Duke Hospital hiring paramedics

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Duke Hospital is hiring paramedics for the emergency department, Life Flight, and the code blue team.

PARAMEDIC I - CODE TEAM - DUKE LIFE FLIGHT

PARAMEDIC I - EMERGENCY DEPARTMENT - DUKE UNIVERSITY HOSPITAL

I can answer some questions, but I know people ;).

@Muppet , @policemedic , if you wanna pass on to your colleagues....
Well damn, a hospital that allows paramedics to practice with their scope of practice. The hospitals in our AO use experienced paramedics as glorified ass wipers, not allowing any practice of our scope of practice. It's why in my 20 years, I never went to the ERs. A near by county trauma center had medics connected to the cath team, would work STEMI pt in ED, transfer to cath lab and participate in cath. That died off years ago, I knew the medics, they liked it.
 
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Well damn, a hospital that allows paramedics to practice with their scope of practice. The hospitals in our AO use experienced paramedics as glorified ass wipers, not allowing any practice of our scope of practice. It's why in my 20 years, I never went to the ERs. A near by county trauma center had medics connected to the cath team, would work STEMI pt in ED, transfer to cath lab and participate in cath. That died off years ago, I knew the medics, they liked it.

In all fairness, though I have not seen what their entire scope will be in the ED, I can tell you what it won't include: airway (what with RTs, med students, and residents), chest decomp, and the more uncommonly used ALS skills. I don't believe it will be fully on the other end of the spectrum as ass-wipers, either.

The medics with Life Flight/code blue team will be intubating (I think) and using their skills more fully.

In full disclosure I am not impressed with the pay band ($15 and change to $27 and change).

Having medics in the ED and on the code team is brand-spanking new; medics on Life Flight is fairly new. I have been lobbying for medics on Life Flight for years. YEARS. It's been like jousting at windmills, man.
 
I wouldn’t get out of bed for that kind of money. If they want to attract the kind of medics you want to be working with—especially FP/CCP-C medics—you’re going to have pay at or near RN rates. That means increasing the requirements and demanding a degree instead of a high school diploma and a medic license. And politics says that will never happen.

Flight medics are a new thing to Duke? Wow.

The problem I have with medics working in the ED is that the positions usually fall under nursing and the medic is subordinate to the nurse. That’s not how medics are meant to function (I’m not implying they should have the autonomy they have in the field either).

None of this is directed at you @Devildoc. I’m ranting generally.
 
I wouldn’t get out of bed for that kind of money. If they want to attract the kind of medics you want to be working with—especially FP/CCP-C medics—you’re going to have pay at or near RN rates. That means increasing the requirements and demanding a degree instead of a high school diploma and a medic license. And politics says that will never happen.

Flight medics are a new thing to Duke? Wow.

The problem I have with medics working in the ED is that the positions usually fall under nursing and the medic is subordinate to the nurse. That’s not how medics are meant to function (I’m not implying they should have the autonomy they have in the field either).

None of this is directed at you @Devildoc. I’m ranting generally.

All the points which you have eloquently brought up, I have as well.

I told them that at the hourly rate you'll be left with people who are inexperienced because people who are experienced will be making much more than that. That said, that's not terribly far off the starting rate for paramedics North Carolina. Sad, but true.

There's a lot of history and politics about using paramedics on the aircraft, and I have said, since long before I was a nurse and when I was still a paramedic, that if they're going to be doing scene runs, they need a paramedic. Now I don't believe in their altruism entirely, I think one reason they're going to this model is because it makes more financial sense.

Regarding medics in the emergency department, I have been told that they will fall under a different chain of command and that they will have their tasks aside from nursing and not under nursing. We'll see.
 
All the points which you have eloquently brought up, I have as well.

I told them that at the hourly rate you'll be left with people who are inexperienced because people who are experienced will be making much more than that. That said, that's not terribly far off the starting rate for paramedics North Carolina. Sad, but true.

There's a lot of history and politics about using paramedics on the aircraft, and I have said, since long before I was a nurse and when I was still a paramedic, that if they're going to be doing scene runs, they need a paramedic. Now I don't believe in their altruism entirely, I think one reason they're going to this model is because it makes more financial sense.

Regarding medics in the emergency department, I have been told that they will fall under a different chain of command and that they will have their tasks aside from nursing and not under nursing. We'll see.

I figured we'd be on the same page.

I agree that using paramedics vs flight RNs represents a cost savings. Depending on the NC scope of practice, the level of care may be equal, but profits would be higher. I have to admit to a bias against flight in many cases, but when it's needed you want the best.

I'd be interested to see how they task the medics in your ED.

Has there been much interest in these billets?
 
I figured we'd be on the same page.

I agree that using paramedics vs flight RNs represents a cost savings. Depending on the NC scope of practice, the level of care may be equal, but profits would be higher. I have to admit to a bias against flight in many cases, but when it's needed you want the best.

I'd be interested to see how they task the medics in your ED.

Has there been much interest in these billets?

I absolutely see a bias in flight, I've seen so many nurses muck up a perfectly well-run scene because they didn't understand the nature of pre-hospital care. That's where the flight medic shines. When I was a flight medic I had the critical care course, but even so I was nowhere even remotely as qualified as my colleague who was a critical care nurse and/or an emergency department nurse with years of experience.

We also have respiratory therapists who fly and run ECMO for those interfacility patients. I think they're on the verge of a really good program.

The director of the emergency department was a flight nurse for many years, I think he is proactive about having medics in the emergency department, but given that it is brand new, and politically our hospital has been anti-medic, I think there's going to be a steep learning curve and I don't think they're going to get a full plate of scope of practice right off the bat, but can see it a couple years down the road.

There's a ton of interest for the life flight jobs, not sure how much interest there's been for the emergency department job. My cousin is a medic in a rural area about 80 mi Southeast of here, she's interested in the ED job, but I don't think she quite understands how busy she's going to be.
 
Out here Air Methods and LFN have always staffed Medic/RN combos on the birds. The RN's typically come from ICU experience, medics are expected to be airway proficient while the RN's are more experienced pharmacy wise. Its a combo that seems to work really well.

I worked a hospital based EMS job in very rural WY where Medics were ER employees until tones went off. I left because admin was having us work way out of our scope to save money on nurses and I wasn't cool with that.
 
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