HJAR Jan/Feb 2022

HEALTHCARE JOURNAL OF ARKANSAS I  JAN / FEB 2022 17 How many paramedics did you start with? Are you still hiring? We started with enough paramedics to ensure 12-hour coverage, seven days a week. They are currently scheduled during the busiest ED times (noon to midnight). Cur- rently, all of our paramedic positions in the ED are filled. What additional training did you have to provide? All of our paramedics have at least one year of experience. Education classes required for our ED paramedics include Basic Life Support (BLS), Advanced Car- diovascular Life Support (ACLS), Pediatric Advanced Life Support (PALS), and either a Prehospital Trauma Life Support (PHTLS) or audit a Trauma Nursing Core Course (TNCC). We have a group of wonderful, experienced paramedics who are actually instructors of most of the above courses. What can’t paramedics do that an LPNs or RNs can? Paramedics are not taking primary care of patients in the ED, but rather assist with defined tasks/procedures and medication administration. How many paramedics are on a typi- cal ED team? What are your ideal shift ratios? Currently, we have a paramedic during our peak time who floats and assists where needed throughout the ED. As of right now, our paramedics are scheduled to work from noon to midnight each day and do not have a defined ratio as they are not assigned a primary group of patients. How do the paramedics/nurses feel about the program? What feedback have you gotten? Our ED nurses absolutely love having the paramedics as part of the team. The resource and expertise that they provide is invaluable, and many nurses will tell you that they “don’t know how they did it before having paramedics as part of the ED team.” Washington Regional ED paramedic, Daniel Fox, states, “I really enjoy the team aspect and being a part of the multidisci- plinary portion of Emergency Medicine.” He also reports that he enjoys the hours as they are more family friendly. Many para- medics work a 48 hours on and 96 hours off schedule, which can be difficult to balance with family life. Having experienced paramedics working alongside our experienced ED physicians and nurses has improved our ED team and patient care. What are the cost savings? What other upsides do you see? Rates of pay depend on the experience level of the paramedic. Upside: paramedics have a more refined skill set when it comes to trauma. Most of the paramedics that we have hired in the ED are also instructors in our local community college and provide a lot of education to our front-line staff. Have there been any challenges? There have been minimal challenges as this program is embraced by both physi- cian and nursing staff. They recognize and appreciate the huge value that paramedics bring to our team. Do you plan to expand the pro- gram? We do not have immediate plans to increase paramedic staff but do continue to monitor and evaluate this with the increas- ing acuity and volume in the ED. The fore- seeable next step would be to add a second paramedic to the busiest days of the week to further help with patient flow. Do you know of other health systems considering it? Have they approached you? Our ED director has discussed our pro- gramwith several other facilities across the state and in Emergency NursesAssociation national healthcare forums. n DANIEL FOX Washington Regional ED Paramedic