----- Original Message -----
From: "Adrian Fogarty" <[log in to unmask]>
To: "Martyn Hodson" <[log in to unmask]>
Sent: Friday, September 26, 2003 9:37 AM
Subject: Re: ECGs at the scene for thrombolysis
> > and this brings us round nicely to the fact that paramedic training
needs
> to be beefed up considerably. [Robbie]
>
> Exactly, as an experienced CCU nurse has already been through years of
> general nurse training before specialising for several further years,
> including various ENB courses, and despite that, as Martyn suggests, many
> still have difficulty with autonomy, especially with the more subtle and
> riskier decisions. Of course, nursing is steeped in anachronisms, so it's
> hard for nurses to - on the one hand - become autonomous in certain areas
of
> practice, while they're still checking drugs with each other in another
area
> of practice.
indeed there are some great ironies there, some which i'm sure we'll never
quite iron out, i have heard it described as seeking a happy medium on
support and autonomy, but Docs and nurses are heading towards the sensible
middle ground from diametrically opposing poles.
Doctors from the 'see one do one teach one ' school of skills acquisition
and Nursing from a it's safe protected historical viewpoint further
reinforcement by hoop jumping to expand skills,
this is further hampered by what is considered by soem of the more
traditional members of the nursing profession as 'Doctor's Jobs'
> And I don't believe ambulance technician training is remotely
> comparable to RGN training, while paramedic training is measured in weeks
I
> believe, as opposed to years.
>
Adrian i think you could do with sitting own and having a chat with some of
the paramedics who bring you patients. indeed the paramedic course lasts a
matter of weeks, but given that there is a requirement to have completed
the technician course and one if not two years of experience before even
being considered for paramedic training.
A few 'traditionally' trained RNs who have made similar comments got a shock
when you sit down and compare the content of 'traditional' pre-registartion
nursing courses and the route to paramedic registration in terms of the
mimmum practice experiences required and the ratio of that practical
experience to their classroom based learning.
> Still, I can foresee the advantages in rural environments as recently
> posted, but these areas are likely to have the benefit of good
telemedicine
> infrastructure already in place to support paramedics' decision making,
and
> with those long journey times, you can easily rationalise the benefits of
> this sort of system. Notwithstanding the impressive newspaper article, it
> does give the distinct impression of a "once in a blue moon" dramatic sort
> of case and, rather like the HEMS thoracotomy-on-the-pub-floor case a few
> years ago, the media, the public, and so the politicians will just love
it!
true especially in rural environments, as there are quite a few places in
the UK where the closest major A+E and /or CCU bed is half an hour of more
away i'm sure there will be some form of telemedicine support , initially to
support decision making by the paramedic and later to provide support and
advice in the less clear cut situations where exising in hospital Chest pain
services are seeking advice before proceeding
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