Does Medic Experience Count?

nurseprnRN, BSN, RN · Mar 2, 2015

No. And the answer may not be what you hope it to be, but here goes.

1) There is considerable knowledge overlap between all members of the helping professions, including medics, therapists, nurses, NPs, PAs, and physicians. While you may well have a jump on some nursing school new grads on some of that, and some (even many) manipulative skills for use in patient care settings, your nursing school peers will catch up with you on just about all of that in the first year of practice. You are looking to be a nurse, not a supermedic with RN after your name. Some of the manipulative skills that are within your scope of practice in the field may or may not be part of your scope of practice when you employed as a nurse, and you should therefore not expect them to be a plus in any "negotiations" for nursing new grad jobs.

2) Many nursing students and nonnurses, including medics, think that "skills" are the psychomotor stuff we do. This is an extremely limited and immature (in the sense of "undeveloped") viewpoint. Nursing skills are not just hands-on stuff-- there are plenty of people who do home dialysis for their spouses or suction their home-vented kids' trachs, and they aren't nurses. If you want to be a nurse, you need extensive education and competence in the core nursing skills of nursing assessment, nursing diagnosis, planning nursing care, and delivering and delegating to accomplish the nursing plan of care, This is, in itself, not all we do; however, implementing parts of the medical plan of care is by far not what nursing is about at its core and you should have a good understanding of that. You need to have a thorough understanding of the nurse role in a way that others do not. I know lots of people think they know about nursing, but believe me, they are much more largely clueless than they know.

If you are seeking work as a nurse, you have to bring those skills, those critical skills, to the table. This is why you have zero nursing experience and cannot claim your medic experience time as nursing time. If someone wants to hire a nurse, they generally want people with nursing skills.

classicdame, MSN, EdD · Mar 2, 2015

GrnTea: BEST explanation I have read!!

OP: Some medics have difficulty with the transition, because they want nursing to fit into the medic role, not vice versa. This is a NEW career, and you will learn many more skills than what you do with your hands. Nothing you have learned will be a waste, but you will learn new applications for those skills. I tell nursing students we are paying them for their brain, not their hands.

allnurses Guide · Mar 2, 2015

One of the best local community college nursing programs in my area has opened up a pilot program that allows paramedics (not EMTs) to bypass the physical skills portion of the education after testing out of it. This brings a 2 year ADN program down to a 10 month program from paramedic to RN. They admit 11 students once a year. Needless to say, the competition is absolutely manic. Most who get in do so because they have an inside connection.

Loo17 · Mar 2, 2015

What part of the country are you from? Where I live the starting pay for an RN is higher than what most medics make.

allnurses Guide · Mar 2, 2015

I think the start pay pretty much everywhere for an RN is more than a medic/EMT/paramedic makes.

BrandonLPN, LPN · Mar 3, 2015

Hey there,
I'm new to the forum but love the blogs/educational opportunities and discussions and hope to offer as much help as I received here during nursing school.
I just had a question. I've been a medic for about 8 years. Has anyone had any experience with going from medic to RN and whether they will compensate you for your time as a medic or not?? Like when I start applying for a nursing job is that something they will take into consideration you think? Any ideas on the best negotiation strategies in this situation. I'm having a hard time understanding why I'm fixing to get a huge pay cut going from medic to nursing after I just busted my tail for a year. I understand it's a completely different beast, however much of my knowledge and skill set will be much more evident vs a traditional grad. I really love my job as a medic but just want to go home to the fam every night instead of working 24 hr shifts. Plus nursing is much more stable and lobbied?? hope i spelled that right. lol.
Thoughts?

What does "more stable and lobbied" mean?

I agree with previous posters in as much as the role of a first responder and the role of an RN are not as close as the general public seems to think they are. Nurses have to learn first aid, CPR, etc. as part of their skill set, but that's about it.

Said general public also seems to have a misconception about what the majority of nurses spend a majority of their time doing. TV would have us believe most nurses spend most of their shift doing EMT-ish stuff like splinting fractured arms or defibrillating every third pt. The truth is, the great bulk of nursing is more along the lines of general health promotion, management of chronic illnesses.

As a medic you obviously focused on first response. Nursing is that, but also everything that comes after, not to mention before.

The suspected MI you dropped off at the ER is going to need a nurse to administer MI protocol in the ER.

Then, maybe they need a nurse in the OR.

Then a specially trained PACU nurse to care for them in those critical hours while coming out of anesthesia.

