. and I did.

    Be nicer (read: speak your mind in a nice way) and repost your comment please. I do understand how you feel, but do me a favor and play a little nicer.. k? Thanks

  • http://www.lifeunderthelights.com Ckemtp

    To the person who's comment I just deleted.. I'm sorry buddy.. I had to. I just can't have people writing bad stuff about the service itself. Come on, I'm not picking on the service by name and I can't have that bad of derogatory stuff said on this page. It's my perogative to delete that stuff as I see fit.. and I did.

    Be nicer (read: speak your mind in a nice way) and repost your comment please. I do understand how you feel, but do me a favor and play a little nicer.. k? Thanks

  • Ems182221

    This truck is staffed by 1 PHRN and a Basic Emt. I work at the above mentioned company. I do find it as a slap in the face. I will be the first to say that I do not have a problem working with nurses. I do have a problem with the way this company has decided to promote this new program. Ever since a few of our upper manager's became nurse's our Paramedic's and Emt's have became low life scum of the earth in the view of the company!!! We our working with equipment that hardly will even turn on and yet we can't do the basic things and the company throws this truck in our faces. They even made it mandatory that we had to take a tour of it. I mean my job has went from being a EMT to being a Driver and I hate it but I have a family who needs me to keep my job so I just try to deal with it. It is really sad that I dread going to work now I love EMS but I do not agree with the direction this company is going!!!!!!

  • Ems182221

    This truck is staffed by 1 PHRN and a Basic Emt. I work at the above mentioned company. I do find it as a slap in the face. I will be the first to say that I do not have a problem working with nurses. I do have a problem with the way this company has decided to promote this new program. Ever since a few of our upper manager's became nurse's our Paramedic's and Emt's have became low life scum of the earth in the view of the company!!! We our working with equipment that hardly will even turn on and yet we can't do the basic things and the company throws this truck in our faces. They even made it mandatory that we had to take a tour of it. I mean my job has went from being a EMT to being a Driver and I hate it but I have a family who needs me to keep my job so I just try to deal with it. It is really sad that I dread going to work now I love EMS but I do not agree with the direction this company is going!!!!!!

  • ShogunofHarlem

    Sounds jealous and whiny.

  • ShogunofHarlem

    Sounds jealous and whiny.

  • Former Employee – and happier!

    Do they still have the 2 Segways? ROFL!

  • JCL NREMTP CCRN

    I find this “slap in the face issue amusing.” There are two points I would like to make since I was one involved in the design of this truck and concept. First, the lettering on this vehicle clearly indicates the main purpose of this vehicle is inter-facility transfers, calls which paramedics btich about taking and sight as a reason for hating their jobs. Yet design a truck that helps relieve this “inconvenience” on the paramedics and “it’s a slap in the face.” It proves one of my axioms of life: “You can change things that people hate in life, but you can't change someone who hates their life.” Also, inter-facility patient care responsibilities are governed by EMTALA Laws. It might be beneficial for those of you outraged by this vehicle to Google EMTALA before you continue to demonstrate further ignorance.

  • JCL NREMTP CCRN

    I find this “slap in the face issue amusing.” There are two points I would like to make since I was one involved in the design of this truck and concept. First, the lettering on this vehicle clearly indicates the main purpose of this vehicle is inter-facility transfers, calls which paramedics btich about taking and sight as a reason for hating their jobs. Yet design a truck that helps relieve this “inconvenience” on the paramedics and “it’s a slap in the face.” It proves one of my axioms of life: “You can change things that people hate in life, but you can't change someone who hates their life.” Also, inter-facility patient care responsibilities are governed by EMTALA Laws. It might be beneficial for those of you outraged by this vehicle to Google EMTALA before you continue to demonstrate further ignorance.

  • http://profiles.yahoo.com/u/A5VHV7DVMS6FOF2D3V3RA64OP4 That Guy

    As somone who live in the town that that rig operates, someone who worked his way through college as a medic, and someone who is not finishing up residency in that same city, I have to say that without a doubt you are overreacting to this. I come from a medic family, my dad has taught EMS for 15 years, I taught it for 4 years. I agree that in general medics get little to no respect for what they do. But to take offense to a rig designed for transfers being staffed by nurses is ridiculous. I've done the medic training, Ive helped teach it. Everyone can agree it is designed for “pre” hospital medicine, which this rig is not. Some have given examples of how nurses freak out under pressure, I would argue that I know nurses, and ones in this city, that can handle more pressure than any medic I have ever met. This is a good service you are bad mouthing. I agree with the person above about taking a look at you life if you have such a problem with a couple of letters on the side of a rig.

