Replacing EMS with nursing revisited

[Aphrodite]

Im not sure where all of you are from, but here, EMS is a degree you can earn! Oh and its the same length of time as nursing

As far as the Golden hour, yes it is going away, all patients have different needs and time frames.

Im not saying having nurses in the field would be entirely bad, but they would need a lot more training than just nursing school.

We have had Doctors (surgeon) and nurses come to scenes via helicopter when needed they provided the best patient care possible under the circumstances, It wouldnt be a bad thing, I just dont forsee it happening

 

[MrBrown]

Im not sure where all of you are from, but here, EMS is a degree you can earn! Oh and its the same length of time as nursing

As far as the Golden hour, yes it is going away, all patients have different needs and time frames.

Im not saying having nurses in the field would be entirely bad, but they would need a lot more training than just nursing school.

We have had Doctors (surgeon) and nurses come to scenes via helicopter when needed they provided the best patient care possible under the circumstances, It wouldnt be a bad thing, I just dont forsee it happening

Same here mate, nurse and Paramedic here are the same length of time at University and Paramedic is probably way more selective on who they admit and graduate. Intensive Care Paramedic (ALS) is another qualification ontop of the Bachelors Degree.

Pay is probably better too!

Alas, we dont have medicinos swanning down out the cirrus too often, and if we do, you are pretty crook.

 

[Journey]

I wasn't trying to make a joke. I just hate to see nurses put on a pedastal like they're perfect. We just had a thread about a nurse placing the blame on someone else and trying to CYA. Sure, most nurses would write a report, try to fix the problem. That's their job. A medic's job is not to figure out why some guy tripped beyond checking them out for medical emergencies that would cause a fall. They're not equipped to go above and beyond. Not all would find it a nuisance, just like not all nurses would look at what problem could be solved.

I'm not putting nurses on a pedastal but I am making a point that there are different expectations which are regulated for nursing by Federal and State rules which can then be followed by the accrediting agencies. Nurses should not have the option to just walk away from a patient and with the regulations now in place. They know the consequences which can mean their license. There are bad apples in every profession. Everybody wants to do CYA and it should be done through proper documentation. If the incident is serious enough, there should be a reporting policy in place for EMS or the hospital to record their concerns. If you allow a serious incident to slide and another professional fully documents it as they see it, you would have no one to blame but yourself for not providing the proper documentation from your point of view in the first place.

There are now many safeguards in place in an attempt to keep patients safe. JCAHO inspects facilities for the insurers. State and Federal agencies also do their own inspections. Diagnostic testing labs are heavily inspected over and over again for many concerns. In EMS, there are not alot of Federal and state mandates that must be constantly evaluated to determine if an agency or facility can become accredited and receive reimbursement. Most mandates pertain to the truck. If a facility loses its accreditation for whatever reason, no Medicare, Medicaid or MediCal payments.

 

[Journey]

Im not sure where all of you are from, but here, EMS is a degree you can earn! Oh and its the same length of time as nursing

Yes there are degrees in EMS but not mandatory. I was just recently corrected about Oregon. I had thought it required a two year degree but there are exceptions to that rule.

But, the focus of the degree should also be considered when determining if one profession is just like another.

Physical Therapists are now recommended to have a Doctorate of Physical Therapy.

Nurse Practitioners are pushing for a Doctorate Nurse Practitioner in 2015.

That does not mean an NP is a PT if both have doctorate degrees.

A Cardiovascular Technologist has a two year degree and knows ACLS from every angle, works in a cath lab and does many of the skills with some of the same knowledge of an RN plus their own specialty education. But, that does not make them "just like an RN". But, an RN can specialize in Cath Lab under his or her own license and acquire some of the same skills. You have to look at the differences in each profession and the special requirements that make it a specialty before you try to be just like or compare one to another.

However, a two year college degree in prehospital medicine would be a good start to getting the Paramedic recognized as a true specialty profession rather than a tech cert from the votech.

