Posted by: notdeaddinosaur | December 17, 2008

Rant Time in the ER

An ER nurse who just doesn’t get it:

I was sitting at work a couple of days ago and one of the other nurses commented that staff nurses could really handle a lot of what comes into the ER without doctors. It got me to thinking, why do we pay doctors big salaries to do what a nurse practitioner could easily do? Honestly I think that a nurse practitioner could easily handle what comes into an ER if they specialized in emergency medicine. My co-worker pointed out that they couldn’t do emergency procedures. Why couldn’t they? They could intubate, place central lines, etc. if they were trained. Nurses are already doing this in some places.

The thing about changing medicine and making it less costly is that there are so many interest groups that would fight it. Among the first would be the AMA which will fight it tooth and nail. I guess that is their purpose to stand up for doctors.

As I see it the future of medicine in primary care, family practice, is the nurse practitioner. Doctors will be the specialists. Will nurse practitioners change the face of medicine? Perhaps. Nurses are taught to look at the whole person. Doctors, for the most part, are taught to treat the physical. Nurses learn more about preventive care. Doctors, for the most part, learn to deal with problems that have already happened.

If you are a young nurse, consider being a nurse practitioner.

Oy. Here’s my comment:

Why stop there? I’ve seen what nurses do in triage. They just ask a bunch of questions off a sheet of paper and do whatever the protocols say. It seems like the unit clerks could really handle a lot of what the nurses do. Why pay nurses big salaries to do what a clerk could easily do? Honestly, I think a clerk could do what a triage nurse did if they were given specialized training.

The thing about changing ER nursing and making it less costly is that there are so many interest groups that would fight it tooth and nail, like the ANA. I guess that is their purpose to stand up for nurses.

As I see it, the future of nursing is the clerks. Nurses will take care of people already in the hospital. Will clerks change the face of the ER? Perhaps. Clerks are taught to do paperwork.

If you are considering a medical career, become a clerk instead of a nurse or a doctor.

(Oh, wait: I guess we already are.)

When are people going to realize that watching someone do something does not make you qualified to do it, even if you think it looks easy? So much of what doctors do (and many other professions as well) is infinitely more complicated than it looks, especially when someone is very good at it. Just because an extremely skilled physician makes medicine or surgery look easy does not mean that anyone else “could easily do it,” regardless of “specialized training” (short of medical school and residency training.)

This is as true for Primary Care medicine disrespected by Partialist physicians as it now appears to be for Emergency Medicine disrespected by ER nurses. I, for one, am getting really sick of it; so cut it out already!

(h/t to Scalpel)

(Note to all you ER folks: not talking about fast track or misuse of ERs for minor shit here, because hell, a clerk really could triage that crap. The question is, would you want them to?)

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