Paramedic to ER Nurse

hospitalstaph · Sep 16, 2007

Depending on where you go, you will likely find that the "nursy" things that you describe are usually done by techs. (not always but often) And to be honest I have NEVER given a traditional bed bath to a pt in the ER. Cleaned them up yes, but not the bed bath taught in school.

If you are comfortable with everything that you decribed, I am sure you do just fine. Just remember that you may have many years of pt care experience but you will be new to ER nursing. Even if you have done something a million times, if someone offers to show you, take them up on it. I have changed the way I do things lots of times just based on watching how someone else does it. Learning never stops and besides your new co-workers will appreciate your desire to learn "their" way of doing things, whether you use it or not.

Best of luck to you:))))

littleRNthatcould · Sep 17, 2007

I think the biggest obstacle you will have is losing your autonomy. That's not to say that ER nurses are not expected to think and do on the fly, it's just more so in the field I'd figure.

I wish you the best of luck and I'm sure you'll make the transition beautifully!:nuke:

rachelgp · Sep 18, 2007

I think the biggest obstacle you will have is losing your autonomy. That's not to say that ER nurses are not expected to think and do on the fly, it's just more so in the field I'd figure.
I agree. Losing some autonomy is hard. Not only that, but learning to juggle patients is difficult, too. Those have been the two hardest things for me so far. As a medic, you do sometimes have more than one patient, but not very often. And if you do, they're much closer together :-) Being a street medic is good experience for you, though. You just can't beat it for learning critical thinking skills!

bigsyis · Sep 20, 2007

I think the biggest obstacle you will have is losing your autonomy. That's not to say that ER nurses are not expected to think and do on the fly, it's just more so in the field I'd figure.
I wish you the best of luck and I'm sure you'll make the transition beautifully!:nuke:

When you are used to following your own initiative and Protocols that you have memorized from using them so often, it may be difficult to ask the MD what he thinks about...(whatever) and whether you can do so and so. Initiative is a great thing, but I would caution you not to develop "Paragoditis"-the dreaded disease that most ERPs hate.

You also may be resentful and irritated with the very slow and methodical pace that some nurses use in the ER. Sometimes you want to say, "get out of the way, I'll do it myself." It is a fact of life-some people are just more deliberate in their actions, while those of us who like to fly by the seat of our pants stand there and stew, waiting to make our move-knowhatImean?

You will probably be a superb nurse with your experience and training. Go for it!

amberfnp · Sep 22, 2007

Hi rigmedic. I agree that some loss of autonomy may be an issue as well.

Your post caught my eye as my husband is thinking of getting his RN as well. I think he would make a wonder ER, ICU or flight nurse. He has great skills and loves to teach.

Good luck and keep up your posts! Would love to know how it's going.

edprincess · Sep 22, 2007

I too agree, between losing your autonomy and multi-tasking several pts are going to be your biggest things. You'll learn - as you have as a medic - that some docs are more leanient than others and will / won't let you do your own thing. Most ER docs trust the ER nurses and trust their judgement. Of course there are a few....

Your other obstacle is that you'll have continuing care. Esp those annoying pts...no more just dumbing and going. They're YOUR pt now. Oh the drunks and the fiesty elderly. Oh what fun.

And Hospitalstaph is right, no bedbaths in the ER. Foley's and bedpans yes but you get used to it. It's no big deal. You'll adjust just fine. Good luck!

CraigB-RN, MSN, RN · Sep 22, 2007

I think the biggest obstacle you will have is losing your autonomy. That's not to say that ER nurses are not expected to think and do on the fly, it's just more so in the field I'd figure.
I agree. Losing some autonomy is hard. Not only that, but learning to juggle patients is difficult, too. Those have been the two hardest things for me so far. As a medic, you do sometimes have more than one patient, but not very often. And if you do, they're much closer together :-) Being a street medic is good experience for you, though. You just can't beat it for learning critical thinking skills!
Actually the autonaomy issue may not be much of an issue. Depending on were you wor as a medic and were you work ar an RN. I spent the past year at a large teaching hospital. I could order CT's based on protocols in some cases. The responsibilty of being an example and teaching both nursing staff an jr medical staff far out weighs any thing I "MIGHT" have lost in autonomy. Besides, after some time as an ER nurse combined with you Medic, you could look into flight nurses. Again depending were you are, you can have pretty much all the autonomy you can grab and handle.
THe difference between medic and RN are actually pretty small, Despite what some in the established nurse pool would have us all believe. What changed in me when I made the transition from Medic to RN was that I started to think of the bigger picture. What happens after I discharge the patient and not about what I needed to do to get the patient alive to the hospital.
Welcome to the fold of Paramedics to Nurses. There are a lot of us out there. Personally I think we make the best ER nurses.
P.S. The ability to take calm control of a scene works the same as a nurse as it oes pre-hospital
P.P.S - Don't let your medic cert go if you can at all help it.

Editorial Team / Moderator · Sep 24, 2007

What changed in me when I made the transition from Medic to RN was that I started to think of the bigger picture. What happens after I discharge the patient and not about what I needed to do to get the patient alive to the hospital.

I'm a paramedic and I work as a tech in an ED, and I totally agree with this. A personal example: I was telling our charge nurse that the EMS ET tube holders were better than what we use in the ED -- the EMS ones are more firm and durable, hold the tube better, etc. He replied that our ET tube holders probably wouldn't cause as much skin irritation/breakdown in the long run, as opposed to the EMS ET tube holders. It was a small "a-ha" moment for me -- that we have to think of the patient in the longer-term vs. the arrive-alive.

I should be finished with my ADN this spring (*fingers crossed*), and I have a standing employment offer from my nurse manager to work as an RN in our ED. I can't wait! And I'm still going to keep my EMT-P (I've been a volunteer since 2003).

edprincess · Sep 24, 2007

Dear Lunah

Yes, there are a lot of those moments that are going to happen. Most hospitals will d/c the medics iv site (on the floors never in the ER) nor will they draw blood off of them. Phlebitis and infiltration seems to happen more often for some reason. Also using different drugs, using amiodorone instead if Lido (now that you'll have time to give it). You'll do fine in nursing school and on the boards. You have the drive and knowledge. Good luck.

Editorial Team / Moderator · Sep 24, 2007

You'll do fine in nursing school and on the boards. You have the drive and knowledge. Good luck.

Thanks, I really appreciate that! :) I know that working in the ED has definitely made me a better medic, too. (Although I do get the occasional hairy eyeball from my medic partner when I use nasal cannulas instead of non-rebreathers in the field ... he tells me the ED has ruined me. I just can't bring myself to blast everyone with O2 @ 15 LPM! Sure, some need it, but not everyone.)

Dallas_RN, BSN, EMT-P · Sep 27, 2007

Like the others stated autonomy issues were the biggest for me. The BEST nurses I know are prior Paramedics.Good luck to you. :)

-Corey

Level I Trauma R.N./EMT-P