Nurses in Pre-hospital Care
Nurses are involved in pre-hospital care in many guises across civilian and military practice. In the civilian world involvement ranges from membership of the various voluntary first aid organisations, to participation in trackside medical teams within a range of sports to those employed by NHS Ambulance Services and those working within the industrial setting to name but a few. In the military world nurses undertake a range of duties across different continents and theatres that range from helicopter borne response teams extricating the injured to duties on major training exercises and within peace keeping forces.
Given this breadth of expertise and activity BASICS is a natural home to nurses with its recognition of their role and wide use of nurses within the BASICS Education faculties bringing pre-hospital education to multi-disciplinary student groups.
Within the BASICS Schemes nurses are gaining recognition for their role and skills with some functioning as an integral part of multi-disciplinary pre-hospital teams whilst others practice as independent practitioners. Skill levels as with their medical counterparts are mixed and reflect the individual nurses own experience, training and competence. Currently not all Schemes utilise nurses operationally for a variety of reasons.
For those who are operational different arrangements exist in different Schemes to match the level of service provided and the expectations of the Ambulance Service. Some nurses provide medications as registered independent nurse prescribers whilst others operate using patient group directions.
First and foremost you need to build experience whilst developing your interest, the voluntary first aid organisations offer excellent opportunities to get involved as do some of the medical teams associated with some of the sporting venues. Thereafter undertaking specialised courses such as the Pre-hospital Emergency Care Certificate which combines acute illness and trauma provides further grounding.
Gathering experience within the workplace is also a tremendous advantage as many of the skills employed in the pre-hospital environment are those of airway management, resuscitation, fluid replacement and fracture management. It’s therefore necessary to have really good underpinning clinical experience so as to be able to transfer the principles into your pre-hospital practice. This frequently involves undertaking a variety of staffing jobs in departments and areas as varied as the Emergency Department, Anaesthesia and Recovery, High Dependency or Intensive Care to develop confidence in managing complex and dependant patients.
More than anything else though pre-hospital care demands a combination of personal attributes that include maturity, team work and respect for other pre-hospital participants ranging from first responders to the non-medical emergency services.
Getting involved as a community responder with your local ambulance service provides excellent insight into the workings of the emergency ambulance service and demonstrates to others your genuine interest and commitment to pre-hospital care.
BASICS Accredited Membership recognises a member’s commitment, training and experience as a pre-hospital practitioner. A number of nurses are accredited members after having satisfied the criteria that exists for this level of membership. Increasingly ambulance services are require BASICS Schemes to use only Accredited Members or those being mentored towards accreditation.
Pre-hospital care: a nursing speciality?
Nursing is structured differently from the medical profession. There is no specific speciality training or part of the NMC Register that recognises the pre-hospital care specialist nurse. Nurses are regular and successful participants in the Diploma in Immediate Medical Care Examinations at the Royal College of Surgeons of Edinburgh (DipIMC RCSEd) and have a seat on the Executive Council of BASICS as a right. Currently a nurse serves as a vice-chairman of BASICS.
Increasingly nurses are moving into the Ambulance world on a salaried basis as Emergency Care Practitioners and Ambulance Nurses to work alongside their ambulance colleagues in the pre-hospital setting. Other occupational groups such as those nurses working as medics offshore and in some parts of the armed forces develop specialised skills that are well recognised within their areas of practice and in the wider pre-hospital world.
Qualified nurses on any part of the register join BASICS as full members with the rights and privileges this level of membership bestows.