RESUMO
BACKGROUND: At an Arkansas emergency department, patient care technicians have been in use, but in looking for innovative ways to manage an ever-changing environment requiring adjustments to staffing needs and shortages, the use of paramedics as nurse extenders within the emergency department was trialed. A paramedic can perform all patient care technician duties along with many registered nurse tasks. PURPOSE: The purpose of this research was to evaluate the perceptions of the emergency department staff about the use of paramedics and determine how working with them directly would change those perceptions. BASIC PROCEDURES: An initial survey was administered along with training about paramedics in the emergency department. Paramedics were hired and the staff were re-surveyed 12 months and 18 months after implementation. MAIN FINDINGS: The results of the surveys were analyzed using X2 Pearson and X2 Kruskal-Wallis. Perceptions about the skill of paramedics improved with very high significance. Patient outcomes, patient throughput, nursing satisfaction, and partner preferences improved with high significance. Comparability between patient care technicians and paramedics improved with moderate to low significance. PRINCIPAL CONCLUSIONS: Overall, the perceptions staff have about paramedics working in the emergency department improved significantly when they collaborated as teammates.
Assuntos
Auxiliares de Emergência , Paramédico , Humanos , Serviço Hospitalar de Emergência , Inquéritos e Questionários , Recursos HumanosRESUMO
Dynamics in the workplace are tumultuous. Downsizing within organizations is one strategy to adjust staffing to volumes. Survivor demoralization and loss of trust in the organization are the primary outcomes of organizational downsizing. These deep emotional responses to psychological contract breach/violation result in decreased organizational citizenship behavior, decreased organizational commitment, decreased productivity, and employees who desire to work elsewhere.
