Nurses vs. Paramedics

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I've recently learned more about the "turf war" going on between nurses and paramedics in emergency departments for hospitals around the country. The battle seems to be heavily focused on having paramedics become licensed instead of just certified and be able to supplement ED staffs when needed and to practice their skills in the case of an off duty emergency. The paramedics I have worked with have ample skill and knowledge to handle difficult and challenging emergency situations, why then are so many nurses opposed to advancing patient care in this regard? Isn't that what our career choices are all about in the first place?

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Specializes in Critical Care, Emergency Medicine, Flight.

i will never understand this "beef"... we are all essentially working towards the same outcome--- help/treat the patient.

i think its great, for such a high level of care that paramedics have to give, you would think this would give them an opportunity to be the best they can be.

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People are going to oppose any action they deem as a threat to their own employability.

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caliotter said it

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We have become liscensed in Arkansas, but the hospitals in rural areas that are so short on staffing haven't come around to the idea of having us as more than PCTs yet. It would be great to have the option, but the nurses that are worried about losing a job to a paramedic have no need for concern.

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i think its great, for such a high level of care that paramedics have to give, you would think this would give them an opportunity to be the best they can be.

Describe a higher level of care? Paramedics can barely hold their own on some ALS transfers without an RN being placed on the truck due to the limited scope of practice for meds and equipment. SCTs and Flight will also usually have an RN as a member of the team and many will have 2 RNs instead of a Paramedic.

People are going to oppose any action they deem as a threat to their own employability.

Valid point. If a tech (Paramedic) with no degree can easily do everything you can in the ED, they would probably be cheaper and schools can churn out as many as the hospital needs quickly just as they do every 6 - 8 months for the FDs and ambulance services.

LVNs were taken out of many EDs because they only had 1 year of technical training for their license. It is a slap in the face to these LVNs and anybody else who has at least one year of education to be replaced by someone who can get a cert and license in 3 - 6 months. Yes, there will be some who will argue their 1000 hours were stretched out to 2 years to accomondate their once a week schedule. A few Paramedics may even have a two year degree but that may be few and far inbetween. If they can now get a job to be "just like an RN" why would they even want to waste a whole two years in college when they could have a great job in 3 months.

Also, if Paramedics are allowed to be just like RNs there will never be an incentive for EMS and the ED jobs are not that plentiful for just a few lucky ones to benefit from the license of Paramedic. There also becomes an issue in the EDs where assignments have to be changed for patients requiring medications, drips, equipment and lines that a Paramedic is not trained or educated for.

The other issue is reimbursement since CMS barely recognizes anything a Paramedic does in the field so it would be difficult to do much more than a few general tech charges rather then professional.

Other professsions are trying to go forward and magnet hospitals want their RNs to have BSNs and all the other licensed professionals to have the highest possible degree available above and beyond the minimun. Now is not the time to go backwards.

EMS, not nursing, wrote their own statutes/regulations specifically to state prehospital and also made set boundaries to keep nursing from the prehospital field. This is why some RNs must have a dual license in some states to do flight or any prehospital work. However, there are now a few states have come up with their own nursing prehospital credential.

It is time EMS steps up to be its own profession by increasing its own standards and monitoring the quality instead of trying to be just like nurses.

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Totally agree with caliotter3. As unfortunate as it is for the overall work environment, it is true!

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Specializes in Critical Care.

I agree with caliotter.

Also, many places use paramedics in the ED already. But they work under the supervision of an RN, like a CNA would. Only difference is they often (depending on facility) can draw labs, start IVs, do sterile dressing changes less than 48 hrs old (which a CNA can't), and in some places the paramedics do the initial triage of patients coming in. There are a few other skills too. But my state's BON does allow it, they just have to have a CNA2 certification with their paramedic cert, and they have to work under the RN supervision.

It is listed on my BON website here http://www.ncbon.com/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=2046

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I agree with caliotter.

But my state's BON does allow it, they just have to have a CNA2 certification with their paramedic cert, and they have to work under the RN supervision.

Interesting point about the CNA2 in your state is that the Paramedics attempted to challenge it and were denied because almost nothing in that certification is covered in a Paramedic program.

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Specializes in Critical Care.
LVNs were taken out of many EDs because they only had 1 year of technical training for their license. It is a slap in the face to these LVNs and anybody else who has at least one year of education to be replaced by someone who can get a cert and license in 3 - 6 months. Yes, there will be some who will argue their 1000 hours were stretched out to 2 years to accomondate their once a week schedule. A few Paramedics may even have a two year degree but that may be few and far inbetween. If they can now get a job to be "just like an RN" why would they even want to waste a whole two years in college when they could have a great job in 3 months.

Also, if Paramedics are allowed to be just like RNs there will never be an incentive for EMS and the ED jobs are not that plentiful for just a few lucky ones to benefit from the license of Paramedic. There also becomes an issue in the EDs where assignments have to be changed for patients requiring medications, drips, equipment and lines that a Paramedic is not trained or educated for.