 

[DFW333]

However, a two year college degree in prehospital medicine would be a good start to getting the Paramedic recognized as a true specialty profession rather than a tech cert from the votech.

And what good is it to be recognized as a specialty profession? The hobos will stop calling us for rides to the opposite side of town because they respect us? Our pay will increase? Never ending dialysis transports will go away? The general public will scratch their heads and say "It takes a degree to be an ambulance driver?"

All requiring a certain degree will do is make it where the profession is closed to those who cannot afford to pursue whatever degree it is. And it doesn't mean those in it will provide any better care. An educated idiot is probably more dangerous than one who didnt go to school.

 

[Veneficus]

I think we have a winner!!!

And what good is it to be recognized as a specialty profession? The hobos will stop calling us for rides to the opposite side of town because they respect us? Our pay will increase? Never ending dialysis transports will go away?

There are easy soltions to those problems...

McDonalds.

The hobos will still call you for help, but then they might receive it and call less.

Your pay might not decrease.

At the current moment, taking people to dialysis is what is keeping you gainfully employed. But it might not very much longer. What then?

The general public will scratch their heads and say "It takes a degree to be an ambulance driver?"

The voices asking why we pay so much for an ambulance driver are steadily increasing.

But no, it doesn't take a degree to be an ambulance driver. It does take a degree to be a healthcare professional. You might want to consider the systems that still employ "ambulance drivers" and what they pay.

If the only value you feel EMS providers bring is driving patients around I suggest you take a real close look at this:

http://www.emtlife.com/showthread.php?t=20803

As firetender pointed out, medical transport is a business, as I pointed out look at the value of laborers world wide.

If what EMS brings is not very special (requiring a degree) perhaps we coould find some people who would be happy to fill those spots for less pay?

All requiring a certain degree will do is make it where the profession is closed to those who cannot afford to pursue whatever degree it is.

Economics are a barrier to improving a persons' educational and career goals for sure. But I am not so sure on why other modern nations value education and the US doesn't. Maybe you have the answer?

And it doesn't mean those in it will provide any better care.

Really? I'll bet dollars to doughnuts my education makes me a better care provider than you.

An educated idiot is probably more dangerous than one who didnt go to school.

LOL,

ladies and gentlemen, the prosecution rests.

 

[MrBrown]

And what good is it to be recognized as a specialty profession? The hobos will stop calling us for rides to the opposite side of town because they respect us? Our pay will increase? Never ending dialysis transports will go away? The general public will scratch their heads and say "It takes a degree to be an ambulance driver?"

The hobos call you because your social security and healthcare are broken

The pay will increase because as professionals you can demand it

Dialysis transports are the realm of the Patient Transfer Officers and not frontline emergency ambulance Paramedics

All requiring a certain degree will do is make it where the profession is closed to those who cannot afford to pursue whatever degree it is. And it doesn't mean those in it will provide any better care. An educated idiot is probably more dangerous than one who didnt go to school.

It will close it because unlike almost every other country you have no universal access to higher education.

... and if you think requiring proper education won't improve care then well, Brown will bite his tongue on that one.

As for a Degree, it needs to be a proper speciality University degree not some two year flout that includes basked weaving, computers 101 and art history as well as the DOT cirricula which has been massaged into a barely qualifying community college course.

 

[Journey]

And what good is it to be recognized as a specialty profession? The hobos will stop calling us for rides to the opposite side of town because they respect us? Our pay will increase? Never ending dialysis transports will go away? The general public will scratch their heads and say "It takes a degree to be an ambulance driver?"

What if patients found out that their barber or dog groomer has 2x more hours of training than the Texas Paramedic? It is to your advantage now that the public probably believes you to be better educated than you actually are.

The recognition is for reimbursement with professional status. This is currently one of the issues NEMSAC is looking at.

Hobos (?) and dialysis patients also need care and transport. They are human beings also and should not be treated differently because of a stigma EMS has placed on these patients. If all you do for a dialysis patient is drive, you are are doing them a great disservice and some insurers are probably paying you too much.

