Going into EMS?

  1. Hey guys! So I'm an RN that currently works in my local ED. In a few months one of our local community colleges is offering an RN to EMT-B bridge course that I am very excited to take! Once I get my feet wet in this, if I find I like it, I'm considering going back to school to become a paramedic. To those of you that are RNs as well as EMS providers, what do you think about it? What are the pros and cons of working prehospital as opposed to working in the hospital?
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    About TNViking

    Joined: Feb '17; Posts: 16


  3. by   SummitRN
    Are you excited about a massive paycut? EMT is not much more than minimum wage with Paramedic typically being only slightly better unless you work for a Fire Department.

    You will feel exceedingly limited as an EMT in your scope.

    However, EMS is fun. The courses aren't hard.
  4. by   Pixie.RN
    I was a paramedic first, then RN. I love EMS! I think that having that additional skill set may lend itself to certain career options, like a transport RN or flight. Or you could do EMS full time and keep the RN job PRN for extra dough. As SummitRN says, the pay for paramedics is not great. I do know many people who work for fire services and even airports, and they make good money but typically that is because they work 2 or 3-day shifts. Of course, you're allowed to sleep during those shift as you can, but you don't always have the opportunity.
  5. by   PeeWeeQ
    I've been an EMT since 2008 (also when I became a combat medic). I am currently on the waiting list for the RN program here at our local Tech school. An instructor who knows I want to work in emergency medicine and possible transport/aviation, has been trying to convince me to take the Paramedic course before I begin core RN courses. I'm very seriously considering it.

    Pre-hospital care is exciting, and, can be frustrating. No matter what your level of training (as an Army medic, I have additional skills closer to Advanced EMT), you are limited to the scope of the service that you work for. This means that as an RN, you likely will not be able to use any of those additional skill in the field. Paramedic gets you closer, but, still in a bit more austere environment.

    All that said, there are a few reasons RN is my ultimate goal even though I love the prehospital work. 1.) The pay is much better. 2.) The opportunities for variety and advancement are MUCH better (that is, if I get sick of emergency work or critical care, I can move on to a different area).

    I say go for it, but, I certainly wouldn't give up being an RN to do it....

    That's just me...Good luck!!!
  6. by   ventmommy
    Are you sure it's RN to EMT-B and not EMT-P (EMT-P would make more sense to me as pretty much anyone with common sense and a capacity to learn can be an EMT-B).

    EMS is amazing! The scope of practice is different between EMT-P and RN. EMT-P is 100% protocol driven so you need good assessment skills. Your patient has a crappy airway? You decide to intubate or perform RSI. Patient has coarse crackles and SOB? You assess their level of sickness and give Lasix, morphine, and/or CPAP.

    I can't say enough wonderful things about EMS.
  7. by   traumaRUs
    I've been an RN for 25 years and a pre-hospital RN for 18 of those years.

    PHRN is an actual license in IL.

    I volunteer on my rural fire dept and love love love it!

    However, I could never WORK as PHRN because of the huge pay cut. EMTs and paramedics are not paid nearly enough in IL (and probably elsewhere as well). Even if I was to work as a PHRN the pay is abysmal!

    Volunteer but don't change career paths.
  8. by   tiffanyB12
    As someone who used to work as EMT-B, it doesn't make sense to go from RN to EMT-B. If you want the "excitement" of prehospital care, why not get a CCT nurse training? As a former EMT, i worked with many nurses doing critical care transports. It doesn't have to be a full time job, just a side thing, and your ER experience would be a great asset.
    Currently i work as an Urgent Care nurse. I loved being an EMT, it was a good experience for my current job as a nurse. Many of my coworkers also used that experience to move on to becoming RN, RT, firefighter/EMT-P positions.
  9. by   amzyRN
    That would be a step back though, less pay, less scope of practice. Do what you love though if you'd like it more than being an RN, by all means, go for it. Someone mentioned flight or CCT as an RN and I think those are great ideas. Good luck!
  10. by   PeakRN
    What makes you want to go into EMS? If you are are doing it as a passion type thing (volunteering at you local FD, getting skills before doing humanitarian missions) it is a great way to think and skill set to have, if you are bored of the ED and doing it as a change of pace I think that you will find it less satisfying and more frustrating than you would expect.

    I went from being a Firefighter/EMT to ED nursing and wouldn't go back. I do volunteer at a pediatric cancer camp as the critical care nurse (we provide ALS care and will ride in as the ALS provider).

    In EMS you will have a very limited scope of practice with a lot of responsibility. EMS does not have independent practice, if you have a negative outcome you can be scrutinized to a very long and impractical set of protocols. Even outside of the protocols you are rarely independent, often a supervisor or fire officer will try to tell you what to do often in a way that does not actually benefit the system or your patient.

    Depending on the system you may or may not have a station, but even then you will often stage in the middle of nowhere for hours with little to do. You and your partner are often the only medical providers on scene. You have to assess and treat the patient yourself with very limited resources even in the most critical of situations.

    I have the utmost respect for our EMS providers, but there is a reason that they leave for another field at a very high rate. You don't really see EMS field providers with decades of experience. They tend to either go to PA or Nursing school, or go into management where they are no longer working in a patient care environment (or are lucky enough to get onto a metropolitan fire department that actually pays decently).
  11. by   HiddencatBSN
    In my state, and RN with an EMT-B cert can become a Prehospital RN (PHRN) after challenging the paramedic practical. So here if you are an RN and want to be a PHRN, you either take an EMT-B course, a paramedic course (but those require EMT-B cert), or take a very expensive PHRN class before taking the paramedic practical exam.
  12. by   TNViking
    I wish I was wrong about the bridge, but in my state there are zero bridges from RN to Paramedic. In fact, this bridge to EMT-B is the only bridge I know of in the state o.O
  13. by   PeeWeeQ
    Pretty sure most bridges go the other way--from Paramedic to RN...
  14. by   AnnieOaklyRN
    Quote from SummitRN
    Are you excited about a massive paycut? EMT is not much more than minimum wage with Paramedic typically being only slightly better unless you work for a Fire Department.

    You will feel exceedingly limited as an EMT in your scope.

    However, EMS is fun. The courses aren't hard.

    The "courses" aren't hard? Are you a paramedic and have you been to paramedic school? I am just wondering how you formed an opinion about paramedic school not being hard if you are an EMT-B.