Lot's of autonomy compared to a nurse, you assess and treat patients solo, and sometimes with online medical direction, but the treatment will always be based on your assessment, not the doctors.
24 hour shifts, so you can work two days a week if you like. This of course depends on where you end up working.
Lots of skills : IV insertion, intubation, IO insertion, injections, IV medications, 12 lead EKG interpretation. You must get good at this because it will be your responsibility as in some systems you may the only medic on the call.
You get to go into peoples houses and other different places, some of which can be kinda scary at times, but it is a lot less matoninous than being in the same place all day everyday.
I love being a medic because you never know what your day is going to bring, there is a total lack of structure because you don't know when someone will call 911.
Less management as well since you are generally with a partner on the road most of the time or at a base.
Recently, at least in my area, there has been an increased utilization of paramedics in different jobs like urgent care, emergency rooms, EMS hospital liaisons, and stress testing.
Patients are generally quite pleasant and thankful because you are giving them immediate gratifications generally speaking, in other words they aren't sitting in an ER waiting room waiting for fluids or an antiemetic.
Less money, but remember it isn't always about money. I am far less stressed working as a medic than I was when I worked full time as a nurse. I just enjoy the job more and that in itself is worth it. Honestly I make less hourly as a medic, but it balances out since I work two 24 hour shifts a week which givens me an automatic 8 hours of OT every week.
Transfers bite. I am not a huge fan of transfers, especially the BLS ones or the stare at the monitor as a "precaution" transports from hospital to hospital. Thankfully I did my time and only work on a 911 truck now and that is far more enjoyable.
Frequent flyers. You will have these, every system does. They are the people who call 911 at least once a week, often times more for some BS complaint that they want to go to the ER for. I find most of them have nothing better to do or they are just lonely and want someone to talk to. Do your best to treat them like people and respect them, as irritating as it is. Some of these people are transients that have underlying substance abuse problems and they want to go to the er for three hots and a cot.
BS calls. This is as annoying as frequent flyers. These are people who call you for crap because they can't find a ride, they don't want to bother anyone for a ride, they cannot afford a cab (wait until they get the 2000 dollar ambulance bill), they have a cold and they just cannot handle it anymore, they want to get seen faster (we put them in triage purposely and it feels good to do it). You get it... ABC ambulate before carry for these people!
Disrespect from nurses. Yes you will get this and yes I am a nurse and I am saying this does exist. Some ER nurses treat us like we are beneath them for whatever reason, even though our scope of practice is broader. Anyway I have been in EMS for 20 years and this has never changed, it does seem to have to do with the culture of the staff most of time. I don't mind it because when the drunk, or the patient with SI doesn't have a hospital preference guess where I take them.
24 hour shifts can be exhausting!
The job is VERY tough on your body, we tend to get over weight. Your body will hurt after a few years if you do not maintain high level of fitness and even if you do you may end up with a back or other injury. One of my co-workers just injured himself and had to get surgery and now will be out of work for 6 months. One of the reasons I became a nurse is because I new I wouldn't be able to do this job forever, one injury and it takes you out of the game possibly permanently. If you do this job make sure you have adequate long term and short term disability coverage. I broke my ankle last may and was out for 2 months, but didn't have to worry about it because of that.
If it's snowing, raining, a tornado is coming through, the car is upside down in a ditch full of mud you are working in it. You are exposed to all sorts of environmental changes depending on where you live etc. Cars in the woods are lots of fun when they are surrounded by poison ivy...
The money, there is a lot to be made depending on what area of the country, but as I said above it isn't always about that.
Less autonomy can equal less pressure and stress. When you have people staring at you expecting YOU to save their loved one and not a doctor the stress can be high. As a nurse you generally will not experience that, there will be stress, but it is a different kind.
You have lots of other nurses to help you, especially when you are new! Difficulty starting IVs or questions about medications, no issue, lots of resources.
Lots of options as far as jobs go. If you don't like one area you can figure out another one that interest you. Although here the job market is poor, even for nurses, so trying to switch areas can sometimes be tough.
In general you get to work in a warm building without worrying about being exposed to the elements or falling on the ice etc.
Generally you get more respect within the medical community.
Generally nursing is A LOT easier to renew every two years.
You get to wear scrubs
which are like wearing pajamas compared to wearing a uniform.
Stress and lots of it. When you are on the ambulance and you have a needy patient or family they are only your problem for about 20 minutes or so. When you are a nurse they are your problem for hours or days. When patients are waiting for hours in the ER guess you gets the brunt of their dissatisfaction, and I will give you a hint it isn't the doctor.
Not a broad range of skills for lack of a better term, especially in the ER. Where I worked we weren't allow to place IOs or EJs, and definitely not intubating. No interpreting 12 lead EKGs etc. Stuff I like to do, I could not.
Lack of autonomy
Depending on where you live the job market can be really tough, especially as a new nurse fresh out of school.
On your feet a lot and very little time for breaks or to even pee! Unfortunately I find this is allowed to happen in many nursing areas which is disgraceful.
You have not just one patient but 4-8 depending on where you work and less staff to help as more hospitals cut staffing and budgets.
Scrubs, they are comfortable, but unfortunately if you are wearing them a lot you can loose track of your waistline!
2) Restrictions on paramedics in the ER is very dependent on the state and the hospital. In my state I am licensed so if I worked as a medic in the ER I could do whatever the hospital allowed that is within my scope of practice. In the state next door paramedics are certified so they are working under someone elses license when in the ER, generally a nurses of physicians, thus they are much more limited on what they can and cannot do. Some hospitals allow medics to do everything a nurse does, plus the skills they are allowed to do in the field. Some hospitals however limit paramedics to being glorified ER techs that can only give a very limited amount of medications and mainly transport monitored patients upstairs, and from what I have seen those paramedics end up unhappy and quitting within a short time frame.
3) The whole ADN vs BSN has been battled out numerous times on here and everywhere else. Ultimately you would more than likely eventually have to get your BSN as more and more hospitals require it to initially hire you or require you to sign a contract stating you will get it upon your hiring within a set number of years. You could always do the ADN first, get a job, and then do your RN-BSN. That is what I did and I am thankful I did it that way because it was a lot less student loan debt. I was able to work extra and pay for my BSN as I went so no more student loans!
Are you an EMT? I thought in most states you had to be an EMT basic before you could become a medic? I strongly advise you to do that first if it isn't to late. In my experience people who become EMTs and then immediately go into medic school make poor medics because they have no foundation in which to build the house. Just some thoughts for you.
In summary whether you do nursing or medic all depends on your personality and what kind of working environment you want. This is America so you can do as you wish, and you can even do both, as I did.
That is kind of a broad comparison between the two. I was a medic first so the autonomy loss was the biggest thing that made me run back to the ambulance, that and needy patient's and families, I just didn't have the patience for it! I have been in EMS for 20 years and a nurse for 10. I do not regret going to nursing school
, as I know I will eventually have to revert back to that full time once I cannot physically handle the ambulance any longer.