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RN to Paramedic Bridge Course



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No. 90
from GilaRN
Old Dec 01, 2008, 06:42 PM

Default Re: RN to Paramedic Bridge Course
Hehehe...you would be surprised if new medics were hitting the streets with fewer than 10 intubations?
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No. 91
from vamedic4
Old Dec 01, 2008, 08:45 PM

Default Re: RN to Paramedic Bridge Course
Medic09...you and I both know that there are programs that simply don't have access to inhospital training, so the possibility of a medic who only has experience with Fred the Head is indeed possible, albeit less so today than 16 years ago when we were all learning skills.

"I train on mannikins for scenarios pretty often. It doesn't compare to a real airway. It doesn't look the same and it doesn't feel the same and it doesn't barf the same."

And this is, of course...oh so very true.
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No. 92
Old Dec 02, 2008, 02:58 AM

Default Re: RN to Paramedic Bridge Course
Originally Posted by HeartJulz View Post
Interesting, I thought an RN was far above a Paramedic,
You're killing me. Two different models of care -one is nursing (one profession); the other medicine (another profession). Two different roles paramedics guide, provide and lead care in the prehospital setting-nurses are not trained to manage care in the often unstable setting of prehospital care. Nurses are not trained in incident management. Although this doesn't seem like a big difference, for those who work as medics its the difference between life and death (not the patients). Nurses are trained in care planning; paramedics are trained to use protocols.


Originally Posted by HeartJulz View Post
but wouldnt an RN who has ER and ICU experience be well qualified enough?
Again, you are killing me. Try to perform this experiment to test this hypothesis (but not in my home town). Get a 20 year vet ER RN or ICU RN without any field exp. and make them the incident commander for all MCI's or the primary on extrication patients with an unstable airway as fire has the Hurst and spreaders going off. Let me know how qualified they are. Of course I could go on and on.

Now flip the script. Try putting a 20 year vet paramedic on a med surg floor and they would be lost. Why? Paramedics aren't trained to care for a floor full of patients. They are not trained in the subtle nuances such as the necesity to get a physician's order to give a Tylenol. Paramedics are trained to recognize pathology and act on their training through online and offline protocols.

In the end, suggesting that nurses or paramedics are above or below one another is similar to suggesting that the color blue is above red. Different professions. Different models of care. Different training styles.
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No. 93
from Medic09
Old Dec 02, 2008, 05:40 PM

Default Re: RN to Paramedic Bridge Course
Originally Posted by GilaRN View Post
Hehehe...you would be surprised if new medics were hitting the streets with fewer than 10 intubations?
Yes, I would be. And VERY disappointed. Some OR time and then precepted tubes on the street are essential to learning it right, as we both know. Especially the OR time, which should be repeated periodically. The few programs I've been involved with over the years all provide that. Anything less is irresponsible and I would advise students to stay away from there. But then, I think all 'medic mills' should be shut down, somehow.
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No. 94
from Medic09
Old Dec 02, 2008, 05:50 PM

Default Re: RN to Paramedic Bridge Course
Originally Posted by vamedic4 View Post
Medic09...you and I both know that there are programs that simply don't have access to inhospital training, so the possibility of a medic who only has experience with Fred the Head is indeed possible, albeit less so today than 16 years ago when we were all learning skills.
Well, if a program can't provide the proper, complete package, they shouldn't be operating. We used to see programs send their students pretty far distances to ensure that they got the appropriate exposure. I don't think 'we can't provide that' is an excuse. The problem is, there are no obligatory standards, and some students are desperate enough or lazy enough to support the medic mills.
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No. 95
from getoverit
Old Dec 04, 2008, 05:26 PM

Default Re: RN to Paramedic Bridge Course
Originally Posted by hherrn View Post
All great points.

I have logged a bit of time as a basic EMT. I also ski patrol at a busy mountain. I have boarded and collared people out of MVC's and various wilderness conditions- including our of streams in the winters. I teach pre-hospital assesment and packaging.

The intimidating part is advanced airway management.

hherrn
Like vamedic and medic09 have said, doing advanced airway techniques over and over again is essential, both with mannikins, in the OR and in the field. The more you do it, the more practice you have under your belt when the next time occurs (and it will happen).
Keeping their sats up with a BVM is the most important and often most-overlooked skill in airway management. I used to always attempt to place an OPA, if the patient tolerated it, then chances are likely they'd tolerate a laryngoscope so I'd intubate them. I'm a little different now and usually don't intubate unless they're a) going to die without being tubed in the next few minutes or b) going to be put on a ventilator.
You can teach a monkey to intubate someone, but you can't teach a monkey to know WHEN to intubate someone. I can't recall any time wishing that I had intubated a patient, but there are a few times when I wish that I hadn't. Take that for what it's worth.
There are some great responses in this thread and I've enjoyed reading all of them. Thanks!
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No. 96
from Medic09
Old Dec 04, 2008, 06:10 PM

Default Re: RN to Paramedic Bridge Course
Originally Posted by RNREMT-P;3289574 I can't recall any time wishing that I [B
had[/b] intubated a patient, but there are a few times when I wish that I hadn't.
Isn't THAT the truth! Thanks for that great observation.

Good judgement about airway management is the hardest skill to develop and maintain. It requires good training and occasional retraining and plain old experiences.
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No. 97
from ARKYLE
Old Dec 09, 2008, 04:31 PM

Default Re: RN to Paramedic Bridge Course
I just graduated with my RN waiting to take boards. I was a former LPN and EMT. Anyone know of a RN-Paramedic program in Ohio? I feel I am qualified for advanced placement with my experience. Thanks in advance. Good luck all.
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No. 98
from GilaRN
Old Dec 09, 2008, 09:01 PM

Default Re: RN to Paramedic Bridge Course
What do you mean by advanced placement? Trust me, give your self some time to transition into the role of RN before taking on a big task like paramedic school. Your LPN experience will help; however, you should still expect at least several months of adjusting.
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No. 99
from Dr.Nurse2b
Old Dec 09, 2008, 10:35 PM

Default Re: RN to Paramedic Bridge Course
Originally Posted by Medic09 View Post
"Should you get a chance" ???

Please don't tell me there are ANY programs graduating medics without at least a week and ten or fifteen tubes in the OR. That's just to start getting a feel for it! Instruction under the watchful tutelage of an anesthesiologist in controlled conditions is essential to start, and needs to be repeated every year to stay sharp! Where we do yearly rotations, the docs also make sure that we're simply proficient with basic management. Good bagging technique isn't always so simple to accomplish, yet it is the most important of all our skills.

I train on mannikins for scenarios pretty often. It doesn't compare to a real airway. It doesn't look the same and it doesn't feel the same and it doesn't barf the same.

You can take short-cuts on almost any other clinicals (OB is kind of hard to get an idea without 'being there'), but a program that doesn't put students through the OR is irresponsible.

That's my .
Our program did rotation through the OR and clinical with Respiratory Therapy as well. I have heard of programs doing a rotation through NICU but I have yet to run into someone who has intubated a neonate in rotation.
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