Going from RN to Paramedic

TraumaSurfer · Jan 1, 2011

actually... a paramedic can perform more skills than a RN and have higher pre-hospital standards. yes they do make less money but working in ems is "fun" and allows you to have actual automony. plus you get save peoples' lives which is better than money.

Actually, no. If you were to list all the skills an RN can do both in and out of the hospital, the RN's list would be much more extensive. If an RN works in the field with the title of prehospital, Flight, CCT or Specialty transport RN, they can extend their skills to the fullest extent of their scope. Even if an RN just brings the skills from the ICU to the truck, that is a great addition in comparison to what a Paramedic is allowed to do expecially when it comes to equipment and medications. Intubation and chest decompression might seem glamorous to a Paramedic but often an RN may get to the opportunity to see and assist with hundreds of intubations and chest tubes before they work on an ambulance to where learning the skill will not be that big of a jump. Some Paramedics are coming out of school with only manikin intubation skills and have never even seen an intubation except on videos. Even some EMS agencies are getting away from intubation because of the lack of initial training and being unable to maintain proficiency. An RN who is hospital based with any of the teams I mentioned will probably not have this issue since the hospital will offer an opportunity for an RN to practice the necessary skills to maintain competency.

As far autonomy, the Paramedic works by protocols and med control who is just a call away. Some scope of practices are very limited for Paramedics which means ED RN may have to accompany the patient to get from one ED to another when EMS must take only to the closest and not the most appropriate facility.

If you want to be a nurse, concentrate on that and get as much experience as you can in 3 - 5 years post graduation in a hospital with a variety of ICUs and a busy ED. Then if you still want to be a Paramedic, you can look for an accelerated program or take what is necessary to challenge it. But, you would be very surprised at the autonomy, scope of practice and skills an RN can do out of the hospital on Flight, CCT, prehospital and specialty. Medicine is so much more than just a few skills but if you have the education behind those skills, you'll be even better at those skills.

Don't sell the nursing profession short for not saving lives.

By your posts, it sounds like your heart is not into nursing especially with wanting to be a FF or work in the wilderness.

Both licenses are of approximately the same weight.

No, that is not necessarily true in most situations. If an off duty RN comes across an accident, the RN will respect the fact that the on duty Paramedic is in charge of the scene. If an on duty Flight RN is called to that scene, that is now a very different situation. If an RN obtains a Paramedic cert/license for a flight team, it is another cert to show proof of extra training. That RN will continue to work under the license of RN. In some states and on some teams, the RN will just have to show the certification of Paramedic by the NREMT and may not even need the state license as one.

I couldn't agree more about learning more in paramedic training than in nursing school. At least so far, that has been my case. I am in an accelerated nursing program that is completed in one year, and after 5 months, I'm not sure I have learned anything. haha.

I don't think you can fault the nursing profession for your selection of a poor program. I seriously doubt if you will be any credit to the nursing profession. There are also several Paramedic programs that only take a little over 3 months. With the EMT-B included, you can be a Paramedic in 4 months.

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Jan 2, 2011

Seems like as explanations get longer they're harder to swallow. Nurses follow Dr's orders. Paramedics follow Dr's orders. Paramedics can do endotracheal intubation on standing orders. Both have ACLS Certification, but I've never seen a hospital that would allow a RN to do it. I think we're comparing apples to oranges, and how they grow in differant states and institutions. Both are indispencible to healthcare. Nuf said?

flightnursetaylor · Jan 2, 2011

I was in the same boat you were. I have been an RN for over 13 years and just got my EMT-B by taking a weekend course and challenging the state (Missouri). I was an ER nurse for several years before becoming a flight nurse. It is awesome being in EMS but it is different working on an ambulance versus a helicopter. There are a few (very few) programs available to bridge over. I can't remember right off hand of any of them except for the one at Missouri Southern State University in Joplin. All online, no clinical and a few trips to Joplin to test out of skills/etc. Check out MSSU EMT RN Paramedic Bridge to give you an idea. I recommend finishing your RN and work in a busy ER for a year to get your clinical judgement and skills honed. This will also let the ER doctors see what you are made of. Then check into the above website or type in RN to Paramedic Bridge Courses into your search engine. The agency that I work at is going to let me work as an RN on an ambulance using RN scope of Care. We are currently working with Human Resources to see what kind of wages I will be getting. Most likely RN wages but you know what? I wouldn't care if I made Paramedic wages, the important thing is.... I am having a blast working in the trenches. Don't worry about the questions... "Why would you want to do that?!" Just smile and go on. Sometimes it doesn't matter what you do in your career, as long as you are HAPPY!

TraumaSurfer · Jan 2, 2011

Paramedics can do endotracheal intubation on standing orders. Both have ACLS Certification, but I've never seen a hospital that would allow a RN to do it.

