Should nurses be required to complete ride alongs with FD

[Carlos Danger]

Than why was it that when I did my hospital time as an EMT I only interacted with a nurse, and that was barely? If I was supposed to be exposed to medicine, shouldn't training facilities be working with the physician group staffing the emergency department than the hospital itself?

I don't know, I wasn't there. The person to ask would probably be the person who told you to follow the nurses around.

My guess would be that they thought you'd get more practical patient exposure with the nurses than with the docs, or that the docs just didn't want to be bothered with an EMT student.

 

[SFLfire]

My Paramedic program required that I do 2 clinical rotations in med/surg with a floor nurse. The staff was great, and I found the estrogen driven gossip of the nurses station interesting. However, beyond that, I got to see the life of a floor nurse. It was interesting and a cool experience, but to be honest it did nothing for my clinical skills, nor did it help me as a Paramedic. It did not relate to my job at all. I am not sure how much the school paid for that time or wasted with it, but it could have been spent much better in the ICU or the OR for a Paramedic student.
I guess this is somewhat what it would be like placing a nurse with the fire department, impractical and wasteful. Also since it is a fire department doing patient care here..... would it not make more since to make the fire department shadow a health care agency?

I think I made a mistake by JUST saying fire department and it might be throwing some people off. I know that throughout a lot of the country, fire departments only hire Firefighter/EMTs...that's not the way it is where I live. Down here FD also runs the emergency ambulance service so everyone has to be a Firefighter/Paramedic. Private ambulance companies only do interfacility transports here.

Nurses would NOT be riding in the trucks or the engines, they'd be on the ambulance with medics.

Doubt that's going to change anyones mind, I just thought that I needed to point that out.

 

[Clipper1]

My Paramedic program required that I do 2 clinical rotations in med/surg with a floor nurse. The staff was great, and I found the estrogen driven gossip of the nurses station interesting. However, beyond that, I got to see the life of a floor nurse. It was interesting and a cool experience, but to be honest it did nothing for my clinical skills, nor did it help me as a Paramedic. It did not relate to my job at all. I am not sure how much the school paid for that time or wasted with it, but it could have been spent much better in the ICU or the OR for a Paramedic student.

That is strange you feel that way since you started a discussion advocating Community Paramedics. 95% of what community medicine is about starts on the MedSurg floors. The assessments, education, retraining and case management to get a patient back home are all part of med surg. Sometimes the responsibility relies heavily on just the RNs and sometimes it is a collaboration of many different professionals. It is too bad you missed that. Being a Paramedic should be more than just getting to the neat skills especially when it comes to an overall assessment. Chances are the average EMS Paramedic will not be managing ICU ventilators, IABPs or multiple IV drips. Working a code in the ED and the stabilization which occurs there would be more practical.


As far a nursing student riding on an ambulance, there is no point. Nursing education is done differently than the vocational tech style done by Paramedic programs. A foundation is done and each step is in increments building up to a general nursing skill level. The education is there in the foundation but the experience and skills are developed as the nursing student advances and later picks a path to follow for the specific training. No one expects an RN to be ICU ready after even 4 years of college since there is just too much to learn to get to that point. This is why there are now extensive internships averaging 3 - 6 months for BSN RN grads to complete in a specialty as a bridge to employment. The Paramedic program teaches the necessary skills to be job ready for a very specialized and also a very small percentage of medical care patients.

 

[Summit]

JPINFV: Around here the EMT and medic students are almost always paired with RNs in the ED, and it is very appropriate.

My Paramedic program required that I do 2 clinical rotations in med/surg with a floor nurse... It was interesting and a cool experience... I guess this is somewhat what it would be like placing a nurse with the fire department

I agree with this analogy 100% for the current vo-tech paramedic model.

However, I agree with Clipper1's response if one is arguing for an educated community paramedic model.

I am not sure how much the school paid for that time

It would be very odd if this number was something other than zero. Nursing schools do not pay for clinical placements, nor preceptors. They only pay for clinical scholars who are employed by the school (though often dual-appointments with the (usually one scholar for 4-8 students).