All requiring a certain degree will do is make it where the profession is closed to those who cannot afford to pursue whatever degree it is. And it doesn't mean those in it will provide any better care. An educated idiot is probably more dangerous than one who didnt go to school.

We are talking about a two year degree. I used doctorates to illustrate the differences between NPs and PTs. However, PTs have no problem with their education if that is what they want to do. Many will work at minimum wage jobs or as PT Assistants which is only a two year degree and doesn't pay much until they get their doctorate. The same for OT and and ST. To be an RN requires a two year degree and many will work for minimum wage as CNAs until they get their license. There are also many nonmedical professions that require at least a four year degree.

My question to you would be, why do you not believe you need to know anything about the body, the medications, different illnesses and have good reading, writing or math skills to be a Paramedic? Shouldn't you know some of the "whys?" for what you are doing?

Education is a difficult battle to win and to get techs to change their views when they are used to doing skills and protocols their way. Nursing also changed slowly and there was a lag as the diploma RNs who were grandfathered finally started leaving the profession. Now, the BSNs will slowly gain ground as the ADNs who also want to keep nursing at a tech level similar to the other A.S. degrees. I also don't want anyone to get the idea that I think the diploma RNs weren't good nurses. They were excellent but it was mostly their skills that they were known for and not their knowledge which lead to nursing not receiving very much respect as a profession.

 

[Aidey]

As someone who used to work in a dialysis clinic, dialysis patients who are being transported from home to the clinic or vice versa do not generally need care. Heck, there are people who drive themselves back and forth, and a large number who take medi-taxis or wheel chair vans. There is a subset who end up needing gurney transport, but it is because they need the gurney, not because of the dialysis itself.

 

[Journey]

As someone who used to work in a dialysis clinic, dialysis patients who are being transported from home to the clinic or vice versa do not generally need care. Heck, there are people who drive themselves back and forth, and a large number who take medi-taxis or wheel chair vans. There is a subset who end up needing gurney transport, but it is because they need the gurney, not because of the dialysis itself.

Some in EMS never see all the patients that can travel by car or van and the total number of dialysis patients each center does everyday. If they did they might realize that the number they transport is actually quite small.

Our dialysis center is within the hospital and takes patients who might be considered a higher risk. The hospital's Rapid Response team will also come to assess and monitor a patient to see if a higher level of care is needed. Dialysis can also be done in the back part of the ED on a monitor if the Rapid Response team determines they need longer monitoring than they can stay for and an admit is in the patient's future. This dialysis center also averages around 200 - 240 patients per day. We also get quite a few BLS trucks that divert to our ED while transporting to and from other dialysis centers. Luckily we are a dialysis center and can stabilize them rather than trying to get them to another hospital which by then will tie up an ICU bed for sure.

 

[DFW333]

There are easy soltions to those problems...

McDonalds.

The hobos will still call you for help, but then they might receive it and call less.

Umm, it isnt a matter of them receiving help. They just want a ride to the other side of town and cannot pay for a taxi.

Your pay might not decrease.

Can't get much lower than $7.50/hour

At the current moment, taking people to dialysis is what is keeping you gainfully employed. But it might not very much longer. What then?

Actually the majority of my transports are interfacility transfers to specialty facilities.

The voices asking why we pay so much for an ambulance driver are steadily increasing.

But no, it doesn't take a degree to be an ambulance driver. It does take a degree to be a healthcare professional. You might want to consider the systems that still employ "ambulance drivers" and what they pay.

A service here pays $12 an hour starting for EMT-B, $20/hour for medic.

If the only value you feel EMS providers bring is driving patients around I suggest you take a real close look at this:

http://www.emtlife.com/showthread.php?t=20803

As firetender pointed out, medical transport is a business, as I pointed out look at the value of laborers world wide.

If what EMS brings is not very special (requiring a degree) perhaps we coould find some people who would be happy to fill those spots for less pay?

