Any other EMS professionals turned nurses having issues!

Nurses General Nursing

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Hi all,

I am an RN also a paramedic, I was a paramedic first. I always dreamed of being a paramedic, since kindergarten to be exact... I will be honest, I went to nursing school really so I could make a better living, and not really because I had a desire to be a nurse. I know I am going to take a beating on here for that statement!!

Just wondering if any other EMS professionals are having problems making a tansition from emt/paramedic to RN... and if so how much time did you give it? (been a nurse for three years now, tried a new area, still love my office on wheels much better).

Any oppinions would be appreciated!

Happy

Specializes in ED, Flight.

I've also had some minor frustration as a nurse. Autonomy and being trusted is definitely different. I've had a doc say he'd trust me to intubate if need be (not actually allowed in-house); but then a nurse manager chews me out (politely) for starting an EJ on a crashing patient. And I just found out that in the hospital only the docs are supposed to do IOs. Really?!!! Nonetheless, my frustration has been minimal. I accept that the roles really are a bit different. At heart, I am still and will always be an infantry medic. Even 25 years later. And I still work outside as a flight medic, to balance my time inside as an ER nurse. This way I have the best of all worlds, and stay fairly happy with it.

At heart, you may always be a medic.

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Specializes in CEN, CPEN, RN-BC.

I had the same problem, but was fortunate to work with several other NREMT-Ps turned RNs. Their main advice to me was to leave the Paramedic ego at the door. I had trouble at first, coming from working as a medic in the AF with a lot of autonomy to working as a staff RN in a community ED, but transitioned quickly. Good luck!

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Specializes in NICU, ER.

I am a flight medic turned NICU RN. Tried ER and unbelievably was not for me. I miss the autonomy and the standing orders. But I am moving up and with experience comes expanded scope of practice.

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Specializes in NICU, ER.

I am sorry wanted to add something. I also think sometimes us EMS people forget that nursing is completely different. So it is a hard transition... Good luck!!

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hell I can't even put in an umbilical line at this hospital as a nurse! give me a break!! I was told oh your job is to just hold the clamps up, oh thats so challenging, NOT!

Already worked in the ER for three years, hated it!

How mny umbilical lines did you place in the back of an ambulance as an EMT or Paramedic?

You are still counting "skills" and missing the big picture of knowledge and experience. Flight or CCT will also not be a good fit for you unless you start getting the broader picture of nursing and putting some of that education to use.

Trying to constantly compare yourself to a doctor will not get you anywhere either. A Paramedic is not a doctor and that autonomy you talk about comes directly from protocols written by a physician for you to follow sometimes to the letter and number with med control to tell you what to do if it isn't in the protocols. You will not be a flight or CCT RN if you stay focused only on the few skills you had as a Paramedic or the limited procedures and protocols available to you in EMS. If you believe your worth is only measured by a few skills which many different professions can easily be trained to do, you're selling yourself very short. Move on or consider returning to the ambulance as an EMT or Paramedic.

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Specializes in Critical Care.

I came from EMS to nursing. My old partner in EMS would always make those comments of "lack of autonomy" and cause some arguments. I'm in adult critical care now, at a large level 1 truama/teaching hospital. I have lots of autonomy. I personally get quite irritated by the "lack of autonomy" argument. If you have a lack of autonomy, that is due to your facility or your unit. In my unit, I have lots of standing orders, where I can order certain diagnostic tests and give medications. This is just like our protocols in the field. I think the difference is, I now deal with more complex patients every shift, as opposed to 10% of my field calls being "real" and the other 90% being total BS. And while I might have to call for a "Dr. May I" for a CT scan or other medication, I think about the fact that in the field I never had the access to those things. Also, when I call the doctor, I'm usually going through an intern or resident who is more then willing to listen to your suggestions of what to do. So I can usually call and tell them the situation, and then say "I'd like to do this, this, and give this." Sure I have to let them say "Okay" but like I said, these are things I wouldn't have been able to do in the field. And I now have many more medications available to help my patient with, and many more diagnositics to have done and evaluate.

Long story short, I love being a nurse now. I have so many more things I can do as a nurse to help my patients. I might not be able to eat, sleep, and watch TV at work anymore, but being able to do the things I now do is a nice trade off. So if "lack of autonomy" you mean lack of being able to eat, sleep, and watch TV when not on a call, then yeah, we have no autonomy.

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Specializes in Critical Care.

Grey Gull is on point with that comment.

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Specializes in ER, ICU.

I am a medic to RN also, also for the same reasons as you. It took me five years to fully feel more like a nurse than a medic. I still work EMS part time. The career options for RNs are so far superior that I have come to appreciate that aspect but still miss the really the fun and intense calls. I'm probably going for my NP so I can regain some autonomy and use my assessment skills more. Just keep looking for the glass half full.

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Specializes in Peds, School Nurse, clinical instructor.

I also was a Paramedic for many years before becoming an RN and I did find the transition kind of difficult. As a Medic, I did follow standing orders written not only by the physician but by an entire team including myself who worked long and hard to develop our protocols. As a Nurse, I follow orders written by the Docs, NP's and PA's. Not a bad thing, just different. I can say one thing, since becoming an RN I have not started one EJ or intubated a patient ( I do kinda miss that ). I love nursing but my heart will always be in EMS. Flight nursing may be a good fit for you....:nurse:

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OP, some day maybe you might pursue a PA for ER? Then work a level one trauma.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Flight nursing is your answer. It is a tough transition from medic to nurse. While the pay is better the autonomy is less. I a hospital setting a paramedic can intubate a nurse can't (most hospitals). I warned a freind of mine the same thing.......she tried ICU nursing and stayed with flight nursing.....I was a nurse frist and aflight nurse second.....betrter of the two when compared to bedisde ICU (in most settoings) FLIGHT! Try cath lab! there's another place you are more of the TEAM

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Its just the total lack of autonomy! I started in the level 2b special care nursery, took NRP the other day... and everything is the Dr. will do... hell I can't even put in an umbilical line at this hospital as a nurse! give me a break!! I was told oh your job is to just hold the clamps up, oh thats so challenging, NOT!

Already worked in the ER for three years, hated it!

I just can't stand the Dr. may I...

*** What you have to do is get yourself into an area of nursing that allows the same level of autonomy you had before. I was in the same boat as you. Medic to LPN to RN. I have found my way to my current position where I have tremendous autonomy.

In nursing the path to autonomy is adult critical care, not nursery. A better question is, why if you crave autonomy (hey I totally get that) why would you choose to work in a nursery?

Get several years of high level trauma, surgical, CV, ER and medical intensive care, get the proper certifications (CCRN, CEN, etc) and just watch what kind of jobs open up to you. There are jobs in medical transport, both ground and air that provide the type of autonomy you are looking for. In addition many hospitals have position where the nurses is expected to work in a autonomous manner. There are different names but some I have heard are Rapid Response Nurse, Critical Care Resource Nurse, SOS nurse. I have just such a position and it's great. To be elligable for a transport or rapid response type job you have to really know your stuff and the place to learn it is adult critical care.

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