 

[Clipper1]

However, for Med Surg a Paramedic can:

Start IVs

Check for IV complications (some might even be from field sticks)

Learn about the different insulins and see how RNs manage glucose protocols

Have at least 50 patients to listen to breath and heart sounds

Do vitals. This also is a weak area for some as it appears in the discussions here.

Do NG tubes (I think some Paramedics are able to do these although I have not seen it)

Learn about aspiration.

See the many different medications given to one patient daily in various forms depending on swallowing ability and how many one RN must give in one shift.

See the many different access ports which are used routinely which was a recent discussion and it seems many do not get the experience even if they are allowed to access them.

Learn about infection control and the various infectious diseases which seems to be a very weak point as we have seen from routine transfers and some EMS providers who continue to wear their contaminated gloves everywhere in the hospital after they drop off a patient.

Learn about spinal injury patients and how to move them carefully pre and post op. This might benefit those who don't believe any precautions are necessary. A LSB might not always be required but we also don't just walk them or toss them around either. Talking to a patient who is a fresh quad and see how they may not have exhibited any symptoms initially might be an eye opener also.

Caring, including suctioning, for a tracheotomy or stoma patient. Learning how to remove or secure a prosthetic speaking valve on a laryngectomy patient is helpful if you need to secure an airway.

Nasotracheal suctioning

Learning the various oxygen delivery devices including those which are considered High Flow. (NRB masks are not)

Learn the various neuro assessments for acute and ongoing for various disease processes both known and unknown.

Rapid response teams in action...nurses working without a doctor present and by their protocols.

Check out the extensive protocol sets of a med surg nurse.

Have a chance to read 50 histories, look up labs and check out X-Rays which are all usually available on a computer. Of course your preceptor will need to have a student access code.

Read the 12 lead ECG interpretations and the cath lab reports. View the actual cath lab diagnostics on the computer.

Learn about the various pacemakers.

Learn more about DVTs and how they could present which is not always textbook.

Have a chance to see what other health care professionals do. Even RNs do more than just gossip at the nurses station. FFs and Paramedics have their own gossip which is often hear in the ER often heard over the patient during a drop off.

Learn about pain management both acute and chronic.

Watch bedside procedures such as a thoracentesis, PICC insertion and sometimes central line insertions. You can take notes on the steps to insure a clean or sterile setting.

If your class instructor structures a clinical rotation correctly there is an unlimited amount of things to see with over 50 patients to have access to. The problem is many instructors fail to structure with an outline of what is expected. Instead they just send a student to the ER or floors to "follow someone" who is usually the person who does not like students because they are not getting paid extra and have a heavy assignment. If the charge RN sees your outline, he or she can see that you get those things done and you may not be stuck with just one person as a tag along.

 

[JPINFV]

However, for Med Surg a Paramedic can:

Start IVs

Check for IV complications (some might even be from field sticks)

Learn about the different insulins and see how RNs manage glucose protocols

Have at least 50 patients to listen to breath and heart sounds

Do vitals. This also is a weak area for some as it appears in the discussions here.

Do NG tubes (I think some Paramedics are able to do these although I have not seen it)

Learn about aspiration.

See the many different medications given to one patient daily in various forms depending on swallowing ability and how many one RN must give in one shift.

See the many different access ports which are used routinely which was a recent discussion and it seems many do not get the experience even if they are allowed to access them.

Learn about infection control and the various infectious diseases which seems to be a very weak point as we have seen from routine transfers and some EMS providers who continue to wear their contaminated gloves everywhere in the hospital after they drop off a patient.

Learn about spinal injury patients and how to move them carefully pre and post op. This might benefit those who don't believe any precautions are necessary. A LSB might not always be required but we also don't just walk them or toss them around either. Talking to a patient who is a fresh quad and see how they may not have exhibited any symptoms initially might be an eye opener also.

Caring, including suctioning, for a tracheotomy or stoma patient. Learning how to remove or secure a prosthetic speaking valve on a laryngectomy patient is helpful if you need to secure an airway.

