RE: Supervision of Paramedics by RN.

[Guest guest]

it depends on two things: 1: your local protocols (ie, what your medical

director is willing to delegate and take responsibility for) and 2: the

wording of the state's Nurse Practice act and the enabling legislation that

authorizes paramedic practice.

Not all states allow PAs to practice independently, and not all states ban

midlevels from providing on line medical control. If a PA is practicing

subordinate to a physician, and that physician has authorized the PA to

provide on line medical control as his agent, that should be fine.

NPs are usually in a more independent, collaborative practice, but unless

they are associated with your medical control facility, are less likely to

be able to provide on line medical control.

ck

In a message dated 01/25/11 16:58:52 Central Standard Time,

medic18752@... writes:

Ok so I have heard it go both ways and can not find anything in the

nursing rules or EMS as to whether or not a RN can delegate or instruct a

paramedic in the care of a person. For that matter what about a NP? I am sure

that they cannot being that you have to get orders from a PHYSICIAN to do

anything outside of your approved protocols, but none the less who can help me

find where it is written?

------------------------------------

Yahoo! Groups Links

[Guest guest]

it depends on two things: 1: your local protocols (ie, what your medical

director is willing to delegate and take responsibility for) and 2: the

wording of the state's Nurse Practice act and the enabling legislation that

authorizes paramedic practice.

Not all states allow PAs to practice independently, and not all states ban

midlevels from providing on line medical control. If a PA is practicing

subordinate to a physician, and that physician has authorized the PA to

provide on line medical control as his agent, that should be fine.

NPs are usually in a more independent, collaborative practice, but unless

they are associated with your medical control facility, are less likely to

be able to provide on line medical control.

ck

In a message dated 01/25/11 16:58:52 Central Standard Time,

medic18752@... writes:

Ok so I have heard it go both ways and can not find anything in the

nursing rules or EMS as to whether or not a RN can delegate or instruct a

paramedic in the care of a person. For that matter what about a NP? I am sure

that they cannot being that you have to get orders from a PHYSICIAN to do

anything outside of your approved protocols, but none the less who can help me

find where it is written?

------------------------------------

Yahoo! Groups Links

[Guest guest]

Check the Nurse Practice Act. Nurses cannot delegate to a non licensed

provider and they do not recognize LP.

Ricky Reeves

Division Chief - EMS

ville Fire Department

P.O. Box 299002

ville, TX 75029

(o)

©

The information contained in this email is meant solely for the intended

recipient.

Access to this email by anyone else is unauthorized. If you are not the intended

recipient,

any disclosure, copying, distribution or any action taken or omitted in reliance

on this,

is prohibited and may be unlawful. No liability or responsibility is accepted if

information

or data is, for whatever reason, corrupted or does not reach its intended

recipient.

No warranty is given that this email is free of viruses. The views expressed in

this email are,

unless otherwise stated, those of the author and not those of the City of

ville or its management.

[Guest guest]

Check the Nurse Practice Act. Nurses cannot delegate to a non licensed

provider and they do not recognize LP.

Ricky Reeves

Division Chief - EMS

ville Fire Department

P.O. Box 299002

ville, TX 75029

(o)

©

The information contained in this email is meant solely for the intended

recipient.

Access to this email by anyone else is unauthorized. If you are not the intended

recipient,

any disclosure, copying, distribution or any action taken or omitted in reliance

on this,

is prohibited and may be unlawful. No liability or responsibility is accepted if

information

or data is, for whatever reason, corrupted or does not reach its intended

recipient.

No warranty is given that this email is free of viruses. The views expressed in

this email are,

unless otherwise stated, those of the author and not those of the City of

ville or its management.

[Guest guest]

The Texas Board of Nursing has rules for nurses to delegate to unlicensed

assistive personnel, Delegation of Nursing Tasks by Registered Professional

Nurses to Unlicensed Personnel

for Clients with Acute Conditions or in Acute Care Environments - §§ 224.1 -

224.11 and RN Delegation to Unlicensed Personnel and Tasks Not Requiring

Delegation in Independent Living

Environments for Clients with Stable and Predictable Conditions. Texas

Medical Board covers physicians and PAs, Texas BON covers nurses including

advanced practice (AP) nurses, DSHS covers EMS personnel. The BON position

statement at one time stated EMS personnel working under nurses in a

hospital setting were considered to be unlicensed assistive personnel,

however that position statement has been removed from the BON list of

position statements. DSHS rules allow delegation from the medical director

to EMS personnel in the prehospital setting. Texas Medical Board rules lets

a physician delegate pretty much anything they want to whomever, that is how

a doctor’s unlicensed office staff, i.e. a medical assistant, do procedures.

In short, working in a hospital, if you are considered part of nursing, BON

rules apply. If you work under the physician, then the physician can

delegate under their rules. Nowhere have I ever seen a statute or rules

about a hierarchy of care where a nurse is higher that a paramedic or the

other way around. It is like comparing apples to oranges, two different

things.

The other is there is not a rule that allows a paramedic to delegate to an

EMT or ECA. Each is allowed to do what the medical director delegates in

the protocols. Recent disciplinary actions by DSHS bear this out where an

EMT started an IV and the provider protocols did not allow this in the scope

of practice. The provider was fined for allowing personnel to act outside

their scope of practice.

Hope this helps.

Randy E. , R.N., L.P.

From: texasems-l [mailto:texasems-l ] On

Behalf Of

Sent: Tuesday, January 25, 2011 4:02 PM

To: texasems-l

Subject: Supervision of Paramedics by RN.

