Is an RN considered a higher level of licensure than a Paramedic?

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Permalink Reply by dr-exmedic on August 13, 2009 at 2:40pm

Ben Waller said:

Dr.ex, thanks for the information. However, the example I gave was that of a resident and an attending, both of whom are MDs.

As Joe P. corrected me, I am a first-year resident (called myself intern out of ease of typing, though technically--and confusingly--there are places and situations where you are an intern but not a first-year resident). Both my attendings and I have the same degree (MD--except for the DO attendings but I don't want to get into that complication now because there's so little difference) but not the same license...and I won't have an equivalent license for another few years...and now I'm distracted enough that I've lost track of what you were trying to say in the first place anyhow. :)

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Permalink Reply by Joe P. on August 13, 2009 at 2:48pm

dr-exmedic said:

(MD--except for the DO attendings but I don't want to get into that complication now because there's so little difference

Do you mean the OMM that most of us don't use or the philosophical differences that aren't really there anymore?

/OMS1 at COMP who's already sick and tired of hearing how "special" it is...

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Permalink Reply by senseihomer on August 13, 2009 at 4:36pm

Hi guys,

I am totally new at this forum.

First i want to introduce myself :

I am 34 and living in the Netherlands, i am a student nurse (last year) with ambition towards emergency medicine (prehospital).

I just want to explain how the prehospital emergency care is organised in the Netherlands.

Here we have ambulance-services called RAV (regional ambulance departement). In the ambulance we have 2 different jobs.

The ambulancedriver is responsible for driving the ambulance and for assisting the ambulancenurse.

The ambulancenurse is a specialised nurse (ER or ICU or CCU nurse with advanced education) who is responisble for the patientcare. The nurses work with protocol, but with good argumentation are allowed to surpass these protocols. They are very independent but to become a ambulancenurse u need to become a basic nurse (4 year study) and then a specialised nurse (2-3 year) and after that a special traningprogram of 1 year.

In the nethelands we have a trauma team with an emergency doctor (usely a traumasurgeon) and a flight nurse who fly in by helicopter to assist the ambulanceteams when needed

I hope u like my example of phtls in the netherlands

just to inform u.

When u want more information just ask

hopely we can exchange information and opinins

greetings

martien



Joe P. said:

dr-exmedic said:

(MD--except for the DO attendings but I don't want to get into that complication now because there's so little difference

Do you mean the OMM that most of us don't use or the philosophical differences that aren't really there anymore?

/OMS1 at COMP who's already sick and tired of hearing how "special" it is...

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Permalink Reply by dr-exmedic on August 14, 2009 at 10:04am

Joe P. said:

Do you mean the OMM that most of us don't use or the philosophical differences that aren't really there anymore?

The only time I've ever seen OMM in use was at one slower community ED, where the one DO used to fix some of the nurses' backs for them every so often. :)

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Permalink Reply by dr-exmedic on August 14, 2009 at 10:05am

Joe P. said:

Do you mean the OMM that most of us don't use or the philosophical differences that aren't really there anymore?

The only time I've ever seen OMM in use was at one slower community ED, where the one DO used to fix some of the nurses' backs for them every so often. :)

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Permalink Reply by robert bethea on August 18, 2009 at 3:31pm

Your supervisor is on "crack" and not the kind you smoke. If you are an EMS provider and have been called to a scene to provide care (i.e. duty to act) the scene and patient care belong to you. I had a similar case asa young medic and I honored the DNR because that is specifically what the DNR stated. No CPR. Diplomacy and tact are always best but sometimes you have let those around you know that you were called and have a legal and ethical duty to the patient. This includes physicians as well.

Justin said:

It doesn't seem like their should be, but I've heard it come up a lot. When I asked one of my supervisors a question about a nursing facility doing CPR on a person with a DNR and if I was allowed to respect the patients wishes and not run the code when I took over care(I'm a paramedic, they called 911), he told me no because a nurse is a higher level of licensure and I should do whatever he/she says.

Skip Kirkwood said:

Different, for sure.

I don't know if there is such thing as a hierarchy of licenses.

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Permalink Reply by Skip Kirkwood on August 18, 2009 at 3:54pm

Right, Robert. That's called "being a patient advocate" and honoring the patient's wishes.

Good call.

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Permalink Reply by Skip Kirkwood on August 18, 2009 at 3:54pm

Right, Robert. That's called "being a patient advocate" and honoring the patient's wishes.

Good call.

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Permalink Reply by George Burnstein on August 18, 2009 at 4:46pm

well stated Skip

Skip Kirkwood said:

Let's not be too hard on folks asking legitimate questions. Just because some of us have already discussed this and formed conclusions, doesn't mean that somebody else can't legitimately begin the critical thinking process.

To say that there is "no relevance" to the comparison is a conclusion that you can only reach after a certain amount of study, discussion, research, etc. Although it may have been "asked and answered" for you, it may be a question of first impression for another member.

Give 'em a break!

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