  • http://www.lifeunderthelights.com Ckemtp

    “There are those that look at things the way they are and ask, Why? I dream of things that never were and ask, why not?” – Unknown (and no, it wasn't JFK)

    Those of us that look at the profession of paramedicine and seek to change it for the better face an uphill challenge. EMS is made up of little kingdoms in every locality where people break down into personal attacks and vitriol when their way of doing things comes under scrutiny. I don't mind, honestly because I didn't start writing about EMS with a thin skin. However, this issue isn't black and white. This post created a firestorm of opinions across the internet. I've seen all of the comments here, on twitter and facebook, and the ones that have been emailed to me. Thousands of people have read this post since it came out and thousands more will. Each one will form their own opinion. Some people will put thought into forming their opinion, and some won't. Some will see me as a shallow, bitter medic, and some will see the company as evil and wrong.

    Honestly, there is a point to this article. It's much bigger than the service this truck functions for and it's bigger than the small town it runs in. It deals with the role that EMS sees itself filling now and in the future. Do we as paramedics and EMTs wish ourselves to staff the most difficult clinical roles? Do we wish ourselves to be in the management positions? Where do we see ourselves? Is it as solely 911 providers who leave patients who we decide are “beneath us” to the “transport trucks” and whomever is on them? Or do we see ourselves as being professional enough to go out there and educate ourselves so that we can fit into the most challenging of field roles? Do we as a profession collaborate and dictate where EMS goes in the future? Or do we allow our profession to languish under the control of the political and special interest groups who now dictate where we are placed?

    This issue bothers me on many levels, but none of them are as egocentric as I have been accused of being. I am bothered because I hear multitudes of paramedics and EMTs when they talk of “furthering their education” or “advancing their career”. When those people talk of this, it invariably leads to them leaving the profession. When these experienced, intellegent, professional men and women leave our profession for greener pastures they take their experience and knowlege with them. When an experienced field provider leaves the field, not only are they immediately impacting patient care but they're also eliminating the chances they would have had to mentor the next generation of paramedics and EMTs. When enough of our experienced people leave, our new generations lose their heritage and the new generation begins again.

    While staffing this truck with nurses may indeed be the most expedient thing to do under the protocol system and reimbursement structure that this truck functions within, it eliminates yet another avenue for the experienced medics to rise to when their careers reach the “I want to advance” stage. This is a problem that is systemic to EMS and it holds back the advancement of our profession when one looks at the broader picture of what this mindset represents. My anger was based upon yet another door being closed in the face of long-time field providers and paramedics in general. This is yet another gust in the wind that pushes the best and brightest among us away from the profession.

    And that is why I take issue. If you work the truck and you took my anger as being directed personally at you… well then please take a look at why I must take the position I've taken. I have written hundreds of articles about EMS and most of them are right here for you to read. I do not wish to offend dedicated people personally but I am passionate about the profession and I will do what I feel is best to see to it's improvement. Whether you agree with me or not, if you feel the same way about improving EMS I invite you to keep coming back for the dialogue that we have here with like minded professionals.

    Your opinions help make us all stronger. My job is to get us all thinking and talking. This issue has sure done that. Please keep it up.

    Thank you to everyone who has commented, I deeply appreciate it.

  • http://www.lifeunderthelights.com Ckemtp

    “There are those that look at things the way they are and ask, Why? I dream of things that never were and ask, why not?” – Unknown (and no, it wasn't JFK)

    Those of us that look at the profession of paramedicine and seek to change it for the better face an uphill challenge. EMS is made up of little kingdoms in every locality where people break down into personal attacks and vitriol when their way of doing things comes under scrutiny. I don't mind, honestly because I didn't start writing about EMS with a thin skin. However, this issue isn't black and white. This post created a firestorm of opinions across the internet. I've seen all of the comments here, on twitter and facebook, and the ones that have been emailed to me. Thousands of people have read this post since it came out and thousands more will. Each one will form their own opinion. Some people will put thought into forming their opinion, and some won't. Some will see me as a shallow, bitter medic, and some will see the company as evil and wrong.

    Honestly, there is a point to this article. It's much bigger than the service this truck functions for and it's bigger than the small town it runs in. It deals with the role that EMS sees itself filling now and in the future. Do we as paramedics and EMTs wish ourselves to staff the most difficult clinical roles? Do we wish ourselves to be in the management positions? Where do we see ourselves? Is it as solely 911 providers who leave patients who we decide are “beneath us” to the “transport trucks” and whomever is on them? Or do we see ourselves as being professional enough to go out there and educate ourselves so that we can fit into the most challenging of field roles? Do we as a profession collaborate and dictate where EMS goes in the future? Or do we allow our profession to languish under the control of the political and special interest groups who now dictate where we are placed?

