Nurses vs. Paramedics

Nurses General Nursing

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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?

I would recommend that another tier of paramedic be added, one that adds the skills similar to an RN so that they can function as a RN in the emercgency room setting only. Would require further education and clinicals. Not to mention the fight they will have to have with the nursing boards trying to protect nurses scope of practice. I would stand up for them if they provided more education and training to protect the patients.

What kind of education in regards to pharmacology and pathophysiology do paramedics get? Is the pharmacology part limited to only what they can administer, or do they learn about everything? I think before any nurses just up and say no to this, they need to learn about paramedics education as it is now and how it can be changed to change their scope of practice.

Skills are just part of a profession. The education really needs to be extended. The ED does not deal only with emergency patients. There are many aspects in the nursing education that must be considered. If a Paramedic wants to be like a nurse they should just go to nursing school. I am saying this as a Paramedic and after comparing curriculums and responsibilities.

It is those of us who are Paramedics and who want EMS to become a profession that would be most opposed. The profession needs to be advanced to where there are only 3 - 4 levels nationwide rather than 50 different ones. Even the term Paramedic needs to be consistent. The last thing we need is another tier for each state to interpret if or how they want to approach it and make a law. Then it would have to be decided on whether the state or the NREMT would be doing the testing. It has taken several years to get the future proposed changes for the NREMT to be in place and not all states are inline with them nor are they with the accrediting of the Paramedic programs. Let's please try to straighten out the mess we have now before we go off looking for more levels and titles.

If only those who claim to be all knowing about EMS or part of EMS would only take the time to get involved with their profession at the state and national level the future of EMS might be clearer and able to take on more responsibilites. Right now there is a debate if EMS should even be doing as much as they are due to poor quality control measures.

Many of those commenting here do not have any idea what EMS is like within their state or across the nation in the U.S. We can all cite stellar examples in all professions just we can those who aren't.

You can ban me if you want for being proactive for EMS and wanting higher standards with some consistency in all 50 states for education. But, you really need to do some research to know if you are banning me for the right reasons. EMS advocacy will never be much as long as so many are in denial and keep saying Paramedics do so much more than nurses. I don't see that and I've been around for a very long time examining scopes from all states. If you want to do more, be proactive and put you mouth to work at the legislative levels.

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If paramedics want to work in the ER I would think going to become a RN would be a wise move because their rate of pay would be so much higher. They work essentially as CNAs where I live and they make roughly $12 an hour. They could almost triple that as a RN. They might even be able to get reimbursed through the hospital for a portion of their education and work in the interim.

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I don't get why paramedics want to work as paramedics in the ER. I agree if that was a career goal then they should've become RNs. Im in an RN/BSN program now and I think my paramedic program was much more demanding but perhaps that's because I was younger and everything was new then. Here, paramedics can't really be paramedics in the ER unless there has been a recent change. Likewise, a RN can't lawfully work in place of a paramedic on an emergency, paramedic licensed ambulance. Here, it's understood that the fundamental training of each occupation is different thus are the scopes of practice.

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It seems there are just too many opinions for a pt care solution to ever be reached. Sad really.

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Show me where a 4 year degree is required for the Paramedic. Many schools do not require even an Associates to teach a Paramedic course.

Your comparison here is like saying all RNs have an MSN but we know that is not true especially with all the ADN vs BSNs are a waste of time threads on this forum.

Here are more University programs to compare.

University of Iowa Hospitals and Clinics Department of Emergency Medicine Residency Program

Welcome Center - School of Health Professions - The University of Texas Health Science Center at San Antonio

Yes with the one in TX you can be a Bachelors but most just take the 2 semesters.

But, several also like this one:

http://www.teex.com/teex.cfm?pageid=training&area=teex&Division=ESTI&Course=EMS135&templateid=14&navdiv=ESTI

How about this one or should I say several.

National College of Technical Instruction, EMS Courses, National Registry, Paramedic EMT Training, NCTI

Some may like to extend their clinical time out and if you are serious, you should be done within a year.

