just need to vent a little 1 of 3...

[irish_handgrenade]

Hey all Handgrenade here, I just need to vent a little about some things that been bothering me (not about this site or anyone on it) to people who might understand me. If you know me or anyone personally from these vents please don't flame me publicly, just pm me im ok with that.

Yesterday, two recruiters from one of the bigger hospitals came to my school to talk to my medic class. Apparently a hospital in Lubbock has, just this month, created a scope of practice for paramedics and EMTs to practice in the ER. I was pretty jazzed about this because I know some medics from DFW that have a pretty sweet gig working in the ER. Well this lady comes in talking about how the job they were offering the medics was titled "ERT IV" and Paramedics would be able to: start IVs, do ECGs, give medications off of a preapproved medication list, apply spints and bandages, and they would work directly under an RN. These "paramedics" would also get the opportunity to go to school and get their RN, and they would get paid a whopping $12.40 an hour.
Well then the lady opened the door to questions, and me being the big mouth that I am started off with, " why the cutoff scope of practice? why can't we practice up to our certified level? I mean with that scope of practice a medic has the same capabilities as an intermediate" The lady seemed like I had just punched her in the chest and didn't really have an answer so she kinda BSed her way around it. Well then one of the visitors said " How does that pay scale compare to the LVNs and RNs that are employed in the ER" to which she replied, " Oh well of course they make 6 to 9 dollars more than that an hour" to which I said... of course " Why?" again the woman looked attacked and then she said, " Well because we all have a 4 year degree." So I felt a little like the mutt in the corner (apparently I rolled my eyes but i don't remember that) said, " well why don't yall just hire more nurses then? I'm sorry but I don't see how you think you are gonna get any medics to agree to that kind of offer" If I had thought about it more before opening my mouth I would have realized that we have no union and they are able to get away with trying to offer people this kind of job so why not hire a medic if you can for 9 dollars an hour less than an RN who can do basically the same ammount of work.
Any way I apparently really insulted this woman by asking her questions and the school doubts that the hospital will send another recruiter out to our school, which I personally thought was childish but ya know, I may have come off a little rude but I think that my thought process was at least semi valid. anyway flame on trolls I'm sure I will get banned for this or at least made fun of but I needed someone to tell this too cuz it was bothering me.

(p.s. sorry for the lack of grammar when I start getting aggitated it kind of goes out the window.)

 

[Ridryder911]

Sorry, it has nothing to do with unions. The reason the pay is the same for LVN/LPN's is simple, look at most Paramedic training. In comparison the LPN/LVN attends longer than many Paramedic programs, hell most Paramedic programs are shorter than a beautician course.

Do I feel it is fair? ... No, but at the same time most hospitals do not have a formal job description for a Paramedic and again I stress that the majority are not properly educated to work in the hospital environment, just alike new graduate nurses are not prepared for prehospital care.

JCAHO does not (as most hospitals are credentialed through them) recognize the Paramedic as a professional provider. Just alike LVN's etc in the critical care areas; hence the reason they are called tech's. As well, even the government will not allow triage and screening and initial assessments to be performed by a Paramedic. As a RN must perform the initial assessment.

Do I wish differently; you bet! Yet, until we have abolished drive thru courses and courses that offer clock hours instead of college hours it will not occur.

I do offer this advice though. Be careful burning bridges; not just for yourself but for others. You did an unjust service for those that potentially may had want to work in that environment. Do you think that your attitude will attribute any positive changes? Do you think that because of your tone will cause them to increase or improve their ideas about Paramedics.... doubtful that will occur but may even cause them to remove the position altogether. A position that with time and those that could demonstrate restraint and professional demeanor may increase the pay and respect it needs. Careless statements such as yours can have lasting impact more than you realize. Not only you might have tarnished your reputation but the schools and the future graduates as well Paramedics in general.


R/r 911

 

[SeeNoMore]

You probably could have been a bit more tactful, and the nurse was also probably being a little oversensitive. Still, I would think if you were not throwing chairs or swearing they would be willing to still engage with your school.

Thanks for sharing though interesting topic.

 

[Sasha]

Why don't you get the same pay as a nurse? Becaue you aren't a nurse, you are working under one. Paramedic is not the equivilant of RN, not by a long shot.

That actually doesn't sound too bad, I know many paramedics here would jump at an opprotunity like that. Here the paramedics are stuck to rescue check in and other PCT work with an occasional 12 lead and assisting the doc with procedures. When I say assist, they set it up and him the instrument or holds something for him, there is little patient care involved.

