Looking for some guidance -- RN to EMT-B/Paramedic

[kChoRN]

Hi all, I've looked through a few threads on here, but couldn't find a lot of guidance on a few things I'm wondering about.

I'm a new RN and work on a Clinical-Surgical-Ortho Unit, did a rotation through the CVICU, and clinicals at the ED, but never had any formal protracted ED or Field experience. I have worked with and have friends that are EMT-Bs or Paramedics and am really interested in their work.

I have heard about Pre-Hospital RNs and Paramedics that work in tandem and have done some field work independently while with my Army National Guard unit, but I would love some advice on how to push forward from here.

I am planning on working on a Masters in Nursing to become a Family Nurse Practitioner, but first want to look at becoming a Pre-Hospital RN. I am unsure of the exact process and there isn't a great deal of information on it that I can find online -- For some reason or another.

I know that Florida allows RNs that also have EMT-B certification to sit for the Paramedic NREMT Exam, but I question whether this is appropriate and if i would actually have the skills necessary without a formal schooling in Paramedic Technical Skills. Thoughts?

The other problem I face is if I go that route, then I'd have to find a school that would work with my schedule at the hospital and my Natinoal Guard duties which is pretty impossible. I'm hesitant to look into the online EMT-B options, but could use some guidance on that as well.

I understand that Paramedics do a profoundly different job than an RN which is why I am very unsure of how to proceed from here. My objective is to either become a PHRN or Paramedic, then eventually a Nurse Practitioner a few years down the road.

How I get there is the big question, so any advice would be greatly appreciated -- Sorry for the rambling.

Thanks for your help !

 

[firecoins]

Take a paramedic program if you have the time and money. Otherwise take the EMT -b class and take the medic exam.

 

[usalsfyre]

Go to school. It's a distinctly different discipline, especially lacking significant ICU or ED experience. You wouldn't feel qualified to be a rad tech without education right? So why a paramedic?

 

[Veneficus]

If you are not looking to work in an acute care environment, what is the purpose of emergency experience or experience where your final goal is to take somebody to the hospital?

If you know what "not sick" looks like, it is too difficult to distinguish who is "sick."

It also used to be that ED RNs were required to have ICU experience. I don't know the exact reason but I could think of some very logicial ones...

Most critical care teams I know of hire RNs but want specifically ICU experience with ED experience either as a corequisite or just a bonus.

 

[Norbi]

craigalanevans, your blog is AWESOME

 

[Norbi]

sorry , wrong topic...:blush:

 

[VFlutter]

I am in nursing school and also want to get my paramedic cert after I graduate. I personally would not just sit and take the test. You might pass but you really will not be able to function well as a paramedic. If you had some experience as an EMT and some ICU experience then I think you would be ok.

That being said I do not think going through and entire paramedic course is the answer. I would look for some kind of bridge program. There are a few places that do them. I think one is like 3 weeks full time and offers clinical rotations.

As far as the ICU vs ED experience, I really think it depends on the hospital. But in most facilities how long do truly sick patients typical spend in the ED before getting shipped up to the ICU? Most places doing CCT want to know you have experience dealing with critical patients for long periods of time and can handle the cluster of various lines, devices, etc

 

[abckidsmom]

I just precepted a guy who was a nurse with bone marrow transplant and PICU excperience. He was reasonably bright, and had been through the entire paramedic class. He was like precepting a medic student who already had a good knowledge base of medicine, but still needed time to learn how to act like a medic, make independent decisions, and keep all the people moving toward the resolution of whatever incident we were working on.

I say, if you want to be a medic, go to medic class. Don't take short cuts. It's a totally different discipline.

I say this as a medic who went to nursing school and became a nurse, worked in an ICU for a year went back to the streets. It's not the same at all.

 

[usalsfyre]

That being said I do not think going through and entire paramedic course is the answer. I would look for some kind of bridge program. There are a few places that do them. I think one is like 3 weeks full time and offers clinical rotations.

Then do you advocate paramedics with a CNA cert be able to do a 3 week transition?

No offense to you personally, but nursing role creep is getting ridiculous.

