Saturday, October 15, 2011

The Stupid Flows.

Hood Hospital, for a long time, has had several paramedics in our employ. Over the last several years, however, it's been pretty obvious that they're trying to phase them out. We've hired one new medic in the past 2 years- meanwhile 3 or 4 have left or gotten fired. Word is that before I got there, the medics could do just about anything the nurses could do- give several meds, apply splints, even triage. The triage function was gone before I started, but over the last couple of years they've pretty much reduced their functions to IV starts (which they can't even flush, because oh noes, normal saline is a med, y'all), EKGs and transports. They can't even apply oxygen any more because it's a "medicine". Last week they decided they were going to slash their hours like crazy, and only have one medic working part of the shift on the floor. The others would be helping the charge nurse move patients to rooms and doing EKGS and shit in triage. Really? In case there's been any doubt up to this point, our management obviously has their heads pretty far up their asses.
I know there's controversy, for sure, about paramedics in the hospital setting. For the setting I work in, though, it's pretty much a no-brainer. We need them. Straight up. They save our asses on a regular basis. I'm actually a pretty good example of the average nurse in our ER. Young and inexperienced in any other area that isn't ER. A lot of the times, I'm the "grown up" nurse on my team- it's me with two other nurses that have been at it for less than a year. All the really experienced folks have moved on to either charge or management. Now, don't get me wrong- I can handle just about any ER situation. But when it comes to some of the really obscure stuff, or when I have to be an ICU nurse- I need my medics. Most of these guys can manage a critical patient on their own- they've worked flight before, so they know how to pace, they know how to set up an art line in their sleep- stuff I review once a year at skills day and maybe deal with twice a year other than that. I can't imagine having to do that stuff without them. It'll get done, but it'll be a clusterfuck. And IV starts? Yeah. As good as I've gotten over the last few years, I can't hold a candle to someone who was doing flight transport while I was still taking my SATs.
And now their talking about relegating their duties to moving patients back to a room. Seriously? You idiots think you need to pay a licensed professional to do that? Because that sounds like a job a tech, or shit, a volunteer could do. Here's the thing- when you start treating licensed staff that are an important part of the healthcare time like idiots, you are the ones that end up looking like idiots, because you're paying someone who certainly makes more money to do a job you could pay someone less money to do. Meanwhile, you rob your young staff of someone who has a lot to teach them. We might be able to get away with this crap if we were a hospital full of sage and learned nurses with lots of experience. But we're not. So we're basically just screwing ourselves. Sigh.
I'm gonna throw a fit and argue my case at the next staff meeting, but if they haven't seen these guys' obvious value by this point, I don't know what will change their mind. It's certainly a huge bummer, though.


  1. So...they're allowed to give O2 and saline in the ambulance, but not in the hospital? I thought it was part of their paramedic license that they were allowed to do these things. Is it some sort of hospital policy?

  2. I guess in the ambulance, they're under a director of medicine and they have protocols, so in order to do the same things in a hospital setting, they have to work under a doctor's license, and someone's being a douche about it- it's unclear as to whether it's the doctors or the management or both.

  3. I agree with you 100%, that's crap....where is the regard for pt safety? It kills me. Keep us posted about the staff mtg

  4. I love my medics! Agree with you 100% that they can teach you things you don't normally do and that they are a very VALUABLE part of the healthcare team, and not just a transporter. I am so thankful that our medics can still assist with med administrations (minus antibiotics or insulin). Good luck at your staff meeting.

  5. I worked in an ER where paramedic utilization dropped significantly because of the "blurred lines" between the hospital and pre-hospital environment. IV starts? gone! Critcal care drugs? gone! Getting patient from the lobby? gone! We were basically using them for transport. What a waste of valuable and experienced resources.

  6. "Meanwhile, you rob your young staff of someone who has a lot to teach them."
    BING-O! It's stuff that management hasn't ever caught onto - that somethings truly are priceless. Meaning? You can't always attach quantitative value (salary) to a qualitative factor (knowledge).

    Would you rather have a medic with 15 years of experience take care of you or your loved one or a green RN fresh outta school? I've never been a medic but I'd chose the former over the latter.