    This issue bothers me on many levels, but none of them are as egocentric as I have been accused of being. I am bothered because I hear multitudes of paramedics and EMTs when they talk of “furthering their education” or “advancing their career”. When those people talk of this, it invariably leads to them leaving the profession. When these experienced, intellegent, professional men and women leave our profession for greener pastures they take their experience and knowlege with them. When an experienced field provider leaves the field, not only are they immediately impacting patient care but they're also eliminating the chances they would have had to mentor the next generation of paramedics and EMTs. When enough of our experienced people leave, our new generations lose their heritage and the new generation begins again.

    While staffing this truck with nurses may indeed be the most expedient thing to do under the protocol system and reimbursement structure that this truck functions within, it eliminates yet another avenue for the experienced medics to rise to when their careers reach the “I want to advance” stage. This is a problem that is systemic to EMS and it holds back the advancement of our profession when one looks at the broader picture of what this mindset represents. My anger was based upon yet another door being closed in the face of long-time field providers and paramedics in general. This is yet another gust in the wind that pushes the best and brightest among us away from the profession.

    And that is why I take issue. If you work the truck and you took my anger as being directed personally at you… well then please take a look at why I must take the position I've taken. I have written hundreds of articles about EMS and most of them are right here for you to read. I do not wish to offend dedicated people personally but I am passionate about the profession and I will do what I feel is best to see to it's improvement. Whether you agree with me or not, if you feel the same way about improving EMS I invite you to keep coming back for the dialogue that we have here with like minded professionals.

    Your opinions help make us all stronger. My job is to get us all thinking and talking. This issue has sure done that. Please keep it up.

    Thank you to everyone who has commented, I deeply appreciate it.

  • ShogunofHarlem

    If you want to be “educated” enough to do nurse transfers…go to nursing school and stop whining. It's really simple.

  • ShogunofHarlem

    If you want to be “educated” enough to do nurse transfers…go to nursing school and stop whining. It's really simple.

  • Pingback: Do you know where I can find a sample ambulance company business plan?

  • jclnremtpccrn

    CKEMTP, your thoughts are well written and I understand your views. However, why are you not just as outraged by situations in other cities where before you can function as a paramedic you must first earn your tade as a firefighter? Aren't the firefighter unions just as gulity as the RNs?

  • paramedic

    you must be a nurse

  • M17

    CK, you nailed it, thanks for putting my feelings into words. As I mentioned above, the direction of said company was only one reason why I left. Furthering my education in “my” profession was another. I did not, do not and most likely never will want to be a RN. I'm a Paramedic, plan and simple.

  • M17

    CK, you nailed it, thanks for putting my feelings into words. As I mentioned above, the direction of said company was only one reason why I left. Furthering my education in “my” profession was another. I did not, do not and most likely never will want to be a RN. I'm a Paramedic, plan and simple.

  • jmw_rn

    Attacking RNs only weakens your argument, especially when you resort to such low brow means as referring to bedpans and the like; it is on the same level with calling all EMTs and medics “ambulance drivers.” It is petty and unnecessary. EMS personnel and hospital-based nurses have entirely different roles. Getting nasty about it will not change the problem. It seems the issue here is the management advertising transport by nurses, not the care delivery. Inter-facility transfers are the bane of everyone's existence, but are a necessary evil. Using nurses in this role makes more sense to me than taking an experienced paramedic out of service for a routine run.

    Perhaps part of the issue is a distinct lack of public (and professional) education about the roles? Would this be as offensive if the other rigs read “MICT” or “Paramedic Unit” or “EMT & MICT” on the side? What if they advertised with a message that nurses rode transport so medics can cover the emergency calls? There are some areas where nurses are trained in EMS to run calls as well. Are these folks any less a part of the team?

    “Starting an IV at 80mph” is a ludicrous comparison for jobs. I am certain that skill did not come to anyone on the very first day on the job. There are going to be good and bad apples out there in all professions. Judging an entire profession by one or two people totally out of their element and in a critical situation is entirely unfair and childish. Were you uber-medic on your first day in the back of the bus? I find it doubtful, and I would not expect you to be. What I expect is professionalism and a selfless dedication to public service, regardless of what some detached manager thinks is best for business.

    Divisiveness in EMS only serves to splinter the public perception. Television perverts every profession it demonstrates; “Nurse Jackie” is only the latest piece of trash out there. I did not base my views on EMS on “Emergency” from the 70s, nor do I expect “Rescue Me” to do anything other than entertain. Yelling and screaming about how unfair something is will not change it. Take a diplomatic approach. Ask for rationale behind the wording. Propose adding “Paramedic Unit” to other rigs. Take an approach that this is an opportunity to educate the public. I urge you to remain professional about it and keep a level head. Yes it is a ridiculous thing to have on the side of a rig, but you have to tackle it in a calm, professional manner.

    Good luck and God bless.

