What states have a prehospital RN scope of practice??

Specialties Flight

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What states currently have RN's working ambulances?

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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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Specializes in ER, Trauma, ICU/CCU/NICU, EMS, Transport.

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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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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Specializes in Cardiac.
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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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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Specializes in ER, Trauma, ICU/CCU/NICU, EMS, Transport.
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.

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.

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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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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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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Specializes in Cardiac.

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.

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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Specializes in Critical Care, Emergency, Education, Informatics.

THe two I know of are PA and IL. Both are different in how you get permision.

Despite what's been posted, when your running pre-hospital, it's the EMS act that runs your scope of practice. No matter what your allowed to do in the hospital, if the EMS act doesn't allow it then you can't do it in the field.

States like KS EMS act allows nurses to run pre-hosptial without any specialty certification. You function under the ALS protocols.

I know about KS and PA specificly, because I ran prehospial in KS and I worked for one of the regional EMS offices in PA and was responsible for certification.

I remember a thread on flightweb.com about the subject, you might wan't to look there.

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Specializes in ER, Trauma, ICU/CCU/NICU, EMS, Transport.
Ummm, it's already happening. That's what this thread is about! We just want to know which states it's happening in.

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

I think we're talking apples and oranges here...

If you define the purpose of a "Prehospital RN" to be that of a RN who is employed by a free standing (non-hospital-based) State licensed EMS provider; who's primary job responsiblity is to sit in a squad room, waiting for 911 calls, to hop in an ambulance, go to the scene and assess, treat and transport a patient... then the question is "why"?

What unique, "RN-only" job skills are being brought to the table here?

How does this improve patient outcomes?

NOW, if we're talking about a hospital-owned critical care transport service that ALSO has the capability of "scene calls" ('ala HEMS), then we're talking a horse of a different color. In many hospital-owned EMS/Transport systems, the "bread and butter" is insured patient transports, and of that we can include specialty transports (cardiac, vascular, neonatal, ICU/MICU etc)...but "scene" calls are not the primary focus of that niche'.

So I think the bigger question is what I said above which is "why?"....

...and from a consumer/tax payer standpoint; if I knew that it was going to cose more to staff pre-hospital 911 services w/RN's - I would say how do we justify the expense (which also includes at least a 2 year degree)....

Oh, and during that 2 year degree, they probably aren't going to learn very much about Emergency/Pre-hospital as ASN/ADN programs have barely enough time for basic competency/entry to practice. This means that any of those RN"s will have to have some "additional" training for the Pre-hospital role - thereby again, increasing costs; and increasing operating expenses and subsequently overall health care costs.

-MB

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