They'll need a nurse to monitor and treat them for a few days/weeks on a med/surg floor, and this nurse will have to manage and prioritize him along with her post-op hysterectomy in room 214, her sicke-cell in room 222 receiving a blood transfusion, her confused 95-year old UTI in room 201 and her actively dying hospice patient in room 230.

Then, your suspected MI call will spend a few weeks in a skilled nursing facility for rehab, medication management, etc. You don't want to know how many other patients/distractions his nurse has there. You better believe that nurse needs to know how to manage time and do an assessment on the fly.

Then the MI pt goes home, but will need a visiting nurse to check on him and make sure he understands his medication regimen that he can properly go about his ADLs, that his loved ones understand their roles, and to generally coordinate and facilitate his recovery and adjustment to the changes in his life now confronting him. Plus, she will hopefully also be addressing the other health issues doubtlessly facing this man in the spirit of preventative care.

As you can see, the "medic" portion of this man's treatment and the "nurse" portions (plural) of this man's treatment overlap in only the tiniest respect.

jadelpn, LPN, EMT-B · Mar 3, 2015

There are many medics who believe that nursing just adds to the skills that they have already acquired. In other words, one can be a medic in the ER with an RN as opposed to limiting to ambulance work.

Any number of the skill set in an ER setting falls under a different protocol than a paramedic. For instance, in a code, many policies are that an RN can not intubate a patient unless they are a CRNA. This is a common skill for paramedics in a pre hospital setting. You may be in a place where you are the code recorder. This means that you can not actively involve yourself in the skills portion of a code. Which can be hard for some medics who are used to being actively involved.

A lot of the interpretation of EKG's and strips are for the MD to do. Again, difficult for a medic to take a back seat to making crucial pre-hospital decisions on the fly. And in every continuing ed/refresher that I have personally taken medics have a sense that nurses are not as educated/skilled as they in the management of patients. Both positions are the epitome of apples/oranges.

Nurses are limited in decision making as opposed to decisions that a medic interprets independently then uses protocol to medically intervene enroute to a facility. Some that ER nurses do not react with such urgency (full shift "high g") as a medic...I am not sure what the disconnect is, however, more than once the term "medical practice" was used in describing what a medic does. Nursing practice is different, and what a nurse does.

Finally, you may find that your ADN is not sufficient to land you a nursing job. Because the scopes of pre-hospital and hospital care are widely different, you may find it not a great fit. And not to mention that you may find yourself on a night shift for months on end.

There are many medics who choose a PA route, specifically due to the "limitations" that nursing puts on a specific skill set. What you could look into is transport nursing. This may be a niche that you could fall into nicely. I would see if your current company has other employment options for you to explore. (Teaching ACLS, PALS, NALS, becoming an EMT instructor) all with more "regular" hours that would grant you more family time. Then you could see if you can land per diem in an ER as a nurse.

reyndonn1054 · Mar 3, 2015

I appreciate your feedback. I live in East Texas. Sounds like I need to get a nurse job!

I will say also that I use the nursing process every day on the ambulance and have been since the beginning. They don't teach the nursing process in medic school but they should. This is something that has been taught, implemented, successful and well documented. Should be taught in prehosp medicine. No difference between a flight nurse doing it and a ground medic.

reyndonn1054 · Mar 3, 2015

What does "more stable and lobbied" mean?
I agree with previous posters in as much as the role of a first responder and the role of an RN are not as close as the general public seems to think they are. Nurses have to learn first aid, CPR, etc. as part of their skill set, but that's about it.
Said general public also seems to have a misconception about what the majority of nurses spend a majority of their time doing. TV would have us believe most nurses spend most of their shift doing EMT-ish stuff like splinting fractured arms or defibrillating every third pt. The truth is, the great bulk of nursing is more along the lines of general health promotion, management of chronic illnesses.
As a medic you obviously focused on first response. Nursing is that, but also everything that comes after, not to mention before.
The suspected MI you dropped off at the ER is going to need a nurse to administer MI protocol in the ER.
Then, maybe they need a nurse in the OR.
Then a specially trained PACU nurse to care for them in those critical hours while coming out of anesthesia.
They'll need a nurse to monitor and treat them for a few days/weeks on a med/surg floor, and this nurse will have to manage and prioritize him along with her post-op hysterectomy in room 214, her sicke-cell in room 222 receiving a blood transfusion, her confused 95-year old UTI in room 201 and her actively dying hospice patient in room 230.
Then, your suspected MI call will spend a few weeks in a skilled nursing facility for rehab, medication management, etc. You don't want to know how many other patients/distractions his nurse has there. You better believe that nurse needs to know how to manage time and do an assessment on the fly.
Then the MI pt goes home, but will need a visiting nurse to check on him and make sure he understands his medication regimen that he can properly go about his ADLs, that his loved ones understand their roles, and to generally coordinate and facilitate his recovery and adjustment to the changes in his life now confronting him. Plus, she will hopefully also be addressing the other health issues doubtlessly facing this man in the spirit of preventative care.
As you can see, the "medic" portion of this man's treatment and the "nurse" portions (plural) of this man's treatment overlap in only the tiniest respect.