    Former medic and EMT

  • 20h10

    You have every right to be upset as was I when I read that. However, after some introspection a couple of things occurred to me:

    1. Perhaps the public needs to be more aware of what it means to be a Medic. I hold a couple of post grad degrees and medic school rivaled in intensity and depth what I found in my Masters Programs. A paramedic is not an ambulance attendant but a highly trained emergency medical provider. Our marketing department needs to take a note from the nurses union.

    2. There are situations in transport of certain patients where having a nurse specialist is value added. That being said, nurses by and large have no place in the field. I have met some awesome ER nurses that would lose their minds having to deal with what we do in the field. Why an EMS organization would pay more for less value is beyond me and in all probability this is a company that is not long for the world or they are a strictly a transport company that the closest they come to a 911 call is the sticker on their telephone.

    3. We tend to be a silent service. Until we are willing to open our mouths and let people know who we are, what we do and what it means to them, we will continue to see this kind of public sleight. Why a police officer with a high school diploma and 12 weeks of training commands a starting pay of $45K and a medic with a year of training who has a greater impact on peoples lives than the cop ever will makes $25K is our fault and no one else.

  • Pingback: More Financial Reform, Less Financial Security | HealthCareDaily.info

  • http://themictstudent.blogspot.com/ The MICT Student
  • moabdeeb

    Well i'm kinda curious, about something. What about the EMT's that are supporting the paramedics, on the regular ambulances? All they say is paramedic unit. Let me tell you, i have worked with a variaty of different medics/nurses in my time, and without EMT's to support, get the equipment, or checking the equipment, or actually just being there, then there would be alot more dead people in the world. I'm not saying all paramedics/nurses are stupid, i work with alot of great nurses, and paramedics, but we need to remember the EMT's also. About the truck, who cares if its staffed by nurses, theres always an EMT driving it. Everything i have said is just an opinion, and i love the medics, and the nurses that i get to work with. People please remember, we are all in this for the same reason.

  • bennett5920

    Maybe they put it on the side to warn the public that there is only nurses on board and don't call them in a real emergency? Now don't get me wrong I am a paramedic, married to a Nurse. I feel we are both important, but people we have to remeber just about (note I did not say all) every nurse I have met after 5 years don't want to be a nurse anymore, and they only got into it because they thought it would be easy or because the pay is great. But just about (note the just about not all) every EMS worker enjoys going to work and we do it because we love it. So I say big deal give the nurses one little thing to make them feel better about themselfs. We as EMS workers have way more pride

  • Kelly Kujawski

    Did you Paramedics know that after you drop that critical care patient off and your transport is done, the patient still requires care? Or lets talk about this, how are these critical care drugs excreted? How do they work, what organs react to them and how? Will your care send a previously healthy person into renal failure because all you know is the protocol of the drug and not how the drug itself works??!! How about the 2-3 weeks of recovery after Multiple Organ Dysfunction due to an arrest situation? The list goes on and on honey…

    Please don't insult me as an ER nurse if you don't want the feedback…

    Buck up, sometimes patients need nursing care. Stop being a cry baby.

  • http://twitter.com/Cynical_Nurse Cranky Nurse

    Try NJ, where *only* RNs with at least a year of ICU, CCU or ER experience are allowed (by law) to staff an ambulance for the purpose of interfacility (referred to as Specialty Care Transport) trips. Thank the Nurses' Associations for this – the more you lobby, the more you get. It's the same reason that Paramedics in NJ must ride two-per-truck and are specifically prohibited from transporting (again, by law). Thank the Volunteer First Aid Council for lobbying that into existence.

  • http://twitter.com/Cynical_Nurse Cranky Nurse

    Try NJ, where *only* RNs with at least a year of ICU, CCU or ER experience are allowed (by law) to staff an ambulance for the purpose of interfacility (referred to as Specialty Care Transport) trips. Thank the Nurses' Associations for this – the more you lobby, the more you get. It's the same reason that Paramedics in NJ must ride two-per-truck and are specifically prohibited from transporting (again, by law). Thank the Volunteer First Aid Council for lobbying that into existence.

  • http://twitter.com/seanhfitz Sean Fitz

    A-fucking-men!
    -Sean (Critical care nurse AND paramedic)

  • http://www.seejanenurse.wordpress.com SeeJaneNurse

    Let me comfort you.

    1. I am a nurse and would not know what to do in an ambulance, or the first thing to do outside of my safe little world in the hospital: except maybe BLS till the paramedics could come.

    2. As an artist and former graphic artist lettering trucks: That script sucks, the whole design is crappy.

  • Medic Instructor

    Seriously?? Have you looked at the Paramedic Curriculum? Not to mention you pretty much stated what everyone was saying “after you drop that critical patient off…..the patient still requires care”. No knock to ER nurses, or any other nurse for that matter……just in the field, I beleive is what people are tring to say.

