Johnson R I, Childress S E, Herron H L
J Emerg Nurs. 1993 Oct;19(5):437-40.
In 1988, the National Flight Nurses Association and ENA published a revised joint position statement advocating that registered nurses (RNs) "should not be required to certify as Emergency Medical Technicians (EMTs) at any level before assuming a nursing role in the prehospital environment." The position endorsed a collaborative role with emergency medical services agencies, regulation of prehospital nursing by state nursing agencies, and additional educational requirements in areas unique to prehospital emergency care. This study examines the existing state of affairs in the regulation of prehospital practice of RNs throughout the United States.
Data were obtained by review of written state rules and regulations pertaining to certification of prehospital care providers and by telephone survey of state emergency medical services agencies nationwide.
All 50 (100%) of the states were contacted. In 44 of the 50 states (88%), no certification in prehospital nursing exists. As a result, most states require that RNs become EMTs at some level as a prerequisite for prehospital practice. Of these states, 36% (16/44) allow RN substitution to meet ambulance staffing requirements without additional certification requirements. Of these states, 61% (27/44) require RNs to complete the entire EMT curriculum to obtain certification, whereas 39% (17/44) allow challenge examinations in combination with varying other educational requirements. Nursing "certification" for prehospital practice exists in 12% (6/50) of states.
As a nation, we are far from actualizing the recommendations stated in the ENA and National Flight Nurses Association position.
1988年，美国国家飞行护士协会和急诊护士协会发表了一份修订后的联合立场声明，主张注册护士（RN）“在院前环境中承担护理角色之前，不应被要求获得任何级别的紧急医疗技术员（EMT）认证”。该立场支持与紧急医疗服务机构的协作角色、由州护理机构对院前护理进行监管，以及对院前急诊护理特有的领域提出额外的教育要求。本研究调查了美国各地注册护士院前执业监管的现状。
通过查阅与院前护理提供者认证相关的州书面规则和条例，并对全国各州紧急医疗服务机构进行电话调查来获取数据。
联系了所有50个（100%）州。在50个州中的44个（88%），不存在院前护理认证。因此，大多数州要求注册护士在某个级别成为紧急医疗技术员，作为院前执业的先决条件。在这些州中，36%（16/44）允许注册护士替代以满足救护车人员配备要求，而无需额外的认证要求。在这些州中，61%（27/44）要求注册护士完成完整的紧急医疗技术员课程以获得认证，而39%（17/44）允许结合不同的其他教育要求进行挑战考试。12%（6/50）的州存在院前执业的护理“认证”。
作为一个国家，我们远未实现急诊护士协会和国家飞行护士协会立场声明中提出的建议。