Nasotracheal suctioning

Learning the various oxygen delivery devices including those which are considered High Flow. (NRB masks are not)

Learn the various neuro assessments for acute and ongoing for various disease processes both known and unknown.

Rapid response teams in action...nurses working without a doctor present and by their protocols.

Check out the extensive protocol sets of a med surg nurse.

Have a chance to read 50 histories, look up labs and check out X-Rays which are all usually available on a computer. Of course your preceptor will need to have a student access code.

Read the 12 lead ECG interpretations and the cath lab reports. View the actual cath lab diagnostics on the computer.

Learn about the various pacemakers.

Learn more about DVTs and how they could present which is not always textbook.

Have a chance to see what other health care professionals do. Even RNs do more than just gossip at the nurses station. FFs and Paramedics have their own gossip which is often hear in the ER often heard over the patient during a drop off.

Learn about pain management both acute and chronic.

Watch bedside procedures such as a thoracentesis, PICC insertion and sometimes central line insertions. You can take notes on the steps to insure a clean or sterile setting.

If your class instructor structures a clinical rotation correctly there is an unlimited amount of things to see with over 50 patients to have access to. The problem is many instructors fail to structure with an outline of what is expected. Instead they just send a student to the ER or floors to "follow someone" who is usually the person who does not like students because they are not getting paid extra and have a heavy assignment. If the charge RN sees your outline, he or she can see that you get those things done and you may not be stuck with just one person as a tag along.

All of which can be done in more appropriate settings (in terms of the likelihood of the device being present, intervention being performed, and patient turnover) like the ED, PACU, or ICU settings than a general med-surg floor. This is, of course, assuming that the licensed nursing staff knows what they're talking about. I've seen rapid response calls put out because the nursing staff couldn't figure out how to trouble shoot a pulse ox and discussions about whether femoral lines are PICCs or not because they aren't on the chest. Similarly, I wonder how many RNs think that a tunneled IJ line is a subclavian due to the location the line exits the body.

 

[Clipper1]

All of which can be done in more appropriate settings (in terms of the likelihood of the device being present, intervention being performed, and patient turnover) like the ED, PACU, or ICU settings than a general med-surg floor. This is, of course, assuming that the licensed nursing staff knows what they're talking about. I've seen rapid response calls put out because the nursing staff couldn't figure out how to trouble shoot a pulse ox and discussions about whether femoral lines are PICCs or not because they aren't on the chest. Similarly, I wonder how many RNs think that a tunneled IJ line is a subclavian due to the location the line exits the body.

You also complained about being with a nurse in the ED.

Not all nurses are as stupid as you make them out to be in your post. I could also list many incidents where EMTs and Paramedics have screwed up on the pulse oximeter. Just read some of the discussions on this forum and you will see those in EMS are not perfect either.

This constant bashing of other health care professionals is what keeps some EMT and Paramedic students out of many clinical situations. No one wants you in their area if you already have formed an opinion based on some anonymous internet forum that you are better than anyone else and haven't even got a good start in your Paramedic program.

Some of the responsibility should also fall on the instructors of the Paramedic programs also.

What exactly is a Paramedic going to learn in PACU? It is very rare they have a code and Paramedics need to know how to keep an ETT in and how to not pull them out.

The patients on med surg would more likely be the type of patients an EMT or Paramedic would most likely see. Not everyone is a trauma and not everyone is just a band aid in the ER. These are the patients who need to be transported and will get admitted for medical illnesses either acute or chronic exacerbations.

Why should a beginning Paramedic student jump right into an ICU and see equipment that most have never even read about and will probably never see in the field? Why not learn patient assessment over and over again? Med Surg floors in major hospitals have hundreds of patients. It seems some just want to dive right into the neat skills part and miss a lot of stuff at the beginning and inbetween.

Also on med surg you can learn to talk to the patients. Of course you might also have to talk to the nurses which might be difficult for some like yourself.

 

[JPINFV]

You also complained about being with a nurse in the ED.

And if we're talking about a limit time to learn how to make clinical judgement, than I stand by my argument that physicians are a better match.

