I just found this interesting post by a good friend of mine, Chris Kaiser, over at the Life Under the Lights blog. He takes issue with the signage on the side of an ambulance that says:

Staffed by Nurses!

He says that this belittles the training and expertise of the paramedics who would staff this unit if nurses weren’t there and in essence that nurses don’t have the skills to get the job done.

Chris Doesn’t Hate Nurses

To be fair, Chris isn’t mad at us nurses, he’s mad at the ambulance company manager who doesn’t think a paramedic can do the job.

The root of this issue is the lack of respect that this sign shows the EMS community.

Nursing is always listed among the most respected professions.  People trust their nurses. They trust them more than they trust their doctors and way more than they trust their firefighter/EMT/paramedic types.

Why is this the case?

Respect and Trust are Earned

Is this because EMTs and paramedics don’t deserve the respect? Absolutely not!

Nurses, however, have worked very hard to shape the way their profession is perceived over the last 100 years. In the U.S. nurses have a national minimum standard for practice in the RN NCLEX exam. Every RN student must take and pass this test before they can put RN after their name.

Nurses have a single unified voice in the American Nurses Association (ANA) who coordinates the various accrediting bodies and provides a platform for nursing care at the national level.  Some countries like Australia have a national cabinet level position for nursing leadership.

Could you imagine the “Paramedic General” of the U.S.? It’s absurd.

The EMS profession (such as it is) is fractured by many different system models and standards of care that doesn’t follow any standardized model in all 50 states. There is no representative body that effectively promotes the unified goals of the industry (heck, there aren’t any industry goals).

Congratulations to Nurses Everywhere!

No, this isn’t a backhanded slap at the EMS community. Most of you know that I’m a paramedic as well as a nurse.

This is a congratulatory golf clap for the nursing profession and the leaders who, years ago, molded our profession into what it is today. Today we are the type of profession that when you load your grandma in the back of the ambulance with “Staffed with Nurses” on the side, you feel a little bit better about her care.

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3 Responses to Paramedics Upset About Nurse Staffed Ambulance

  1. Well put.

    I’ve long said that EMS could get farther if they’d emulate the successes of the nursing profession, instead of being jealous of them.

  2. Wayne Hodges says:

    I read the above comments and while I agree that Nursing has done well in self-promotion and national standards, this is not the entire answer.
    EMS is a profession that dates less than 40 years. It is fragmented due to the lack of a national professional organization. It is also due to the Federal DOT setting standards but not having the power and authority (and I view this as a VERY GOOD thing) to enforce the standards on all 50 states. Of course, whenever a vacuum exist, a bureaucrat will attempt to fill it (usually poorly).
    I also hold both professions, AS degrees in both. I have been in nursing since 1972 and EMS since 1974 (first as a Navy Corpsman, then EMT, and in 83 paramedic). I have worked both in the streets and in the hospital, many years doing both jobs at once.
    There is a difference in skill sets for EMS versus Nursing. It is a very large difference. It even involves a mind set. Medics must make decisions and develop working diagnosis on each and every patient. No, Nursing diagnosis are not the same, and the Medic is not making the “Medical Diagnosis”. But without a working diagnosis, the Medic has no direction in how to proceed to treat a patient. A nurse will make an assessment (yes, as detailed or even more in-depth than the Medic might make) and then will contact/consult the physician for direction on how to proceed. The Nurse will coordinate care with a variety of hospital departments and other health care professions, the Medic will deal with the patient, family, public, Law Enforcement Officers, Fire Services, every other person that thinks they are in charge of the scene, and then at least one hospital. And all of this will occur while trying to formulate the working diagnosis and treatment of the patient WITHOUT any lab, x-ray, or Medical Consultants.
    Both professions share many traits and skills. Even some of the training is the same or similar. But let me ensure any Nurse that feels they can work in the field: You need more training. I first worked as a Medic after nearly 10 years ICU and ED experience. I will never forget the feeling of fear, being totally lost and out of my element, and near helplessness I had doing my first field arrest in a house with only my EMT partner there to assist me. Nowhere in any nursing training or experience did anything really prepare me to work THAT code.

  3. Ivan A. Mustafa, EMT/P, MSN, ARNP-C, CMO says:

    As a Division Chief of EMS for a large metropolitan department and an Advanced Registered Nurse Practitioner involved in emergency medicine for the last 23 years I have to agree with Wayne in regards to what is construed by the sign on the side of that transport unit as well as the roles that each professional service has – nursing and EMS.

    Nursing has indeed a role but so does EMS. These roles encompass specific portions of the patient care continuum and do not coexist in a parallel universe as they each have specific missions and goals. In today’s healthcare arena it is confusing enough for the public to differentiate between a doctor and a nurse practitioner or PA to expect them to understand that the ways in which nursing and EMS operate, or that the standard of care will be radically different because a nurse is staffing the transport unit. If this unit is what appears to be a “critical care interfacilty unit” – then say that! Do not misinform the public – It is not just an ambulance.

    I strongly believe that instead of bickering between nurses and EMS, perhaps we can engage in a symbiotic relationship. There is an age old antagonistic relationship between the two professions which is detrimental to our common mutual ultimate goal which is to provide the best patient care possible. Most tend to believe that there is a grudge between professions. Whether that remains true is anyone’s opinion. This adversarial relationship needs to stop! It does not help anyone to continue fighting amongst our professional ranks. Lets focus on how we can work well with each other to provide superior patient care instead of trying to beat each other up.

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