What does an RN do in pre-hospital EMS?

Much depends on state practice act. I practice in IL. I am a pre-hospital RN certified at the ALS (advanced life support) level. I volunteer on a rural fire/EMS squad. In the field, I do everything that a paramedic can do.

As to what is best to have: EMT-P or RN, it depends on what you want to do. Personally, to be a pre-hospital RN is to be the best of both worlds.

Pre-Hospital nurses care for patients either prior to their arrival at a HCF or during their transfer from facility to facility.

The role tends to model paramedic functions. However, many RN's can do additional skills in the HEMS/transport roles. Skills and practices do overlap frequently.

I am given these "authorities" from my physician medical director and I spend a great deal of time in competency assured requirements.

•*I maintain authority at a scene in matters of overall safety and direct patient care.
• I fully assess and stabilize any immediate life threats in a patients condition.
• I can administer a wide range of medication and therapeutic interventions.
• I can electively paralyze/sedate and administer analgesia to a patient that has an impending or actual threatened airway - or a marked ventilation or perfusion derangement.
• I can preform advanced clinical procedures for RN's including intubation/airway management, ventilation management, central line and intraosseous access, place chest tubes, "read" CXR and c-spine films, most CT scans, hemodynamic monitoring and arterial line placement.

I LOVED : being a paramedic - I LOVE : being a flight nurse.

The difference is about 15-20,000+ salary yearly.

Best job in the world!


Practice SAFE!

I work a dual provider platform. (RN/Paramedic) The differences in practice between providers is limited and the roles each provider fills are essentially interchangeable.

With that, the paramedics usually take on the airway and scene management roles. No offense to RN's; however, airway management education is the bread and butter of any well educated paramedic. The focus of advanced airway management is simply not part of the RN's initial education and usually not part of the typical RN practice.

The RN in many cases will take the lead when it comes to the inter-hospital transfer. Mixing drips, calculating doses, titrating meds, assessing labs and diagnostics, and managing the IV pumps. This makes sense, as most of the flight RN's I know have either a strong critical care or ER skill set and background.

With this in mind, I think a service that performs multi role missions, (CCT, scene calls, peds, and OB) should have a dual provider setup. I know I would not feel safe without a medic at my side.

I second GilaRN in being thankful for having the paramedic at my side. I count my blessings every shift.

Our roles interchange as well. However, my paramedic partner is a great critical care provider and I aggressively manage the airway - it depends on the crew.

Bottom line - RN or paramedic we both do what needs to be done.

Truly, one of the best nursing jobs in the world - IMHO!