  • Travis

    First I agree with the discussion as far as I have read. Where I come from protocols are written so that a nurse and paramedic compliment one another, not placing one higher then the other. However I do find myself wanting to play devils advocate. The fact that the amblance reads “Staffed by Nurses” may not mean that one is trying to place a nurse above a medic. For example there are amabulances that are clearly marked as BLS and others as Paramedic. Does that mean that we as medics are going to put our value higher then an EMT-B? Granted we can do more interventions but, depending on the system it often times would not work without BLS units, there are many interventions we can do that would be ineffective without the smaller more trivial BLS interventions being done at the same time. Perhaps now medics are able to feel the same way EMT's have felt about markings on an ALS unit. Just something to think about, I still agree that an RN should be in a hospital where they were trained to be in and there is a shortage of them, why spread them even thinner when we already have educated professionals to staff the ambulances?

  • Pingback: Happy EMS week « See Jane Nurse

  • Chitownmedic

    I can fully comprehend the last part of your posting concerning how some RN's act or regard Paramedics. I just completed 8 clinical hours for re-licensure here in Illinois & I wasn't treated rudely, but was not made to feel welcomed either. I said at the end of my hours 'I felt like I was more in the way & a swollen thumb' !

  • 0.9% Paramedic

    Kelly,

    People like you are exactly the problem. You belittle paramedics and assume we know nothing but protocols without actually being familiar with the paramedic education process. Yes, there are some three-month medic mill programs out there, and they are deplorable. But let's not forget the two-year associate degree programs that expose the student paramedic to over 2000 hours of clinical experience. Let's also not forget the paramedics who take advanced college-level pharmacology and/or anatomy and physiology courses. I know several paramedics with bachelor-level education, and some even have a master's degree. So before you go shooting your mouth off about “those derned ammalance drivers”, take a moment and educate yourself on the reality of the situation. Realize that EMS is no longer what is was in the days of Johnny Gage and Roy DeSoto on Squad 51, and it most definitely isn't like on Trauma. If you want to keep taking potshots, I'm sure I could bring up some of the more embarrassing things I've seen members of your profession do… like the nurse who stared at me with a dumbfounded look on his face when I explained to him the difference between ventricular tachycardia and supraventricular tachycardia… or the nurse who stated matter-of-factly that you should never touch the insertion site when starting an IV due to risk of infection, then proceeded to tape the IV down with tape that had been stuck to her sleeve before she even thought about applying a tegaderm… or the nurse who blew both ACs in a patient before I calmly stepped in and put an 18 in the gentleman's hand. I'm sure we could both site humiliating examples from either's profession, but please, do not make assumptions that have no basis in fact or else you will end up making yourself look like an idiot. More specifically, an idiot who cannot do anything but make an argument that is the philosophical equivalent of “You suck you suck nanny nanny poo poo I can't hear you na na na na naaaa naaaaa…”

    All the best.

  • 0.9% Paramedic

    Please forgive any grammatical errors… it's early for us night shifters!

  • 0.9% Paramedic

    Kelly,

    People like you are exactly the problem. You belittle paramedics and assume we know nothing but protocols without actually being familiar with the paramedic education process. Yes, there are some three-month medic mill programs out there, and they are deplorable. But let's not forget the two-year associate degree programs that expose the student paramedic to over 2000 hours of clinical experience. Let's also not forget the paramedics who take advanced college-level pharmacology and/or anatomy and physiology courses. I know several paramedics with bachelor-level education, and some even have a master's degree. So before you go shooting your mouth off about “those derned ammalance drivers”, take a moment and educate yourself on the reality of the situation. Realize that EMS is no longer what is was in the days of Johnny Gage and Roy DeSoto on Squad 51, and it most definitely isn't like on Trauma. If you want to keep taking potshots, I'm sure I could bring up some of the more embarrassing things I've seen members of your profession do… like the nurse who stared at me with a dumbfounded look on his face when I explained to him the difference between ventricular tachycardia and supraventricular tachycardia… or the nurse who stated matter-of-factly that you should never touch the insertion site when starting an IV due to risk of infection, then proceeded to tape the IV down with tape that had been stuck to her sleeve before she even thought about applying a tegaderm… or the nurse who blew both ACs in a patient before I calmly stepped in and put an 18 in the gentleman's hand. I'm sure we could both site humiliating examples from either's profession, but please, do not make assumptions that have no basis in fact or else you will end up making yourself look like an idiot. More specifically, an idiot who cannot do anything but make an argument that is the philosophical equivalent of “You suck you suck nanny nanny poo poo I can't hear you na na na na naaaa naaaaa…”

    All the best.

  • 0.9% Paramedic

    Please forgive any grammatical errors… it's early for us night shifters!

