MassCops - Massachusetts Law Enforcement Network, A Mass Police Web Portal

Massachusetts Law Enforcement Network

Massachusetts Police News, Information and Discussions on MassCops

Pages: 1

Main Page Are Registered Nurses First Responders?
(Click here to view the original thread on the MassCops Message Board)

Posted by: wordstew

Could someone please clarify the law regarding this. Is a registered nurse considered a first responder like a cop or EMT. I know they have a greater scope of medical training but legally speaking are they considered a first responder. I couldn't find the Chapter or section to clarify.

Posted by: gooday

I dont know if they are first responders because the patient is brought to them by the first responder. They dont respond to situations just as the injury or the medical emergency happens. They are a hire level of medical care and are a big pluss if there.

Posted by: SOT

What about ER nurses?
They respond to emergencies...

Posted by: benike84

When I went through First Responder i was told RN's are not first responders so they could not relieve us. Only a EMT, paramedic or a doc could. I would easily take any help an RN could provide though.

Posted by: John J

Quote:

Originally Posted by benike84

When I went through First Responder i was told RN's are not first responders so they could not relieve us. Only a EMT, paramedic or a doc could. I would easily take any help an RN could provide though.

It is my understanding that you could be relieved by someone with an equal or greater level of medical training? I would say a RN has a higher level of training than a first responder.

Posted by: Mongo

They have a duty to act and care as do all of us with even the most mininimal training such as CPR.

Posted by: screamineagle

what if it was an rn who worked for a foot doctor and knew nothing about emergency medicine?

Posted by: Portable81

RN's are not first responders. First responders are CERTIFIED. An RN could take a state mandated class and gain first responder certification, but just because they are an RN or even an MD does not make them first responders. Now, an EMT is covered as a first responder and so is a Paramedic, as they are also CERTIFIED by the state at a higher level of training overseen by OEMS (or licensed in some states).

Posted by: Nachtwächter

From an EMS stand point if a doctor decides he wants to treat a patient he must accompany the patient in ambulance to the hospital. For a nurse to work on an ambulance they have to be at least an EMT-B. We often get notices of people posing as firefighter and EMTs showing up on scenes.

Nurses are dependent on a doctor's order before they do anything. Some of the nursing home nurses are downright scary.

I've respond to doctor's office where the wrong dosage of a med was given by the MD. (I got a new doc after that one.)

Most docs and RNs are trained to work in a controlled environment where they have everything they need.

I think you could be held responsible if you allowed an untrained person to treat a patient.

The ones that would be the greatest help to you are the ones smart enough to keep on driving.

Posted by: Delta784

The only times I've surrendered care to an RN were when I recognized them as ER nurses from the hospital. As Nacht alluded to, everyone's an EMT at a vehicle crash.

Posted by: USMCMP5811

Quote:

Originally Posted by John J

It is my understanding that you could be relieved by someone with an equal or greater level of medical training? I would say a RN has a higher level of training than a first responder.

I was always under this impression also.....or at least this is what I have been taught for the last 17 years.

Posted by: screamineagle

A doctor technically has a greater level of training, but what is their specialty? podiatry, gynecology, cardiology, endochronologist? None of these people probably have the slightest idea about emergency medicine. An emergency room doctor by all means will, but a endochronologist(diabetes specialist) probably wont. Pshychiatrists are also doctors, I sure as hell wouldnt let them take over a patient.

Posted by: USMCMP5811

Quote:

Originally Posted by screamineagle

Pshychiatrists are also doctors, I sure as hell wouldnt let them take over a patient.

Well, they could discuss how the MCI is feeling and why it is that they want their host body to expire.........

Posted by: masstony

Nacht, Nurses are not dependent on a doctors order before they do anything, half the time their off the floor or asleep in the on call room.

Therefore they have to take action, because if they waited around the bed for the doc to make his way to the floor everytime something critical happened, there would be a lot more people dying in hospitals.

And I believe nurses to do not need a "certification" to be considered a first responder, they have what is called a "nursing license". I do believe that the training they go through usaully covers a first responders training and then some.

RN' are far more trained and qualified than first responders, emt's and paramedics...I know that may hurt the feelings of a lot of people on this web site, but it's the truth.

Posted by: USMCMP5811

Quote:

Originally Posted by masstony

Nacht, Nurses are not dependent on a doctors order before they do anything, half the time their off the floor or asleep in the on call room.

Therefore they have to take action, because if they waited around the bed for the doc to make his way to the floor everytime something critical happened, there would be a lot more people dying in hospitals.

