November 12, 2024 • 11 mins
Understand Your RN Role in the Healthcare System
In this episode, I discuss a topic that may seem simple but it's highly misunderstood by new and even some experienced nurses. Understanding your RN role, your role as an RN in the healthcare system is SUPER important and will give you an "edge." Feel free to reach out to me directly with feedback and questions, I'm happy to help. I can be reached at paramedic2rninfo@gmail.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
I gotta tell you, there's a lot of misconceptions about being a nurse versus being a paramedic,
(00:07):
especially when you're transitioning.
So my biggest mistake was just really letting others know my plans.
Everyone has an opinion of you.
And when you break that opinionated vision they have, they really just can't deal with
it.
And you gotta understand, some people put their self-limited view on you.
(00:31):
So I'm going to talk about something that's really interesting and it's something I figured
out that most people don't understand a place in the healthcare system.
And I'm going to explain that a little bit more.
So welcome to my podcast.
(00:55):
So my plan was to never stay a medic or even an RN.
Really my plan was always from day one was going to be advanced practice, whether that
was going to be a nurse practitioner or being a PA.
So when I started out, I know I had some really negative experiences because people kind of
(01:18):
put me in the box.
I think that they viewed themselves in.
I had field training officers that were some were new FTOs and some were FTOs that's been
medic for 30 years.
And so I realized that my thought process was different than their thought process.
(01:39):
I had my own way of thinking, my own way of internalizing, but mainly I had a plan from
the get-go.
And to be honest with you, I know some great medics.
And I also know some that really have no business opening their mouth because their practice
is a lot weaker than their talk.
(02:00):
So there are some that tried to kind of talk me out of nursing.
And I heard a lot of little negative innuendos and people saying things like, why you want
to be a nurse?
I can innovate.
They can't.
Well, honestly, a flight nurse can innovate.
They will say, well, I can do an IO.
(02:23):
And I'm like, well, a nurse can do an IO too.
And then they say things like, you have to follow orders and I don't have to follow orders.
And I'm like, well, yes, you do.
It's called protocols or standing orders.
As a matter of fact, everyone follows orders from a physician, physical therapy, occupational
(02:44):
therapy, psych, case management, CT, x-ray, dietary, everybody.
Because for them to build insurance, it takes an active order from a physician to do that.
So what that told me is when people say things like that is they really don't understand
their place in the health system.
(03:05):
And I think that's kind of the overall theme.
Because without their knowledge, you can let others talk you out of your dreams.
And I don't want that to happen to you.
So you have to understand your role in the health care system.
For example, EMS has a role in the health care system overall when you're thinking
(03:26):
about transition to care.
In EMS, you bring a patient to the emergency department.
The emergency department triages and they send the patient to where they need to go,
whether they need to go to surgery, whether they need to be managed by a hospitalist,
or maybe they need to be managed by a cardiologist or neurologist, or go to the intensive care
(03:47):
unit.
And then from once they finish that acute phase, now do they need to go to rehab?
Do they need to go to short-term rehab?
Do they need to go to acute inpatient rehab?
Or do they need to be discharged with home health?
So as you see, everyone has a role in the health care system.
You have to understand your role.
(04:10):
So EMS role is a lot different than the EDRN.
Role is a lot different than the EDRN.
EDRN role is a lot different than a FLORRN role.
ICU role is a lot different than the surgical RN role.
CathLab RN is a lot different than endoscopy RN role.
Ambulatory care RN is a lot different than a psychiatric nurse role.
(04:31):
RN case manager is a lot different than a wound osmium nurse role.
So with that saying, everybody's scope is different.
Everybody's assessment is different.
You have to have a bigger view and figure out what role you want to have.
And I give you two cases about practitioners or people just not understanding their role
(04:54):
in the health care system.
For example, I remember when I was in the ED, I had someone from EMS bring in abdominal
pain and that abdominal pain, I remember when I asked for the EKG, he said I didn't do one.
I said, when I was triaging them and doing the takeover, I asked him, hey, do you have
(05:20):
an IV?