Not all nurses are as stupid as you make them out to be in your post. I could also list many incidents where EMTs and Paramedics have screwed up on the pulse oximeter. Just read some of the discussions on this forum and you will see those in EMS are not perfect either.

...and not all EMTs and paramedics are stupid either. However I see a lot more documentation issues when I look through nursing documentation than EMS documentation.

This constant bashing of other health care professionals is what keeps some EMT and Paramedic students out of many clinical situations. No one wants you in their area if you already have formed an opinion based on some anonymous internet forum that you are better than anyone else and haven't even got a good start in your Paramedic program.

1. I'm not in a paramedic program.
2. If you want some interprofessional bashing, have you tried looking in the mirror?
3. My chain of command doesn't involve nurses anyways.

Some of the responsibility should also fall on the instructors of the Paramedic programs also.

Completely agree.

What exactly is a Paramedic going to learn in PACU? It is very rare they have a code and Paramedics need to know how to keep an ETT in and how to not pull them out.

You were the one who mentioned oxygen administration devices, not me, and I've seen more variety on ways to deliver oxygrn there than on the floors where often my team wouldnt have any patients on supplemental oxygen. Also, unless the patient was going to the ICU, they were extubated in the OR anyways.

The patients on med surg would more likely be the type of patients an EMT or Paramedic would most likely see. Not everyone is a trauma and not everyone is just a band aid in the ER. These are the patients who need to be transported and will get admitted for medical illnesses either acute or chronic exacerbations.

Why should a beginning Paramedic student jump right into an ICU and see equipment that most have never even read about and will probably never see in the field? Why not learn patient assessment over and over again? Med Surg floors in major hospitals have hundreds of patients. It seems some just want to dive right into the neat skills part and miss a lot of stuff at the beginning and inbetween.

because it makes more sense than med surge due to the acuity of the patients. However, for assessment and management, the ED is the best place for them.

Also on med surg you can learn to talk to the patients. Of course you might also have to talk to the nurses which might be difficult for some like yourself.

I always love your personal attacks. It warms my heart and tells me that I'm right.

Of course taking to patients can also be achieved in the ED.

 

[Clipper1]

And if we're talking about a limit time to learn how to make clinical judgement, than I stand by my argument that physicians are a better match.

...and not all EMTs and paramedics are stupid either. However I see a lot more documentation issues when I look through nursing documentation than EMS documentation.

1. I'm not in a paramedic program.
2. If you want some interprofessional bashing, have you tried looking in the mirror?
3. My chain of command doesn't involve nurses anyways.


Completely agree.


You were the one who mentioned oxygen administration devices, not me, and I've seen more variety on ways to deliver oxygrn there than on the floors where often my team wouldnt have any patients on supplemental oxygen. Also, unless the patient was going to the ICU, they were extubated in the OR anyways.

The patients on med surg would more likely be the type of patients an EMT or Paramedic would most likely see. Not everyone is a trauma and not everyone is just a band aid in the ER. These are the patients who need to be transported and will get admitted for medical illnesses either acute or chronic exacerbations.
because it makes more sense than med surge due to the acuity of the patients. However, for assessment and management, the ED is the best place for them.


I always love your personal attacks. It warms my heart and tells me that I'm right.

Of course taking to patients can also be achieved in the ED.

A disgruntled med student. What does it matter for this discussion who your chain of command is as a med student? Did the mean nurses pick on you again?

I will only comment on a couple of things out of all that stuff you wrote since you want to resort to insults on nurses again.

You might read more documentation from nurses because they do a heck of a lot of documentation per patient. There are also a heck of a lot of nurses. Some of the larger hospital will employee over 1000 - 2000 RNs easily. We have over 200 in just our Neonatal units. Since you have not been a Paramedic, you may only have read a few of the Paramedic charts which happen to be on the patients admitted. The important thing is "what did you do about the errors you found"? Do you know the regulations for the state and facilities you are in for reporting errors? Do you report only the errors of the nurses and not the Paramedics?

I will also agree that there probably should be more physicians on the ambulances in the US like some of the European models.