  • Bmwpia

    It’s a nice truck, but it creates a lot of resentment inside AMT among the EMTs towards the nurses. Although the nurses that staff it are very nice people and good at what they do, they do seem to get “special” treatment from administration and get their way on issues. However for me
    the biggest problem with the truck is that it has that script on the side advertising the use of nurses.

  • Ems_oceanrn

    Nurses have always been in the field. Many moons ago, paramedics were authorized to practice in their county only. This meant, if they rolled across county lines, they were no longer authorized to practice. Theoretically, those “lines” went straight up into space. Physicians, Nurses and Respiratory Therapists are licensed by the State; they could practice in any county. The State EMS Authority didn’t exist then. CCT crews, both flight and ground, were MD/RN/RT staffed and came from the receiving facility to pick up the patient. In the late 70′s to early 80′s, the Field MICN staffed with an EMT worked the streets and did transfers. Counties began Paramedic Programs *yeah* and this began to change.

    Direct online medical radio control was provided by ED Physicians. That too was given to the RN. As Paramedic training/education expanded, so did their diameter of service. Counties formed Regions to share the training and coordinate expenses. The EMS Authority was born, providing medics with the ability to practice state-wide. Protocols expanded to what they are now. Most counties no longer have direct online medical ratio control anymore. Medics use field protocols. Some DCF’s still delegate who goes where for multiple counties, but by and large, medics practice very autonomously here in California.

    CCT is a huge revenue generating ticket. Even documentation reimbursement in hospitals must state “1:1 critical care begins now” and then “1:1 critical care ends now” for reimbursement purposes! *blech* It’s about money. Plain and simple, folks. Higher “level of skill” = higher educational degree = higher reimbursement.

    As far as skills go, ANY skill can be taught..it’s monkey see, monkey do, if you ask me. Skills are important, you can’t get shit done if you can’t DO. But what really makes a good practitioner is knowing HOW to think critically, not just what cookbook to follow. Not one profession is without their duds, EMT, Paramedic, Nurse or Physician. I’ve been around long enough both the street and in house to have seen some pretty clueless folks in ALL services. Personally, if you don’t have strong BLS skills, I don’t care what degree or license you have…nothing else matters.

    Working the field is a unique environment. Many of my Paramedic students over the years failed miserably once they hit their field internships; they were EMTs but had never worked an ambulance; therefore, had no clue on how to manage a scene, much less delegate and lead one. The Paramedic Program I am very proud to have been a part of provided an Associates Degree. Our medics scored in the high 90th percentile, first time pass, National Registry. They are employed in some of the most hard-hitting cities of California. Lucky Cities! Some RNs wanted to crossover as medics and some failed during field internship for the very same reason. Some, rocked it up and are terrific CCT flight/ground staff.

    My advice to you: Get organized. Require at least an undergraduate degree for your profession. Lobby for yourselves. Once you do that, you can advocate at the federal level for acknowledgement of your CCT skills. Nurse Anesthetists can now practice autonomously and bill on their own without having to do so under an MD. Why not Paramedics? Paramedicine = Para(llel) Medicine. Stop sniping at nurses…we have an ugly job nowadays..lol

  • BoxerRob

    Thankfully my area worked thru these issues long age. A paramedic is a known skill set in an ambulance environment. RN could be just about anything, and it is very rare that a RN will have the skill set of a paramedic. I’ve held both. High speed level 1 trauma hospital ICU experience helps when a transfer has an ICP device, balloon pump, ECMO, PA catheter, 7 drips…the medic in me knows what that stuff is, but only my ICU RN self can operate/adjust it to hospital standards. Hopefully there is strong MD control…field crews stridently proclaiming what they will and won’t do need it.  

  • Hit the weights

    Dude, You are an IDIOT.

    Nurses have been transporting Patients for over a hundred years. Nurses and doctors have taught you the Paramedic everything he or she knows. Paramedics have invented nothing, How dare you become so envious, I am a Registered Nurse, and swin circles around medics. You have need to come to grips with what is called the Pecking order!

  • http://www.globalgenericpharmacy.com/levitra.html Generic Levitra

    Good Information has been established in this page.. Good source mate.. 

  • Katy

    Oh my goodness. I am an RN and have worked as a nurse in ED and I have so much respect for the paramedics, they have such amazing knowledge and skills. It’s hard to imagine (where I live anyway) how promoting an ambulance without any paramedics is suposed to be good marketing. That makes so little sense.

    Honestly my first impression when I saw the photo was that is was some sort of transport ambo, because honestly, nurses can’t do the things that you guys do. We can do a lot, but it’s an entirely different skill set.  

background image Blogger Img

Chris Kaiser aka "Ckemtp"

I am a paramedic trying to advance the idea that the Emergency Medical Services can be made into the profession that we all want it, need it, and know it deserves to be.

