Paramedic or Pre-Hospital RN?

[djd7101986]

Hey guys,I needed some advice on something; recently I've become an EMT-B and really enjoy the work and am looking to continue my education but I'm at a crossroads. I don't know if I should become a paramedic or a nurse. I would still like to do pre-hospital care in the field but don't know which would would be a better decision. Both programs are offered at a local community college by me and both are two years with an AS at the end of the program I'm just curious which one would be better ? If anyone has any insight I'd really appreciate it! Thanks a lot

-Dave

[bargraphix]

First let me say I have the utmost of respect for my paramedic colleagues, and I do mean colleagues but the two careers are not the same. We may overlap in skills but there is a difference in philosophy,education, scope of practice (while in the MICU) and final responsibility. Things often differ from state to state but I can assure you it would be my butt on the line first if anything went wrong on a transport. Paramedics bring many wonderful things to the table including scene management experience and the ability to think outside the box but they often lack the critical care experience that is required to manage an ICU type patient beyond initial stabilization. That is not to say that with education and a lot of precepting they can't learn it but there is a reason that in most states an MICU is not staffed by paramedics alone. It's the same reason I as a nurse can't just hop in the back of a squad and run EMS without additional training (which I have). This is not something easily understood unless you are a nurserand a medic and I happen to be both. Also, any state that would allow a nurse with just one year of ER experience to run on an MICU is crazy. If you are interested in persuing a career in transport medicine you ought to sign up for a ride-along with your local transport system.

once again i havent looked into it but as an emt wouldnt they have the scene management and other things necessary to be a paramedic?

[FlyingScot, RN]

Not out of the box. I have worked for programs that are primarily ground based (no scene response) and helo based. In my state it is required that there be a minimum of 2 EMT-B or higher certificated personnel in the transport vehicle. This means that the RNs must have their EMT-B or higher but does not mean they have ever had any scene experience whatsoever. They have the classroom part but we all know the real education comes from actually doing the job. As far as nurses being the same as paramedics it just ain't so. I'm desperately trying not to start an us versus them argument but nursing education, as a rule and there are exceptions, is much more in depth than the usual paramedic education. Believe me it is a very big difference. Until you are actually in nursing school it will be difficult for you to understand this. Again, our skills sometimes overlap but at least in my state there are skills that I can do that a medic cannot (chest tubes, art line insertion, central line insertion, x-ray interpretation). In my situations the RN was ultimately responsible for the transport. The proverbial poo rolled downhill from there.

[nurse2033, MSN, RN]

Depending on your state, it is usually very easy to go RN to paramedic as the RN is considered a higher level of education. Going medic to RN takes just about as much work as getting RN in the first place. It also depends on the employment prospects which has a lot to do with where you live. I'm both a medic and RN, feel free to message me if you like.

[johnssmrn]

i would recommend getting your rn license. i was in the very same situation and chose to go rn and have not regretted it at all. get your rn license and then get a job in a trauma ed and after a bit challenge the emt-p exam. then get a job on a 911 ambulance (a busy one) and start floating to the icu. the best flight nurses are ones with rapid assessment skills who can think on their feet and can quickly adjust from down and dirty medicine to fine tuned icu care. a solid paramedic/field, ed rn, icu rn background will get you far in the flight community. i currently work as a flight rn in a very busy area - i use my icu experience a lot - remember flight nursing is not all about trauma and scene calls- you get a fair amount of medical transports and interfacility patients who are on multiple drips and weird vent settings and icu experience is incredibly valuable in these situations. just my two cents.

[Rob72, ASN, RN]

once again i havent looked into it but as an emt wouldnt they have the scene management and other things necessary to be a paramedic?

To paraphrase FlyingScot, the RN will have a longer view- what needs to be done to stabilize the patient over the next 6 hours-2weeks. The para will be looking to manage/enhance survival over the time of transport. Those goals are not always exactly a concurrence.

The bridge bewteen the two is a professional able to manage the scene, stabilise the patient, and perform interventions that enhance long-term survival.

Lord, I just realized this was a dredged up critter...

[mmutk, BSN, RN, EMT-I]

Depends on how important money is to you. You will make much more as a nurse (at least down here in the south )