I guess by your reasoning, Paramedic students really should not doing much interaction at all in the hospital since they will have to encounter nurses at some time. Nurses also should not ride on with the fire department either if it is only to be for a superiority pissing match.

Maybe we should have more physicians on the ambulances in the US. Why is it that when of the advantages of certain clinical situations like in med surg are pointed out EMTs and Paramedics feel insulted? Maybe an EMT or Paramedic student might get some ideas about what to ask for in clinicals or do something to take the initiative rather than just stand around waiting for someone to tell them to do something or for something cool to come into the ED. I bet a lot of Paramedic students never knew what all they could see and maybe do in the hospital.

Why is it EMS wants a nurse to ride on a fire truck or ambulance but is not willing to experience more patient care volume per time spent in a hospital situation? Some Paramedic students are barely seeing 3 or 4 patients in each clinicals and will limited assessments or skills. The RN on the ambulance or fire truck probably will see the same and most patients will not need ALS skills.

 

[Achilles]

Clipper, I notice you don't have your education listing below your name, do you mind telling th class what your education level is? Please.

 

[SFLfire]

This constant bashing of other health care professionals is what keeps some EMT and Paramedic students out of many clinical situations. No one wants you in their area if you already have formed an opinion based on some anonymous internet forum that you are better than anyone else and haven't even got a good start in your Paramedic program.

Based on what I've seen (from internet forums) nurses bash medics just as much as medics bash nurses. Go check out allnurses.com. You know it happens both ways.

 

[Akulahawk]

Clipper1, JPINFV is a 3rd year medical student, probably under a bit of stress, but I wouldn't describe him as disgruntled. In his case, he is going to be a DO. Because of his education, he will not need to attend Paramedic School after he's completed his formal education. If he wishes to add a Paramedic License, there's a challenge process through which he could do precisely that.

I've read most of the thread. Something that popped up in my own mind after reading the last page or two is that I'm starting to think that it would be a good idea for a paramedic student to spend about a week in a hospital, doing (basically) just vitals and assessments, moving progressively from a very "basic" M/S unit for a few days to a tele unit for a couple days, to an ICU step-down unit for a couple days, and some may be offered the option of an observational shift in ICU. Then at the conclusion of that time, the paramedic student then rolls into the ED for their regular 160 hour clinical experience, as is currently structured, followed by their regular field internships.

The idea is not so much to get the student to talk to patients, rather it's to get experience doing physical exams on progressively more complex patients without the "drive" for them to do skills. Since each patient gets their own writeup, it gives the student a chance to really begin to see how problems can interact with each other. Then when they "arrive" at the ED for their rotation, they won't have to learn assessment on top of trying to get their required skills in. Instead, they'll simply be adding that stuff to their assessments. They begin learning how to manage patient care too. Later, when they get to their field time, they'll simply need polishing off for specific paramedic education.

The end result (hopefully) is that paramedics educated this way will have a higher level of ability and knowledge as entry-level paramedics than they'd have been had they gone through a more "traditional" program... and it only adds a week or so to the entire length of the program.

 

[Summit]

Akula makes some great points. The big barrier is you'd have to justify the paramedic student's learning experience being important enough to bump nursing students from those m/s floors and stepdowns because in many areas there are barely enough (or quite simply not enough) acute care clinical placements for nursing students. This shortage is why competitive programs get better clinical placements.

 

[Akulahawk]

Akula makes some great points. The big barrier is you'd have to justify the paramedic student's learning experience being important enough to bump nursing students from those m/s floors and stepdowns because in many areas there are barely enough (or quite simply not enough) acute care clinical placements for nursing students. This shortage is why competitive programs get better clinical placements.

Thanks! I think...

Anyway, the way you bypass that problem is that you schedule those paramedic clinical times to coincide with an inter-session break that the RN/LVN programs have. What that results in is some medic students being loosed on the floors for about a week in between semesters. There won't be any nursing students on those floors and it's quite literally only (at most) 3-4 days per floor and they'll all be gone, with quite a few weeks remaining before the nursing students return. This does mean more care must be taken by the paramedic school's part to ensure that the group is ready for the in-hospital rotations on time.