You also sound like you got a little rude, and you probably ruined it for your entire class (and classes to come, if they wont send another recruiter). Congrats, dude, see if you can get a job on the street. I don't know where you live, but unless you are hospital based, either on one of their trucks or as a tech here or with major experience 12/hr is the best you can hope for.

 

[timmy84]

Just let it slide off your shoulders. The paramedics in our ER are ED techs, same title as the EMT B's, same pay scale as well. Bottom line... paramedics are cheap, RN's are expensive. The hospital love to take UAP's (even licensed medics are UAP's as far as the hospital is concerned) who can help them with short staffing. If the hospitals could get away with it, I am sure they would be more than willing to completely cut out RN's and hire medics for half the price in the ER, and hire all LPN's on the floors.

 

[VentMedic]

It seems some still believe in comparing skills as their worth. However, if one was to compare the skills of the RN and even the LVN with a Paramedic, it would be at least 10 -1 in the nurses favor and that is if we only compared a general nurse. It will be much higher for an ICU, Specialty or ED RN. As well, since the Paramedic is not recognized with Professional status for reimbursement, none of the skills you believe you should perform are reimbursed at the higher level. And then there is the education thing. TX only requires about 600 hours of training to get a Paramedic patch. We could also ask how many hours did you spend in clinicals with Neo, Pedi and OB/GYN emergencies vs what a nurse gets. How about training with all the medications? Lab values? Diagnostic test preps? Case management and Social Services issues? Teaching and instructing patients on many aspects of care? Wound/Skin integrity assessment and intervention?

In many states the prehospital certs are not recognized in a hospital. They were written as PREHOSPITAL ONLY. The nurses has nothing to do with this but EMS wrote them because they wanted to be different.

This hospital may now consider the PCT, which has about 500 - 700 hours of training, for ERT positions. They would also be the better choice since can do most of the skills a Paramedic can do inside a hospital and they have training in many aspects of patient care and can be used in other areas of the hospital when needed. They know how to deal with many of the things I mentioned in a previous paragraph. They also know the day to day routine of hospitals and have worked with a variety health care professionals. The Paramedic is very limited since the specialty is prehospital.

The hospitals were probably trying to extend other opportunities to Paramedics since not everyone will be able to join the FD in Abilene. In fact, I would imagine jobs will be tough to get for awhile.

As well, the hospital does not have to allow Paramedic students to do their clinicals in their facility. Hospitals in my area have banned Paramedic students from certain areas such as NICU and from doing skills like intubation and even IVs. This was partly due to a poor show of knowledge or being inadequately prepared and attitude or behavior.

Health care in the hospitals encompasses a lot but it is still a small community. Word will get around to other hospitals who may also review their experiences with Paramedics for future positions.

If you know me or anyone personally from these vents please don't flame me publicly, just pm me im ok with that.

I find this to be a strange statement since you have no problem with your own behavior toward the nurse.

Consider this an educational post full of facts about health care and not a flame.

 

[VentMedic]

Just let it slide off your shoulders. The paramedics in our ER are ED techs, same title as the EMT B's, same pay scale as well. Bottom line... paramedics are cheap, RN's are expensive. The hospital love to take UAP's (even licensed medics are UAP's as far as the hospital is concerned) who can help them with short staffing. If the hospitals could get away with it, I am sure they would be more than willing to completely cut out RN's and hire medics for half the price in the ER, and hire all LPN's on the floors.

Read my post and Rids to see a few of the reasons why there is a pay difference.

For the LVN/LPN this was already decided about 20 years ago. In most states the LPNs/LVNs were removed from the Critical Care and ED areas and even from the general floor areas. In fact, our SNFs have not used LVNs in 20 years. The insurances (including Federal and State) want to know they are getting the money's worth with care provided by those with high education and training. But this is nothing new since every allied health care profession, except EMS, have advanced their education. The certified vs the Registered RT could also be cheaper but the professional standard is RRT which is why there is a time limit to advance to RRT. Physical Therapy is now at a Doctorate level. OT, SLP and Dieticians are Masters. Nurse Practitioners will be required to have a doctorate in the next 5 years. PAs are moving to Masters. As well, the nursing assistant and PCT has to become certified and are requried CMEs or CEUs just like the EMT. They also must take all the mandatory education and training required by the hospital and JCAHO in addition to the other CEUs.

 

[timmy84]

Read my post and Rids to see a few of the reasons why there is a pay difference.

