I did apply for an ED tech job, fancying name for Nursing Assistant, It said you had

[VentMedic]

Whoa. ED tech is usually splinting, triaging, running EKGs, taking vitals, bagging a patient, etc. A CNA is trained to help wash a patient, change a bed, clean up, and maybe take vital signs. A CNA should not be handling emergency patients. A EMERGENCY MEDICAL tech should, as they are already trained in splinting, CPR, lead placement for EKG, taking vital signs, bagging a patient, etc. They may have piss poor education, but at least they are competent in the basic duties a ED tech needs to be. I doubt a CNA could recognise cardiac arrest, actually, I have been on a few calls where the CNA told me the patient was "not waking up". Ends up to be a full code.

I cant wrap my head around your reasoning here, maybe you should help me out?

That totally depends on where the CNAs work. Our CNAs are very well trained and very much a part of the team.

You really don't want anyone here who's been around for awhile to get started on "Do you know what I saw an EMT do?" stories.

Very few 110 hour EMTs are trained in EKG lead placement. CNAs should know how to place the leads since they do that everyday during daily care on tele. They also should be trained and utilized in CPR.

Now for training: EMT 110 hours with very few clinical hours.
CNA 80 - 120 (2 - 3 weeks) with mostly hands on.

If hired for the ER, the CNA will get at least another 2 - 3 weeks (80 -120 hours) of just ER training. Gee, isn't that the same amount of time for EMT? How many clinicals hours for EMT in the ED? 10 average? Combine that with the CNAs other hospital experience of 60 - 100 vital signs per shift and patient communication skills, you have a fairly well trained individual. These individuals may also have received additional training of 40 - 80 hours in each different area such as OB, psych and ortho. Much of what they will see and do in the ED is not that much different from the med-surg areas. The ED isn't always about codes and traumas. 97% will be clinic stuff.

Also, CNAs don't waste time comparing themselves to EMTs.

I think you can see that when EMTs with 110 hours of training try to discredit another member of the health care profession in an attempt to make themselves look good only succeeds in making the EMT look very insecure.

If you are not a team player and can not accept all team members for their strengths and expertise in what they do best as well as their weak areas, don't apply for a hospital job. It will only make for a very long day for those who would have to listen to you at work.

 

[LucidResq]

Vent... I'm not trying to discredit CNAs at all... but in most cases I don't think CNAs are any more trained than EMTs.

My EMT course has 60 hours of clinicals, with half of those in the ED, in addition to 180 hours of classroom. Now I know that 240 hours isn't outstanding or anything but I have about 10 friends in a CNA program currently and it's much more than they're getting. Almost all of their 32 hours of clinicals are done in nursing homes and on the med/surg floor. None of them have spent time in the ED, but I do have one friend who scored some clinical hours on the multi-trauma unit.

All I'm saying that neither is really better or worse than the other because both are barely prepared for work as a tech, although both certificates do provide a good foundation for the training a tech needs.

 

[VentMedic]

My idea of a good EMT clinical would be 2 shifts on a med-surg floor doing vitals on a wide variety of patients and not just the random few in the ED during EMT-B clinicals.

How many CNAs you know are worried that the EMT is better or less trained?

It is not the skills, it is the attitude that makes or breaks your status in a job. Both CNA and EMT are entry level. I would prefer the one that can play the best with the others. The skills part is no problem to teach.

 

[Airwaygoddess]

CNA and EMT

I first trained and worked as a CNA in a nursing home and then in an acute care hospital before I went back to school to become an EMT. It is true, the training, schooling are different, but the bottom line is this, both are related to providing patient care.
I would like to say that having done both jobs has given me some of the best training, theory, and experience at the bedside and on an ambulance. It should not matter about who is on top or the bottom of the team tot tom pole. What is important is the professionalism, education and pride that one has in themselves and in their job. This is the bases of providing good patient care. -_-

 

[daedalus]

My idea of a good EMT clinical would be 2 shifts on a med-surg floor doing vitals on a wide variety of patients and not just the random few in the ED during EMT-B clinicals.

