ER New Grad RN - Previously Paramedic

Specialties Emergency

Published

In my experience during nursing school, many of the nurses didn't know what a Paramedic was compared to an EMT. Many times they believed that the EMT was higher than a Paramedic. They obviously didn't know what the scope of practice these licenses had. I thought going into nursing school that I might be able to use my experience and training as an EMT and Paramedic toward getting a job in the ER, but now I'm not so sure.

Does anyone know how nurse managers or hiring managers will look at Paramedic/EMT licenses in relation to an ER RN position. Will they consider it experience or disregard it because it isn't Registered Nurse experience?

In the hospitals around my area, being an EMT-B, I or EMT-Paramedic would sure put you more to the top of the list of new grads who are applying to the position if they are willing to hire a new grad RN.

Have you thought about going to the hospital(s) where you are known by the nurses and/or NM? Maybe put the bug in the NM ear that you are now an RN and would really like to be in the ED.

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In my experience during nursing school, many of the nurses didn't know what a Paramedic was compared to an EMT. Many times they believed that the EMT was higher than a Paramedic. They obviously didn't know what the scope of practice these licenses had. I thought going into nursing school that I might be able to use my experience and training as an EMT and Paramedic toward getting a job in the ER, but now I'm not so sure.

Does anyone know how nurse managers or hiring managers will look at Paramedic/EMT licenses in relation to an ER RN position. Will they consider it experience or disregard it because it isn't Registered Nurse experience?

You list LA, California in your profile. California has 60% BSN degreed RNs. I will tell you what I was told in Boston a few years ago when I was considering the RN. "ASN + Paramedic" does not equal BSN. I have heard the same thing on the west coast. Focus on enrolling in a BSN program before blaming the nurse vs EMT/Paramedic thing if you are going to stay in California or on the west and east coasts. Try states like Texas or Kansas which probably welcome anybody with RN behind their name regardless of education level. Very small rural hospitals would be a good start if you are looking for a job.

You also say training as an EMT and Paramedic but you didn't say what type of experience. I hope you know LA is the butt of EMS jokes. Everyone knows about its mother may I system. California is a very limited state when it comes to protocols and with the county system, some Paramedics are basically BLS especially if they are not with a fire department. For most California Paramedics, working in a system like Seattle is only a dream and will never be a reality for them. RSI and most of the meds used in other states are not now used by Paramedics in California. So you see in California, scope of practice for a Paramedic varies considerably and is probably best left as a mystery with fond reruns for Emergency!

In nursing school you should not have been so eager to prove something about EMT and Paramedics. You should have been learning more about those you were meeting in the hospital. What is the different levels of RNs and techs you met? RN 1, RN 2, RN 3? Do you know the education and certifications of all the other professionals in the ER like radiology and lab? These are the people you will be working with and coordinating patient care with on a daily bases as an RN.

You might also be adding to the confusion about credentials. California and the NREMT is eliminating EMT-P and it is about time. Most just identified by letters. Complete a couple of skills and you got another letter. First it was EMT-B. Complete a couple of modules or about 200 hours of training and you were an EMT-I. A few more hours and you got a P behind the EMT. So you see the credential has always been based off of EMT. I think California used the NREMT but had EMT1, EMT2 and EMT-P. Some states had EMT-CC which had nothing to do with Critical Care. Others like Washington had 7 titles which were totally based on a skill like IV or intubation. Since our love of abbreviations, it was EMT-P and not the word Paramedic. Unless people are directly involved in the profession, no one know and probably don't care unless there is a special interest just like you probably didn't give a damn about who does what in a hospital. The student nurses you were quizzing were probably focused on learning about all the hospital people they were meeting since networking with them will help in their job hunt.

Right now you are an EMT-P. If you choose to move and keep the NREMT, you will have to transition to NRP. The titles on the left are the current titles. On the right are the new titles. By the time we get these memorized there will be another layer of certs to add to the confusion among EMS providers. The forums are full of discussions and California is one of the worst because of its county stuff.

