Flight Nurse vs Flight Paramedic

MassED, BSN, RN · Jul 28, 2008

FlyingScot said:
I'm really hoping you're kidding because if not that's pretty damn ignorant of you to say. As a flight nurse I depend on my medic and absolutely believe they are underpaid which is why we, the nurses, on our crew are sticking our necks out to try to get them better pay. But I NEVER have needed a medic to tell me when or what drug to use on a patient. WE work as a team and discuss our plan of care, often we don't even have to use words just looks to get the job done. I don't think my job is harder than the medics and the medics don't think theirs is harder than ours. We have a ton of mutual respect for each other and it shows by us not making stupid ccomments such as these.

Boy I'm glad you said that... I was thinking that as I was reading this thread. A medic "telling" a nurse when to give a drug, pleeeease. Little high and mighty for no reason, are we??

Matt,RN · Aug 7, 2009

Ok, but technically speaking, the training of an RN is at a higher level than a paramedic when it comes to medications, procedures, and protocol. I would expect and RN and an EMT-P to work together as a team, each just as valuable as the other, just like other medical teams do or should, RNs and CNAs and EMT-Ps and EMT-Bs. RNs, despite them both of them having associates degrees, have a higher medical authority, thats just how it works. Lets not kid ourselves.

Also, with as much experience as I have in the field, and now becoming an RN, I would say that I have about the same expertise as a Paramedic....and once I graduate, I will have a higher medical authority as well.

Look, im not trying to upset anyone, and if you knew me, you would know how much of a team player I am and how I treat EVERYONE in the medical team equally and value their expertise specifically and their help, for that matter. But, just as I acknowledge a NP, PA, and MD as higher medical authorities, RNs are higher medical authorities over Paramedics. Just my two cents.

Now, please do not get me wrong. I have met nurses that I have had more experience than, and more common sense too, as an EMT-B. But RNs should not be held to a stereotype of not having field experience just as Paramedics should not be held to a stereotype of an RN being "better" than them. Its just not true. Just because someone is a RN and another person is a Paramedic, that does not make one "better" than the other, but unfortunately, even if the RN lacks common sense, skill, and everything else, the RN is still the higher medical authority. Yes, most RNs focus more on in-hospital/medical facility, but others dedicate their entire lives to working in the field and in undesirable environments.....as I will be doing and have already done.

A Paramedic/Nurse Flight Team is invaluable and should be treated as such, but technically speaking, the RN has a higher medical authority and training.

I hope this doesnt anger anyone, I'm just telling it how I know it to be in Cali. I have many years of experience in the medical field, as an EMT-Basic, a medical assistant, an emergency dispatcher, and now an RN.

GilaRRT · Aug 7, 2009

Having EMT experience and nursing school is not equivalent to paramedic school. While a RN may be considered higher medical licensure in your neck of the woods, that is simply not the case in other areas of the country. In New Mexico for example, the paramedic is a licensed profession much like nurses. In addition, some states require RN's to obtain paramedic credentials before they can work in the EMS or transport environment.

In addition, any flight company worth anything will recognize what each provider brings to the table. Giving the RN ultimate authority is potentially dangerous IMHO. Both team members must know when to take the lead or take a supportive role. Creating an environment that prohibits a provider from applying their specialized skill set is a recipe for disaster.

IMHO as always.

Matt,RN · Aug 7, 2009

And that is precisely why California RNs have higher reciprocity than those of other states. Other states may require additional schooling, testing, or licensure, but an ADN RN from California is able to work in a much more broad region than RNs from other states.

AND there are other states that have the same as California RNs. To my knowledge, California and some other states have the highest standard of Nursing.

I do indeed believe that having as many years of EMT experience as I have and getting my RN does surpass the expertise of most Paramedics that I know, not to mention the higher medical authority.

Bottom line is, there are two different territories, the field and the hospital, and each has their own specialty, but the RN is the higher medical authority, at least California RNs are and they are held to the highest standard, along with a few other states.

Matt,RN · Aug 7, 2009

Might I just add one more thing. Also, with ambulance companies, which I have many years of experience with, if a patient needs a higher level of care, the MD requires an RN, if the patient is not as critical as to need an RN, a Paramedic is requested.

