NREMT Paramedic/AEMT Challenge

Nurses General Nursing

Updated:   Published

I was wondering if anyone has challenged the NREMT (National Registry of Emergency Medical Technician) Paramedic or AEMT with their RN. I believe there is a method but many times someone who has gone before can shed light and save time. I called them a couple times and left VM with the program coordinator but they haven't called back. My state EMS Department knew about it and had no problem with it but didn't really know the details or know of anyone who had done it (which leads me to believe its one of those things that sounds good but the devil is in the details), they are pretty much whatever NREMT says they go with since the state accepts them as the certifying agency.

I do have many years fire service EMTB expereince and went BSN as opposed to medic school and now work per diem in an ED. My local department is short volunteer/call medics and one can only perform to the level of EMS licensure.

Specializes in Nephrology, Cardiology, ER, ICU.

And in some states, like IL there is a licensure for pre-hospital RN. I've been one since 1999, licensed at the ALS level and run with local rural volunteer squad.

It is NOT a paramedic but a PHRN license.

1 Votes
Specializes in Adult and pediatric emergency and critical care.

In some states you don't need a PHRN or EMS certification to work in EMS, although you do have to find an agency that will support it. When I work in the field I am working under my RN license and not my EMS certs since I'm doing stuff that would be out of scope for our paramedics, but I'm (and our other critical care nurses) are supported in policy and protocol by our medical directors.

I do always love these threads when they pop up.

Do you feel comfortable starting an EJ? I start ultrasound guided IVs and art lines, and occasionally an EJ when we really can't find anything else.

Do you feel comfortable inserting an IO? That has been standard of practice for nurses for years (at least around here).

Interpret a 12 lead? Who do you think is calling the cardiac alerts? It may be ultimately up to the doc but the world doesn't end when they are in a sedation or some other hour long procedure.

Are you seriously asking if critical care nurses can manage a vent or cpap?

ET tube? Do you even retrograde intubation bro?

I could go on...

They are two different jobs, and nursing school does not train you to be a paramedic but critical care nurses can learn those skills (which is of course all dependent on your states BON). I have never fully understood the desire to go work for half the pay, nor work for an agency who doesn't recognize my current license but wants a different set of letters for their paperwork.

1 Votes

What many posters do not understand is that there is a majority part of the country where unfortunately you gods of paramedicine do not live, volunteer ambulance and ems services are in desperate need of providers. Many of the gods immediately jump on the pay disparity- what about the pay for volunteers, which makes me question your motives for medicine to being with. I've been around for a while there are good medics and not so good medics, there are good rn's and not so good rn's, there are good docs and not so god docs. I'll take a good rn over a not so good medic/doc any day of the week and vice versa.

How about US medics train to developed world international standards, think EU and UK which I believe is BS plus additional.

Be sure and wear hearing protection when blowing your own horn.

1 Votes
Specializes in Adult and pediatric emergency and critical care.

Why the concern over pay disparity? It is how much your agency values you. Certain private ambulance corporations are able to buy each other up and rake in tons of cash but are paying their staff an atrocious wage. They also work these people to the bone, expecting them to run 10+ calls in a 12 hour shift. It isn't fair and it isn't safe.

Volunteering is great but are they taking volunteers because they cannot pay, or because they are buying new equipment that they don't need (countless of our rural departments have more apparatus than they will ever have staff for them, departments that see 2 working fires a year have brand new scott packs, and BLS departments are running around with philips MRXs). I actually do volunteer my time both as a nurse and in EMS, but these are for causes that I believe in and there is no way we would ever have the money to pay people for. Our ems monitor is a old but very functional lifepak 12, most of our supplies are donated by local hospitals, and we don't bill for a penny. I am able to volunteer a good portion of my time because I make good pay at my day job, if I was still in EMS and had to pull OT to pay the bills I wouldn't be able to volunteer.

I agree that education needs to be better in the US. We rely on paramedics to seek out their own education, the mandatory minimums are in no way sufficient to get to or maintain a safe level of practice. All that 'horn blowing' I got to type, that is from education I have gone through.

1 Votes
Specializes in Cardiac ICU.

I was an infantry medic in the army for many years and worked in EMS and as a Firefighter for 13 years, paid on call. As medic, I learned crics, IOs, and intubations along with quite a few standing order meds.

Having been an EMT, I understand the the prehospital role is different in very critical ways from "standard" nursing (if there is such a thing--hopefully, you catch my drift). Also, having now been exposed to the nursing program and the nursing world, I also understand that many RNs are MUCH more highly trained and capable (particularly those in critical care and working in EDs) than many in the EMS world would give them credit for. Anyway, I'm just about to finish my first semester of nursing and, I hope to work at earning my Paramedic cert when I'm done. I plan on speaking with the Paramedic/EMT director at the tech to find out what coursework HE would be comfortable with me skipping, if any.

I don't want a "shortcut", but, I'm certain I'm not going to need another year of coursework to catch me up to the paramedic standard our technical college goes by. That said, if that's what is determined that I must do to achieve that goal, I'll do it. I'll do it because I love EMS and I want to serve in as many ways as I can, even after I achieve my RN. I would, perhaps, even like to work on a helicopter, someday, if circumstances allow. Money isn't even a consideration for me--its just in my blood, cheesy as that may sound...

1 Votes

You can if u want too! It's up to them not u just saying

1 Votes
Specializes in CRNA.

this topic drives me nuts as EMT-Ps clearly have an ego problem. Having been an ICU RN and Paramedic since the late 90s and now being a CRNA for the last 10 years where I have worked from CA to MA, no one should be intubating execpt those who intubate daily. Fact- Paramedics cant intubate and routinely kill people by placing the ETT in esophagus. If you can count the number of times you have performed a skill in the last month, then you shouldn't be doing it. Some RNs can work as EMT-P. Some EMT-P can work as an RN. All depends on your skillset. There is no problem with challenging the exams form RN to EMTP or EMTP to RN. It all depends on experience and skillset. Both BSN and EMT-P require roughly 120 credit hours or 1500 clinical hours. The arrogance of paramedics trying to sound smart about RSI, 12 lead, stemi, if you challenge the EMTP you can not take care of my family, its all BS. The fact is our EMS system is far inferior to many First world nations where advance practitioners routinely work rigs. One day we will get there. Until then paramedic, follow your written protocols and call before you kill someone by trying to be a "doc in a box". DO NOT INTUBATE.

1 Votes
Specializes in EMT.

I agree that some medics seem to have an ego problem. RNs' scope of practice far surpasses paramedics, and having worked EMS before/throughout nursing school ... it ain't rocket science. Second semester nursing students are easily on par with most new medics as far as knowledgeability goes, in my experience. I highly encourage RN students to challenge the medic exam, if allowed, ... because you can make more money that way than as a CNA/PCT!

I am going to put in my 2 cents on this. I spent 32 years in the Army. I am a retired LPN. Not only did my training have me go to school to become an LPN. My military training is as follows. (1) NREMT-B (2) EVOC-Instructor (3) Set up, Manage, and work a Nuclear-Biological-Chemical decon center. (4) Emergency delivery procedures (5) interosseous IV (6) Emergency Chest tube insertion (7) Suture instructor, Not hands or face.  Now that I am retired I am at home doing fine woodworking.?

1 Votes
+ Add a Comment