Where's your IV?
He said, no, we don't have IV.
Then he said something really snarky.
When I asked him, I said, oh, you didn't start a line?
He said, why would I start a line?
There's no medications I'm giving.
And also, y'all can do that here.
I don't see a reason why I need to give an IV and all she got is food poisoning.
(05:43):
And I looked at him and I thought, obviously he don't understand his role and he doesn't
understand transition to care.
I'm pretty sure abdominal pain, I haven't been a medic since 2019, but I do remember
(06:04):
abdominal pain, you do run a 12 lead and you do run a line.
And I just remember me asking him, said, man, you must got x-ray vision.
So you can literally see the abdomen and you can tell if there's any type of internal bleeding
(06:25):
or anything, right?
Or bowel obstruction, you can see that.
And keep in mind, I said that outside the room, I didn't say that in front of the patient,
but it kind of floored me.
And I had to talk with that medic outside in the hallway, like, look, this ain't how
we operate.
Because here's one thing I asked him, I said, if that patient would have crashed on you,
(06:47):
then you would have been fumbling around trying to get that IV in.
And so, all he needs to say is that was my patient and that patient wound up going to
the floor because they was going to need surgery.
Come to find out if he would have really done a good, a thorough assessment in history,
he'd have found out that she had bariatric surgery in the past.
(07:12):
And with that brings a big, a big holly indicative of what she had.
She had adhesions and those adhesions was causing ischemic bowel.
So, just because she had something and now she's throwing up, she has abdominal pain,
that doesn't necessarily mean, oh yeah, I know you got food poisoning.
(07:34):
You can't come to that type of decision.
And I keep in mind, I do understand his thought process in that because yeah, if you eat about
four hours later, you start throwing up, I may think that too.
But at the same time, I have enough medical experience to understand that that's what's
called a differential diagnosis.
Differential diagnosis is not going to be the definitive admission diagnosis.
(07:58):
But if you understand your role in the healthcare system, your role in healthcare system isn't
to come in with a definitive diagnosis, it's to have a differential diagnosis and use your
protocols to treat your patient.
But protocols for abdominal pain, I'm pretty sure has IV and 12 lead in it.
So the second case I want to talk to you is as an ED, I remember I used to dread calling
(08:25):
in reports to the floor and because I used to get so much pushback, it's like being
a floor or mid-surge RN versus an ED RN, it was almost like tension there because no one
understands each other's roles.
(08:45):
So I would call in and they would ask me a hundred questions.
Well, what does the patient's skin look like?
How's the patient's potassium?
And I'm like, whoa, whoa, whoa, whoa, whoa.
First of all, you can go into Epic and you can see the same thing that I'm seeing.
But what it showed me was that the floor nurse didn't understand the role of the ED RN.
(09:12):
ED RN is a place of triage.
They come from EMS or they come from home.
If it's a life threat, we treat.
If the hospital is don't feel it's something that they need to admit or ED docs say, hey,
they can be discharged, be managed by the primary care.
They will be discharged and they would be referred to their primary care.
(09:37):
If the hospital is say, hey, look, we need to go ahead and admit this patient, then the
patient gets admitted and it's a place of triage.
It's constantly moving.
So when we used to get the kickbacks to me, that just let me know that the floor RN didn't
understand the role of the ED RN.
And that can be said for vice versa.
That was sometimes where there were certain things we didn't do in the ICU or certain
(10:01):
protocols, especially when we were boarding patients that needed to go to the floor and
those orders switched over to managing that patient on the floor.
There were some things that we wasn't familiar with because we wasn't on the floor.
We never been floor RNs or some of us had never been.
So what it boils down to is you have to understand your role in the healthcare system.
(10:26):
And I think if you understand as a medic now what role you want to have, what do you want
to go, what do you feel you can make the most impact, then that will help you a lot in your
journey because I'm not going to lie to you.
It is real hard to find your fit.
And what I mean by your fit, trying to find where you're comfortable.
