What do I do?

[emtbass]

I have a question. I am starting as an ER Tech tuesday... I am an EMT-B, and a medic student. While doing clinicals, I have noticed that the Techs would do many things that were not in their scope of proctice (IVs, NG Tubes, etc.)

I asked the nursing director durring my interview about this, and he said that is shouldn't happen, but it does on a daily basis.

So my question is... What am I supposed to do when I am asked by a Dr. or RN to do something that outside of my scope of practice. I know how to do these things, and I have, but If I am being paid to work as a ER Tech, what do I do in this situation?

 

[MMiz]

Around here EMT-Bs can work at ER Techs doing IVs, Tubes, blood draws, and many other common tasks that are out of the Basic scrope of practice. As long as you have training on how to do it, I think you're safe. You're not acting as an EMT-Basic in your ER job, you're acting as an ER Tech.

At least that's how it was explained to me by several ER Techs.

 

[emtbass]

That was my first impression. But then I was informed otherwise by higher officials. I guess I just take the punches as they roll. I'll be an intermediate soon, so it wont matter then anyways.

 

[Jon]

ER's try to hire EMT's, because they are already reasonably skilled medical workers. Locally, the techs can preform venipuncture (blood draws) but in this county, the Techs can't start IV's. Techs do a lot of patient transporting, and also cardiograms (12 leads).

In the city, techs start IV's, DON'T give meds. Most of the city Trauma centers want the techs to be EMT-P, or almost there (thru medic school). EMT-P techs are just techs, can't push meds or intubate, except in the "what *didn't* happen in the code in the elevator" situation.

Also, the Trauma Center techs become VERY GOOD at using a traction splint.

Jon

 

[Wingnut]

Originally posted by MMiz@Sep 2 2005, 08:44 PM
Around here EMT-Bs can work at ER Techs doing IVs, Tubes, blood draws, and many other common tasks that are out of the Basic scrope of practice. As long as you have training on how to do it, I think you're safe. You're not acting as an EMT-Basic in your ER job, you're acting as an ER Tech.

At least that's how it was explained to me by several ER Techs.

It's the same here, our hospitals send EMT-B's to a 2 or 3 day class to learn the extra skills. We can't start IV's but can do basically everything else. But if you haven't been specifically trained for it, you'd better cover your butt and tell that RN or Dr that you haven't gone through any classes for it (unless you have since you've done it before)

 

[TTLWHKR]

If they train ya to do it... why not do it? It's a controlled enviroment, beyond the scope of EMS practice. They are training you for an occupation, you only do it in the ER, not the ambulance.

Besides, it's not every day ya get to stab someone with a needle for the fun of it...

 

[emtbass]

I got stabbed with a needle 7 times for the fun of it in class yesterday And I did my plenty share of stabbin. Thanks for the advice guys. (and gals.. dont know if there were any.. didnt look)

 

[ResTech]

In Franklin County, PA the one hospital permits ER techs to start IV's and draw blood. The ER techs also drive the ALS unit (chase unit).

 

[emtbass]

Well I talked to the charge nurse last night, and she said technically the only thing that I can do is venipuncture. But since I am a medic student, and I have been checked off on other skills, I could perform them, I just have to wear another name tag (student in HUGE letters) in addition to my hospital name tag. So, I am cool for now.

 

[rescuejew]

Heres how it works in NC: You're allowed if you concede to do it and dont get caught. We had a HUGE thing here last year because one of the hospitals was allowing medic students and EMT-I and P employees to push meds that were outside thier scope. Some refused to do it and according to NC state law, were they to get caught, EVERYBODY involved would lose thier license/cert. I found out that its okay to do something you wouldnt do at your service at the ER, as long as it is contained in your scope as provided by the State. Anything completely outside of your scope is off-limits to you unless outting your cert on the line is what you what. But thats just NC, Im sure its WAY-different in other places.

 

[Jon]

Originally posted by emtbass@Sep 14 2005, 12:15 AM
Well I talked to the charge nurse last night, and she said technically the only thing that I can do is venipuncture. But since I am a medic student, and I have been checked off on other skills, I could perform them, I just have to wear another name tag (student in HUGE letters) in addition to my hospital name tag. So, I am cool for now.

I know someone who works as an ED tech in a hospital, and also just finished their medic program.... he had 2 ID badges, and occasionaly would go beyond the Tech scope of practice when the sh*t hit the fan.... he also liked that his student ID got him into some of the "locked units" that the ED ID card didn't - great when doing transfers to those units.

 

[Jon]

Originally posted by rescuejew@Sep 18 2005, 09:14 AM
Heres how it works in NC: You're allowed if you concede to do it and dont get caught. We had a HUGE thing here last year because one of the hospitals was allowing medic students and EMT-I and P employees to push meds that were outside thier scope. Some refused to do it and according to NC state law, were they to get caught, EVERYBODY involved would lose thier license/cert. I found out that its okay to do something you wouldnt do at your service at the ER, as long as it is contained in your scope as provided by the State. Anything completely outside of your scope is off-limits to you unless outting your cert on the line is what you what. But thats just NC, Im sure its WAY-different in other places.

As a student, during clinicals, under supervision, I was told I was allowed to give any medication (I wasn't technically giving the medication, as I had no cert, it was being done under the nurse's cert). I was able to pus demorol, and give TB shots (big help to the nurses.... on a busy sat. night I gave out 5 in a 2-hour period to the clients of the lovely trauma center ).

Jon

 

[ffemt8978]

Originally posted by MedicStudentJon@Sep 18 2005, 05:42 PM
I was able to pus demorol, and give TB shots (big help to the nurses.... on a busy sat. night I gave out 5 in a 2-hour period to the clients

Your TB stick that bad that they needed the demerol first to kill the pain?

 

[Jon]

Originally posted by ffemt8978+Sep 19 2005, 03:22 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (ffemt8978 @ Sep 19 2005, 03:22 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-MedicStudentJon@Sep 18 2005, 05:42 PM
I was able to pus demorol, and give TB shots (big help to the nurses.... on a busy sat. night I gave out 5 in a 2-hour period to the clients

Your TB stick that bad that they needed the demerol first to kill the pain? [/b][/quote]
I've also given ketorac IM and IV.... In PA, only analgesic we can carry is MSo4... no NSAID's, no synthetic narcotics... thats why I mentioned them both.

And in N.O. - I heard of some basics (with other training - ie - Old EMT-I, ER tech, etc.) giving vaccinations when they were short medics.

Jon