Going from point A to point B is all an ambulance is. Maybe one of every hundred transports is actually requiring an ambulance. But there's so many things that make them "qualified" such as isolation reasons. I always have to laugh when I document that patient meets medical necessity for ambulance transport due to isolation precautions for *insert disease here* but we are dropping them off in a dialysis center that does not have the ability to isolate the patient. Or when a hospital checks off the PCS to show the patient is bed confined...and the patient is being discharged to a home that cannot handle bed bound patients, or residence where they live alone.

Economics are a barrier to improving a persons' educational and career goals for sure. But I am not so sure on why other modern nations value education and the US doesn't. Maybe you have the answer?

Because as part of our requirements we have to learn about so much useless crap. For example, as part of my bachelor's degree for firefighting I have to learn about the various sub-cultures that exist in today's prison systems. What the hell does that have to do with anything? I'm not going to be a prison warden, or even a cop. Yet I have to know what motivates a gay man to rape the guy who drops the soap.

Really? I'll bet dollars to doughnuts my education makes me a better care provider than you.

Really? There's a post I made in this thread earlier about a director of nursing who has much more education than I do who nearly killed a patient. She actually said, "Well I knew the BP but I had to choose between good BP or getting rid of chest pain."

LOL,

ladies and gentlemen, the prosecution rests.

And having a degree doesnt mean you're not an idiot. Barrack Obama and George W Bush both have degrees from Harvard. How many people think one or both of them are idiots?

 

[Veneficus]

Can't get much lower than $7.50/hour

A service here pays $12 an hour starting for EMT-B, $20/hour for medic.

So you are cool with a $12.50/hour pay cut?

Because when the required reimbursements from medicare are finally adjusted, without providing some kind of value, that might just be what you can expect.

Going from point A to point B is all an ambulance is. Maybe one of every hundred transports is actually requiring an ambulance..

Yes, I am aware. So you can bet the people who pay for it are too.

But there's so many things that make them "qualified" such as isolation reasons. I always have to laugh when I document that patient meets medical necessity for ambulance transport due to isolation precautions for *insert disease here* but we are dropping them off in a dialysis center that does not have the ability to isolate the patient. Or when a hospital checks off the PCS to show the patient is bed confined...and the patient is being discharged to a home that cannot handle bed bound patients, or residence where they live alone...

Is it possible that perhaps so many "qualifications" were written into the payment schedule so that people who did need transported but didn't qualify for aid or other means could get transported?

That it saves money by freeing up resources at the sending facility by moving patients out quicker?

Is it possible that the educated people who wrote those "qualifications" felt that complications requiring an EMT were 1 in $100,000 but felt it was worth giving everyone the best chance?

Is it possible that a group of "EMS" providers who owned or worked in an IFT companied lobbied that for profit or even to offer their employees a livable wage?

Because as part of our requirements we have to learn about so much useless crap..

If knowledge is power, is there a such thing as useless knowledge?

I always have to laugh when I document that patient meets medical necessity for ambulance transport due to isolation precautions for *insert disease here* but we are dropping them off in a dialysis center that does not have the ability to isolate the patient. Or when a hospital checks off the PCS to show the patient is bed confined...and the patient is being discharged to a home that cannot handle bed bound patients, or residence where they live alone

For example, as part of my bachelor's degree for firefighting I have to learn about the various sub-cultures that exist in today's prison systems. What the hell does that have to do with anything? I'm not going to be a prison warden, or even a cop. Yet I have to know what motivates a gay man to rape the guy who drops the soap.

But if you are erroneously or falsely checking off medical qualifications for billing, that last part might be damn useful information.

Really? There's a post I made in this thread earlier about a director of nursing who has much more education than I do who nearly killed a patient. She actually said, "Well I knew the BP but I had to choose between good BP or getting rid of chest pain.".

She is luckier than I.

I don't even know how many patients I probably killed following protocols I didn't understand while getting awards and accolades for my ability to do it.

Some even lived in spite of my attempts.

Looking back on some of the treatments I performed that I was taught to, expected to, and boasted my skill at, I am confronted with the reality that knowing what I know now, I probably did cause harm in many instances.

