paramedic nursing

magilassalvacion · Jun 30, 2007

what are the differences and similarities of a Nurse and a Paramedic... please forgive me to ask a very straight forward question... is a nurse higher in a degree over the paramedics???

I am a nurse in the philippines... would like to know... whatis the policies, protocols and culture all over the world. thank you

APNgonnabe · Jun 30, 2007

As many people have done I'd like to ad my two cents( or one as it maybe). I believe TraumaRN was correct in finding the reason that we are all here and that is to provide excellent pt care. I do believe that an RN can transition to the role of the paramedic w/o actually taking the paramedic class. I may be a little bias since I am currently completing my PHRN. I would like to ad that i have been an EMTB for 5yrs knowing that i would eventually go for PHRN as my goal was to be an RN. If people have the right training like i feel I have had by attending the EMTP CEU's, PHRN class taught by paramedic instructors. PHRN's can be very effective and good. All of course IMHO

KenCCRN · Sep 26, 2007

I am Police Inspector Magilas S. Salvacion, RN. currently employed here in the philippines as a Nurse in the Philippine National Police. I have red your EMail in the ALLNURSES web site. Good day sir. I would like to ask you, or any body who can read this email... is really possible for a nurse to be do the job of the EMT-P. Thank you.

In my state of NJ if you are a nurse with some emergency and or critical care background and also an EMT-B you can be sponsored to ride with the medics for at least 200 hours and become an MICN which is a Mobile Intensive Care Nurse. This is the equivalent of being a Paramedic and answering 911 calls. Athough some Medics would disagree with that....hehe...

Ken

JCPuros · Dec 1, 2007

i have a different take on this i guess. after the better part of 2 decades in ems, working with nurses in the streets, in the air and recently as a nicu nurse myself, i have come to conclusion that the comparison of rn to paramedic is like comparing a plumber to an electrician. both work toward building a house and understand large parts of each others jobs truly can't do each others jobs without more training. granted, the training would be abbreviated.

the biggest problem in paramedicine is a lack of understanding of what exactly we do and where we fit in the world of medicine not only by others but by paramedics ourselves. as it is the same in any profession where a gap in service is filled with specifically trained personnel. until we are able to have a no bs comin' to jesus and establish ourselves as a separate and stand alone field, these questions will continue to arise. it is up to medics to fix this. we have grown and have been come and very important link in the care of the public. i think we can start with the term "pre-hospital"; it is antique and needs to drop from our vocab. we aren't prepping them for hospital care anymore that the said electrician is prepping for the plummer. we are providing emergency treatment, emergency management and extrication of sick and injured. as with the electrician and plumbers, we are the medic’s and rn's that are part of the whole that is the house of the complete patient picture.

dutchief · Aug 7, 2008

Michigan approved an RN to EMT and RN to Paramedic Curriculum in November of 2007. The Great Lakes EMS Academy has presented both courses with great success. They now have RN to EMT courses every October - December. Then Nurses are required to have ER or ICU experience. The classes meet on Thursdays and Fridays every other week. The Paramedic course runs from January through April (followed by an internship) on the same days.

GilaRRT · Aug 10, 2008

As many people have done I'd like to ad my two cents( or one as it maybe). I believe TraumaRN was correct in finding the reason that we are all here and that is to provide excellent pt care. I do believe that an RN can transition to the role of the paramedic w/o actually taking the paramedic class. I may be a little bias since I am currently completing my PHRN. I would like to ad that i have been an EMTB for 5yrs knowing that i would eventually go for PHRN as my goal was to be an RN. If people have the right training like i feel I have had by attending the EMTP CEU's, PHRN class taught by paramedic instructors. PHRN's can be very effective and good. All of course IMHO

Agree and disagree with your stance. First, I think it is possible for most anybody to learn how to do anything with proper education and motivation. I disagree that RN's can transition into the pre-hospital role without some type of paramedic course or transitional course. I am not sure what is required for PHRN licensure in your state, so the course may actually mirror some of the paramedic bridge courses offered.

However, we simply cannot take an RN out of the ER or ICU and expect him/her to function as a pre-hospital leader. This is exactly the role of a paramedic. On the other hand, I believe the same is true of paramedics who think they can function as RN's. Even core concepts of pre-hospital care such as scene size up and the incident command structure are simply not part of nursing education. In addition, we have to worry about scene safety issues, mass casualty incidents, triage (yes, this is different from ER triage) extrication, advanced airway management, and a different process for making patient care decisions. Even something as simple as pulling somebody out of a car can be complicated. What dangers exist, how do we use cribbing to stabilize the vehicle, how do we deal with airbags (The days of disconnecting the car battery to cut power to the air bag are over. We now have to worry about multiple airbag locations and many often have their own power supply and can pose a significant problem for extrication), what tools and techniques are required, how do we protect the patient, how do we care for the patient with prolonged extrication, can we take time to go slow or is a rapid extrication required? These and several more concepts all go into our scene management and decision making.

While I think the RN can transition into the pre-hospital role, a strict well structured program is required to properly transition the RN into this role. I am not sure some of these two week shake and bake programs are adequate.

Trauma Columnist · Aug 10, 2008

I live in IL and am a licensed pre-hospital RN at the ALS level. Don't know if other states have this, but it is up to the medical director at the EMS level to decide on qualifications. I had 4 years as a level one staff RN when I became a PHRN.

APNgonnabe · Aug 18, 2008

Gila,

I spoke on the bias opinion only thinking about my training.

GilaRRT · Aug 18, 2008

Not sure I understand your statement. I am a little dense at times. Again, I am not sure what is required for PHRN credentials in your state. You very well may have completed an intense program that prepares you for pre-hospital work.

APNgonnabe · Nov 20, 2008

In Illinois the RN is expected to have "clinical experience" to be determined by the agency providing the course, trauma cert one of(TNS, TNCC, PHTLS), ACLS, PALS or PEPP, emtb competency (done in class), at least 10 als runs or more if preceptor feels you needed it.

Gila if you do not think that being an EMT-B on a ALS rig qualifies as a transition into being an ALS provider what would. Furthermore I did tell you that the current way PHRN is being taught may not give your average RN the right training, however, many of the RNs that take it are not your average RN. You say that you were not questioning my abilities but yes you are by questioning my training. While I understand that that was all said IMHO you can not just going around saying that you dont question someone abilities and make statements that you do nor can you say that you are not opposed to PHRN when you apparently are by previous post.

If you are across the pond supporting us I thank you.

GilaRRT · Nov 20, 2008

I do not think EMT-B alone, even on an ALS unit qualifies an RN to transition into a paramedic type role. Again, I do think EMT-B provides experience. Especially, with with an RN who has no EMS experience.

A comprehensive program that consists of several weeks of didactic and clinical experience would be my idea of an optimal transition program. You may in fact have completed such a program.

In addition, I did not question your training. I stated in my PM that I know of places where RN's could complete the requirements to work in the field in as little as a week. This concerns me. Never did I question you personally, I am concerned about the system as a whole. I hope that would have been obvious.

Once again, I am not opposed to RN's working in EMS; however, I want to be sure we are adequately preparing the said RN's to transition into a new role.

APNgonnabe · Nov 20, 2008

You are questioning my training as I did complete it in less than a week didactic only.

I understand that you are questioning the system...but I am a produce of it.