Nursing Opportunities in EMS

Today's economic difficulties in the health care industry are producing an ever-increasing number of reasons for nurses to seek other areas in which to market their skills or to develop entrepreneurial ventures in which they can invest their experience. Most experts on career change recommend that prospective job-changers in already overcrowded fields search in areas where their skills and experience relate to the work of the company in ways that may be unexpected (Costa, 1994; Neidlinger, Bartleson, Drews & Hukari, 1992). Barring the availability of fields directly related to the individual's experience Costa (1994) also suggests that job seekers investigate fields where pressures for better cost management and fallout from systemic changes (as in the health care industry at large) make the job-seeker's expertise particularly valuable. In the health care fields, the economic problems of hospitals have had negative effects on all types of providers except for those instances (e.g., home care) where entrepreneurs step in to fill gaps created by broader changes in the system. The point has finally been reached where nurses are finding it difficult to locate jobs. Over half of the hospitals surveyed in a recent study intend to hire fewer RNs and greatly increase the number of unlicensed assistive personnel (UAPs) on staff (Manuel & Sorenson, 1995, p. 251). Emergency Medical Services (EMS) is one area that is undergoing the same downturn in business as that experienced by h

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in trauma centers continues to drop under managed care rules (Nordberg, 1995, "Trauma 2," p. 66). And, in ambulance services, broader coverage is expected while, over all, workloads lighten (Turner, 1995, p. 44). As Nordberg (1995, "Trauma 3") notes, the disappearance of large numbers of trauma centers, especially in large cities, has produced extra pressures for ambulance service management. Emergency management consultants have proposed an expanded list of functions for EMS services, with emergency medical technicians (EMTs), paramedics, and EMS managers all actively involved in understanding exactly how the trauma system operates. If prehospital workers do not "recognize a trauma system and its operational capacity", the system breaks down (Nordberg, 1995, "Trauma 3," p. 65). In addition to standard knowledge regarding the operations of various trauma centers, managers can facilitate a more equitable distribution of patients to centers when they can direct them on the basis of the kinds of trauma each center is best equipped to handle. EMS administrators are also required to negotiate with centers regarding acceptance of patients and to deal with the new managed-care purchasers of emergency medical services. As Turner p

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