How many CNAs you know are worried that the EMT is better or less trained?

It is not the skills, it is the attitude that makes or breaks your status in a job. Both CNA and EMT are entry level. I would prefer the one that can play the best with the others. The skills part is no problem to teach.

Im not worried one bit about comparing myself to a CNA. We have different jobs to do. I would never become a CNA and stay a CNA nor will I stay an EMT. They are both lower than entry level. And I was taught 3 lead and 12 lead placement as the STEMI system is in full force in my county, and EMTs are expected to assist the medic in obtaining the EKG.

My argument stands that a CNA out here in LA usually doesnt speak english and, while no measure of his/her intelligence, cant say anything to me beyond pointing with her/his finger. Im sure there are EMTs even less competent. However with training directed at controlling bleeding, a nurse in the trauma bay who yells at the EMT to hold pressure, probably will be done better than a CNA, just as the CNA can probably move my patient with a trach better and safer than I can.

 

[daedalus]

That totally depends on where the CNAs work. Our CNAs are very well trained and very much a part of the team.

You really don't want anyone here who's been around for awhile to get started on "Do you know what I saw an EMT do?" stories.

Very few 110 hour EMTs are trained in EKG lead placement. CNAs should know how to place the leads since they do that everyday during daily care on tele. They also should be trained and utilized in CPR.

Now for training: EMT 110 hours with very few clinical hours.
CNA 80 - 120 (2 - 3 weeks) with mostly hands on.

If hired for the ER, the CNA will get at least another 2 - 3 weeks (80 -120 hours) of just ER training. Gee, isn't that the same amount of time for EMT? How many clinicals hours for EMT in the ED? 10 average? Combine that with the CNAs other hospital experience of 60 - 100 vital signs per shift and patient communication skills, you have a fairly well trained individual. These individuals may also have received additional training of 40 - 80 hours in each different area such as OB, psych and ortho. Much of what they will see and do in the ED is not that much different from the med-surg areas. The ED isn't always about codes and traumas. 97% will be clinic stuff.

Also, CNAs don't waste time comparing themselves to EMTs.

I think you can see that when EMTs with 110 hours of training try to discredit another member of the health care profession in an attempt to make themselves look good only succeeds in making the EMT look very insecure.

If you are not a team player and can not accept all team members for their strengths and expertise in what they do best as well as their weak areas, don't apply for a hospital job. It will only make for a very long day for those who would have to listen to you at work.

Vent, I wouldnt want an EMT or a CNA taking part in patient care beyond cleaning on a tele floor.

 

[daedalus]

Strange, the hospital I volunteered at had CNAs taking V/S (machine, but NIBP was used in the emergency care unit as well as on the floors), hooking up patients to cardiac monitors (something that isn't standard in EMT-B class to begin with (ignoring the fact that I don't think I've seen 5-leads used prehospital for continuous monitoring instead of 3 lead, as well you can train just about any monkey to put little sticky pads on the proper location on a body), nor really all that complicated to begin with), PPV was generally done by an RN or RT, CPR was done by just about anyone who was CPR certified (including the college volunteers who weren't EMT-Bs) and I seriously doubt that an EMT-B will be triaging solo. Which comes first, the abd pain or the fever? Not exactly a question that a 110 hour course helps to provide the answer for.

So, wow, splinting. A skill that is taught to middle school boy scouts. I'm sure that CNAs can't be trained at all to do that.

I know, since I've had plenty of "Why the hell are you not calling 911?" nursing home calls, lets just do away with all RNs and LVNs in SNFs! After all, we might even be able to find some volunteer EMT-Bs to save cost (call light is tied to a pager so that they can respond from home/work/school). Ain't logical fallacies fun and useful?

"Straw man argument" or not, its true. Rather an EMT be near me when I fall to the ground in a bought of VT than a CNA. I went into SVT in elementry school a few months after open heart surgery, and the school nurse told the paramedic she couldn't feel for a pulse because she had no stethoscope. She was a CNA that reported to the district's one RN. Common, its common sense.