The big problem I see on the clinical side is ensuring that there are enough instructors available to supervise the students and ensure that they keep a tight lid on behavior. The other problem is ensuring that the students know their authorized scope of practice (effectively NONE), limited to vital signs and assessments as that's exactly what they're there to do and to whom to report to, when, and why!

This actually also sparks an idea... have them also give report on their findings to the patient's nurse or clinical instructor. This way they get nearly immediate feedback about their assessments. I can also see a minor issue with authorizing charting in the EMR systems they'd have to add a category of student that's in a non-nursing category but has the ability to enter vitals and assessments.

 

[Ecgg]

That is strange you feel that way since you started a discussion advocating Community Paramedics. 95% of what community medicine is about starts on the MedSurg floors. The assessments, education, retraining and case management to get a patient back home are all part of med surg. Sometimes the responsibility relies heavily on just the RNs and sometimes it is a collaboration of many different professionals. It is too bad you missed that. Being a Paramedic should be more than just getting to the neat skills especially when it comes to an overall assessment. Chances are the average EMS Paramedic will not be managing ICU ventilators, IABPs or multiple IV drips. Working a code in the ED and the stabilization which occurs there would be more practical.


As far a nursing student riding on an ambulance, there is no point. Nursing education is done differently than the vocational tech style done by Paramedic programs. A foundation is done and each step is in increments building up to a general nursing skill level. The education is there in the foundation but the experience and skills are developed as the nursing student advances and later picks a path to follow for the specific training. No one expects an RN to be ICU ready after even 4 years of college since there is just too much to learn to get to that point. This is why there are now extensive internships averaging 3 - 6 months for BSN RN grads to complete in a specialty as a bridge to employment. The Paramedic program teaches the necessary skills to be job ready for a very specialized and also a very small percentage of medical care patients.

Clipper1 I must say every post you make is trying to showcase how much education and superiority you think you hold in this forum full of sheep. If you are such an astute ICU scholar why not produce a strong conducive argument to support your stance with facts without resorting to attacks? This only makes you look foolish and anything substantial you had to say is nullified by such statement:

"Chances are the average EMS Paramedic will not be managing ICU ventilators, IABPs or multiple IV drips." I have some news for you, as long as there are community hospitals, small rural hospitals, clinics and the MD deems so appropriate (see MD.... makes decisions) that the patient needs to be transported and (RN.... records notes for discharge) to a regional center via ground or air there will be EMT's and Paramedics doing said job. I know this may cause you a great deal of pain to read that, but it's the reality.

I not going to lie, I never held nurses as someone I go check in with for differentials or diagnosis. Nor did I care for what were nursing interventions , because to me this was not medicine. You alluded in another post "If you want to be the best in ICU care you should become a nurse" no if you want to be the best in ICU care you would become a physician do 3 years IM residency and a fellowship in Pul/CC and be called an Intensivist that is what the best is.

 

[Summit]

Ecgg: I hope you are only letting Clipper1's abrasive attitude drive your silly response. If so, rise above your emotions. I hope that you are not really that misinformed about the capabilities and regular practices of ICU nurses. If you think RNs are for "recording notes" and don't know anything about diagnosis, you need some perspective. Sure, RNs do not "diagnose"... just like paramedics don't "diagnose."

 

[ExpatMedic0]

However, for Med Surg a Paramedic can:

Start IVs

Check for IV complications (some might even be from field sticks)

Learn about the different insulins and see how RNs manage glucose protocols

Have at least 50 patients to listen to breath and heart sounds

Do vitals. This also is a weak area for some as it appears in the discussions here.

Do NG tubes (I think some Paramedics are able to do these although I have not seen it)

Learn about aspiration.

See the many different medications given to one patient daily in various forms depending on swallowing ability and how many one RN must give in one shift.

See the many different access ports which are used routinely which was a recent discussion and it seems many do not get the experience even if they are allowed to access them.