I don't dwell on it though, because it was the standard of the time, but it does make me wonder. If I had known more could I have done better? Made better decisions? Helped more people? At the very least harmed less?

 

[EMSLaw]

Really? There's a post I made in this thread earlier about a director of nursing who has much more education than I do who nearly killed a patient. She actually said, "Well I knew the BP but I had to choose between good BP or getting rid of chest pain."

And having a degree doesnt mean you're not an idiot. Barrack Obama and George W Bush both have degrees from Harvard. How many people think one or both of them are idiots?

Your arguments are simply fallacies. One case, even if true, does not disprove the case that a provider with a greater depth of knowledge is able to offer more to a patient than one who has a short technical course. Moreover, the fact that the Nursing Director you mentioned made a mistake does not mean that, in general, she isn't a better provider, whatever a "better" provider is in this argument. As we go on about time and time again in this forum, the plural of anecdote is not data.

Your second argument likewise fails to hold any water. While you may be right that a degree doesn't necessarily make you naturally smarter, it does make you more educated. And while some might disagree with the policies of either or both of the presidents you mentioned, I don't think it's fair to call either of them "stupid", despite the sort of polemics that one sees thrown about on cable news.

Anyway... the workforce in general is becoming increasingly more educated, and that's especially true in healthcare. A doctorate degree was necessary for me to practice my profession, and has been necessary for a generation or more (one can still find a few very old attorneys with an LL.B., but that degree was actually the same thing - a three-year post-graduate degree - it was just called a Bachelor of Law). Would you argue that because a paralegal and an attorney can both draft a complaint, they're the "same"? Are a CPA and the "guy who does your taxes" the same?

It's only in EMS that we maintain the fiction that being a technician is the same as, and just as good as, being a technologist (generally, the latter has a degree in the field, while the former went to trade school), on the rather tenuous basis that they can perform the same skills. There's more to it than being able to cannulate a vein or perform an intubation or an emergency thoracotamy (or any other skill you can name).

Now... as to whether nurses should take over EMS. I think the distinction here is that, for better or worse, what we consider to be EMS is a subset of medicine, not a subset of nursing. While the distinction is sometimes very grey, what EMS does is diagnose (whatever you like to call it) and treat (however imperfectly) acute medical emergencies to stablize the condtition until the patient can be delivered to definitive care. EMS does not generally develop nursing plans, provide for protracted care, or engage in wellness work or patient education. Those are key functions (or some of them) of nurses, which is what makes the two professions (or jobs, since I'm hard pressed to call EMS a profession at the moment) different. Even in the case of Nurse Practitioners, the focus is on traditional nursing areas - maintaining wellness, handling long-term care, and the like.

You'll notice, for example, that in those states that don't have a separate EMS licensing authority, paramedics are credentialed by the Board of Medical Examiners, rather than by the Board of Nursing. Indeed, the things that nurses have traditionally done very well are the things that EMS has traditionally done very poorly, if at all.

Even if you talk about changing the nature of EMS in part to allow EMS providers to be, in limited circumstances, definitive care, you're still talking about the practice of medicine, albiet in a very limited way, rather than the practice of nursing.

So, I think that the change in philosophy is significant enough that if you move nurses into EMS on a wholesale basis, you get some sort of hybrid that is no longer really a nurse. Better to enhance the skills and education of EMS providers to allow them to flourish in their selected role.

 

[Aphrodite]

Hobos (?) and dialysis patients also need care and transport. They are human beings also and should not be treated differently because of a stigma EMS has placed on these patients. If all you do for a dialysis patient is drive, you are are doing them a great disservice and some insurers are probably paying you too much.

AMEN!!

We all have the frequent flyers and the not so fortunate, but why should that determine the amount of care you give?

Bedside manner, care, and respect, the best care you can give, I could go on and on..

When you stop providing the best care you can to every patient GET OFF THE RIG!

