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What states have a prehospital RN scope of practice??



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Jun 06, 2009 01:17 AM

What states have a prehospital RN scope of practice??


What states currently have RN's working ambulances?

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15 Comments
No. 1
from GilaRN
Old Jun 06, 2009, 05:02 PM

Default Re: What states have a prehospital RN scope of practice??
Hu? You may want to ask something a bit more specific. Nearly every area of the country has RN's in the pre-hospital environment. Even if it is having an RN ride with the EMS crew to provide specialty services, such as a balloon pump transfer.
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No. 2
from mwboswell
Old Jun 07, 2009, 12:03 AM

Default Re: What states have a prehospital RN scope of practice??
Also your original question is to "pre-hospital" scope of practice....?
Not sure what you are asking -
RN scope of practice is not defined by the work environment; but by the board of nursing; thus there is no "pre-hospital' scope of practice......
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No. 3
from GilaRN
Old Jun 07, 2009, 12:20 AM

Default Re: What states have a prehospital RN scope of practice??
Originally Posted by mwboswell View Post
Also your original question is to "pre-hospital" scope of practice....?
Not sure what you are asking -
RN scope of practice is not defined by the work environment; but by the board of nursing; thus there is no "pre-hospital' scope of practice......
Some states even require EMT/P credentials or a pre-hospital licensure/credential. Nevada, for example requires nurses to obtain a stand alone license in addition to the RN license. It was called EMS RN last time I checked. However, as you stated, the SOP was still dictated by the BON.
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No. 4
Old Jun 07, 2009, 12:40 AM
Updated Jun 07, 2009 at 12:48 AM by cardiacRN2006

Default Re: What states have a prehospital RN scope of practice??
Originally Posted by mwboswell View Post
Also your original question is to "pre-hospital" scope of practice....?
Not sure what you are asking -
RN scope of practice is not defined by the work environment; but by the board of nursing; thus there is no "pre-hospital' scope of practice......

I can't intubate. In Illinois, Prehospital RNs can. Big diff.

Our scope of practice can be defined by our training, which is defined by our work environment. I can do things in the ICU that other nurses can't, L&D nurses can do different things that I can't , etc, etc..

What the OP is really asking is, where can I practice as an RN, in the field, on an ambulance taking 911 calls. Not interfacility transport, not just watching the balloon pump or the integrellin gtt. But real EMS calls.

To the OP, I was just thinking of posting this same question the other day. I even googled it to see where I could practice as a Prehospital RN. I would love that job.
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No. 5
Old Jun 07, 2009, 11:45 AM

Default Re: What states have a prehospital RN scope of practice??
I am taking classes for my intermediate right now. Eventually I will go for the red patch. thanks for catching on!
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No. 6
from mwboswell
Old Jun 07, 2009, 01:09 PM

Default Re: What states have a prehospital RN scope of practice??
Originally Posted by cardiacRN2006 View Post
Our scope of practice can be defined by our training, which is defined by our work environment. I can do things in the ICU that other nurses can't, L&D nurses can do different things that I can't , etc, etc..
Nursing practice is regulated by your board of nursing - period.

Originally Posted by cardiacRN2006 View Post
What the OP is really asking is, where can I practice as an RN, in the field, on an ambulance taking 911 calls. Not interfacility transport, not just watching the balloon pump or the integrellin gtt. But real EMS calls.
You probably won't see that happen; it's much cheaper to put a paramedic on there, requires less training, and is directly responsible to being supervised by medical control.

Originally Posted by cardiacRN2006 View Post
To the OP, I was just thinking of posting this same question the other day. I even googled it to see where I could practice as a Prehospital RN. I would love that job.

Then what you're looking for is a Paramedic job.

(If I'm wrong about this someone let me know).
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No. 7
from GilaRN
Old Jun 07, 2009, 01:32 PM

Default Re: What states have a prehospital RN scope of practice??
Agreed. While RN's are working in the pre-hospital environment, much is a matter of pure economics.

-Paramedics are paid less in most cases.

-People line up to volly in some places, thus services are free or less than a paid service.

-Initial nursing education is not designed to prepare the RN for an EMS role, thus more money and resources are needed to provide additional instruction.

Even as a flight nurse, my initial orientation was several weeks long (~135 hours) with EMS clinical rotations, followed by 240 hours of preceptor shift time before I was considered a "competent" pre-hospital provider. Still, I default to my paramedic partner on some cases such as a big MCI or a difficult airway.

The typical crew configuration in the USA consists of a paramedic and EMT partner. Therefore, a pre-hospital RN would have to take on all the duties of a paramedic without backup from a paramedic partner, as their EMT partner would be driving.
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No. 8
Old Jun 07, 2009, 05:30 PM

Default Re: What states have a prehospital RN scope of practice??
I'm pretty sure that Pennsylvania has a "pre-hospital RN" cert. I was wondering if any other states have some thing like this.
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No. 9
Old Jun 07, 2009, 06:45 PM

Default Re: What states have a prehospital RN scope of practice??
Originally Posted by mwboswell View Post

You probably won't see that happen; it's much cheaper to put a paramedic on there, requires less training, and is directly responsible to being supervised by medical control.
Ummm, it's already happening. That's what this thread is about! We just want to know which states it's happening in.


Originally Posted by mwboswell View Post
Then what you're looking for is a Paramedic job.

(If I'm wrong about this someone let me know).

You're wrong. TraumasRUs, one of our mods, is a Prehospital RN in Illinoids doing exactly what I've described. I didn't just make it up...


http://osfniems.org/program_descriptions.html#phrn
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