And I believe nurses to do not need a "certification" to be considered a first responder, they have what is called a "nursing license". I do believe that the training they go through usaully covers a first responders training and then some.

RN' are far more trained and qualified than first responders, emt's and paramedics...I know that may hurt the feelings of a lot of people on this web site, but it's the truth.

I'll have to agree with this.

Posted by: SOT

All I know is half my family are MD's and none have MD plates so when we drive by accidents, they don't have to stop.

Posted by: Sniper

this thread is usless without pix.............

Posted by: Portable81

"RN' are far more trained and qualified than first responders, emt's and paramedics...I know that may hurt the feelings of a lot of people on this web site, but it's the truth."

They may cover a broad range of different topics, but a paramedic has many more class hours of emergency medical prehospital care, probably most EMT's do as well. Emergency medicine is our specialty, so we are proficient in it. Not to mention medics are able to choose when and which meds to push, and we can intubate, which many RN's aren't able to do. Basically what I'm trying to say is we are far more trained in our specialty, which are field emergencies.

This is why RN's still have to take a paramedic class and pass all of the required state tests, just as they would have to do if they wanted to become 1st responders.

Posted by: texdep

Quote:

Originally Posted by wordstew

Could someone please clarify the law regarding this. Is a registered nurse considered a first responder like a cop or EMT. I know they have a greater scope of medical training but legally speaking are they considered a first responder. I couldn't find the Chapter or section to clarify.

In MA Emergency Medical Services is regulated by MA Dept of Public Health, Office of Emergency Medical Services. The definition of first responder by OEMS is very specific and is reflected in CMR 105 cmr 171.0000

First Responder means a member of any of the following entities: a police or fire department; the state police participating in highway patrol; an emergency reserve unit of a volunteer fire department or fire protection district, and persons appointed permanent or temporary lifeguards by the Commonwealth or any of its political subdivisions. A first responder shall not mean a police officer, firefighter or persons engaged in police and fire work whose duties are primarily clerical or administrative.

First Responder Agency means a police department, a fire department, the state police participating in highway patrol, an emergency reserve unit of a volunteer fire department or fire protection district, or the Commonwealth or any of its political subdivisions that appoints permanent or temporary lifeguards. A first responder agency shall not mean a service that is a licensed EFR service, as defined in 105 CMR 170.020.

By legal definition nurses , doctors, etc are not first responders.The discussions above about RN's being required to be EMT's is not related to first responders but is becauseof other OEMS regulations requiring the personnel staffing an ambulance to be certified EMT's.

To the point of turning over care of the patiant. The normal flow is First Responder turns over to responding ambulance staff (EMT-B, EMT-I, EMT-P)turns over to designated receiving medical facility.

On scene however, the question would be whether a first responder could turn over care to to a RN or Doctor. Assuming the FR has some way of validating the the individuals claim of being a RN or Doctor, yes the FR can and would not be "abandoning" their patiant.

As a matter of fact a First Responder can in some cases turn over care to an untrained individual and not be charged with abandonment.

Case in point. A lone first responder is first on the scene of a Mass Casualty Incident, The FR starts triage and first victim found has a serious bleed. The FR calls over a bystander and instructs them to apply pressure to the wound. The FR then goes on to the next victem. Perfectly legal and correct actions by the FR.

Posted by: csauce777

Quote:

Originally Posted by Portable81

Not to mention medics are able to choose when and which meds to push, and we can intubate, which many RN's aren't able to do. Basically what I'm trying to say is we are far more trained in our specialty, which are field emergencies.

Please correct me if I am wrong, but arent most ER nurses certified in ACLS which includes intubation? No offense, but if I had my choice, I'm taking a skilled, experienced nurse over an EMT-B who knows "high-flow O2 and rapid transport." Paramedics, I agree, are very skilled in field emergencies, but not all ambulances are staffed by medics. My town is lucky enough to have the FD ambulance which is staffed by EMT-I's, and a regional Paramedic truck housed at the FD as well.

Posted by: Irish Wampanoag

Quote:

Originally Posted by wordstew

No! They do not come under the prehospital care. They could come under that scope if they work in a school or other institutional setting but typically they are not considered first reponders. Emergency Room nurses are considered hospital medical staff not FR. However sometimes emergency nurses will for example work a Red Sox game (Beth Isreal ER nurses) while on duty at the game they will be considered first responders.

