HJBR Jan/Feb 2022

Q&A 36 JAN / FEB 2022 I  HEALTHCARE JOURNAL OF BATON ROUGE   What prompted the idea to use paramedics in the ED? As the demand for nurses has increased over the past decade, Ochsner continues to look for new and innovative ways to sup- port nursing. Was it COVID-related or in theworks before the pandemic? The United States has needed more nurses for over a decade. The pandemic helped bring that shortage to the public eye, but hospitals have needed more nurses for a while. Was it primarily to address a short- age of nurses, or were there partic- ular skillsets and experiences you were seeking from the medics? There are many ways adding more staff can support our nurses — everyone from paramedics to environmental services to nurse techs. All these jobs are vital, but having adequate staffing means nurses are being used at the top of their license. Para- medics have a great skillset that allows them to take on several patient care tasks. This support helps our RNs provide a greater focus on critically ill patients. Hadyou seen it modeled elsewhere? In addition to Baton Rouge and Iberville, Ochsner currently uses paramedics at its main campus in New Orleans. When did the program start? After many months of preparation, Och- sner piloted the program in Iberville in early 2020 and expanded it to Baton Rouge in 2021. Howmanyparamedics didyou start with? Are you still hiring? We started with one paramedic in Iber- ville and now have two full-time and one PRN position. Baton Rouge has seven full- time and three PRN positions. What additional training did you have to provide? Our paramedics go to Flight Care in New Orleans for a competency/annual skills check-off and then have orientation in the emergency department for 6-8 weeks. What can’t paramedics do that an LPN or RN can? Paramedics can’t perform initial triage assessments, be assigned specific patients nor discharge patients. There are also spe- cific nursing tasks that cannot be delegated from the nursing staff, such as initiating blood, heparin or insulin transfusion and inserting Foley catheters. Howmanyparamedics are on a typ- ical ED team? What are your ideal shift ratios? We generally have four paramedics in Baton Rouge and one in Iberville covering various shifts each day. Howdo the paramedics/nurses feel about the program?What feedback have you received? The program has been well received from both teams. Paramedics enjoy the more controlled environment of the emergency department compared to the uncertainty of house calls. Our nurses are very happy to have the added support from professionals with specific training in critical care. Have there been any challenges? As with any career change, there are adjustments. Paramedics usually come to Ochsner from different work backgrounds and usually had been working indepen- dently. Working in an emergency depart- ment and functioning within a team is dif- ferent and takes time to transition. With experience, our paramedics enjoy the com- radery of being part of a team and the emo- tional and physical support it provides. Doyou plan to expand the program? The program has been a resounding suc- cess, and we are considering expansion. Do you know of other health sys- tems considering it? Have they approached you? We have been asked about the successes of our program by others, specifically around roles and reporting structure. n Susan Green, MSN, RN Emergency Department Director Ochsner Baton Rouge Susan Green, MSN, RN, currently serves as the emergency department director for Ochsner Baton Rouge, a position she has held since August 2017. Her oversight includes the ER at both Ochsner Medical Center – Baton Rouge and Ochsner Medical Complex – Iberville. Green has nearly three decades of experience working at Ochsner. She has a strong background in emergency medicine, healthcare management and patient safety. Green earned a Master of Science in Nursing focused in leadership and management from Walden University. Q & A