Ok so I have heard it go both ways and can not find anything in the nursing

rules or EMS as to whether or not a RN can delegate or instruct a paramedic

in the care of a person. For that matter what about a NP? I am sure that

they cannot being that you have to get orders from a PHYSICIAN to do

anything outside of your approved protocols, but none the less who can help

me find where it is written?

[Guest guest]

The Texas Board of Nursing has rules for nurses to delegate to unlicensed

assistive personnel, Delegation of Nursing Tasks by Registered Professional

Nurses to Unlicensed Personnel

for Clients with Acute Conditions or in Acute Care Environments - §§ 224.1 -

224.11 and RN Delegation to Unlicensed Personnel and Tasks Not Requiring

Delegation in Independent Living

Environments for Clients with Stable and Predictable Conditions. Texas

Medical Board covers physicians and PAs, Texas BON covers nurses including

advanced practice (AP) nurses, DSHS covers EMS personnel. The BON position

statement at one time stated EMS personnel working under nurses in a

hospital setting were considered to be unlicensed assistive personnel,

however that position statement has been removed from the BON list of

position statements. DSHS rules allow delegation from the medical director

to EMS personnel in the prehospital setting. Texas Medical Board rules lets

a physician delegate pretty much anything they want to whomever, that is how

a doctor’s unlicensed office staff, i.e. a medical assistant, do procedures.

In short, working in a hospital, if you are considered part of nursing, BON

rules apply. If you work under the physician, then the physician can

delegate under their rules. Nowhere have I ever seen a statute or rules

about a hierarchy of care where a nurse is higher that a paramedic or the

other way around. It is like comparing apples to oranges, two different

things.

The other is there is not a rule that allows a paramedic to delegate to an

EMT or ECA. Each is allowed to do what the medical director delegates in

the protocols. Recent disciplinary actions by DSHS bear this out where an

EMT started an IV and the provider protocols did not allow this in the scope

of practice. The provider was fined for allowing personnel to act outside

their scope of practice.

Hope this helps.

Randy E. , R.N., L.P.

From: texasems-l [mailto:texasems-l ] On

Behalf Of

Sent: Tuesday, January 25, 2011 4:02 PM

To: texasems-l

Subject: Supervision of Paramedics by RN.

Ok so I have heard it go both ways and can not find anything in the nursing

rules or EMS as to whether or not a RN can delegate or instruct a paramedic

in the care of a person. For that matter what about a NP? I am sure that

they cannot being that you have to get orders from a PHYSICIAN to do

anything outside of your approved protocols, but none the less who can help

me find where it is written?

[Guest guest]

i agreed with randy. i think the things is is that a RN can delegate all day

long to a paramedic as an unlicensed assistive personnel but a paramedic cannot

act on that delegation because a RN is not a physician. i've actually worked

somewhere in a hospital

where they wouldnt allow me to give oxygen (because it's a drug) but would let

me push blood products (allegedly because blood isn't a drug- i know that's BS,

but that's what they said). the FDA regulates blood and products of blood so

that make it drug IMHO.

jim davis

paramedic

Subject: RE: Supervision of Paramedics by RN.

To: texasems-l

Date: Tuesday, January 25, 2011, 6:22 PM

 

The Texas Board of Nursing has rules for nurses to delegate to unlicensed

assistive personnel, Delegation of Nursing Tasks by Registered Professional

Nurses to Unlicensed Personnel

for Clients with Acute Conditions or in Acute Care Environments - §§ 224.1 -

224.11 and RN Delegation to Unlicensed Personnel and Tasks Not Requiring

Delegation in Independent Living

Environments for Clients with Stable and Predictable Conditions. Texas

Medical Board covers physicians and PAs, Texas BON covers nurses including

advanced practice (AP) nurses, DSHS covers EMS personnel. The BON position

statement at one time stated EMS personnel working under nurses in a

hospital setting were considered to be unlicensed assistive personnel,

however that position statement has been removed from the BON list of

position statements. DSHS rules allow delegation from the medical director

to EMS personnel in the prehospital setting. Texas Medical Board rules lets

a physician delegate pretty much anything they want to whomever, that is how

a doctor’s unlicensed office staff, i.e. a medical assistant, do procedures.

In short, working in a hospital, if you are considered part of nursing, BON

rules apply. If you work under the physician, then the physician can

delegate under their rules. Nowhere have I ever seen a statute or rules

about a hierarchy of care where a nurse is higher that a paramedic or the

other way around. It is like comparing apples to oranges, two different

things.

The other is there is not a rule that allows a paramedic to delegate to an

EMT or ECA. Each is allowed to do what the medical director delegates in

the protocols. Recent disciplinary actions by DSHS bear this out where an

EMT started an IV and the provider protocols did not allow this in the scope

of practice. The provider was fined for allowing personnel to act outside

their scope of practice.

Hope this helps.

Randy E. , R.N., L.P.

From: texasems-l [mailto:texasems-l ] On

Behalf Of

Sent: Tuesday, January 25, 2011 4:02 PM

To: texasems-l

Subject: Supervision of Paramedics by RN.

Ok so I have heard it go both ways and can not find anything in the nursing

rules or EMS as to whether or not a RN can delegate or instruct a paramedic

in the care of a person. For that matter what about a NP? I am sure that

they cannot being that you have to get orders from a PHYSICIAN to do

anything outside of your approved protocols, but none the less who can help

me find where it is written?