Paramedic to ED RN

trackhead, APRN · Oct 29, 2014

I was a medic for a few years in an ER, working with an expanded scope of practice (we were essentially nurses), then became an RN. I learned almost nothing in nursing school that I didn't already know from my experience as an ER medic.

Being an ER tech would be invaluable not to your education, but more toward real life work in the ER. I'm obviously not a fan of education as the answer to competency.

BR157 · Oct 29, 2014

Being an ER Tech is definitely beneficial as long as you aren't just a nursing assistant. At least you have a better chance of getting hired as an RN in that hospital. I hear in California it can take over 2 years for a new grad to find a job even with a BSN.

We just got our Community Paramedic program going which is also a great way to get to know the hospital staff if you can get into something like that if the ER is not an option.

It is doubtful being a Paramedic will help with admissions. Quite a few Paramedics start the nursing program and drop out when they think the education is fairly useless. The schools look at GPA a lot.

I was a medic for a few years in an ER, working with an expanded scope of practice (we were essentially nurses), then became an RN. I learned almost nothing in nursing school that I didn't already know from my experience as an ER medic.
Being an ER tech would be invaluable not to your education, but more toward real life work in the ER. I'm obviously not a fan of education as the answer to competency.

That sounds like a great ER to work in for a Paramedic. Are you allowed to do all of the same meds as the RN including blood and insulin drips? What about art sticks and ventilator management? I would really like to hear your experiences in that area. The Paramedics in the ER here will be taking over all the RT stuff in a couple of months which will include not only the ER but also responding to the codes and rapid responses on the floors. The Paramedics will be getting an iSTAT in the ER to run labs which they can also take on the codes. This will include arterial sticks and ABGs since the Paramedics will be doing intubation and ventilator management. They are still limited on the meds they can give but that could change also very soon. If they are managing the ventilator there is no reason they can not be primary and do all the meds for that patient. Hopefully they will also get their foot into the ICUs at least for the RT duties.

trackhead, APRN · Oct 29, 2014

That sounds like a great ER to work in for a Paramedic. Are you allowed to do all of the same meds as the RN including blood and insulin drips? What about art sticks and ventilator management?

This was work I did from 1997-1999. They phased out medics in this role, but yes, I did insulin drips, heparin drips, everything RN's did. I had to have some things double checked, just as I have to do as an RN now. We did the same scope of practice as RN's, just got paid really crappy. But regardless, that experience was invaluable to me as an ER RN.

Either way, some of the best RN's I've worked with were previously ER techs.

zmansc, ASN, RN · Oct 29, 2014

I can't give you specifics regarding SC, but we have had several ex paragods, er, paramedics go through our local RN program and then come work in the ER. One had to go to the floor first, then after one year transferred to the ED. That was just because the ED didn't have enough openings for her when she graduated. The others have come straight to the ED first. One, well, no one really liked him, he went to the ICU first, never seemed to be an opening in the ED for him.... He hasn't stuck in any department for more than a year yet, just sayin! So, moral of that, I don't think it's cut and dry that you will have to "pay your dues" somewhere else in the hospital.

ER Tech: About 1/2 of the local paramedics are employed by the hospital ambulance service, most of these and a good number of those employed by other services take PRN jobs as techs in our ER at some point in their career, so most of the folks I mentioned above had worked as techs in the ER. Was good for familiarity and building a network, helped some just to get a feel for what goes on after the pt is received and get more of a feeling of the day to day workflow in the ER. I would not say it was make or break, but certainly made the transition from paramedic/tech to RN much easier. We also have a fair number of EMT-I as techs, many of whom have chosen the RN route. The numbers are more split on which ones have come directly to the ED upon graduation and which ones have gone to the floor, just as a FYI. I'm sure this varies by hospital, so you might keep your eyes and ears open at the hospitals that you frequent.

I would think your question about admissions requirements and GPA would be a question for the schools you are looking at applying to. My local universities RN program awards points based on years of "quality" experience. So, my EMT experience got me a point or two, but the paramedic x20y in my class maxed out his experience points. I had a higher GPA than he did, but neither of us had to sweat getting into the program.

I think the most valuable thing you can do is to remain humble about what you know and what you don't know. There are many aspects of RN school that you will go into and think, I already know this better than what these yahoos are teaching it do. Well, they are trying to get everyone up to a certain level. Be patient, and you will find that there are many things that you will learn along the way. Like any program, much of what you learn is in the short amount of hands on time, don't try to skim through this, go in and do as much as you can, find ways to help out. You will learn a ton more than others will, and you will be demonstrating to potential employers your work ethic and value as a future employer. Don't think they aren't watching each and every student and evaluating you every day your at their facility! Third, have fun with it, it can be drudgery, monotonous, and tedious, but you can still have fun with it.

