Advice for firefighter, paramedic, soon to be RN

[streptococcus]

Hello

Based on the following brief biography, I would appreciate any advice from this large group of nurses for a soon to be RN.

My main career is as a Fire Lieutenant and Paramedic for my fire department where we respond to structure fire, vehicle collisions, and prehospital patient care. Because of my duty hours, the only avenue open for me to obtain my RN degree is through Excelsior College, which involves a tremendous amount of self-study. This sort of program is open to LPNs and Paramedics. My shift consists of working from seven in the morning until seven the next morning. 24 hours on duty and then I am off duty for 24 hours. I work this 24 on and 24 off shift for three cycles, and then I am off duty for four complete days straight. So, if I understand correctly that most RNs only work an average of three 12 hours shifts per week, I should be able to work full time as an RN as well, while off duty from the fire department. Confusing, I know.

I love my current career as a firefighter /paramedic and only plan to work as an RN while I am off duty. I need the RN job so I can send my two girls to college. It's my job to make sure my two girls grow up to be better than their dad, so off to college they must go!

Based on your experience, what area of care in a hospital do you suggest I try to work as an RN first? As a paramedic, I naturally think about the emergency department. However, I also wonder if I should get floor experience first. I also think about the ICU. However, the ICU seems to me to require advance nursing knowledge in order to perform well. I know that no matter where I initially start, I will have a lot to learn. However, I desire a position that requires continued learning.

I will appreciate any advice.

David

[ivanh3]

David,

I am an RN that went through Excelsior. From reading your post it sounds like you have not started the program (or perhaps have just started). In any case, you have not finished. Having said that I believe you are putting the cart before the horse. You have several fairly major steps ahead of you not the least of which is passing the CPNE (which had a 40 percent failure rate when I took it) and then the NCLEX.

I too was (actually still am) a paramedic and it has served me well. As an RN I have worked in an adult ICU and ED (both in a very busy level I trauma center). I have worked as an agency and staff RN. Currently I work as a neonatal and pediatric ICU RN. I have also done some work in adult occupational health. So as you can see, you can work in a variety of different places.

What helped me the MOST however was that while I was a paramedic, I took a job as a tech in an ED. My duties included starting IVs, doing EKGs, applying splints, wound care, assisting the docs on procedures even giving some meds. ED tech jobs vary in terms of responsibility from city to city, but what helped me the most in that job was just working around the RNs and docs. If I had a school related question I had people with tons of experience to go to not to mention just what I learned by keeping my mouth shut and observing.

Between my time in the ED and my time on the rig I was well prepared to be a new grad RN in the ICU (my first RN job). In fact I can say I was miles ahead of the other new grad RNs in my department who had no real medical background. I am NOT saying I was miles ahead of the experienced RNs, just the new grads, and that is all that counts right?

One last word. Excelsior really is very HARD. Not the material, but the self discipline involved. Particularly the CPNE (Which is daunting and expensive if you fail, and people, good people, do fail). I have known a few people who work your exact type of shift who have become RNs. They worked out trades so they could go to traditional school. I highly recommend that. You don't have to trade the whole shift, just the hours you need for school if your department allows that. It is tough but in way easier. Not necessarily advocating traditional schools, just food for thought.

Let me know if this helps or if you have any other information. Paramedics becoming nurses is a topic I feel very strongly about. As for me? I am in the graduate phase of an associates to masters program for family nurse practitioner (Graceland University). There are several other males in my class and we are all medics that went to Excelsior.

Good luck,

Ivan

[streptococcus]

Thank you very much for your advice.

I obviously did not articulate my thoughts very well last night while typing my question. To clarify, I am already in the Excelsior program and just completed all of the concepts of nursing exams, and all of the non-nursing exams with the exception of Bioethics, for which I am studying for now. I have made an (A) on all exams except for Life Span, which I made a (B). I often wonder if the grading system is messed up, because I never feel I am doing well while taking an exam, and then when I am done, up pops a score of (A). I am amazed each time and think the system most certainly has a flaw. Ha.

I will give serious consideration to your advice to get a part time job as a tech before I complete all requirements.

Thank You

[ivanh3]

Congrats on doing so well on the modules. Something to consider would be to take the Excelsior workshop. I did and it was very helpful. Also, if you would like shoot me an email and I can send you some notes I have typed up in PDF format on what I did to pass. It is fairly complete. I wrote it right after I passed in 2005 and sold several copies on e-Bay and got some decent feedback on it. I don't sell it anymore because it needs to be updated as I am sure there have been some changes in the last 3 years.

Anyway, good luck and let me know if ever have any questions.

Ivan

[streptococcus]

I would appreciate that very much. [PM Member]

Again, thanks for your help.

David

[cpnegrad07]

I am a Paramedic-to-RN thru EC, also. (Graduated last year!)

The transition is/has been very hard for me. If i could do it over, i would definitely get some hospital experience before coming in at the top of the ladder (RN). There is just so much to learn all at once: the hosp. culture, routines, procedures, papers, personnel, etc. It would be a lot easier if i had some of that under my belt. Here, the best bet for a Paramedic is to work in the ER as a Tech. But if i had even worked as an Aide or a Secretary i would have learned a tremendous amount, in that i didn't know squat the first day.

But that is all behind me now. I just got off 3 days that went fairly well. I know there will be more terrible ones to come, but i learn something every time i go to work.

[ivanh3]

One big advantage you have though is that while all of the background in the hospital might be unfamiliar your patient care should be fairly solid (my wife started less than 10 IVs during her traditional BSN program). As a paramedic you have dealt with the sick and unknown before, this is no different. Remember to not compare your self to anyone but other new grad RNs. While they might have steadier feet in some of the areas you mentioned (culture, routines, procedures, papers, personnel, etc) they often are not as comfortable as we where it really counts: by the patient's side. That is not to say that we are better because we are not, we just took a different road to get to the same place. In fact I was lucky enough to start with other "traditional" new grads and we were able to learn a lot from each other. So very cool that you are doing it. Get your RN skills down and then help other paramedics do the same!