[TABLE]

[TR]

[TD]NREMT First Responder[/TD]

[TD] Emergency Medical Responder (NREMR)[/TD]

[/TR]

[TR]

[TD]NREMT-Basic (NREMT-B)[/TD]

[TD] Emergency Medical Technician (NREMT)[/TD]

[/TR]

[TR]

[TD]NREMT-Intermediate/85 (NREMT-I/85)[/TD]

[TD] Advanced Emergency Medical Technician (NRAEMT)[/TD]

[/TR]

[TR]

[TD]NREMT-Intermediate/99 (NREMT-I/99)[/TD]

[TD] Paramedic (NRP)[/TD]

[/TR]

[TR]

[TD]NREMT-Paramedic (NREMT-P)

[/TD]

[/TR]

[/TABLE]

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I let my EMT-P expire from the NREMT. In California the levels are EMT and Paramedic. I don't have any medic experience other than paramedic school. I went to school in Kern County which has a large scope of practice and the ambulance companies are still the medical control. This isn't so for LA and you are right about their limited scope, but luckily I went to school in Kern County and got a greater experience because of it.

I never quizzed the nursing students, it was the RNs, the preceptors that didn't know what the difference were. They werent ER nurses but I know that they didn't know because my fiance had her EMT and they thought she was the one with a higher level of care.

I'm familiar with the differences in nursing and it wasn't that I was holding on to my paramedic identity. I knew during my paramedic clinicals that I wanted to be an RN. Thabks for your input though.

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

In Virginia, we had EMT-CT (cardiac tech) and EMT-ST (shock-trauma). Basically EMT-Bs with an expanded but narrowly focused skill set. Interesting!

In any case, I was hired directly into an ED as a new RN with 5 years of paramedic experience and 3+ years as an ED Tech. (And yes, there are ED nurses who don't know an EMT-B from an I from a P.) My experience as a paramedic was very helpful, but only to a point. :) Good luck!

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EMT-CT

EMT-ST

EMT-B

EMT-I

EMT-P

Some states don't have all of those levels and some states have had more levels.

Many in EMS can't keep track of all the levels for what is basically a 1 year certificate leading to EMT-P or Paramedic or MICT. All 3 titles are used for the level of Paramedic or whatever you want to call it. Now it is NRP in some NREMT states. Basically just a few skills separate the titles and then it is up to the medical director to decide which of those skills can actually be used. I really can not fault nurses for not memorizing all the levels of EMS which will change again and when no many in EMS bother to keep up with them unless it directly affects them. Some EMTs try to make themselves out to be Paramedics and some Paramedics barely do enough to be considered EMT-Basics.

It would be nice if nurses knew every skill a Paramedic or EMT can do but it really isn't necessary once the patient is in the ER. In EMS we really don't care if an ER nurse is classified as a RN 1, 2, 3 , 4, Senior or Junior. As long as they are qualified to receive report and take over the patient, don't care. If the RN is directly responsible for arranging transport, that is another issue. But most of the time that is not their responsibility. I

@OP

In California, most of the IFT is done by RN CCT teams because the Paramedics are very limited in their scope of practice. Kern county might be an exception but California state scope of practice is still very weak when compared to medics in other states. Any thing an RN might believe about what a Paramedic can do pretty much goes out the window in California. If you think I am insulting, read the EMS practice guidelines for California or at least for southern California.

Going into nursing in California is a step up for a Paramedic in that state. Don't dwell on it. Just go forward. You will be able to do a lot more as a nurse than you did as a California Paramedic. But if you still want to be a Paramedic, move to another state.

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Specializes in ER.

As a ER nurse, if I was a manager, I would hire an ex-emt/paramedic new grad over brand new gn; you already got the basics down like iv starts, priming tubes, medicating, vs parameters, and more dire ones like intubation, stemi, trauma, etc. But as you already know nursing and paramedic-ing is very different, you do have to put up with more bull from pts and admin, but most of medics at our place are very good. Just don't be cocky it doesn't go down well when you are new nurse, but you already knew that right you smart one! Sell your paramedic experience, but be humble :)

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