Article: Paramedics equal to RNs

ixchel · May 15, 2015

This is a regular topic of discussion on an EMS forum I post on. I'd say it gets discussed there about 20x as often as here.

I feel like there is not at all a peeing match like this from the nurse's point of view. I'm baffled at the drama this is causing with the lone EMT in this thread. Is it really that big of a deal to be considered unilateral to the RN's scope of practice? I just don't get it.

Medic_5 · May 15, 2015

Summit -

Actually I am one of those paramedics with a bachelor of science degree in emergency services/critical care:) (And soon to graduate with a master's in emergency management....)I had many classes with nursing students and the school I went to actually chose to place medic/nursing students in some of the same classes.

There are differences between NRPs and RNs and unfortunately, the actual field of paramedicine is fairly new - approximately only 30 or so years old versus the nursing skills. As one mentor (dual NRP/RN) told me when I was in my undergrad degree, RNs and NRPs have different strengths, but both are equally useful. I actually work as a paramedic in an ED and very slowly, other hospitals are choosing to employ paramedics in the ED, instead of just utilizing paramedics in the field. (There are levels of EMS....EMT, AEMT, NRP, and the critical care paramedics....different level = different scope of practice/education).

Medic_5 · May 15, 2015

An EMT (6 weeks of training) is not the same as an NRP (2 to 4 years of training). An EMT is educated at a vocational school vs. a paramedic who is educated at a college or university.

Medic_5 · May 16, 2015

"Most patients of that type are transported by a RN/Paramedic critical care transport team and the paramedic on the team is experienced and has extra training because neither DOT nor NRP curricula covers IABP. "

Actually - the curriculum for CICP/CCEMT-P/FP-C/CCP-C all cover IABP :)

"Sure, because someone with 1 year of votech school is a lot cheaper than someone with a university degree.

So we want to replace TWO people who have 2-4 years of education with a person who has 1-2 years, and call it a bonus in care?"

In my state, an NRP has a minimum of 2 years in college (community college, not vocational school), similar to the time in an ADN program and this has now increased to 4 years at a university, similar to a BSN.

"Again, most do not. Most paramedic programs still have integrated vocational level A&P, not college level A&P. Extremely few require biology, chemistry, microbiology, pathophysiology, statistics, evidenced based practice, etc."

Actually, I was required to take all the above classes at my university....alongside the biomedical students, nursing students, etc.

.

SummitRN, BSN, RN · May 16, 2015

"Most patients of that type are transported by a RN/Paramedic critical care transport team and the paramedic on the team is experienced and has extra training because neither DOT nor NRP curricula covers IABP. "
Actually - the curriculum for CICP/CCEMT-P/FP-C/CCP-C all cover IABP :)

Absolutely! We agree! That was exactly what I said with extra training and mentioned CCEMTP in another post.

But what percent of medics have that those? 2%? Less? The discussion is not about outliers have.

The discussion is whether most or all medics have, because the article in question (or the TX billBR157 mentions) are not talking equating or expanding practice for a tiny segment of paramedics, but ALL of them.

In my state, an NRP has a minimum ... now increased to 4 years at a university

What state is this??? I am not aware of any state that requires a 4 year degree to be a medic???

Actually, I was required to take all the above classes at my university....alongside the biomedical students, nursing students, etc.

And that is outstanding!

SummitRN, BSN, RN · May 16, 2015

An EMT (6 weeks of training) is not the same as an NRP (2 to 4 years of training). An EMT is educated at a vocational school vs. a paramedic who is educated at a college or university.

Yea EMT is 140 hours taught over 6 weeks or a semester. EMT texts are written at a 7th grade level.

Most Paramedic programs are 6-12 months (there are 3 month programs), not 2-4 years. Most Paramedic texts are written at a 10th or 11th grade level. There are plenty of AAS programs, but usually the AAS is totally optional and few complete it instead most just complete the Paramedic cert. Very very few 4 year Paramedic programs exist in the US. They are common in some other countries.

Here is one of the many paramedic in 3 months programs http://www.mpcc.edu/health-occupations/accelerated-paramedic-training very popular with firefighter candidates.

Medic_5 · May 16, 2015

There are at least 9 four-year universities that offer this....these can be googled....

Medic_5 · May 16, 2015

Gee....I have never heard of a 6-12 month paramedic program. In my home state, all the programs I know of are a minimum of full-time classes of 2 years, extending to 4 with additional specialization.

I know my textbooks were not written at a 10th grade level....