 

[Veneficus]

Then do you advocate paramedics with a CNA cert be able to do a 3 week transition?

No offense to you personally, but nursing role creep is getting ridiculous.

My friend, US nurses now-a-days try to do everything except nursing.

But having said that, I think we both agree, since EMS providers as a group have attempted to show being a medic is an add on cert that doesn't require any education, when a group such as nursing which has demanded a considerable minimum level including the basic foundations that permit movement into any area of healthcare, they are going to be successful at it.

 

[VFlutter]

Then do you advocate paramedics with a CNA cert be able to do a 3 week transition?

No offense to you personally, but nursing role creep is getting ridiculous.

I admit I probably do bring up the nursing role too much around here and I will try to cut it down. However I just am trying to offer my opinion after being on both sides of the fence. Diversity is what makes this website great and sparks great discussion. Except the medic vs RN is just a pissing contest that no one will ever win.

In very specific circumstances, yes. If a paramedic had an associates degree (Ideally a bachelors) which included all of the required prerequisites such as college level anatomy, physiology, pharmacology, (Mine were all separate 4 hour classes not one combined A&P) etc as well as their CNA and some experience then I would have no problem with them taking the NCLEX, preferably with some type of bridge program. I am sure they would be just as good if not better than some of the nurses diploma programs pump out.


Also the 3 week course I am referring to is Creighton, and from what I understand it is very fast paced and condensed and is literally all day every day those 3 weeks. Personally I think a 3 month (with clinical) course would be plenty to transition.

 

[ZootownMedic]

I think that RNs who want to be paramedics is a good thing, as long as they respect the profession. There are far too many nurses out there who think a RN and 3 week course makes them ready. The streets are harsh. In a hospital you have unlimited resources and lots of staff readily available. Plus let's be honest, RNs primarily work with doctors who give them dire t orders. In the field you have limited resources, just you and your partner much of the time and must make decisions quickly and on your OWN. One of the hardest things for me to get down as a new medic is pulling the trigger on advanced and dangerous interventions. I think that working with less makes you better at working with more. That's why I think paramedics make better RNs than RNs do paramedics, generally. Just my .02 cents.

 

[VFlutter]

I agree. I think the 3 week example is extreme but still better than just challenging the test with no extra work.

The reason why I think bridge programs make sense vs taking the entire program is because most RNs have already taken A&P, patho, pharm and such (usually more indepth than a lot of medic programs) and need more focus on the specific knowledge and skills outside of the nursing profession instead of spending time going back over basic science

 

[kChoRN]

Hey all, thanks for the advice. I guess I stepped on a nerve and I don't want to lead y'all to the impression that I think medics are below nurses on the ladder. I only wish there were more RN to medic transition courses out there, FL has none.

I have had experience in the CVICU and it was there that got me really interested in acute care. At my ARNG Unit, I'm forced to make independent decisions without other personnel present which is why I wanted to look into also becoming a Paramedic before venturing into advanced practice nursing.

Do y'all know of any programs that you think would be beneficial as a bridge program? I'm not opposed to doing a full fledged program, it just isn't easy to find one that fits in my schedule and at least some of the foundational content seems like crossover...

Just wondering, thanks for all the input.

 

[JakeEMTP]

One of the hardest things for me to get down as a new medic is pulling the trigger on advanced and dangerous interventions. I think that working with less makes you better at working with more. That's why I think paramedics make better RNs than RNs do paramedics, generally. Just my .02 cents.

Can you define or give examples of advanced or dangerous? Dangerous for you or the patient? Do you feel you have not been adequately prepared as a new medic which makes a procedure advanced or dangerous?