(10:49):
And so I'll talk about that in another podcast, but just kind of think about that for you
guys that want to come over to RN, what role do you want to have and what do you see your
fit?
So thank you for joining me and keep fighting the fight.
And we love to see you here in the land of nursing.
(11:10):
Take care.
I gotta tell you, there's a lot of misconceptions about being a nurse versus being a paramedic,
(00:07):
especially when you're transitioning.
So my biggest mistake was just really letting others know my plans.
Everyone has an opinion of you.
And when you break that opinionated vision they have, they really just can't deal with
it.
And you gotta understand, some people put their self-limited view on you.
(00:31):
So I'm going to talk about something that's really interesting and it's something I figured
out that most people don't understand a place in the healthcare system.
And I'm going to explain that a little bit more.
So welcome to my podcast.
(00:55):
So my plan was to never stay a medic or even an RN.
Really my plan was always from day one was going to be advanced practice, whether that
was going to be a nurse practitioner or being a PA.
So when I started out, I know I had some really negative experiences because people kind of
(01:18):
put me in the box.
I think that they viewed themselves in.
I had field training officers that were some were new FTOs and some were FTOs that's been
medic for 30 years.
And so I realized that my thought process was different than their thought process.
(01:39):
I had my own way of thinking, my own way of internalizing, but mainly I had a plan from
the get-go.
And to be honest with you, I know some great medics.
And I also know some that really have no business opening their mouth because their practice
is a lot weaker than their talk.
(02:00):
So there are some that tried to kind of talk me out of nursing.
And I heard a lot of little negative innuendos and people saying things like, why you want
to be a nurse?
I can innovate.
They can't.
Well, honestly, a flight nurse can innovate.
They will say, well, I can do an IO.
(02:23):
And I'm like, well, a nurse can do an IO too.
And then they say things like, you have to follow orders and I don't have to follow orders.
And I'm like, well, yes, you do.
It's called protocols or standing orders.
As a matter of fact, everyone follows orders from a physician, physical therapy, occupational
(02:44):
therapy, psych, case management, CT, x-ray, dietary, everybody.
Because for them to build insurance, it takes an active order from a physician to do that.
So what that told me is when people say things like that is they really don't understand
their place in the health system.
(03:05):
And I think that's kind of the overall theme.
Because without their knowledge, you can let others talk you out of your dreams.
And I don't want that to happen to you.
So you have to understand your role in the health care system.
For example, EMS has a role in the health care system overall when you're thinking
(03:26):
about transition to care.
In EMS, you bring a patient to the emergency department.
The emergency department triages and they send the patient to where they need to go,
whether they need to go to surgery, whether they need to be managed by a hospitalist,
or maybe they need to be managed by a cardiologist or neurologist, or go to the intensive care
(03:47):
unit.
And then from once they finish that acute phase, now do they need to go to rehab?
Do they need to go to short-term rehab?
Do they need to go to acute inpatient rehab?
Or do they need to be discharged with home health?
So as you see, everyone has a role in the health care system.
You have to understand your role.
(04:10):
So EMS role is a lot different than the EDRN.
Role is a lot different than the EDRN.
EDRN role is a lot different than a FLORRN role.
ICU role is a lot different than the surgical RN role.
CathLab RN is a lot different than endoscopy RN role.
Ambulatory care RN is a lot different than a psychiatric nurse role.
(04:31):
RN case manager is a lot different than a wound osmium nurse role.
So with that saying, everybody's scope is different.
Everybody's assessment is different.
You have to have a bigger view and figure out what role you want to have.
And I give you two cases about practitioners or people just not understanding their role
(04:54):
in the health care system.
For example, I remember when I was in the ED, I had someone from EMS bring in abdominal
pain and that abdominal pain, I remember when I asked for the EKG, he said I didn't do one.
I said, when I was triaging them and doing the takeover, I asked him, hey, do you have
(05:20):
an IV?
Where's your IV?
He said, no, we don't have IV.
Then he said something really snarky.
When I asked him, I said, oh, you didn't start a line?
He said, why would I start a line?
There's no medications I'm giving.
