Quote from DE-ED-RN
With no disrespect intended, it is obvious that you are unaware of the curriculum of a paramedic course, certificate or associates. i am both a NREMT-P and BSN RN CEN. I can tell you that most medic programs are longer than 6 months, and the ones that are 6 months consist of 5 day per week 8 to 10 days of class room didactic and then 600-1000 hrs of clinical time. The "few extra skills" you write about include intubation, chest decompression, EKG recognition, and in some states central line placement in the field along with other immobilization, extrication, and transportation techniques.
As someone who completed BOTH programs I can assure you that paramedic school was much more challenging and when completed you are tasked with managing pt care w/o the benefit of yelling out side of the room " I need help in here!" Cause there is no one else to call. With all of this said they are different scopes of practice with different missions and goals for pt care, but both have the best interest of the pt in mind. There are many pre hospital providers with big egos and attitudes that don't understand other practices so in the end don't fall into the same trap and take the position that they are less educated or that you could just " jump" right into a pre hospital provider role. I ASSURE YOU, there is ALOT more to the job than you are recognizing.
The information is very easy to look up on each state's website.
Most states in the US require only 600 - 1000 hours total. No FD, which now many areas for Fire based EMS, is going to put their FFs through a 2 year program or the number of hours you suggests.
Texas is only 600 hours total.
California is just over 1000 hours total.
The Carolinas and GA are only 800 - 900 hours total.
The other states also fall within that range.
The exceptions are Kansas but then in that state RNs are given special provisions when working or volunteering with an ambulance.
Oregon always gets mentioned as having a 2 year degree requirement but if you actually read the website, you will find there are many exception and a certified Paramedic can take up to 5 years while working to complete it and there are also options for extensions.
You also have to consider that the EMT text book is written at the 8th grade level and the Paramedic text is at the 10th grade level. This is common knowledge. The Paramedic program is often taught at a tech school or in the Votech section of a college.
You also have to consider that the Paramedic programs usually have only the requirement of an EMT cert with a HS or GED diploma. Many of the "hours" you might have in a Paramedic program is spent teaching an overview of A&P. There is no reason an RN should go for an extra 6 - 9 months retaking basic A&P and Pharmacology which is not even considered a college level standard course for other health care professions. Overviews are vastly different in content and hours required for outside learning along with required labs.
Another point is that many of the clinical situations are actual hours and not necessarily patient contanct. You might spend 400 of a 500 hour rotation sleeping in an ambulance or FD station. The only hours awake might be if you are in an ER rotation. A few states like California might require 40 ALS patient contact but that might just mean sticking a cardiac monitor on and calling it ALS just to get the number for the student. Again, each state is different and each school may be free to interpret training in a different way.
Another point to consider is that intubations are suggested but not always required in a Paramedic program. Due to the degree of difficulty of finding sites to allow Paramedic students to intubate, many are coming out of programs with just successful manikin intubations. The same for IVs. It is a hit or miss so to speak. Therefore, the Paramedic student is at the same level for actually performing the skills as the RN. But, the RN may have witnessed dozens or even hundreds of intubations before attemption on. The new Paramedic will not have that advantage. The RN who has worked in the ED and ICU will also have the advantage of already have given many,many meds which are not even in a Paramedic's protocols or allowed by the state. Not many states allow for meds used for RSI. But, in states like PA which uses the PHRN, the RN can give the meds not allowed by Paramedics. The RN may also have performed or seen many of the skills which are reserved only for Flight Paramedics (maybe) and some like NG/OG placement will be common place but often not found in many Paramedic protocols.
And yes, I have seen and worked both sides for a long time. That is why I am an advocate for higher education standards for Paramedics across the board rather than just one exceptional FD or ambulance company. I prefer not to bury my head in the sand and ignor existing problems in EMS which are well published if you care to do a simple search. They have the topic in the national level of politics for awhile since reimbursement has been an issue. The sooner you realize not all is rosy in EMS the sooner you can get on board to support Paramedics.