 

[fit4duty]

Anyway... the workforce in general is becoming increasingly more educated, and that's especially true in healthcare. A doctorate degree was necessary for me to practice my profession, and has been necessary for a generation or more (one can still find a few very old attorneys with an LL.B., but that degree was actually the same thing - a three-year post-graduate degree - it was just called a Bachelor of Law). Would you argue that because a paralegal and an attorney can both draft a complaint, they're the "same"? Are a CPA and the "guy who does your taxes" the same?

It's only in EMS that we maintain the fiction that being a technician is the same as, and just as good as, being a technologist (generally, the latter has a degree in the field, while the former went to trade school), on the rather tenuous basis that they can perform the same skills. There's more to it than being able to cannulate a vein or perform an intubation or an emergency thoracotamy (or any other skill you can name).

Now... as to whether nurses should take over EMS. I think the distinction here is that, for better or worse, what we consider to be EMS is a subset of medicine, not a subset of nursing. While the distinction is sometimes very grey, what EMS does is diagnose (whatever you like to call it) and treat (however imperfectly) acute medical emergencies to stablize the condtition until the patient can be delivered to definitive care. EMS does not generally develop nursing plans, provide for protracted care, or engage in wellness work or patient education. Those are key functions (or some of them) of nurses, which is what makes the two professions (or jobs, since I'm hard pressed to call EMS a profession at the moment) different.

Couldn't agree more! What I have never been able to get is why we are so resistant to education? Professions require education. Period.

S/N - it occurred to me two days after I finished my paramedic program that as thorough as the program was it wasn't enough. So I picked up a Bachelors in Physiology. In my senior level physio classes were BSN students and Med students - confirming in my mind that if I don't know what they know how can I effectively perform my own functions. And yes I am most definitely a more competent provider because of my education.

 

[medicRob]

I haven't read anything but the original post, nor do I intend to, seeing as this is a 14 page thread. However, I will weigh in by saying that one need only look to the majority of Trauma I based HEMS services which require all individuals on the medical crew to be a Registered Nurse (BSN preferred) at a minimum, if not dual RN / Medic or RN / EMT licenses.

An RN, CEN could more than handle themselves in the prehospital environment. After all, let's be real.. We spent 3 years at a minimum in school if not 4, and were required to have courses such as REAL Anatomy & Physiology I and II, not just survey of anatomy, Microbiology, Pathophysiology, English Composition, Psychology, College algebra, Biology, Chemistry, and Nutrition amongst other courses along with our core nursing. We spend more time in clinicals than the paramedic does in class and clinicals (excluding systems such as NZ of course).

 

[EMSLaw]

Couldn't agree more! What I have never been able to get is why we are so resistant to education? Professions require education. Period.

On one of the first days of law school, all the new 1Ls had a meeting with the Dean, who gave us a talk about the nature of the law school, the nature of law practice, etc. She didn't mention the long hours and relative difficulty of finding a job, but that's besides the point...

One of the things that was mentioned, and this isn't original to the Dean in question, is that law is one of the three traditional professions, the other two being medicine and the clergy.

What characterizes a profession? Three things, generally: 1) A long period of formal learning; 2) self-regulation; and 3) a degree of monopoly rights.

Lawyers spend at least 7 years in school, and have post-JD education and training requirements. The Supreme Court or Board of Law Examiners (other lawyers) decide who gets to be a member of the profession. Only lawyers, generally speaking, may take money to appear in court.

Doctors spend 8 years in school, plus residency and other post-MD education and training. The Board of Medical Examiners (other doctors) decide who gets to be a licensed doctor. Generally speaking, only doctors may practice medicine, though they may delegate certain functions to other trained people.

Clergy in many organized religions have a master's degree or equivalent. The Bishop or some sort of other clergy determine who gets ordained. In many churches with an organized clergy, only the properly ordained minister can perform certain functions.

Paramedics spend approximately 1100 hours in school. The state office, lead by a doctor or nurse, which may or may not include any paramedics at all, decides whether they get a certification or license. They do have a certain monopoly on pre-hospital care, but then again, lots of other people can do the same things paramedics can do.

