firefighter girl steps up on the bitch box

The ED is where the maimed, sick, injured and generally decrepit paramedics are put to pasture. At least, that's what I tell patients when they ask me. What I don't tell them is that we are also put in the ED for comic relief, manual labor and general ass-chewing from grouchy nurses. When I'm at work, my nametag says "everybody's bitch." I also don't tell them of the number of times we've saved some not so great RNs from making very bad decisions with their patient care, or that we've had numerous great nurses say that in critical situations they'd much rather have a medic than another nurse in the room, or that "where's my medic?" is one of the first things most doctors will yell upon entering a room and finding a patient in a bad way.

A decade ago, several nurses in the ED where I currently work took offense to the medics' scope of practice in the ED, and fought long and hard to limit it. At that time, the physicians' group petitioned to have control of the medics, but the hospital chose to take it on itself, and the "ED tech" job description was so vague that it left much room for interpretation, so you never knew, really, when you were going to get in trouble for something.

Two years ago, we got a new department manager, and he and I spent a lot of time rewriting the job description of the medics. Somewhere along the way, our little hospital was bought out by a nasty, terrible, horrible company, but things didn't change much in the day-to-day stuff. We continued to flesh out our job descriptions, and had several of the doctors volunteer to be our physician advisor. We were finally starting to feel like more than housekeeping with IV and CPR skills.

And then, a couple of months ago, we get a letter from the nasty, terrible, horrible company stating that ED techs in their hospitals (techs with the same number of years of training as RNs, mind you, with the same associates' degree and prerequisites, but with more clinical hours and more requirements for continuing education) are no longer able to cardiovert, pace, start EJs or IOs, remove sutures or staples, etc etc etc etc. We are, however, now able to digitally disimpact.

rock on.