My brother, an R.N. once told me that he would rather have an E.M.T. arrive at an accident or emergency than a nurse. Because while a nurse may be better schooled they are used to having all the hospital tools backing them up while an EMT is better schooled for the emergency. Is this true in your opinion?
EMT Basic? Or Paramedic?
I’d rather have an RN respond than an EMT-B. Hell, I’d almost rather have a school nurse show up.
I’d take an EMT-P over the RN, though.
I don’t know which one he meant, we had just narrowly avoided a wreck. I commented that it was good that I had a nurse in the car to save me. And he went on a minirant saying what I mentioned above.
I worked with RNs, and I was married to a paramedic. In a true emergency, give me a medic any day.
Don’t get me wrong. I love RNs, some of my best friends are RNs, and I want to BE an RN someday. But RNs generally don’t have to continually practice advanced life support techniques like medics do. They tend to be good at what they do most, but many of them aren’t trauma nurses or emergency room nurses–they’re likely to be more adept at extended care, or rehab, or any other of a number of non-emergency specialty areas.
My ex–and some of you know how I feel about That Man–would be my #1 choice in the list of “People I Want to See Right After I Crash My Car.” Those guys know their stuff.
Now, if you’re come into surgery after the medics get you back to the hospital–a surgical team–RNs, docs, CSTs–in full STAT mode is truly beautiful and amazing. And those guys know their stuff, too.
EMT at any accident/emergency. Mrs Fireman is a nurse, and works with a lot of nurses, and none of them have much of an idea on how to stabilize a trauma patient. They would be lost on an extrication.
A strictly medical issue would be different. Most nurses could handle that.
I found out a long time ago that a degree or certificate is not what makes a person a nurse or EMT or Paramedic.
Depends on what kind of training the R.N. has. If it’s a pediatric nurse and there’s a kid in the accident, could better than an EMT. OTOH, if the nurse has not had any practice in emergencies or does not have specialized training in an appropriate field (pediatric or geriatric), I’d pick the EMT.
As for Paramedic vs RN, I choose EMT-P every time, for emergency settings only.
There’s sort of a weird rift between EMT-P’s and RN’s. EMT-P’s have less schooling, but more autonomy. Nurses, by training, are usually supposed to act as an assistant, whereas EMT-P’s are, by training, supposed to act as the leader and take charge (usually with an EMT-B or EMT-I to help).
The only reason that this system works is that the EMT-P knows they will be taking care of only emergency stuff. Anything beyond the first 15 to 30 minutes of treatments and caring is beyond the scope of most EMT-P’s training & knowledge. So the RN’s have a much broader, but not deeper training / skill set, whereas EMT-P’s have a very deep knowledge of emergency situations, but very little else.
And then, just to confuse things, some RN’s and MD’s will take EMT-P training to work on medical helicopters.
And, to confuse things more, EMT’s (of all levels) that respond to sports emergencies may often “be in charge” while letting the trainers do most of the work. (Trainers’ knowledge of musculo-skeletal injuries far, far outstrips that of almost all EMT-P’s and most RN’s, too.) Unless the player is having an MI or drug interaction, the Trainer will be better equipped to deal with the injury.
ETA: Oh, and I almost missed from the OP: Yeah, most EMT’s get pretty comfortable improvising. I could very easily see someone who is used to having a very specific (and detailed) assortment of equipment around them get lost without it.
Ex-EMT-1 with firefighting training here.
Minus their rig, not alot of difference between the two EMT’s. Off duty minus all of their drugs, IV fliuds, defibrillators, airway gear, etc EMP-P’s have pretty much identical skill sets. Granted most EMT-P’s used to be EMT-1/B and are more likely to have more experience in the biz.
As many have surmised, its more about the specialty. Acute care specialty nurses like ER, ICU, Labor/delivery, understand the mechanisms of trauma and crisis intervention and have the mindsets to do so successfully with lives on the line.
Even so, nurses are not trained/experienced in scene related problems like small fires, electrical hazards, traffic hazards, sharp edges of damaged cars, etc. They are also less experienced with moving/handling unstable seriously injured people.
I just wanted to point out that this isn’t always the case. Some places are moving towards associate degree paramedic programs. I could have gotten my RN in the same amount of time as I did paramedic school. Unfortunately, this isn’t always the case. I think it’s criminal that you can go to school for 4-6 months and come out as a paramedic.
Generally because they can’t bill for the ambulance transport without having at least an EMT on board.
A service that I used to work for covered sporting events for a Big XII school. We had to take a class before we could work football games (which was really fun) that essentially consisted of “The trainers know what they’re doing. Be nice to the trainers.” We did actually do some splinting because we carried orthoglass on the ambulance.
Thanks for the informative replies. I was weirded out because he was pretty much talking bad about his profession. He has been on the ICU floor since becoming a nurse and says if it wasn’t for the tools he has “it would be like a carpenter building a wall without his tool belt”
Well that’s the point. It’s the experience that matters more than the silly course and registry exam.
I completed an EMT-B course and passed the National Registry in under 30 days. Did that make me any better than Joe Anybody or John F. Responder at handling emergencies? I doubt it.
Unless it’s an ER Nurse or one of those flight nurses, I’d want an EMT to respond to the accident.
In an emergency situation, it’s often very important to have practiced what you are trying to do. We know for sure the EMT will at least have practiced field triage, extractions, initial assessment. An RN may or may not have some knowledge of those areas, and is unlikely to have practiced them as much just because of the way patients get to him/her.
Emergency response is definitely a specialized situation where a lot of general medical knowledge may not be as helpful as knowing what typically works in an emergency.
I think my palliative care skills might not be what’s required in a life-threatening emergency.
Heh. I was debating with myself about adding something about the increasing length of EMT-P programs…
However, I think we should also mention that there is a similar push, not for an increase in RN’s length of training, but rather an increasing call for BSN qualifications. I think both fields are experiencing a similar trend in increasing education. (Which is, needless to say, a good thing.)
As for the ‘quick’ programs… Hey, that was me! Of course, it was 6 months of 70-80 hr weeks… But you’re absolutely right that most programs don’t try to rush through in that short a time, and having the programs become an Associates Degree makes a lot of sense for all sorts of reasons.
In an emergency out in the field, give me a paramedic. A few years ago, I worked with one guy who was so damn good at his job, if you gave him Abraham Lincoln right now, fresh from his grave, he’d probably have the former President stabilized by the time they got the ambulance to the hospital. Chris is a paramedic-savant!
Now, once you’re in the hospital, I’ll take the nurse and the docs. Different environment; different specialists. I don’t consider one discipline more important or “better” than the others; just better suited to one environment over the other.
I’ll second it depending on what department the nurse is from. Back when I did ward work we responded to another ward’s code blue as it was on the same floor to find the nurses standing around the patient not knowing what to do – my charge nurse wound up running their code with me goforing.
On the other hand, now I’m in ED I’d take an experienced ED nurse over a paramedic – heck, I’d take 'em over an intern and some residents! (note I said experienced!)
Having said that I’ve seen patients come in with absolutely marvelous stuff done by paramedics. My first major trauma was a motorbike vs semi-trailer that had been airlifted in and the paramedics had stabilised him so well that there wasn’t a lot for the docs to do as far as airway and pulse go (The severed arm on the other hand, well, that’s not exactly a field fix!).
i’m an RN and would think that a paramedic would be best, just due to the fact that they spend the whole day responding to emergencies.
I’m a RN and unless there’s a woman giving birth, I’d rather an EMT be there instead of me. The only triage I ever did was for pregnant women.
Cyn, OB/GYN RN