Paramedic to RN

L2750 · Jan 25, 2005

I am once again goint to be a nursing student. I atempted NSg courses about 3 yrs ago but due to having kids and all I had to quit. Thought I would have to repeat everything so I went to become a Paramedic. They say tht I am not a good Paramedic because I think too much like a nurse. I disagree with the idea of restraining people to intubate them, except for burn victims or, head bleeds that are combative, something like that. I don't think that a chronic GI bleed requires 2 lines of LR, ect.. I would love to keep my current job and go to school at the same time, but I could never physically attend classes, we are mandated all the time. I am looking for a NA position at a hospital, but I am not sure where in the hospital would be best for me. i am hoping that you can give a little advice, or a lot 'cause i need it. I don't want to work in the ER because I would have to see the people I work with now and they are going to be upset when I quit. More OT for them. Where do you think I could go in the hospital to "fit IN" the best? Should I tell anyone there that I am a paramedic or just play dumb? What are some ways that I could best transition from working almost independently to being back in the hospital setting? Any feedback at all would be greatly appreciated.

Medic2RN, BSN, RN, EMT-P · Jan 28, 2005

Sorry to get off the topic of your question......but why are you restraining a patient in order to intubate them? :confused:

Mags4711, RN · Jan 28, 2005

Try the Surgical ICU or a Trauma ICU if your hospital has one. Those would give you the broadest experiences. Not only would you get time management skills, but you would be exposed to surgical and medical diagnoses. If you were to work in a Medical or Coronary ICU, you may get a narrow sampling of disease conditions. One of my favorite quotes is: "trauma doesn't discriminate." I have had a post-op heart transplant get hit by a semi about two weeks after his d/c for his txpt.

paraloco · Jan 28, 2005

Sorry to get off the topic of your question......but why are you restraining a patient in order to intubate them?

That perked me up too! If I have a combative head-injured patient, a combative patient in fulminating pulmonary edema, whatever, the only restraint necessary might be until the IV is secured, and I can sedate, then paralyze them. I don't do it just because I can, or because its 'cool' or 'b*tchin'. I had a 14 year old in status epilepticus. Even after the valium stopped the seizure, he was clenching his teeth, was choking on secretions that I couldn't get at with a Yankeur tip. I nasally intubated him, transported without incident, and he was discharged later in the day, rather than being in ICU on a vent like he would have been if I had RSI'd him.

L2750 · Jan 28, 2005

we don't have RSI here. Our docs wouldn't let us sedate anybody anyway. we can use Ativan for status seizure, only after we call first. the service I work for intubates alot of people. they tell me they are aggressive. they intubate drunks all the time. i get into trouble for not doing it, they ask how i knew the pt wasn't going to vomit and then aspirate. I tell them that if they are conscious enough to fight painful stimuli, their gag reflex should be in tact. They don't like my answer and say that I am not aggressive enough. As for reasons to restrain and intubate, the other post mentioned some of them. The only other good one I can think of is anaphalaxis or asthma when their airway is closing and they are literally fighting to breathe, I can not sedate. Benadryl (per protocol) is iv for adults. If they are that bad I would want to restrain and intubate first, rather than give benadryl once airway is closed can't wait for it to open to get a tube. Oh, have to call a Supervisor to came and do a needle cricothyrodotomy, so that is not a viable option either. Maybe it is our protocols, that are really bad.

BETSRN · Jan 30, 2005

I am once again goint to be a nursing student. I atempted NSg courses about 3 yrs ago but due to having kids and all I had to quit. Thought I would have to repeat everything so I went to become a Paramedic. They say tht I am not a good Paramedic because I think too much like a nurse. I disagree with the idea of restraining people to intubate them, except for burn victims or, head bleeds that are combative, something like that. I don't think that a chronic GI bleed requires 2 lines of LR, ect.. I would love to keep my current job and go to school at the same time, but I could never physically attend classes, we are mandated all the time. I am looking for a NA position at a hospital, but I am not sure where in the hospital would be best for me. i am hoping that you can give a little advice, or a lot 'cause i need it. I don't want to work in the ER because I would have to see the people I work with now and they are going to be upset when I quit. More OT for them. Where do you think I could go in the hospital to "fit IN" the best? Should I tell anyone there that I am a paramedic or just play dumb? What are some ways that I could best transition from working almost independently to being back in the hospital setting? Any feedback at all would be greatly appreciated.

Bottom line is that paramedic training is specific to a certain type of work. When and if you are back in the hospital as a CNA(for instance) those are your duties and nothing else. You can NOT function outside of your role. It won't matter if you thik that a GI bleeder does not need two lines of LR. Of course, your observations as an ex paramedic will be very useful, as long as you do not overstep your bounds with the nurses (in particular).

You sounds like a bright person. I think you will be frustrated being a CNA. If you can afford to just go to nursing school, personally I think you wil be better off. Good luck.