Posted by: Nachtwächter

My feelings are not hurt. I admit nurses have more training, but it is just not in emergency medicine. They do have to ask for a doc's permission to make any changes in the patient’s treatment. ICU nurses and ER nurses may have more freedom in giving meds without out the doctor's immediate orders. RNs in nursing homes have to call for orders to increase a patient’s oxygen. Many nurses have never been to an ACLS course, which is required for paramedics. If you have a burn victim with a closing airway are you going to want a nurse or a paramedic? FYI nurses can’t intubate.
It comes down to training paramedics are trained for prehospital care and nurses are trained for long term care. You would not see a psychiatrist if you are having a heart attack. So why would you let a nurse do something nurses are not trained to do?

CSauce just because nurses are trained in ACLS does not mean they can intubate. Basics are now carrying epi-pens, albuterol, nitroglycerin, and aspirin. I would worry about a nurse showing up on scene having any of those or anyone for that matter. I have been to many nursing homes where they have had patients on 2 liters oxygen by nonrebreather. If you don't know that is bad you might as well stick a pillow over the patients head.

Posted by: Tango

Comparing Nurses to Medics is like comparing apples and oranges. Generally a very different role..of course there are RNs that work in an EMS aspect and Medics who work in, for example and ED, but for someone to say that one is BETTER than the other makes no sense. There is also a big difference in what type of nurse one is that makes them effective as a first responder.

RNs who work on an ambulance, even in a non emergency setting (critical care transports), need to be EMTs. Flight Nurses need to be at least EMTs. Flight Nurses,although one of the most highly trained nurses you will ever see, cannot technically care for someone on, for example, an accident scene without their EMT Cert.

Posted by: texdep

Quote:

Originally Posted by Irish Wampanoag

They could come under that scope if they work in a school or other institutional setting but typically they are not considered first reponders. .............. However sometimes emergency nurses will for example work a Red Sox game (Beth Isreal ER nurses) while on duty at the game they will be considered first responders.

NO! They are not first responders in those circumstances either. I suppose they would be called "onsite medical personnel".

Read my post above. The state regs are very specific as to who are first responders.

First responders are those who arrive as part of a First Response Agency as a result of a activation of the emergency medical response system.

(ps let's not get into an arguement about that not making sense....when has any regulation in MA had to make sense????)

Posted by: Nachtwächter

Tango flight nurses have to be EMTs since the helicopter is considered an ambulance.

http://www.harthosp.org/lifestar/Crew.htm
http://www.bostonmedflight.org/trans.html
http://www.umasslifeflight.com/aboutStaff.html

Posted by: Tango

[quote=Nachtwächter]Tango flight nurses have to be EMTs since the helicopter is considered an ambulance.

Yes, that's the point I tried to get across, the aircraft also have to have a siren

(seriously). ]

Posted by: texdep

Quote:

Originally Posted by Tango

Flight Nurses need to be at least EMTs. Flight Nurses,although one of the most highly trained nurses you will ever see, cannot technically care for someone on, for example, an accident scene without their EMT Cert.

You're mixing things up. Yes in order to meet the mandated crew requirements of an air ambulance the flight nurse must be an EMT. However, once the required staffing is met there is nothing prohibiting a "non-EMT" nurse from going on the flight and providing care. As a matter of fact it is not unusual at all for other members of the staff at UMass to go on flights as a learning experiance and asist with patiant care while on the flight.

Posted by: Nachtwächter

Tango knows a lot about EMS more than most.

Posted by: rocksy1826

.

Posted by: texdep

Quote:

Originally Posted by Nachtwächter

Tango knows a lot about EMS more than most.

I'll take your word for it that he does......but so do I .......so whats your point????

Posted by: Slimer

One of my jobs is being a training officer for a PD with the responsibility to certifiy the officers in the department as First Responders and keeping them current with CPR and First Responder Training pursant to MA OEMS and MPTC Standards. Here is the standards set forth by the Commonwealth of Massachusetts.

105 CMR 170.000: Emergency Medical Services System

. First Responder means a member of any of the following entities: a police or fire department; state police participating in highway patrol; an emergency reserve unit of a volunteer fire department or fire protection district, and any persons appointed permanent or temporary lifeguards by the Commonwealth or any of its political subdivision. A first responder shall not mean a police officer, firefighter or person engaged in police and fire work whose duties are primarily clerical or administrative. First responders are required to successfully complete, at a minimum, the course of emergency medical care thah meets the standards of M.G.L. c. 111 , S201 and 105 CMR 170.000.