Again with the ignorant and uninformed comments. Utah Valley University offers a 4 year paramedic degree, with a one year branch program offered to become an RN. University of Utah has also begun a 4 year degree program in EMS and prehospital care. No one is discrediting nurses, no one is seeking their jobs this is about the ANA stop throwing a temper tantrum and work with paramedics in requiring more for prehospital care. It seems like nurses are the one who want to ride the hero train and not allow paramedics more freedom because then nurses like yourself won't get the "saves"

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again with the ignorant and uninformed comments. utah valley university offers a 4 year paramedic degree, with a one year branch program offered to become an rn. university of utah has also begun a 4 year degree program in ems and prehospital care. no one is discrediting nurses, no one is seeking their jobs this is about the ana stop throwing a temper tantrum and work with paramedics in requiring more for prehospital care. it seems like nurses are the one who want to ride the hero train and not allow paramedics more freedom because then nurses like yourself won't get the "saves"

it is now easy to see which direction you wanted this discussion to go.

why are you calling me ignorant? all of the information i have provided can easily be checked out by just going to the state ems websites and see the variations in provider levels and "hours of training" required. i have also repeatedly stated that i am not a nurse but rather an ems advocate who believes in promoting the profession through education and unification of providers through some national consistency rather than having many, many different levels of providers with titles that do not even transfer from one state to another.

utah may have a 4 year paramedic degree but it may also be focused on management. utah does not require any degree, including the associates, to be a paramedic. your statement is like saying all rns require a bsn or a msn for entry. you also have to remember many paramedics are with the fire departments and may prefer to get a bachelors in fire science.

there have also been a few posts here that have criticized nursing education and have also stated nurses have very few skills and may not have as much value in the ed as a paramedic. i would rather give the nurses the benefit of the doubt that they do have value and their initial education allows them to expand easily into whatever area they choose. the paramedic is a very limited technical certificate (state license comes after getting the cert) that focuses on prehospital emergency care and a limited number of emergencies that might be alleviated by rapid treatment. it does not cover all emergencies which can not be readily identified or treated which is also due to limited time and equipment in the field as well as education in the u.s. there are other countries that are definitely exceptions.

we can do more than a nurse but dont get paid as much or get any respect from the medical community due to the fact that we are "technically" trained rather than holding a degree. some states have associate degrees others dont.

people post statements like this but don't quantifiy or qualify their information. saying "some states" have a degree requirement is overstating it. oregon states a degree but also allows for exceptions for entry. that is about the only state that comes close to requiring a degree.

just because every rn does not do what they are fully capable of by their state scope does not make them less of an rn. if they get a job that requires them to intubate, they intubate. if they get a job in an ed that requires them to be cross trained for icu holding to manage multiple drips, ventilators, iabps, various lines for monitoring, evds or whatever, they do it. to say a nurse does not or can not do more than a paramedic is a misrepresentation and a gross understatement of what a nurse is capable of. however, go to any state ems website and you will see it spells out exactly what skills and what medications a paramedic is allowed to handle. i being realistic from an ems point of view in saying paramedics are not ready to step up to the full responsibities of working in an ed like a nurse due to the inconsistencies and limitations of the education and training. i don't need to consult with a nursing association for that. those in ems should be aware of their own associations and advocacy groups to understand what has yet to be accomplished and shortcuts with more titles will not get that done.

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Specializes in Oncology; medical specialty website.

I fail to understand why people who aren't nurses come to nursing forums with the intent of stirring up controversy.

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I fail to understand why people who aren't nurses come to nursing forums with the intent of stirring up controversy.

Maybe it is unfortunate to some that each health care profession isn't an island and then could ignor all the others.

However, it wouldn't be controversial if some would know a little bit about each profession their are trying to discuss.

For EMS (and nurses also):

Look at the state website. It will list the different levels and what the minimum education requirements are for each level. Just because one college in your state offers a Bachelors degree in EMS does not mean that is the entry level requirement.

There may be wording in the licensure definition that clearly states "license for prehospital". This can be interpreted into legal terms and why in many states hospitals have the title of ED Tech with a very defined job description rather than Paramedic. However, there are also a couple of states that have recently amended their statutes to allow Paramedics function under their own title in the ED with an expanded scope.

This wording also extends to the definition of an emergency vehicle as far an RNs are concerned. A Paramedic on every ambulance licensed for emergencies was and still is the wording in many states. However, there are states that allow RNs to function in EMS under their own license under a medical director such as in very rural areas. There are also a couple of states with PHRNs. SCT, CCT and Flight fall into a different category and the statutes may have been written to be more specific to scene response.

Also, just because your state scope of practice says you can do certain things does not mean you can in the field. The medical director will determine what your protocols will be in the field.

