Opportunities for RNs in the Field

I just recently gratuated from school and am working on finishing up my orientation in the ICU. I am interested in getting some field experience on my days off. Does anybody have any suggestions on how to go about getting quick and dirty field experience? Thanks.

Take an Emergency Medical Technician class and work as an EMT in an ambulance on your off days (preferrably for a city/town service or a service that does a lot of emergency work). The EMT class is about 120-150 hours long and is challenging, but definately not impossible. Contact the Office of Emergency Medical Services in your state (I think I read that you're from Texas) for info on class locations. The website is http://www.tdh.state.tx.us/hcqs/ems/emshome.htm

Also, once you gain some experience on an ambulance, you might then be eligible to challenge the EMT-Paramedic exam (because you're an RN). That is, depending on your state's policy. I don't know about Texas, but where I come from (Massachusetts), RN's who are EMT's (and who have completed other skill training requirements) can challenge the Paramedic exam. There are at least a handful of other states that have some sort of provision like this Hope this info helps.

Best of Luck,

Ian

Eric, you are where I was 3 years ago. After a while in the unit (1 year after orientation) I wanted to go outside the doors of the hospital and get knee-deep into EMS or flight to add some diversity / get out on my own. I can tell you what worked for me and hopefullly something will carry over to your situation. Get involved with continuing education with a local EMS company, the one near me actually had a training center and did not only in-house requirements for their company, but also taught EMT and Paramedic courses, and also ACLS, PALS. I am sure your hospital does continuing education, but I preferred to take my reqs with the EMS company. It is a different style of teaching and I really enjoyed the engaging converstation. Take TNCC (Trauma Nurse Core Certification) as soon as you can.

What really stinks about your situation is that it will take time. I was two years out of school, working everyday in the units and EDs, and the PR lady for the EMS company (who happened to be a flight nurse) approached me about working for their critical care ground transport (very large ICU transport ambulance). I was required to take TNCC and something called CCEMT-P (critical care emergency medical transport-provider). The latter teaches transport for very sick pts, but I think requires 2 years critical care experience. The link is:

http://www.mcg.edu/ems/ccemtp/index.htm

Don't worry, it is taught at various sites, but is put on by UMBC, find out when you may can take this.

Finding a PHTLS (prehospital trauma life support) class would not be a bad idea.

Something else to consider: Instead of going to a very hour-intensive EMT course while trying to work in the unit at the same time, check out the following at Creighton University:

http://ems.creighton.edu/courses.edu

Go to a one-week ($300) EMT-B certification. Have in place ACLS, BLS and current EMT cert and take the 2 week course for RN to Paramedic ($1500).

This sounds bad, but most flight programs will not consider you unless you have 3-5 years ED experience. Sadly, this will take some time to formulate. What worked for me and might for you is to get involved with local EMS, take all the classes you can, become a recognized face with them and that you know your stuff, and try to get into ground transport. This will open the doors for flight alot easier than trying to bust down all the doors at once.

I hope this helps, feel free to PM me if you need anything else. The only thing I don't know is how Creighton grads go about securing national registery (EMT or Paramedic) so that your license is good everywhere. Perhaps someone else can answer this question.

I think that Creighton grads are eligible to sit for the national registry exam. If you complete their program, you should be able to take the registry. By the way, I hear that their abbreviated program is super intense, as I guess it should be considering its length. If you want it and you are comfortable with your clinical skills, this would probably be a good way to go. The Creighton website should answer any questions you may have. Good luck!

Hey rn29306, are you talking about the CCEMT-P program at Puckett with Kate? If so, I went through the same course in Oct/Nov 2003. I thought it was an awesome class. I highly recommend it to anyone hoping to enter critical care transport.

I think that Creighton grads are eligible to sit for the national registry exam. If you complete their program, you should be able to take the registry. By the way, I hear that their abbreviated program is super intense, as I guess it should be considering its length. If you want it and you are comfortable with your clinical skills, this would probably be a good way to go. The Creighton website should answer any questions you may have. Good luck!

Hey rn29306, are you talking about the CCEMT-P program at Puckett with Kate? If so, I went through the same course in Oct/Nov 2003. I thought it was an awesome class. I highly recommend it to anyone hoping to enter critical care transport.

Let's all hold hands and sing "Its a small world after all". That means you and I were in the same class. I ended up working with them on MIC1. I'm going to PM you.

With regards to the RN to EMT-B and EMT-P courses taught at Creighton, you take the national registry exam and practicals on the last day of each course. As a Creighton BSN grad and having taken their RN to EMT-B course I cannot say enough positive things about the university or the EMS program.

Thank you all for responding to my post, rn209306 you are very thorough. I am considering the class that you speak of for Basic EMT certification. One of my patients, an EMT for a local fire department told me that as an RN I just needed to submit an application to the fire department. He said that they would teach all the field skills I needed to know on the job. This was surprising to me, not sure how accurate this information was.