Do we all see the difference here? If you want the respect of other professionals, the first step is to have the same sort of credentials as other professionals. But when even trades that measure education in clock hours tend to require many, many more of them (anyone ever looked at how long it takes to become a licensed plumber or electrician?), the arguments about EMS education start to ring hollow.

 

[the_negro_puppy]

Universities in my state are now offering dual degrees in Paramedicine and Nursing. 4 Years study at the end you can work as both an RN and a paramedic

http://www.courses.qut.edu.au/cgi-b...wa/selectMajorFromMain?pres=sf&courseID=12576

B)


If I was just finishing High School and interested in working as a Paramedic I would definitely consider this.


I already have a science degree and a masters (lol) but I am completing a diploma of paramedic science while working full-time in an ambulance. This qualifies me to work as a paramedic at the end of 2.5 years, with 2.5 years of paid experience under my belt (student paramedic earn around 50k)

 

[Journey]

I haven't read anything but the original post, nor do I intend to, seeing as this is a 14 page thread. However, I will weigh in by saying that one need only look to the majority of Trauma I based HEMS services which require all individuals on the medical crew to be a Registered Nurse (BSN preferred) at a minimum, if not dual RN / Medic or RN / EMT licenses.

Not always will they require the RN to actually get the state license for Paramedic but just test for the NREMT certification. The RN will continue to work under their own license and scope of practice which can be expanded for different roles. Regardless, the EMT and Paramedic are often viewed as extra certs much like some the other specialty certs but sometimes easier to obtain. The EMT cert is basic first aid which everybody should have whether they are in medicine or not. The Paramedic cert can then be obtained by challenging the exam in some states. Colleges and trade schools can also give credit for the RN license and nursing classes to where the time spent in the program is about 150 - 200 hours which is also consistent with some PHRN programs. This is a lot shorter than some of their specialty certs such as hospital based critical care transport which may take them over a year of additional training after they have gotten several years of experience in that area and are finally qualified to do transport for high acuity patients. Every specialty for RN may require several weeks of additional classroom lecture and months of being precepted. Even the CCRN certs require about 18 months in that specialty.

The BSN is also highly recommended for RNs who want to work a specialty unit especially if it is a Magnet hospitial or if they want to join a specialized team such as transport. But, just like those in EMS, for nursing the ones opposing the BSN are the ADNs who believe they have more than enough education.

 

[BluesMedic]

Two Cents...

I am brand new to this forum and this site, yet I am not new to the profession or the argument that is currently being debated. I can see both sides of the argument and after reading many of the posts that have been written, I see no real-world, viable solutions.

There has always been a rift between nurses and medics, it seems there always will be. If this thread can be said to comprise the "whole" of the EMS and RN community, we will never come together for what we all should be here for in the first place, the patient. Paramedics are trained for a very narrow slice of the healthcare pie and I believe that as a whole, we are very good at it. Nurses are trained (I claim no expertise on nursing education, just stating generalities here) for a broader piece of the same pie and they are very good at it as well. I am very pro-education and I do believe that is the first step in elevating Paramedicine into a true profession.

But I also believe that having a degree does not make you a good practioner. I can see 1- and 2-year long certification courses being just as effective at producing quality paramedics as a Associate degree program. Yet, the world as a whole puts a lot of weight on formal education and as a profession, we in EMS need to understand this.

There has been a lot of mud slinging in this thread between Medics and RN's. I see it as just another form of prejudice. Meaning there are a lot of people, on both sides, that reject the idea of cross training just on principle alone. "I am a Medic and I do not want to be a Nurse" and vise versa.

How about this: Come up with a nationwide degree program starting at the Associate level and going up through Master or Doctorate and calling it "Health Care" or something of the like. Take "nurse" and "paramedic" out of it. Give the same base education and then allow for a subset in the final year(s) for prehospital or in-hospital. Much like an MD specializing in Emergency Medicine or Cardiology, etc. That will allow cross training, provide education and take the stigmata of "nurse" and "medic" out of the equation.

Anyways, that's my two cents...