Quote from traumaRUs
Nope nothing at all. The RN is not impressive to the paramedics. You get judged on your street sense, not your credentials. I have the respect of the paramedics in the street because they know me in the streets.
Speaking as a (former, still credentialed) Paramedic and now RN you are correct. Iowa has a nurse exception rule, which allows RN's to function as an Intermediate, Paramedic or Paramedic-Specialist with medical director approval.
During 10 years as a hospital-based EMS service director I never had a single nurse who tried the exception work out. An RN is not a Paramedic and vice-versa. Nursing teaches you nothing about trauma kinematics, working a dirty code surrounded by hungry hogs, balancing care with the need to first extricate the patient from the tangled remains of their vehicle, etc. Their ACLS skills were good and they were routinely used as extra qualified hands for tPA transfers, etc. But when it came to primary emergency response the differences showed.
The mindsets are different; not quite but almost alien in many respects. It is probably easier for a medic to earn the respect of the ER staff than it is for an RN to earn the respect of the medics when they transfer to the field.
I did EMS for 26 years; I have been practicing nursing as first as LPN (earned during to early 80's but never used) and now as an RN for about 2-1/2 years - or 4 years total in active nursing. The Paramedic cert might help a bit in the ER when it comes to understanding why what was done, etc, and in a few systems there is a need for qualified pre-hospital, or even inter-hospital (think critical care transfers) RN's. But thinking, as mikelpn2rn has mused, that an RN will further your career as a Paramedic, just isn't in the cards. Such dual licensure is for a highly specialized situation insofar as finding decent employment that will make the most of the skills mix.
Would I dissuade anyone from pursueing same? I would not. In my case it was forced on me by dint of a line-of-duty accident that left me physically unable to resume my previous career. I reactivated the LPN license, found a position with the first employer who would even deem to interview me (new grads had more experience, as I found out) and went back to school later that year. That said I'm still looking for a situation that will allow me to practice in both areas.