.First Responder Agency means a police departmnet, a fire department, the state police participating in highway patrol, an emergency reserve unit of a volunteer fire department or fire protection district, or the Commonwealth or any of its political subdivisions that appoints permanent or temporary lifeguards. A first responder agency shall not mean aservice that is lisensed EFR (such as an ambulance service)

When a police officer responds to the scene of a medical emergency thay have a duty to act as prescribed by statute. They can only turn over care of that patient to a person with the same level of training or higher such as another First Responder, EMT, Basic, Intermediate or Paramedic who accepts responsibility for that patient's care other wise it is abandonment. In most cases RNs and MDs do not want to take over care and accept responsibility for the patient which includes accompaning the patient to the hospital. In order for an RN to be certified as a First Responder they have to go throught the same level of training as set forth by 105 CMR 170.000.

Most RN don't feel comfortable outside their own ER enviroment with everything at their disposal plenting of lighting all the supplies they need right at hand. They aren't use to being in an overturned vehicle at 3AM with dim lighting intubating a driver who is in respiratory arrest with multiple trauma. The exception to this is the RNs and MDs who work on the medical helicopters such as Medflight RN Medic or Life Flight MD, RN, Medic they under go specialized training for emergency treatment in the field. If you are at a scene and an RN from a nursing home arrives on scene they can't take over patient care but if they are competent enough they can assit you.

Posted by: texdep

Nice post Slimer.

The CMR's were already posted 12 posts ago but, some folks participating in this thread would rather still spout their own opinions rather then accept what the regs say.

Posted by: Tango

TexDep,

No, I think you are screwing it up. The flight crew of an RN and Medic, because the helicopter is an ambulance and the state says so, must be the RN is also an EMT. UMASS (RN an MD) and BMF do offer a fly along program for "learning experiences" of other professionals. ( UMASS is a whole new ball of wax, as they are MDs, but the RN needs his/her EMT.) I can ASSURE you, that those individuals are not performing any care on someone. If you say they are, you are full of it. There are cases where additional staff may accompany a crew, example a specialty Neonatal patient, but there is an exclusion of the EMT rule on this one and a few others. Plus, you wont see a neonatal extra crew member on a scene call.

Sorry I am off topic as this has nothing to do with the initial first responder question posted.

Posted by: wordstew

Wow!

I did not think there would be such a response to this post. It appears that by the letter of the law Registered Nurses are not first responders unless they take a certifying course like everyone else. But from what I understand legally an EMT or paramedic can only act as a nurses aide when in a hospital. Also, I thought nurses could challenge the EMT exam. (no offense intended to EMS folks)

All very confusing.

Posted by: Irish Wampanoag

Quote:

Originally Posted by texdep

What to make a bet!!!! Tell this to the civil lawyers when a school nurse does not repond and perform first responders actions when an emergency happens.

Posted by: texdep

Quote:

Originally Posted by Irish Wampanoag

What to make a bet!!!! Tell this to the civil lawyers when a school nurse does not repond and perform first responders actions when an emergency happens.

Irish, you even quoted me and still didn't get what I said.

Where in my statement did I say the school nurse shouldn't give or can't provide patiant care???? I even called them on-site medical personnel.

What I said is that the LAW (not me!) doesn't define the school nurse as a first responder.

Posted by: Crvtte65

Quote:

Originally Posted by Nachtwächter

CSauce just because nurses are trained in ACLS does not mean they can intubate.

Actually, I am ACLS certified and I can intubate. It is one of the first things I learned in the class....

Now, legally speaking, I am only an EMT-B, so LEGALLY I cannot intubate... but I can do the skill. (wow that was a lot of comma's)

Posted by: John27

Im not sure if they are first responders but i would never refuse the help

Posted by: cchc28

I have a nurse sitting next to me... and she says.... im SEXY as HELL!

Posted by: Nachtwächter

Quote:

Originally Posted by cchc28

I have a nurse sitting next to me... and she says.... im SEXY as HELL!

If that is your picture she needs help. Unless she is a rusty spoon.

Posted by: mopar6972

As an ACLS instructor, Id like to know where you can teach someone to intubate in a 8-16hr course... Just because somebody showed you how to perform a skill on a manikin doesnt particularly make one competent to actually go out and do it...

Posted by: stm4710

Keep nurses and doctors far, far away from my accident scene. If I need med control I will call you.....

My favorite was a nurse at a MVA saying to the paitent...."Save your strength, just nod your head yes or no".