Have you been through a paramedic program? :)

BR157 · May 16, 2015

This is a regular topic of discussion on an EMS forum I post on. I'd say it gets discussed there about 20x as often as here.
Head on over to EMTLife and tell them how Paramedics are more educated than nurses, can serve as equals of CCRNs, CENs, and RTs in the hospital, plus if they take one CP community college class they become "Advanced Practicioners" and become the equal of "LCSWs, Case Management RNs, and Home Health RNs."
Try it. It won't go the way you seem to think it will..

You haven't posted this on the forums which are seriously discussing the Texas bill and Community Paramedicine. EMTlife is hardly the standard especially since it is mostly EMTs at a basic level like you. Why didn't you write a reply to the original article you posted?

Hey, if the hospitals want to require that paramedics have a BS or at least an AS with the same science prereqs that RNs have, there wouldn't objections on the grounds of education. I've been advocating for that for 10+ years, long before I ever considered nursing.

But you didn't even try to be a Paramedic. You stayed an EMT for 10 years.

But that isn't happening and it isn't what you are advocating for.
The EMS services would never allow it because then they'd have to pay Paramedics a liveable wage. Your attitude dumps right into their playbook. You aren't helping EMS. You are hurting it.
I again point to Canada, New Zealand, and Australia. They have highly educated practitioners who are autonomous sometimes to the prescription level, are well paid and make careers that don't involve advancement only through going into management or a different job title/environment.
US EMS will never get there until an AS is the basic level of entry to work on an ambulance.

EMS is moving forward. If you really have an interest in EMS you would have noticed the advancements over the past 5 years and those coming in the near future.

SummitRN, BSN, RN · May 16, 2015

Gee....I have never heard of a 6-12 month paramedic program. In my home state, all the programs I know of are a minimum of full-time classes of 2 years

It is helpful to know how things work in the rest of the country. Most P schools in the nation are 1 year or less in length.

I ask again: What state are you in?

BR157 · May 16, 2015

Hey, if the hospitals want to require that paramedics have a BS or at least an AS with the same science prereqs that RNs have, there wouldn't objections on the grounds of education. I've been advocating for that for 10+ years, long before I ever considered nursing.

If you were advocating for Paramedics, why didn't you go on to be a Paramedic? Spending 10+ years is as an EMT-Basic is not the same.

You are not listening to what people are telling you about EMS as it is today. Education has moved forward with new opportunities. You don't have to stay locked into the DOT standard. That is only the minimum guidelines for testing. Washington and Oregon both exceed them as to a lot of other states. It is like saying an nurse can only stay at the minimum of what the NCLEX tests for. What if a CNA was to post a rant about how undereducated RNs were and how they shouldn't be working in certain areas? You really should have gotten your Paramedic cert during those 10 years and actually worked as one before forming an opinion which you want to paint on all Paramedics.

Even the link you posted for the Texas Regs clearly states "AS in EMS" for licensure.

The Paramedics here have tried to explain about the education and new opportunities (Critical Care, ER, Community Paramedicine) but you are not open to change in EMS. You posted this on a nursing forum for whatever reason. Maybe you should pick apart every line of the article you posted and allow the author to explain himself.

Paramedics do not lack the ability to get educated. Diploma nurses can get the AS, BSN or higher. ASNs can move up even if not required. Why do you not believe Paramedics are not capable of gaining more education to meet the needs of an employer or their own satisfaction.

It is up to the employer to post for higher education. Hospitals can say BSN even though there are AS and diplomas as entry level for RNs. Once the Texas Bill passes, the ERs can require what they want and this is where EMS can really push forward with change. But, right now TX has many Paramedics who fit the description you gave. Look up their college degrees.

Some do, but a lot of the prehospital ventilators particularly on 911 units are very simplistic and below the standard of care for hospitals except short term transports to imaging.

That is not true for all areas. We use the Draeger OxyLog which is also used on CCT and Flight. Many of our 911 transports can be up to an hour if the helicopter can not fly. Welcome to rural America. There is plenty of rural America which has had to step up to higher education and training for EMS. Seattle is not rural but their standards exceed the minimum established by the DOT. You may have only seen one very small area and only saw it as an EMT-Basic. That again can be like asking a CNA to talk about the medicated drips an RN works with. A few might but most wouldn't be able to discuss which med is better.

Medic_5 · May 16, 2015

It is helpful to know how things work in the rest of the country. Most P schools in the nation are 1 year or less in length.
I ask again: What state are you in?

Sorry - I can't reveal my hometown on an internet forum. Almost all the states now offer paramedicine through an AAS. Many paramedics now choose to go on to a four-year degree (BS in emergency services related field)...while others choose to do dual roles (NRP/RN or RRT/NRP).

What state are you from? That must be one of the few states that do not require a two to four degree for jobs :)

It takes time to change and eventually, many medics will probably be required to do four-year degrees, as most RNs are now required to have an ADN or BSN :)

Anyway....just my two cents...have a great day