Just because you've never seen a nurse intubate does not mean it doesn't happen. There are RNs who work Flight, CCT and Specialty who intubate in the hospital to maintain their skills to perform while on transport. Our RNs need 20 intubations per year for Flight. For NICU and PICU transport they need only 10 per year but are usually partnered with an RRT. There are also several hospitals t/o this country that use RN intubators in L&D.

This does not mean that 1000 RN in hospital should all learn how to intubate. I think we now know what happens when you have over 2000 FFs intubating in one county or 6 Paramedics on every scene. Getting 0 -1 tube per year just doesn't keep one's skill current especially if they had only don't manikin intubations in school. There are Paramedics who haven't started an IV or intubated in over 5 years.

hiddencatRN, BSN, RN · Jan 2, 2011

A local EMS training school near me offers a Pre-hospital RN course. It prepares nurses to take the national registry paramedic exam (which I believe you can challenge as a nurse without a course as well?).

JeffSTAT

If you're interested in being a flight nurse or doing critical care transport, I think it's a great idea.

lilmedic98 · Jan 2, 2011

I've been a medic for 12 yrs and a flight medic for nearly 2 ( I still do both parttime) and there's nothing more exciting than being one. Ive since gotten my RN degree & am now working in a hospital ICU and love it too. If I had my choice I'd still be working as a medic fulltime but considering my education background im employed as a RN. As some have stated the pay isnt the best and you're not as limited as what you are in a hospital. Medics do all ACLS in the field they even intubate! RN's cant atleast not in Ga. I as a medic can do everything an RN can do except hang blood. I function under protocols & standing orders where I work as a medic & can give most meds w/out calling a physician. So your decision needs to be based on what you love to do. The medic pay isnt as good as a RN pay but the freedom is great and the addrenaline rush is even better! If it wasnt for the pay I'd still be doing it! You could do it parttime. My Grandmother once told me that if you had a job that you loved to do then it's not considered work! I agree!

Editorial Team / Moderator · Jan 2, 2011

I was a medic first, then became an RN. I love doing both. :) Some days I like being a medic better, because I can drop the pt. off in the ED and wave buh-bye ... LOL

I've found both roles to be challenging and worthwhile.

Larry77, RN · Jan 2, 2011

Paramedics are stupider than us smarty RN's!!!

He he...just kidding but it gets to be the immature argument of some insecure RN's...different job totally if that's what you want to do great I'm happy for you :-)

Charmander · Jan 2, 2011

just my 2cents... but I took a PAY CUT to become a nurse.... went from flight with 15 yrs to BSN RN.... just for some perspective... :)

Paramedic scope of practice varies WIDELY state to state, and region to region. I totally agree with the different thinking. This is what makes the RN / EMTP -as in one P and another RN-combo on the helicopter so great. (This is my experience.... ) Paramedics think from the outside in (scene safety, hazards, stabilizing the car, how to manage extrication...) and Nurses think from the in out (patient, comfort, more longer term care, etc.... ). The paramedic brings the ER, the nurse brings the ICU. It's a great combo. That being said, the RN's who just go and get their P-card (without any experience in the field... I know many do it and are great) don't bring the ER like a field born and raised medic does. Not saying that nurses are oblivious in the field, or paramedics can't do a crazy critical care interfacility... because they do and can and are awesome.

Do what you love, do what makes you happy. Do one thing.... awesomely. so my advice for what it's worth... keep on keeping on with nursing school, you'll have many more opportunities in the long run, but don't let your EMT go either. As a RN with ICU time and your EMT, you are / will be way appealing to a flight company. even with 'just' your basic.

PM me if you have questions.... best wishes what ever you choose.

ImThatGuy, BSN, RN · Jan 2, 2011

You're not going against the grain. Do what you want. It's your life. Paramedics do generally get paid less mostly because of two things: lack of lobbying and insurance reimbursement. Around here they all work 24 or 48 hour shifts, but between runs you do whatever you want. Here, you'd also only be held to a paramedic standard since nurses don't work in back of emergency ambulances. Statute requires a paramedic to be in the compartment. Your dual credentials, which many on this forum have, would lend well to critical care transport.

You also do not do less as a paramedic. Your role is treating emergencies autonomously, and paramedics do that well. Perhaps because you don't work in case management, dialysis, the OR, or wound care that you can be perceived as doing less, but you work with much more freedom than any RN will.

Most paramedics get a lot of time off. Again, around here due to the 24 hour shifts you get a lot of time off. You could moonlight as a floor nurse and make a little extra cash if you wanted.

rshenry · Jan 2, 2011

Hi,

I am a Paramedic and an RN. I love being a Paramedic! I find that working in the hospital is too confining for me. EMS is just in my blood! I am currently working full time as a Paramedic and love it. Plus I make more money thanks to the "Golden Handcuffs". I make less as an RN than as a Paramedic due to my years of service (23) as a Paramedic. I have no desire to be a flight nurse because I hate flying (lol). Follow your heart and do what feels right!

Robin RN, EMT-P

ImThatGuy, BSN, RN · Jan 2, 2011

Golden handcuffs? Not a phrase I've heard of before now.