For the LVN/LPN this was already decided about 20 years ago. In most states the LPNs/LVNs were removed from the Critical Care and ED areas and even from the general floor areas. In fact, our SNFs have not used LVNs in 20 years. The insurances (including Federal and State) want to know they are getting the money's worth with care provided by those with high education and training. But this is nothing new since every allied health care profession, except EMS, have advanced their education. The certified vs the Registered RT could also be cheaper but the professional standard is RRT which is why there is a time limit to advance to RRT. Physical Therapy is now at a Doctorate level. OT, SLP and Dieticians are Masters. Nurse Practitioners will be required to have a doctorate in the next 5 years. PAs are moving to Masters. As well, the nursing assistant and PCT has to become certified and are requried CMEs or CEUs just like the EMT. They also must take all the mandatory education and training required by the hospital and JCAHO in addition to the other CEUs.

Exactly Vent... it takes time. My mom was a "respiratory tech" for years, then a CRT for more than three (times change), then finally an RRT, and went from making what a CNA made to something much closer to a nurse in her career. I think the organization of the respiratory care professionals was excellent and should be looked at by other groups to assist in their advancement. A Pharmacist used to be little more than a BS in Chemistry (not saying that is easy at ALL), now they need to doctorate as well. I am all for advancing the education! I would absolutely love to see a BS in paramedicine, and there are some very good paramedic programs at the associate degree level. There was a time when an LPN would have been laughed out of town if he/she wanted to give a PO med, now the system uses/abuses their license to do just this (LTC's come to mind where one LPN passes meds to 30+ residents, no time for a proper assessment there).

Paramedics have a hard time with organization. The need for their services has brought on medic mills, which by the way is very similar to the 19th century struggle to eliminate MD mills. The licensing/certification system varies so greatly from state to state, and each state cannot even seem to decide if it is a branch of public health or safety/homeland security. Even within the field I get grief from others. The paramedics in my ED tell me to just go get my BSN since I have a degree. Do they tell this to me because they are unsure of their education, maybe, do the tell me this because they are still called ambulance drivers, possibly. Regardless I believe that the field will grow, we will grow, and eventually we will not have to send the educated members of the field to become nurses or RT's, there will be a route for them to take in paramedicine.

Also, about my comments regarding the hospital getting rid of RN's if they could, it was a quip at hospital administrators who really would cut them if the Joint Commission/Medicaid/Medicare would allow it. I understand that they are taught completely differently, I do not need an education in that. I do want to make it known that I believe that paramedics will rise above their obstacles. We can organize better, form better education standards, defend ourselves from other health care providers, improve our research methodology, and maintain high standards across the board.

 

[VentMedic]

I do want to make it known that I believe that paramedics will rise above their obstacles. We can organize better, form better education standards, defend ourselves from other health care providers, improve our research methodology, and maintain high standards across the board.

I've been waiting for that to happen since 1978.

As far JCAHO and hiring LVNs instead of RNs, JCAHO also looks at the standards from Medicare and other insurances to ensure the hospitals are maintaining standards of care for reimbursement. This is solely not JCAHO as CMS will also monitor for deficiencies missed by JCAHO.

 

[daedalus]

You did the right thing. Don't let someone come into your classroom and belittle your profession which you are working hard to join. Get your education which will hopefully include a college degree and don't settle for that women's pitiful offer, tell her to get her slave labor somewhere else.

 

[medic417]

get paid a whopping $12.40 an hour.
Oh well of course they make 6 to 9 dollars more than that an hour"

LOL. 911 Paramedics in my part of west Texas make as much as the RN's are getting there. How sad with the better education that they make so little. Wonder how soon before more RN's challenge Paramedic so they can get pay raises?

 

[Shishkabob]

Crap, I thought you were SOUTH Texas?

Awe man. Don't come east in February.

 

[VentMedic]

You did the right thing. Don't let someone come into your classroom and belittle your profession which you are working hard to join. Get your education which will hopefully include a college degree and don't settle for that women's pitiful offer, tell her to get her slave labor somewhere else.

Belittle? From his description of the incident, he didn't do his homework before he opened his mouth. It is too bad he didn't at least read the many threads we've had on the forums explaining the reasons for the pay and job description of the ERT. Nor did he know the difference between an RN and a Paramedic. He was rude to the person who was offering his classmates an alternative especially since the FD may take over the ambuance service. Not everyone wants to be a FF and this would be a great opportunity for those that don't if there are very few ambulance jobs to get.

The facts may not be pretty but they are what they are and it is no fault of the nurse or the hospital.

 

[VentMedic]

LOL. 911 Paramedics in my part of west Texas make as much as the RN's are getting there. How sad with the better education that they make so little. Wonder how soon before more RN's challenge Paramedic so they can get pay raises?

We've got the same thing in parts of Florida which is why some RNs challenge the Paramedic exam and join the FD.