 

[JPINFV]

Ok, we can play the "Stupid Provider straw man game." I've seen basics let patients walk around a TC in a c-collar. I've had a basic treat bleeding (venous bleeding) as a life threatening emergency on the simple fact that the patient was, gasp, bleeding. Yes, I also have my fair share of idiot nursing home stories too, but I've also been to nursing homes where I wouldn't mind sending my parents to. Shall we continue to swap stories? The fact is that there are bad apples in each group doesn't mean the bunch as a whole are rotten.

 

[Jon]

OK Folks. We've seen crappy care from SNF's/ECF's... RN's, LPN's, CNA's. We've all seen crappy care from EMT-B's, EMT-IV's, EMT-I's, EMT-P's, and MD's.
We've even seen crappy care from the average Joe on the street.

Please... this thread isn't about that. This thread is about the differences between working in an ED as a tech, and working on the street as an EMT, and by extension, the difference between the training of an EMT and the training of a CNA.

Lets try to keep this on topic... and be nice to everyone... even when we disagree.

Jon

 

[BossyCow]

Exactly, and how the system works varies wildly from ED to ED. Originally, the ERT at our local hospital was used to transfer the pt coming in the back door, into an ER bed while on a backboard, hooked up to an IV or splinted into a Hare or Sagar. The initial idea was to use personnel familiar with that equipment that could also work in the ER assisting the nursing staff as needed.

Since then, the position has morphed more into a ward clerk position. They arrange for the computer data entry, paperwork and transfer into and out of the ER. Ward clerks traditionally didn't have to have any more medical training than a simple medical terminology class and the ability to type.

 

[LucidResq]

Since then, the position has morphed more into a ward clerk position. They arrange for the computer data entry, paperwork and transfer into and out of the ER.

This is a good point. In the EDs I've been to there will typically be anywhere from 2-5 techs working per shift. One or two will be focused entirely on the computer and phone, while the rest do patient care. The techs are all qualified to do patient care, so they just rotate whoever is working the desk.

So if you want to be a tech, prepare to spend some shifts doing nothing but computer, phones, and paperwork.

 

[Eydawn]

In the same boat...

I've been throwing apps at ED tech jobs to no avail... so I bit the bullet and coughed up the money for my IV class (finally!)

I too have seen the "CNA, MA or EMT-B preferred" listing in job postings. Basically they want someone with some sort of patient care experience with a professional certification or licensure to operate under. The thing is, with an ED tech position, either a CNA or an EMT-B needs extra training to bring them up to speed on the job, it just is a difference of *what kind* of extra training.

The CNA will need to learn to work in a high-pressure environment in which they have to be more independently responsible for care than they were previously. They will have to get used to the emergent side of medical care, and become more familiar with splinting, bandaging, etc. They've probably already got the "dealing with poo" thing down, as well as knowing how to monitor patients in a hospital type of situation. CNA's will have to become more familiar with acute trauma and their role in caring for said trauma.

The EMT-B needs to learn to work in a confined hospital environment. While familiar with the high-pressure situation and caring for acute illness/injury, they need to learn to monitor and participate in care with a longer-term view, rather than turfing the patient to the hospital staff. The EMT-B will need to learn basic bedside skills, as well as how to change diapers, insert foley caths, etc. They also need to learn the chain of command; in hospital, they answer to a nurse, rather than operating in an almost totally independent fashion...

So that's why that's there (at least, that's the only thing I've been able to figure out). Some postings have wanted the two concurrently. Go figure!

Wendy
CO EMT-B

 

[dadotwins]

EMT working in an ER

I will never take away from CNAs. Work with many. My fancy title is ER Liaison. I'm responsible for patient/costomer service for those waiting in our waiting area. I am asked to do tech type duties from time to time. I get to do rapid triage and smilar pt. care as if though I had pick them up from home. It pays some what better than the local going rate for EMT's on an ambulance. As an older EMT I enjoy this job because it's somewhat easier. Not in and out of foul weather all the time.Not lifting five hundred pounders any more. Finally their walking to me. I think it's great that EDs are seeing EMTs as source trained personell along with CNAs