JEMS Talk: Google Hangout

Categories
  • 2009 (2)
  • 911 (4)
  • 911 fail (20)
  • accident (4)
  • ACLS (3)
  • Administration & Leadership (85)
  • aed (2)
  • AHA (3)
  • Als (9)
  • ALS Intercept (14)
  • Ambulance (90)
  • Ambulance cleaning (4)
  • Ambulance Driver (6)
  • ambulance humor (20)
  • Ambulance maintenance (4)
  • ambulance report (3)
  • American Heart Association (3)
  • amulance (1)
  • appreciation (13)
  • attack (2)
  • bad calls (5)
  • Bed pan (1)
  • Bed pans (1)
  • bedpan (1)
  • bernoulli (1)
  • blog (5)
  • blogger (4)
  • blogosphere (3)
  • boy scouts (1)
  • camaraderie (2)
  • Case law (2)
  • cat puke (1)
  • cats (1)
  • CCC (5)
  • CCR (7)
  • CDC (1)
  • change (20)
  • chart (1)
  • CISD (3)
  • ckemtp (14)
  • ckemtp rants (29)
  • cnn fail (1)
  • code-3 (2)
  • comfort (1)
  • Command & Leadership (54)
  • cool pics of thunderstorm (1)
  • courtesy (2)
  • cpr (10)
  • cpr fail (4)
  • cpr save (4)
  • crisis (6)
  • dave barry (2)
  • dextrocardia (1)
  • disaster (2)
  • disinfection (4)
  • Dispatch & Communications (2)
  • DNR (5)
  • Do Not Resuscitate Order (5)
  • domestic violence (1)
  • Dr. Bledsoe (1)
  • drive fast (2)
  • duty boots (2)
  • Economics (17)
  • edemse (28)
  • EKG (10)
  • Emergency Communications (5)
  • Emergency Medical Services (189)
  • Emergency Nurse (11)
  • Emergency room (11)
  • Emergency Room Nurse (5)
  • emotions (17)
  • EMS (250)
  • ems 2.0 (67)
  • EMS Blog (19)
  • EMS Blog Carnival (3)
  • EMS blogosphere (11)
  • ems boots (1)
  • EMS Conference (4)
  • EMS Dispatch (3)
  • ems education (54)
  • EMS ethics (54)
  • ems garage (2)
  • EMS Health & Safety (69)
  • EMS Humor (41)
  • EMS Management (52)
  • EMS Motivation (21)
  • EMS motivational posters (1)
  • ems narrative (7)
  • EMS narrative report (6)
  • ems pants (1)
  • EMS paramedics (25)
  • ems patient care report (6)
  • EMS pay sucks (7)
  • ems pcr (1)
  • EMS pep talk (21)
  • EMS practice (8)
  • EMS protocol project (1)
  • EMS protocols (12)
  • EMS rant (27)
  • ems report (3)
  • EMS safety (10)
  • ems salary (8)
  • ems scenario (9)
  • ems scenario based education (12)
  • EMS system (9)
  • EMS Topics (237)
  • EMS training (58)
  • ems uniforms (1)
  • EMS week (10)
  • EMS Week 2009 (2)
  • ems week 2010 (8)
  • EMT (73)
  • emt narrative (3)
  • EMT-Intermediate (6)
  • EMT-Paramedic Specialist (5)
  • ER (8)
  • ET Intubation (3)
  • Ethics (27)
  • everyday ems ethics (29)
  • explosion video (1)
  • extrication (1)
  • ez-io (2)
  • FEMA (2)
  • fire (13)
  • fire boots (2)
  • Fire department (38)
  • fire department taser training (1)
  • Fire Dispatch (1)
  • Fire Prevention & Education (4)
  • Fire Rescue Topics (96)
  • fire truck (1)
  • Firefighter (21)
  • Firefighter Safety & Health (20)
  • firefighter Tazed (1)
  • Firefighting Operations (4)
  • Fires (2)
  • first call (1)
  • first day of school (1)
  • first responder (2)
  • friendly (1)
  • Funding & Staffing (15)
  • funny (8)
  • grumblemedics (6)
  • Happy Medic (2)
  • harry reid (1)
  • HazMat (1)
  • hospital (5)
  • humor (14)
  • hurricane (1)
  • idph (3)
  • illinois (4)
  • In the Line of Duty (13)
  • infection control (5)
  • information (1)
  • inside the mind of a paramedic (16)
  • intraosseous (3)
  • Introduction (1)
  • intubation (3)
  • IO (3)
  • Iowa (4)
  • Iowa EMS (4)
  • ireland (1)
  • Irish EMS (1)
  • IV (3)
  • jaws of life (1)
  • kindergarten (1)
  • kneeling (1)
  • las vegas review journal (1)
  • Letter (2)
  • letter to the editor (4)
  • lights and sirens (2)
  • Line of Duty (12)
  • link (3)
  • MABAS (1)
  • Magnum boots (2)
  • magnum elite equipment (2)
  • mainstream media sucks (3)
  • Major Incidents (3)
  • Management (10)
  • Mass Casualty Incident (1)
  • medical ethics (19)