And also, y'all can do that here.
I don't see a reason why I need to give an IV and all she got is food poisoning.
(05:43):
And I looked at him and I thought, obviously he don't understand his role and he doesn't
understand transition to care.
I'm pretty sure abdominal pain, I haven't been a medic since 2019, but I do remember
(06:04):
abdominal pain, you do run a 12 lead and you do run a line.
And I just remember me asking him, said, man, you must got x-ray vision.
So you can literally see the abdomen and you can tell if there's any type of internal bleeding
(06:25):
or anything, right?
Or bowel obstruction, you can see that.
And keep in mind, I said that outside the room, I didn't say that in front of the patient,
but it kind of floored me.
And I had to talk with that medic outside in the hallway, like, look, this ain't how
we operate.
Because here's one thing I asked him, I said, if that patient would have crashed on you,
(06:47):
then you would have been fumbling around trying to get that IV in.
And so, all he needs to say is that was my patient and that patient wound up going to
the floor because they was going to need surgery.
Come to find out if he would have really done a good, a thorough assessment in history,
he'd have found out that she had bariatric surgery in the past.
(07:12):
And with that brings a big, a big holly indicative of what she had.
She had adhesions and those adhesions was causing ischemic bowel.
So, just because she had something and now she's throwing up, she has abdominal pain,
that doesn't necessarily mean, oh yeah, I know you got food poisoning.
(07:34):
You can't come to that type of decision.
And I keep in mind, I do understand his thought process in that because yeah, if you eat about
four hours later, you start throwing up, I may think that too.
But at the same time, I have enough medical experience to understand that that's what's
called a differential diagnosis.
Differential diagnosis is not going to be the definitive admission diagnosis.
(07:58):
But if you understand your role in the healthcare system, your role in healthcare system isn't
to come in with a definitive diagnosis, it's to have a differential diagnosis and use your
protocols to treat your patient.
But protocols for abdominal pain, I'm pretty sure has IV and 12 lead in it.
So the second case I want to talk to you is as an ED, I remember I used to dread calling
(08:25):
in reports to the floor and because I used to get so much pushback, it's like being
a floor or mid-surge RN versus an ED RN, it was almost like tension there because no one
understands each other's roles.
(08:45):
So I would call in and they would ask me a hundred questions.
Well, what does the patient's skin look like?
How's the patient's potassium?
And I'm like, whoa, whoa, whoa, whoa, whoa.
First of all, you can go into Epic and you can see the same thing that I'm seeing.
But what it showed me was that the floor nurse didn't understand the role of the ED RN.
(09:12):
ED RN is a place of triage.
They come from EMS or they come from home.
If it's a life threat, we treat.
If the hospital is don't feel it's something that they need to admit or ED docs say, hey,
they can be discharged, be managed by the primary care.
They will be discharged and they would be referred to their primary care.
(09:37):
If the hospital is say, hey, look, we need to go ahead and admit this patient, then the
patient gets admitted and it's a place of triage.
It's constantly moving.
So when we used to get the kickbacks to me, that just let me know that the floor RN didn't
understand the role of the ED RN.
And that can be said for vice versa.
That was sometimes where there were certain things we didn't do in the ICU or certain
(10:01):
protocols, especially when we were boarding patients that needed to go to the floor and
those orders switched over to managing that patient on the floor.
There were some things that we wasn't familiar with because we wasn't on the floor.
We never been floor RNs or some of us had never been.
So what it boils down to is you have to understand your role in the healthcare system.
(10:26):
And I think if you understand as a medic now what role you want to have, what do you want
to go, what do you feel you can make the most impact, then that will help you a lot in your
journey because I'm not going to lie to you.
It is real hard to find your fit.
And what I mean by your fit, trying to find where you're comfortable.
(10:49):
And so I'll talk about that in another podcast, but just kind of think about that for you
guys that want to come over to RN, what role do you want to have and what do you see your
fit?
So thank you for joining me and keep fighting the fight.
And we love to see you here in the land of nursing.
(11:10):
Take care.
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