Good Luck!

Editorial Team / Moderator · Oct 30, 2014

I was an ED tech from early 2005 until mid-2008, when I graduated with my ADN/RN. The same ED where I was a tech offered me an ED RN position immediately along with a very awesome ED RN fellowship at our hospital system's Level 1, and my job interview was something like this: "We're not letting you leave." Get that ED tech job and make yourself an asset, the rest will come. But don't go in as a paramedic and tell all the RNs how you can already do their job with your paramedic education and experience - that is not helpful or productive. Yes, there is much overlap in our paramedic education and even in what we do, but you'll see that it's not quite the same thing (generally speaking, unless your ED uses paramedics exactly like RNs, which is rare but happens). Be humble and work hard. There is no reason to NOT go straight to the ED as a new grad, it can be done. Good luck!

Horsebytes · Oct 30, 2014

....
I think the most valuable thing you can do is to remain humble about what you know and what you don't know. There are many aspects of RN school that you will go into and think, I already know this better than what these yahoos are teaching it do. Well, they are trying to get everyone up to a certain level. Be patient, and you will find that there are many things that you will learn along the way.
...
Good Luck!

Yep,

I know a paramedic who failed out of nursing school because he was arrogant and insisted he knew more than his instructors. He would argue every test question that he got wrong etc.

Just as well, he would never have passed the NCLEX...

Eric_Medic · Oct 30, 2014

I just want to be clear that I am in no position to be arrogant or "know-it-all." I am eager to learn and improve both myself, my knowledge, and my patient care overall. Part of the reason I feel that moving into nursing is a good for for me is because of the difference in culture I have noticed. I feel like the role as an RN and the culture that is supported via that role speaks to me more than what I have experienced this far as a medic. I come in contact with arrogant medics all day. I also come in contact with arrogant nurses just the same. It's a two way street and it bothers me that there is this seeming hierarchy "I'm better than you" attitude. We are all in it to better the patient and patient advocacy should come first. Sometimes people get caught up in what they know or what they think they know and instead of advocating for the patient, they advocate for their position in being correct (which may or may not be right).

All I'm saying is I am not big headed or arrogant. I find humility is something that is extremely important in life regardless of career path.

Sorry for the tangent.

I appreciate everyone's responses thus far. I am looking into and have applied to ER tech spots. My goal is to get a spot as a tech hopefully at cottage in Santa Barbara and get into csuci BSN satellite program in Goleta.

Thanks again everyone!!

zmansc, ASN, RN · Oct 30, 2014

OP - I know I didn't intend to suggest you were coming across as arrogant, it's just something we all have seen and it doesn't work out for anyone. Sorry if I came across that way. As I said, and others have said, I think ED tech will be great for you in many ways, the biggest being: 1) You get more/different experience in the way the ER works when you aren't there. 2) You get to network and show your work ethic. Our ER is alot like pixie's, if we have a good tech that becomes an RN, you bet we are going to do everything we can to get that person hired into the ER. We don't want to loose someone who works hard!

Editorial Team / Moderator · Oct 30, 2014

What zmansc said - you didn't come across that way, but it happens often enough that we mention it, kind of a knee-jerk reaction. :)

Medic/Nurse, BSN, RN · Oct 30, 2014

Just follow your instinct on this one. I think you are 100% on the right track with ED Tech, ED Unit Clerk, etc. Experience there will get your foot I the door, make you a team player and a "known" quantity when it comes hiring time. Be open, be willing, work hard, learn and realize that every shift brings you closer to a new option. Options are great to have.

I spent a couple of years at the right hand of the ED docs as a unit clerk (16 hrs week for uber benefits) in addition to being a medic, teaching at the university level and wrapping up my Excelsior nursing.

I learned more sitting at their (the ER and consulting MDs) right hands (sometimes I asked way too many questions, might have been a PITA at times, but make no mistake if I was needed in some clinical fashion I acted immediately) than I would have learned in any other manner. Period. It was the best clinical education - I now knew the reasoning behind most every clinical decision.

I am eternally grateful for the education & opportunity I gleaned from being a UNIT SECRETARY. Yep, you read that right.

Once my EC RN was finished - I was hired without any question, interview - 6 weeks of "orientation" for a 12 hr RN spot in the ED as my initial RN job. I've had my pick of positions since. ED, CCU, Transport, Flight, Teaching

Good luck - I think you are on a very bright path! PM me anytime if you need to "chat".

AnnieOaklyRN, BSN, RN, EMT-P · Nov 1, 2014

I don't think the OP was asking about your past experiences with "arrogant" paramedics... lets not turn this into an argument/debate thread! I have met plenty of arrogant know it all nurses in both my paramedic and nursing career! IT GOES BOTH WAYS, trust me!!