  • medicblog999 (7)
  • mental illness (2)
  • mental imagery (6)
  • Mission Lifeline (1)
  • Music (1)
  • narrative (4)
  • narrative report (3)
  • new perspective (16)
  • News (23)
  • newspaper (3)
  • NOAA (1)
  • northern illinois (3)
  • nursing home (2)
  • obama (1)
  • odansetron (2)
  • Paramedic (195)
  • paramedic education (74)
  • paramedic narrative (7)
  • paramedic pants (1)
  • paramedic salary (11)
  • Patient Assessment (7)
  • patient care (37)
  • Patient Handovers (3)
  • Patient Management (77)
  • pcr (2)
  • pediatric cardiology (2)
  • physician (10)
  • politics (36)
  • potential (14)
  • PR (5)
  • pride (15)
  • profession (27)
  • professionalism (32)
  • Protocol development (5)
  • psychology (6)
  • Public relations (14)
  • puke (2)
  • rant (7)
  • relationships (2)
  • renaisance (1)
  • rescue (1)
  • rescuing providence (1)
  • RN (3)
  • Rockford (1)
  • roll-over (1)
  • run sheet (2)
  • rural ems (3)
  • sadness (6)
  • safety (4)
  • salary (7)
  • sanitize (3)
  • save (3)
  • scenario (13)
  • scenario based training (15)
  • school bus (1)
  • Scope of Practice (4)
  • severe storm pictures (2)
  • sherman frederick (1)
  • shift length (2)
  • show tunes (1)
  • SitRep (1)
  • Skilled Nursing Facility (2)
  • SMG (7)
  • SMO (7)
  • soap (4)
  • soap charting (3)
  • socialized medicine (4)
  • southern wisconsin (4)
  • Special Operations (1)
  • STEMI (8)
  • stories (11)
  • swine flu (2)
  • Taser (1)
  • tattoo (1)
  • tattoo humor (1)
  • Technology & Communications (9)
  • technology-communications-ems-topics (10)
  • thank you (3)
  • The EMT Spot (2)
  • The Handover (3)
  • The Shine Factor (2)
  • thom dick (1)
  • thunderstorm (1)
  • train derailment (1)
  • train explosion (1)
  • Training (16)
  • Training & Development (49)
  • training-fire-rescue-topics (19)
  • Transfer of Care (1)
  • UK Child custody (1)
  • UK medic attacked (1)
  • UK paramedics (5)
  • Uncategorized (230)
  • united kingdom (4)
  • universal healthcare (5)
  • us (2)
  • US economy (11)
  • Vehicle Operation & Ambulances (3)
  • Vehicle Operations & Apparatus (1)
  • Videos (3)
  • volunteer fire department (9)
  • volunteer firefighter (6)
  • wall cloud (1)
  • Week (1)
  • whattaya do (4)
  • when god made paramedics (1)
  • wisconsin (3)
  • wolf parkinson white (1)
  • wpw (1)
  • wpw syndrome (1)
  • Your Happy Medic (5)
  • zofran (1)
  • Comments
    Ianto Jones
    The Natural Alignment Movement – Freedom of Choice from the Orthopedic Conspiracy
    Oh, dear G-d. This was hilarious, but I'm fighting not to find it dangerous as well -- someone's gonna share it on FB, and one of _their_ friends is going to send it to Bright Star MorningGlory Rainbow, who will send it to her YahooGroup, and someone there will reply that he *thinks* he broke…
    2014-11-18 09:54:00
    Thad Torix
    Patient Friendly Jokes
    Have you heard my construction joke? I'm still working on it.... (Credit to my youngest daughter for that one. My partners are absolutely sick of hearing that joke...) On another note, what a fantastic blog. If you are ever in SW Missouri, stop by and say hello. Thad Torix - EMS Instructor & Clinical Coordinator…
    2014-11-03 18:27:00
    mr618
    Welcome to the Club
    Well said, Chris. We can't save everybody, but the ones we don't save tend to stick around a lot longer than the ones we do save.
    2014-10-18 14:40:00
    Steel City Medic
    Welcome to the Club
    Particularly appropriate for me this week. Thanks.
    2014-09-23 21:46:00
    DiverMedic
    Welcome to the Club
    Very well done, Chris.
    2014-09-17 22:15:00

    Care to Search the Blog?

    FireEMS Blogs eNewsletter

    Sign-up to receive our free monthly eNewsletter

    LATEST EMS NEWS

    HOT FORUM DISCUSSIONS