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----- Original Message ----- From: "Robbie Coull" <[log in to unmask]> To: <[log in to unmask]> Sent: Monday, March 18, 2002 10:24 PM Subject: Re: Treat and Release schemes > > If a paramedic wants to be a nurse or a doctor then why not simply go and > > do the appropriate training? > > You seem to want paramedics to be all things to all people all of the time. > > I think you are missing the point here, Robin. > > -doctors cost more to train and maintain than paramedics (even with a North > American training) you can't fault that and the way things are going doctors wil cost even more, while paramedics wil become 'cheaper' to train, if and when we move to more of a Higher education based Ambulance straining rather than trust delivered training to employees > -doctors don't want to do pre-hospital work. some doctors don't , some aren't given the opportunity to do so, whether because hospitals don't rate the flying squad approach and /or BASICS schemes aren't supported by the ambulance service and influnetuial docs > Paramedics came into being > because a lot of doctors (or their insurance companies!) refused to take the > risks of driving around at high speed in ambulances. paramedics came about as a way of filling a gap, where there were already an effective shortage of Docs and a Nursing profession hidebound by tradition and ritual > -you can't get doctors to work in remote areas (eg: crisis in general > practice in the Highlands) because docs want a life too ! > -GPs are increasingly unwilling to do home visits or emergency work it has to be said that becasue the public have abused the system in past the professions have become less receptive to home visits. as for emergency work, some ambulance services seem to think that they don't need any assistance, plus it can upset the Union activists > > There is an argument that paramedics should be extended-trained A+E nurses > (as they are in Holland), but the shortage of nurses and the increased costs > makes this unlikely in the UK. hmmm, i don't know about that, maybe some of the nurses wholeft nursing because of the politics and back biting wouldn't have done so if that option was there ,also all this money spent on NHS direct could have been spent on this instead, and would this have raised as much controversy? > > Paramedics are an extension of a physician (usually the medical director of > the ambulance service) - they are trained to assess and treat specific > conditions under medical control (either by radio or via protocols). As > such they are far cheaper than doctors or nurses to train and deploy. this of course depends on how we as health professionals see the role of the paramedic develop, how much of a comparison could be drawn with the concpet of the nurse as the doctor's hand maiden - an extension of the Docotor's authority, as seems to be seen still in the states or maybe i've got the wrong end of the stick of the descriptions of the way care is planned in the US. > > So 'treat and release' schemes, particularly with better online medical > control, is something that would be very useful in many situations. One point which has to be made, with not a little irony, is that first aiders can treat and release yet SRParas working for an NHS ambi trust can't Martyn Hodson [log in to unmask] Registered Nurse SJA Ambulance Attendant writing for myself, views expressed are entirely my own, and may not reflect those of my employer or St. John Ambulance , Nationally or locally -Duct tape is like the force, it has a light side and a dark side, and it holds the universe together.