An RN may be part of procedures everyday in an ED, ICU or OR that a Paramedic may only see in a video or practice on a manikin. An ICU or ED RN from an larger hospital may participate in 3 or 4 intubations daily by administering more medications than what is typically in the scope of practice for a Paramedic. They will also maintain the care of a patient who is on a ventilator and/or post ROSC on a daily bases using medications which become very routine to them. Some many even participate in the intubation themselves if working in L&D. They may also be part of bedside trachs which become routine. They assist daily with central lines and some may be part of inserting them along with arterial lines. Once you have been part of all these procedures or medications which you might deem as "scary and dangerous" on a daily basis and they are part of your normal routine, picking up extra training to perform them in another environment is not that big of a stretch. Other out of hospital teams do this all the time and for greater distances and with very sick patients who require many advanced skills and knowledge. Some of which is even controversial and very new but often necessary to get the patient to a higher level of care.

It is far easier to do a few skills in 3 weeks than cover 3 semesters of full time classes involving the sciences in 3 weeks.

 

[JakeEMTP]

Also the 3 week course I am referring to is Creighton, and from what I understand it is very fast paced and condensed and is literally all day every day those 3 weeks. Personally I think a 3 month (with clinical) course would be plenty to transition.

The Creighton program does not take new grads. In some states like Texas it only takes 3 months to become a Paramedic. Why should it take just as long for a nurse who already has the sciences, 1000 hours of patient contact in clinicals and some working experience to become a Paramedic? Just become someone has RN in their title they are not automatically dumber.

 

[JakeEMTP]

To the OP:

Since you are from PBC, talk to the members of Trauma Hawk. Talk to the EMS and nursing programs at the local community colleges. Talk to the Trauma Nurse Specialists at the trauma centers. Take the RN certs for trauma (Basic and Advanced) at the major trauma hospitals. Network and get their opinions which will carry much more weight than what you will find here on an anonymous forum of egos. You could also get into a hospital which has specialty transport teams such as pedi and neonatal. You will definitely be way ahead in advanced procedures and knowledge on these teams and probably won't feel the need for Paramedic school.

 

[VFlutter]

The Creighton program does not take new grads. In some states like Texas it only takes 3 months to become a Paramedic. Why should it take just as long for a nurse who already has the sciences, 1000 hours of patient contact in clinicals and some working experience to become a Paramedic? Just become someone has RN in their title they are not automatically dumber.

I know they do not take new grads. They require 2 years ICU/RN experience as well as the various add on certs.

I did not know it only took 3 months to get your paramedic cert in some places. Especially in Texas, with their broad scope. My EMT-B took 3 months and the paramedic was a 1.5 year associates.

 

[JakeEMTP]

I know they do not take new grads. They require 2 years ICU/RN experience as well as the various add on certs.

I did not know it only took 3 months to get your paramedic cert in some places. My EMT-B took 3 months and the paramedic was a 1.5 year associates.

Texas only requires 600 hours to be a Paramedic. There was a school which ha a 12 week program plus another month or 2 of clinicals which used promoted alot. There are also other accelerated programs where the students just to the bare minimun. If the program allows 24 hour clinical shifts and just bases it on time, your clinicals could be done sleeping. Others might only require 40 ALS patient contacts which could be just an IV or 12 lead being done. It is often left up to the school which may be influenced by the contracts they have with certain ambulance companies or fire departments. NCTI is usually around 6 - 7 months with a 1 week A&P class at the beginning. MidPlains still has an Accelerated Paramedic program being advertised on the EMS websites.

The average length of a Paramedic program is 1000 hours which is the number of just clinical time for other health care students. When an EMT program is still listed by the state in required hours such as 110, 3 months does not say much except you might have only gone 1 or 2 evenings per week. An 18 month Paramedic program that does not include a recognized college degree and not a Technical Associates also does not say much except may you went 1 or 2 days per week instead of what would be considered full time. This is all just part of the inconsistency in EMS eduation.

 

[VFlutter]

Plus let's be honest, RNs primarily work with doctors who give them dire t orders. In the field you have limited resources, just you and your partner much of the time and must make decisions quickly and on your OWN.

Just because a doctor is giving me a direct order does not mean that I did not already know and anticipate what was going to happen or would have been clueless without them. If you spend some time in an ICU you would be surprised how much input doctors actually get from nurses and how much their opinion matters in treatmeant decisions. Also, right or wrong, you will see a lot of nurses do various things first and get orders later. Just because they work under physican orders does not mean they could not function in their own.