The other issue is reimbursement since CMS barely recognizes anything a Paramedic does in the field so it would be difficult to do much more than a few general tech charges rather then professional.

Other professsions are trying to go forward and magnet hospitals want their RNs to have BSNs and all the other licensed professionals to have the highest possible degree available above and beyond the minimun. Now is not the time to go backwards.

EMS, not nursing, wrote their own statutes/regulations specifically to state prehospital and also made set boundaries to keep nursing from the prehospital field. This is why some RNs must have a dual license in some states to do flight or any prehospital work. However, there are now a few states have come up with their own nursing prehospital credential.

It is time EMS steps up to be its own profession by increasing its own standards and monitoring the quality instead of trying to be just like nurses.

Its funny, much of your post sounds just like physician's forum where they are complaining about mid-levels and NPs trying to take over their "turf" or as they call it "mid-level creep."

I've yet to see paramedics or anything trying to get paramedics to be "just like RNs" I think you've read too far into the OP's post. Everything I've seen is allowing paramedics to do a few more advanced skills then NA2s, by allowing them to do blood draws, start IVs, give O2 and monitor a pulse ox. ALL of the same things they can already do in the field. Actually, it allows them to do only a FEW of the skills they can perform in the field, but not all. They are not replaceing RNs, they area only there as an additional tech in the ED to perform some routine skills. I'd think the ED RNs would like it, less routine skills for them to do, so they can focus on much more important things.

Also, i've yet to see any paramedic program completed in 3-6 months. Perhaps you've seen EMT classes, which must be completed before one can take a paramedic class. Please don't forget that very important pre-req. DOT curriculum for paramedics is for 1000-1200 hours of classroom instruction. Then there is usually around 150 hours of hospital clinical time, and about 250 hours of field clinical time. Just 1000 hours, doing five 8 hour days would take 25 weeks to complete, just over 6 months. 3 months for a paramedic class doing 1000 hours plus all the clinical time would be impossible. I do agree they don't go to school for as long as an RN does, but they come out with a wealth of knowledge, lets not discount that.

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Specializes in Oncology; medical specialty website.
Describe a higher level of care? Paramedics can barely hold their own on some ALS transfers without an RN being placed on the truck due to the limited scope of practice for meds and equipment. SCTs and Flight will also usually have an RN as a member of the team and many will have 2 RNs instead of a Paramedic.

Valid point. If a tech (Paramedic) with no degree can easily do everything you can in the ED, they would probably be cheaper and schools can churn out as many as the hospital needs quickly just as they do every 6 - 8 months for the FDs and ambulance services.

LVNs were taken out of many EDs because they only had 1 year of technical training for their license. It is a slap in the face to these LVNs and anybody else who has at least one year of education to be replaced by someone who can get a cert and license in 3 - 6 months. Yes, there will be some who will argue their 1000 hours were stretched out to 2 years to accomondate their once a week schedule. A few Paramedics may even have a two year degree but that may be few and far inbetween. If they can now get a job to be "just like an RN" why would they even want to waste a whole two years in college when they could have a great job in 3 months.

Also, if Paramedics are allowed to be just like RNs there will never be an incentive for EMS and the ED jobs are not that plentiful for just a few lucky ones to benefit from the license of Paramedic. There also becomes an issue in the EDs where assignments have to be changed for patients requiring medications, drips, equipment and lines that a Paramedic is not trained or educated for.

The other issue is reimbursement since CMS barely recognizes anything a Paramedic does in the field so it would be difficult to do much more than a few general tech charges rather then professional.

Other professsions are trying to go forward and magnet hospitals want their RNs to have BSNs and all the other licensed professionals to have the highest possible degree available above and beyond the minimun. Now is not the time to go backwards.

EMS, not nursing, wrote their own statutes/regulations specifically to state prehospital and also made set boundaries to keep nursing from the prehospital field. This is why some RNs must have a dual license in some states to do flight or any prehospital work. However, there are now a few states have come up with their own nursing prehospital credential.

It is time EMS steps up to be its own profession by increasing its own standards and monitoring the quality instead of trying to be just like nurses.

This is probably the most ill-informed post I have ever read regarding paramedics. Maybe the paramedics where you live are as unskilled as you describe (doubtful), but the ones where I live are outstanding. They have made the difference between life and death for many people, and they do their jobs under extreme circumstances.

Do I think paramedics should take positions that could be filled by a nurse? No. But I can't tolerate seeing a profession that has done so much for so many being described in such a dismissive manner.

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Specializes in Emergency & Trauma/Adult ICU.

As with nursing education, there are various educational routes to becoming a paramedic. A major university in my region offers a 4-year bachelors degree in emergency medicine, something that might shock those of you who seem to have a vested interest in viewing paramedics as technicians with 3 months of training.

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