Your example was very good. You paint a great picture of the evolution of patient care. More stable and lobbied means there are far more jobs and always will be; and laws that support the nurse and protect the nurse that paramedics don't get, this likely because there are more organizations and organized lobbyists for nursing specifically vs paramedics. Prehosp medicine is still a relatively young career vs nursing which is potentially why. In addition to this the curriculum is significantly different. Here in East Tx you can get your paramedic w/o having a degree and there's no entrance HESI or cognition test. In Texas you now have to pass national registry to pass your medic test but you can let it go (after two yrs) and keep your texas cert which runs for like 4 yrs and do a less amount of CE and recert to work. It lacks transparency like nursing does. In nursing you have to have at least a two yr degree and pass NCLEX. EMS has not developed consistent career pathways that might reward a person seeking higher education so the motivation to attain a degree is not there. If it was supported more at a higher level of govt this could change. As a medic I get mandated to work days not on my schedule. Literally an email that says 'you've been mandated to work on March 12, 2015' for 24hrs. Oh wait, that was my sons birthday so no i'm not. Well, you get disciplined and your hand spanked. Texas BON states specifically that a nurse cannot be mandated to work more than their regularly scheduled shifts (unless of MCI, disaster). . . Support here for the safety of the patient population...none for EMS.

reyndonn1054 · Mar 3, 2015

There are many medics who believe that nursing just adds to the skills that they have already acquired. In other words, one can be a medic in the ER with an RN as opposed to limiting to ambulance work.
Any number of the skill set in an ER setting falls under a different protocol than a paramedic. For instance, in a code, many policies are that an RN can not intubate a patient unless they are a CRNA. This is a common skill for paramedics in a pre hospital setting. You may be in a place where you are the code recorder. This means that you can not actively involve yourself in the skills portion of a code. Which can be hard for some medics who are used to being actively involved.
A lot of the interpretation of EKG's and strips are for the MD to do. Again, difficult for a medic to take a back seat to making crucial pre-hospital decisions on the fly. And in every continuing ed/refresher that I have personally taken medics have a sense that nurses are not as educated/skilled as they in the management of patients. Both positions are the epitome of apples/oranges.
Nurses are limited in decision making as opposed to decisions that a medic interprets independently then uses protocol to medically intervene enroute to a facility. Some that ER nurses do not react with such urgency (full shift "high g") as a medic...I am not sure what the disconnect is, however, more than once the term "medical practice" was used in describing what a medic does. Nursing practice is different, and what a nurse does.
Finally, you may find that your ADN is not sufficient to land you a nursing job. Because the scopes of pre-hospital and hospital care are widely different, you may find it not a great fit. And not to mention that you may find yourself on a night shift for months on end.
There are many medics who choose a PA route, specifically due to the "limitations" that nursing puts on a specific skill set. What you could look into is transport nursing. This may be a niche that you could fall into nicely. I would see if your current company has other employment options for you to explore. (Teaching ACLS, PALS, NALS, becoming an EMT instructor) all with more "regular" hours that would grant you more family time. Then you could see if you can land per diem in an ER as a nurse.

Wow, Thank you for your comments. After reading all the posts I feel like I'm just going to take an ER job, for now. I'm in a BSN program so hopefully that will give me more options once I finish (crna vs pa). . Because your right. The autonomy thing sometimes drives me nuts. However, the stress free non decision making is pretty good too....and the extra help.. Thanks again.

BrandonLPN, LPN · Mar 3, 2015

Is there a vocal lobby in DC advocating for nurses? I never got the impression our profession particularly had much influence with lawmakers. Especially when compared to physicians.