Learn about infection control and the various infectious diseases which seems to be a very weak point as we have seen from routine transfers and some EMS providers who continue to wear their contaminated gloves everywhere in the hospital after they drop off a patient.

Learn about spinal injury patients and how to move them carefully pre and post op. This might benefit those who don't believe any precautions are necessary. A LSB might not always be required but we also don't just walk them or toss them around either. Talking to a patient who is a fresh quad and see how they may not have exhibited any symptoms initially might be an eye opener also.

Caring, including suctioning, for a tracheotomy or stoma patient. Learning how to remove or secure a prosthetic speaking valve on a laryngectomy patient is helpful if you need to secure an airway.

Nasotracheal suctioning

Learning the various oxygen delivery devices including those which are considered High Flow. (NRB masks are not)

Learn the various neuro assessments for acute and ongoing for various disease processes both known and unknown.

Rapid response teams in action...nurses working without a doctor present and by their protocols.

Check out the extensive protocol sets of a med surg nurse.

Have a chance to read 50 histories, look up labs and check out X-Rays which are all usually available on a computer. Of course your preceptor will need to have a student access code.

Read the 12 lead ECG interpretations and the cath lab reports. View the actual cath lab diagnostics on the computer.

Learn about the various pacemakers.

Learn more about DVTs and how they could present which is not always textbook.

Have a chance to see what other health care professionals do. Even RNs do more than just gossip at the nurses station. FFs and Paramedics have their own gossip which is often hear in the ER often heard over the patient during a drop off.

Learn about pain management both acute and chronic.

Watch bedside procedures such as a thoracentesis, PICC insertion and sometimes central line insertions. You can take notes on the steps to insure a clean or sterile setting.

If your class instructor structures a clinical rotation correctly there is an unlimited amount of things to see with over 50 patients to have access to. The problem is many instructors fail to structure with an outline of what is expected. Instead they just send a student to the ER or floors to "follow someone" who is usually the person who does not like students because they are not getting paid extra and have a heavy assignment. If the charge RN sees your outline, he or she can see that you get those things done and you may not be stuck with just one person as a tag along.

haha wow, what med/surg is this? The BSN nursing staff that I was attached to where not allowed to start IV's, they called an "IV team" for that. They did not do any NG tubes while I was there, and to be honest it would be surprising if anyone could do such a thing on this floor.
I did follow one of the CNA's around when the RN was to busy. Helped out with cleaning up and vitial signs (all of which where done with automatic machines) I checked IV's that where setup, ect ect.

In my 2 days time following them I mostly saw how they charted, worked the pixus, and handed mrs/mr smith their pills to take with a cup of water.

This was over 7 years ago and to be honest it has not been very helpful in my career or education as a Paramedic, or furthering my higher education. I did my best to my manage my time there and it was interesting to say the least, but Paramedic programs are not very long. We do not even get enough hours in the OR or the the ICU, or even the ED. Its not practical to place a paramedic student on a med/surg floor, just like its not practical to place an RN with a transporting fire department for all the same reasons.

 

[ExpatMedic0]

As far a nursing student riding on an ambulance, there is no point.

double standard: noun
: a set of principles that applies differently and usually more rigorously to one group of people or circumstances than to another
Also see Definition of HYPOCRITE

 

[ExpatMedic0]

JPINFV: Around here the EMT and medic students are almost always paired with RNs in the ED, and it is very appropriate.



I agree with this analogy 100% for the current vo-tech paramedic model.

However, I agree with Clipper1's response if one is arguing for an educated community paramedic model.

Using the concept of community Paramedicine to support facts which have to do with clinical rotations of entry level paramedic students is a little out of context.
Entry level Paramedic students are not even getting nearly enough clinical rotations in critical areas like the OR.

All of which can be done in more appropriate settings

Yes, that is an easy way of saying it. I agree. (Regarding the post above)

 

[ExpatMedic0]

Clipper, I notice you don't have your education listing below your name, do you mind telling th class what your education level is? Please.

If I was a betting man, I would put it all on RN. Espially if you read other post from that same person.

or "VentMedic" the RT lol, if anyone has posted on this forum long enough to remember that uplifting character.