By Debra Wood, RN, contributor
The fire service offers new opportunities for nurses and allows them to
expand their reach by educating emergency medical service personnel and
improving care outside the hospital.
"What we are doing is improving patient care to more folks than we could as
an individual practitioner," said Ruth Grubb, RN, and EMS coordinator for the
Orange County [California] Fire Authority, a 13-year fire service veteran.
"Frequently something comes across my desk that is a result of something you
did, education or equipment you decided to purchase or changes in policy, and
you can see the end result is that does improve patient care. It’s almost in a
stealth mode but it’s very rewarding."
Responsibilities of fire service nurses differ depending on the fire
department. Most fire service nurses provide education to paramedics and field
personnel while also handling quality improvement initiatives. Some nurses spend
time in the field, observing techniques or providing care if there are mass
casualties at an accident scene or airplane crash.
Many nurses gravitate to the fire service after working in the emergency
department. Regular Monday-to-Friday schedules, with no nights and weekends,
make it an attractive practice setting.
"ER nurse junkies like a little excitement and an unplanned aspect to our
day," former ED nurse Jodi Nevandro, chairperson of the California Fire Chiefs
Nurses and EMS Professionals-Southern Section clinical working group. Nevandro
serves as a nurse educator consultant to the Santa Monica and Santa Fe Springs
fire departments in Los Angeles County California.
"I go out on calls," she said. "It’s one of my more enjoyable times. Having
an appreciation for the environment the medics and EMTs work in is a good
thing."
Jan Purkett, RN, EMS coordinator for California’s Santa Barbara County Fire
Department, explained the difference between the two settings: "The ED is a
controlled environment. Our environment is not controlled until we get there and
put control on it."
Riding along on calls, also lets nurses provide real-time feedback about what
went well and opportunities for improvement. As observers they can often spot
things missed by the care providers. By participating in calls fire service
nurses can better tailor education programs to field situations.
Fire service nurses need strong clinical, teaching and quality improvement
skills and a knack for management.
"You take all the stuff you got from nursing and use it a different setting,"
Nevandro said. "It’s very challenging. You need to keep up with the literature
and know what is going on in terms of changes in clinical care. And you need to
be able to teach to multiple learning styles."
Some nurses have moved into management roles in the fire service. Stephanie
Rasmussen, RN, BSN, MICN, CEN, EMT and EMS administrator for the Rancho
Cucamonga Fire Department in San Bernardino County in California, supervises all
the city’s 33 paramedics and 90 care providers.
"They are out giving care and I’m improving their knowledge base and,
hopefully, the medical care in our city," said Rasmussen, a former ED nurse and
flight nurse. "I like the idea of making a difference."
In some fire departments, nurses perform occupational health duties,
administering vaccines and monitoring firefighters exposed to communicable
diseases. During forest fire season, nurses employed by the fire department
typically set up on-site medical units to provide care to firefighters battling
the blaze.
Grubb represents her department in discussions with county officials,
hospitals and ambulance companies. She stays abreast of regulatory changes and
updates her department accordingly. Her primary objective to be maintaining
delivery of high-quality emergency medical services.
"Firemen truly care and take care of the personnel that work with them and
for them," Grubb said. "What makes it fun is it is not profit driven. Our motto
is do the right thing for the right reasons, and we live it every day."
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