You should watch the websites of state and national associations to see exactly what is happening in your profession.

EMS providers must also take responsibility for their own profession and stop blaminng the nursing profession for the shortcomings of their own.

If you don't know the minimum requirements for entry or what the state statutes for your own profession state about specific working situations, it is very difficult to present a valid argument.

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Specializes in Oncology; medical specialty website.
Maybe it is unfortunate to some that each health care profession isn't an island and then could ignor all the others.

However, it wouldn't be controversial if some would know a little bit about each profession their are trying to discuss.

For EMS (and nurses also):

Look at the state website. It will list the different levels and what the minimum education requirements are for each level. Just because one college in your state offers a Bachelors degree in EMS does not mean that is the entry level requirement.

There may be wording in the licensure definition that clearly states "license for prehospital". This can be interpreted into legal terms and why in many states hospitals have the title of ED Tech with a very defined job description rather than Paramedic. However, there are also a couple of states that have recently amended their statutes to allow Paramedics function under their own title in the ED with an expanded scope.

This wording also extends to the definition of an emergency vehicle as far an RNs are concerned. A Paramedic on every ambulance licensed for emergencies was and still is the wording in many states. However, there are states that allow RNs to function in EMS under their own license under a medical director such as in very rural areas. There are also a couple of states with PHRNs. SCT, CCT and Flight fall into a different category and the statutes may have been written to be more specific to scene response.

Also, just because your state scope of practice says you can do certain things does not mean you can in the field. The medical director will determine what your protocols will be in the field.

You should watch the websites of state and national associations to see exactly what is happening in your profession.

EMS providers must also take responsibility for their own profession and stop blaminng the nursing profession for the shortcomings of their own.

If you don't know the minimum requirements for entry or what the state statutes for your own profession state about specific working situations, it is very difficult to present a valid argument.

You need not educate me on my scope of practice. I'm well aware of what is required of me.

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Okay, let me respond this.

How/why are you combining initial pre-certification education and continuing education after initial certification?'

That's like trying to roll post-licensure continuing ed requirements for RNs into the diploma/ADN/BSN debate. It makes no sense.

The other poster was saying after her husband obtained a cert as a Paramedic he continued learning through continuing education or CEUs. My point is that CEUs are required by almost every licensed profession but are not the equivalent of obtaining a degree. You can take ACLS as many times as you want but it will not get you a Bachelors degree.

No, I don't see the relevance, as the previous poster stated that the program she was discussing was nearly one year in length for full-time students. She did not state that it was 1000 hours.

A college program can offer a cert for Paramedic in 2 or 3 semesters. On a semester hour system 12 credit hours may be considered "full time". For the summer, 9 credit hours might be full time if the session is 12 weeks instead of 16. For a tech school program, FT can be anywhere from 24 - 40 clock hours. The semester hour is actually easier to transfer than a clock hour. It might take some 5 years to complete a 70 semester hour AS degree and others 18 months by increasing their load. However, the end result of the degree is the same. The college programs at 33 - 45 semester credit hours for a Paramedic cert are a little better measured for transferable hours and those that are less than 45 semester are probably just doing the bare minimum. If a college program actually requires prerequisites such as college level A&P and raises that semester credit hour total with transferable hours, even better. Those who have an A&P class measured in clock hours as part of their Paramedic program may find it will transfer to nowhere and this is also why many Paramedics do not go on for a college degree after a cert at a tech school.

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You need not educate me on my scope of practice. I'm well aware of what is required of me.

Now you are just being argumentative and defensive. What about my advice to research the profession being discussed is offensive to you? Looking through this forum I see numerous threads where nurses are asking for advice that might be found under the BON site. Some may not know where to look and some may take some things for granted. However, when some claim entitlement but don't know their own statutes and limitations under the regulations, it is hard to put up a valid argument for their cause.

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Specializes in Oncology; medical specialty website.
Now you are just being argumentative and defensive. What about my advice to research the profession being discussed is offensive to you? Looking through this forum I see numerous threads where nurses are asking for advice that might be found under the BON site. Some may not know where to look and some may take some things for granted. However, when some claim entitlement but don't know their own statutes and limitations under the regulations, it is hard to put up a valid argument for their cause.

You, as a non-nurse, do not need to educate me, a nurse with 25 years of experience, about my profession. Your presumptuousness is offensive. You need to know your audience before you speak.

BTW, I am more than familiar with where to find my BON website.

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