护理人员特点
护理人员必须是一个自信的领导者,能够接受这个职位所带来的挑战和高度的责任. The Paramedic must have excellent judgement and be able to prioritize decisions and act quickly in the best interest of the patient, 必须自律, 能够与病人建立融洽的关系, 会见怀有敌意的病人, 保持安全距离, 并认识到并利用不同文化群体和这些群体中的年龄特有的交流. 必须能够在不断变化的非结构化环境中以最佳水平独立工作.
Even though the Paramedic is generally part of a two-person team generally working with a lower skill and knowledge level Basic EMT, 护理人员负责包括麻醉品在内的药物的安全和治疗性管理. Therefore, 护理人员不仅要有关于药物的知识,而且必须能够在实际意义上应用这些知识. Knowledge and practical application of medications include thoroughly knowing and understanding the general properties of all types of drugs including analgesics, anesthetics, 抗焦虑药物, 镇静剂和催眠药, anti-convulsants, 中枢神经兴奋剂, 心理治疗,包括抗抑郁药, 还有其他抗精神病药物, anticholerginics, cholergenics, muscle relaxants, anti-dysrythmics, 抗高血压, anticoagulants, diuretics, bronchodilators, opthalmics, pituitary drugs, 肠道的药物, hormones, antibiotics, antifungals, 抗炎, serums, vaccines, anti-parasitics, and others.
护理人员个人负责, legally, ethically, 对每一种药物都是如此, 使用正确的预防措施和技术, 观察和记录所给药物的效果, 保持自己的药理学知识基础的变化和趋势的最新管理和使用, 根据病人的体质,及时了解他们服用特定药物的所有禁忌症, 并使用药物参考文献.
The responsibility of the Paramedic includes obtaining a comprehensive drug history from the patient that includes names of drugs, strength, 日用量及用量. 护理人员必须考虑到许多因素, 与所给出的历史有关, 会影响给药的种类吗. For example, some patients may be taking several medications prescribed by several different doctors and some may lose track of what they have or have not taken. 有些人可能正在使用非处方/非处方药. 了解药物反应和药物与其他药物联合的协同效应,在某些情况下, food, is imperative. 护理人员还必须考虑到给孕妇和胎儿施用药物的可能风险, 记住,药物可能会穿过胎盘.
护理人员必须认识到基于大小和体重的药物对儿科患者的影响, 对新生儿的特别关注, geriatric patients and the physiological effects of aging such as the way skin can tear in the geriatric population with relatively little to no pressure. 必须认识到受管制物质的高度滥用可能性和成瘾的可能性, therefore, the Paramedic must be thorough in report writing and able to justify why a particular narcotic was used and why a particular amount was given. 测量和重新测量受控物质/药物滴注速率的能力至关重要. 一旦停止用药或不使用, 护理人员必须将未使用的部分送回适当的库存场所.
The Paramedic must be able to apply basic principles of mathematics to the calculation of problems associated with medication dosages, 执行转换问题, 区分摄氏和华氏温标的温度读数, 能够使用适当的先进生命支持设备和用品(1).e. 根据病人的年龄和静脉状况选择合适的静脉注射针, 并且能够找到获取血液样本的地点并完成这项任务, 静脉注射药物, 通过胃管给药, 服用口服药物, 直肠用药, 遵守普遍的预防措施和身体物质隔离, 妥善处理受污染的物品和设备.
护理人员必须能够运用知识和技能,帮助过量服用的病人通过解毒剂克服创伤, 并且对毒药有一定的了解并能进行治疗. The Paramedic must be knowledgeable as to the stages drugs/medications go through once they have entered the patient’s system and be cognizant that route of administration is critical in relation to patient’s needs and the effect that occurs.
The Paramedic must also be capable of providing advanced life support emergency medical services to patients including conducting of and interpreting electrocardiograms (EKGs), 电干预来支持心脏功能, performing advanced endotracheal intubations in airway management and relief of pneumothorax and administering of appropriate intravenous fluids and drugs under direction of off-site designated physician.
护理人员不仅要在困难和紧张的情况下保持冷静, but must be capable of staying focused while assuming the leadership role inherent in carrying out the functions of the position. Good judgement along with advanced knowledge and technical skills are essential in directing other team members to assist as needed. 护理人员必须能够提供高质量的护理, 同时处理高水平的压力, 并愿意承担该职位所要求的个人责任. 这不仅包括精确文件的所有法律后果, 但也有责任使用在真正危及生命的紧急情况下获得的知识和技能.
The Paramedic must be able to deal with adverse and often dangerous situations which include responding to calls in districts known to have high crime and mortality rates. 自信至关重要, 与人合作的愿望也是如此, 稳固的情绪稳定性, 能承受高压力, 以及满足生理需求的能力, intellectual, 以及这个职位所要求的认知能力.
Physical Demands
这种性质的工作所需要的才能是良好的体力, endurance, 身体状况也不会因为经常走路而受到不利影响, stand, lift, carry, 有时需要平衡, 体重超过125磅. 运动协调是必要的,因为在不平坦的地形上, the patient’s, the Paramedic’s, 其他工人的福利也不能受到损害.
Comments
护理人员提供最广泛的院前护理,可能为消防部门工作, 私家救护车服务, 警察局或医院. 工作性质的响应时间取决于呼叫的性质. For example, a Paramedic working for a private ambulance service that transports the elderly from nursing homes to routine medical appointments and check-ups may endure somewhat less stressful circumstances than the Paramedic who works primarily with 911 calls in districts known to have high crime rates. Thus, 护理人员角色中固有的特殊压力可能会有所不同, 取决于工作地点和类型.
However, in general, 在分析师看来, 护理人员必须灵活应对不断变化的紧急情况. 紧急情况发生时, 情况可能很复杂,必须立即开始对患者进行护理. In essence, 紧急医疗服务系统中的护理人员使用先进的培训和设备将急诊医生的服务扩展到救护车上. 护理人员必须能够在遵循口头指示的同时做出准确的独立判断. 及时履行职责的能力是必不可少的, 因为这对病人来说可能意味着生与死的区别.
需要使用电话或无线电调度来协调迅速的紧急服务, as is a pager, 取决于工作地点. 通过看地图准确辨别街道名称, 正确区分门牌号或公司地址对于以最方便的方式完成任务至关重要. 简明准确地向调度员和其他相关人员口头描述, 对病人状况的印象, 是至关重要的,因为护理人员在紧急情况下工作,可能没有时间进行审议. 护理人员还必须能够准确地口头和书面报告, 所有相关患者资料. At times, reporting may require a detailed narrative on extenuating circumstances or conditions that go beyond what is required on a prescribed form. 在某些情况下,护理人员必须在救护车上的笔记本电脑上输入数据. 语言表达能力和推理能力被广泛运用.
资料来源:美国交通部1998年国家标准护理人员课程