RNs can also extend their scope and licensure to the field as MICNs, CCRNs, as well as others. These specialties prepare RNs even more for what they face in the field. Some companies may request these credentials and others do not. I am unaware of an expanded scope of practice for Paramedics like they have for RNs in California.

GilaRRT · Aug 7, 2009

Absolutely disagree. I have many years of EMS and flight experience under my belt along with the typical alphabet soup and I do not consider my self the medical authority. You are sorely mistaken in thinking your experience is better than a paramedic. In addition, with few exceptions, ( online courses ) RN reciprocity is fairly easy. I was not educated California, and have had not problems with reciprocity. I have never been told that California has superior education when compared to other states. Does the NLN have a special California nursing school credential?

While undereducated shake and bake paramedic courses still exist, many of the old standards are going away. This is especially true in light of the EMS SOP changes. In fact the technician has been removed from the paramedic title and soon all PM national standard courses will require certification.

While things may work one way in your area, do not assume this is a national standard.

Matt,RN · Aug 7, 2009

I never made any assumptions about National Standards. Even EMT-Basics know of differences between states and regions.

Also, I never denied that Paramedics are licensed professionals just as RNs and they should be treated as such.

But, as I lack the energy to continue this conversation, I will simply say that I disagree when it comes to RNs within the state of California. RNs within California are the medical authority over Paramedics.

GilaRRT · Aug 7, 2009

CCRN is an ICU RN credential. While it is a difficult exam and a great achievment, it does not prepare the RN for the EMS or transport environment. Paramedics in fact do have an exam that tests their critical care transport knowledge. It is called FP-C. In addition, a CCT ground credential has finihed beta testing. The FP-C is a very difficult exam that is a mirror of the CFRN.

Matt,RN · Aug 7, 2009

I understand what the CCRN credential entails and how it can be obtained by gaining experience working in the ICU or the ER for certain amount of time along with an exam to pass. I feel that it does prepare the RN for the more critical patients that may be encountered in the field.

And that is good to hear that the Paramedic has extended scopes/specialties, but I believe that they are still limited.

Also, just to mention, I will be getting my Paramedic after I achieve RN. I have conducted much research in these concepts as far as California goes.

I respect your feelings and the workings of your state however.

Matt,RN · Aug 7, 2009

Also, to whomever it may concern, the California EMSA requirements for an RN to become a Paramedic simply requires a confirmation in skills and a 40 ALS Patient Contact internship. It takes more for a Paramedic to become a RN.

GilaRRT · Aug 7, 2009

Matt O. EMT, ETC, SN said:
Also, to whomever it may concern, the California EMSA requirements for an RN to become a Paramedic simply requires a confirmation in skills and a 40 ALS Patient Contact internship. It takes more for a Paramedic to become a RN.

Point being? Take care of 40 patients and drop a few tubes in Fred the head and you are ready to hit the streets? I had a 160 hour didactic flight orientation followed by EMS field rotations and a hospital rotation where we had to spend time in the OR intubating. Then, I had to work 240 hours of precepted flight shifts where a flight medic preceptor evaluated every flight. After all of that, I still did was not on par with our experienced flight medics.

Medic/Nurse, BSN, RN · Aug 7, 2009

WOW! I've seen this before, but it never gets any less amusing (or amazing).

Hey there Matt O - thanks for the "explanation" of your authority and position on teamwork and clinical standing, it sure taught me a few things. I was really moved when you detailed out the California system as the "highest" in the land - and to think that everyone else is in the sucky land of the lost.

Come on man, are you a troll or trying to stir the pot or what? I may be a bit dry of humor, jaded on a bad day and occasionally sarcastic in a funny way - but you REALLY seem to believe what you have posted.

Well all I can say is --- ROCK ON! You are so going to be the best nurse to ever fly. I'll even bet that when you enter a crowd, a hush will follow and then all with breathlessly wait for you to speak from your position of AUTHORITY! As for your experience - I'd expect for all the flight companies to fight for you - I'd even expect that a bidding war may develop! Good times are coming!!

Actually, I'm not gonna keep busting on you - it is clear that you have no idea what you are talking about. At least I will never have to work with you - you won't last long enough to even know that you don't know.

Practice SAFE!