Posted by: firefighter39

Quote:

Originally Posted by Portable81

"

This is why RN's still have to take a paramedic class and pass all of the required state tests, just as they would have to do if they wanted to become 1st responders.

RN, MD and PA DO NOT have to take the class - only challange the exam

Posted by: csauce777

Quote:

Originally Posted by Nachtwächter

CSauce just because nurses are trained in ACLS does not mean they can intubate. Basics are now carrying epi-pens, albuterol, nitroglycerin, and aspirin. I would worry about a nurse showing up on scene having any of those or anyone for that matter. I have been to many nursing homes where they have had patients on 2 liters oxygen by nonrebreather. If you don't know that is bad you might as well stick a pillow over the patients head.

A. I do know that is bad...
B. I would stick a pillow over their head anyway

C. Now that I read more of these posts, I have have no vested interest in this topic and I am not sure why I am still typing.
D. I need a beer

Posted by: rg1283

Quote:

Originally Posted by mopar6972

As an ACLS instructor, Id like to know where you can teach someone to intubate in a 8-16hr course... Just because somebody showed you how to perform a skill on a manikin doesnt particularly make one competent to actually go out and do it...

I think the reason why nurses take the ACLS course is for an understanding of what is happening in a Cardiac Situation. Like if a patient is doing this maybe the nurse should grab the LMA Tube and have it ready for the MD.

Something along that lines. Very few Nurses (if any with the exception maybe being Flight Nurses) in Mass I think can legally intubate as a Medic or EMT-I would in the Field.

As far as nurses being first responders what are they going to have with them besides a Band Aid Bag, unless the nurse happens to have all the gear an ALS Ambulance would have in the trunk of their Kia.

Its one thing if a nurse is shopping and some guy falls down in front of him or her. Its another thing if nurses stop on the side of the highway. Its silly for a nurse to stop at an accident scene unless its a MCI situation.

Posted by: wordstew

It still does not make sense to me. I would figure that a registered nurse education would trump at the very least basic first responder training. You can't tell me that a police officer after having a first responder course is more medically competent than a Registered Nurse emergency or not. If that was the case than first responders would be working in hospital emergency rooms instead of nurses.
I am not comparing a Paramedic who soley and extensively trains for emergency medicine.
Mind you most people use the terms nurse and first responder loosely. Many levels of nursing and of first responders.

Posted by: Crvtte65

Quote:

Originally Posted by mopar6972

Mine was a 40 hr course in college. Myself and one other guy were the only non-medical field students. Most were respritory/physical therapy majors. Maybe it was changed to give them skills they will have to do while doing hospital rounds? All I know is that I cannot do it at my level, no idea what level you have to be to do it.

ma police, boston ma police, massachusetts police, massachusetts police, mass state police, mass police, ma, mass, massachusetts, massachusetts, massachutes, massachusetts law, massachusetts polece, police, officer, police officer, cops, police gear, law enforcement, police duty gear, state police, sheriff, law, police supply, police agency directory, police agency, police department, traffic officer, police dept, state trooper, dispatcher, massachusetts county sheriff, massachusetts sheriff, massachusetts department of corrections, ma doc, doc, dept of corrections, police information, civil service, ma civil service, massachusetts crime, police training, police academy, ma police academy, massachusetts officers, masscop, masscops, mpa, bpa, ibpoa, police association, massachusetts police news, massachusetts crime news, mass most wanted, police career information, police patrol, police administration, police books, crime scene training, police discussion, crime discussions, cops

About MassCops, the home for Massachusetts law enforcement.

The Massachusetts Law Enforcement Network opened in 1998 and is now a part of the New England Police Network The site is a pro-police discussion forum intended for sworn police officers and civilian law enforcement officials as well as those interested in pursuing a career in law enforcement here in Massachusetts.

The goal of The Massachusetts Law Enforcement Network is to provide an informal network of law enforcement officials here in Massachusetts for educational and informational purposes.

The forum covers many topics such as Police Related News Articles, Agency & Profession Discussions, Police Training as well as Law Enforcement Career Information.

The Massachusetts Law Enforcement Network and The New England Police Network (NEPN) and it's network sites are privately owned websites/domains and are not affiliated with or endorsed by any government association or agency.

MassCops (masscops.com) and (masscop.com) are privately owned are not affiliated with or endorsed by the Massachusetts Coalition of Police (masscop.org)

3 4 5 6 7 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 49 50 53 54 55 56 57 58 59 60 61 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 98 99 100 101 102 103 104 105 106 107 108