[apathy]

This simply shows the power of a union. If physicians operated more effectively there would be no NPs prescribing.

It cuts both ways. I do not begrudge nurses their income, they sure as hell earn it for the most part. Put an investment banker in a nurse's job at County and see how long they last, then tell me it costs too much.

[jrnichols]

and it shows what happens when you lack a union too. :/ Us folks in EMS run into this often. There's IAFF which we can join, but they actively seem to hate any private EMS at all. Yet fire departments don't want to do the stuff that us in private EMS do. so we're kind of caught in between.

Texas recently made some legislative changes that will allow facilities to utilize paramedic level providers to their full scope in an emergency room setting, though. that's a huge plus.

[apathy]

Go Texas! (First time I've ever said THAT in my life...)

[jrnichols]

Not everything here is perfect but there are a lot of things that I like. Good example in my line of work is that it's a "delegated practice" state, like South Carolina. This means that different EMS services can use their own medical director instead of how it was in California where the county had one that all of the providers had to use. This allows a lot more flexibility and for more progressive pre-hospital protocols.

It's been a pretty good system.