Eric,

As a Licensed Paramedic in Texas, I can tell you that there's not an easy way for you to just jump into the field. I wish I had better news for you , but Texas generally does not allow nurses to work on an ambulance (with the exception of inter-facility transports) without having a pre-hospital certification or license, and nurses are not elligible to challenge the National Registry (which is the only way to get initial certification/licensure now in Texas). I believe Texas used to allow nurses to challenge the exam, but with more and more services opting for aggressive protocols (central lines, RSI, even tube thoracostomy), RN education alone just can't be considered adequate anymore.

HALO Flight in Corpus Christi does hire nurses, but I believe they must have some level of pre-hospital certification/licensure, and several years of ED/ICU experience.

Del Mar College in Corpus Christi offers a night EMT class that is two nights a week I believe. What might happen is that if you get your EMT certificate, you can ask a service's medical director to approve more skills for you (the things you have been trained to do). Texas tends to give medical directors carte blanche in that regard.

"and nurses are not elligible to challenge the National Registry"

Nurses are allowed to challenge the National Registry Paramedic exam.

You need to have your National Registry EMT-B card. Call the National Registry number (find it on the web) and tell them you are a RN interested in challenging the exam. They have a specific person you will speak with. You can challenge the EMT-B as an RN and Challenge the EMT-P as an RN with a emt-B card. There are several states where you can challenge as well SC, and Mass are two.

Several of our nurses in our ED and ICU as well as some flight nurses have done this. Now that being said I have to say that I don't agree with it at all. I have been a paramedic for 18 years and an RN for 14 years. They are two seperate fields. A nurse has no buisness out on the streets as a "paper medic". I think one has to look at the reason they want to become a medic. Is it just to make yourself look more marketable to a flight team etc? Or is one trying to better themselves in the pre-hospital field (where you would be much better served going to paramedic school and learning the right way). I hate to be on a soap box but I have seen so many nurses become paper medics to jump around the EMS rules. The experience I learned by spending my time on the "box" became invaluable to me in my flight position. After 8 years I am weaning out of the flight arena and into anesthesia school where once again I find my EMT-P training putting well ahead of my classmates. Think long and hard about your goals and ways to accomplish them

qanik (Brent)

Actually, you are mistaken. Nurses cannot challenge the NREMT-P exam by virtue of their RN license. They can apply to have their credentials evaluated at a college/university for possible credit toward paramedic educational requirements, but it is assinine to think that the NREMT would allow people who might not have had any training in such things as advanced airway management (or any prehospital training at all for that matter) to sit for the Paramedic exam. Here is a link to their requirements: http://www.nremt.org/EMTServices/reg_para_history.asp

OK I do not want to get into a pissing match with anyone. For those nurse wishing to pursue this avenue ( I already stated I don't agree with it) this is what you need to do.

Call The NREMT national office- 1-614-888-4484 ask for Brandy(spoke with her at 09:00 this A.M.) and tell her you are an RN with an EMT-B cert and you wish to challenge the NREMT-P. She will walk you through the process which is as follows-

Must have valid State RN

Must have valid/current EMT-B card

Must have Valid current CPR card

Must get a letter from the local medical director saying that they support you taking the exam.

Pay the $20.00

Once approved you have to schedule the exam and obviuosly pass both parts

That is it. I will not argue the point just call for yourself. We have had 4 RN's in our hospital obtain thier NREMT-P this way and my old program in Mass had all the RN's get thier cards this way.

Brent

Just wondering..how can an RN challenge the Paramedic exam when Paramedics actually performance advanced airway mgmt? Are nurses learning intubation techniques in RN programs?

I work in AZ doing interfacility xport (like a mobile ICU)

We do get EMS calls (chest pain at a nursing home) when the medics are busy...And pass by MVAs/traumas, and are required to respond (Note: I know MY limitations...9 years as an ER RN, does not a paramedic make)

In AZ, medics can't xport a pt on PEEP, on diprovan, levophed, and a few other IV meds.

And Phoenix is a big enough city, that for insurance reasons or specialty needs, pt's often require an RN xport...

The board says we can do what EMTs and medics do, as long as our company trains us

I have been trained in C-spine, central line placement, and intubation...

I have offline protocols (standing orders) from my base hospital (actually the same protcols that Phoenix Fire uses)

I love the job...

Many RNs think it's not real nursing, but I laugh at them when I take a patient to their already overcrowded ER, give report, and the go grocery shopping ON THE CLOCK...

Respect ALL RNs, no matter what they do (AND respect the EMTs and medics...try starting an IV in a moving ambulance, it's NOT as easy as all you ER nurses think that it is)

And I have also set up the RN ambulance as a clinical site for Grand Canyon University's accelerated RN program (I am a clinical instructor)

We all wish we could have done a ride-along instead of wiping a butt or passing a pill (your head to toe has to be done in about 10-20 minutes)

Interfacility RN xport is important work!

sean