Paramedic-turned-RN advice

[saraCOS]

So here's my dilemma. I am a paramedic, and (not bragging) a pretty darn good one. I have 12 years in EMS and 10 as a medic in busy 911 systems. I have a BS in health science, and I'm ready to advance, but I'm stuck. I spent a short amount of time looking around at public health and policy jobs, educator gigs, anything that would be the next step up, and found I was either underqualified, or that I would take a massive pay cut. There's no way I can pay for PA school on medic wages, but the path to DNP, or MSN seems much more manageable. All of these great jobs simply seem much more accessible to someone with a nursing license. So, I somewhat reluctantly have applied to an accelerated BSN program in my city. I am excited about the potential change and all of the amazing opportunities available to a BSN, but I'm a little nervous about the transition.

My questions are these: those of you who have made this transition from medic to RN, how different was the schooling? I know the philosophy is a bit different, was this a difficult change?

I have heard a rumor that the "old guard" in my future nursing program have historically rejected paramedics, likely because of bad experiences with trying to reprogram our arrogance:) Any tips on how to diffuse this in the interview? It seems pretty unfair.

Now that you are graduated and practicing, do you miss street medicine? Your autonomy? Your freedom? Or is it nice to have a lunch break and a bathroom and make a living wage?

I started out very optimistic, but am now not entirely sure if this is the right move. Some honest, constructive advice would be great.

If you have nothing but negative things to say about paramedics, you can keep them to yourself. This forum has enough trolls on it already.

[RunBabyRN]

I'm coming from a different, but in some ways similar, place.

I was a hospital corpsman in the Navy. I worked pretty independently, as I quickly earned the trust of the doctors with whom I worked. I was making a lot of medical decisions, performing minor procedures, and doing a lot of things that are no longer in my scope of practice.

However, the hardest thing for me was the shift in thinking from medical/first response stuff to nursing. You look at the patient differently, and it took me some time to shift my thinking (I kept my mind open, which kept me more successful than some other prior military members that have been in, and failed out of, our program). I really like the nursing approach, though I do miss some of the things I used to be able to do, and I do miss the autonomy. I look forward to being able to do them again once I do my master's (though I'm sure I'll learn how to do them differently).

It has been interesting learning more of the pathophysiology and the "whys" behind things I did in my previous life. Before it was, "See this, do that." Now I'm able to think more critically through the situation.

Two things I think that can REALLY help you in nursing school with your experience- an open mind and humility. Know when to say, "I don't know." Be open to the new way of thinking and the new approach to patient care. You'll see the bigger picture more.

Also, when you go in to interview with the new program, don't go on about what a stellar paramedic you are, because they may see you as set in your ways. My instructors were nervous about me, too, but by putting it right out there that yes I do know some things, but there are definitely things I don't know, too, I've earned their trust (and had more autonomy than some of the other students in my class). Show them that you're open-minded and capable of change.

I'm graduating from my BSN program in May, so I'm not yet practicing, but this has been my experience. Again, it varies from yours, but it might contribute a few ideas.

Good luck!

[Gina_Marie]

Many hospitals will pay for tuition when you want to go back to school if you sogn a 2 yr work committment to them...? My fiance had his RN paid for, I had mine paid for and we are both going back this fall for a higher degree.

[JBudd, MSN]

The biggest problem a preceptee of mine had, in changing from medic to RN was having to keep a much larger group of people in mind. As a paramedic, he had one, sometimes two people in the rig, and was able to totally tunnel vision on that one person. He had trouble prioritizing, meaning not the ABCs, but that you do what is most important for that one person, and moving to another, instead of doing every single thing all at the same time for the first person.

Nursing is not as task oriented: it isn't enough to just get that line in and start resuscitation; you have to follow up with possible overload, is that IV appropriate for the tests that might be ordered, (18g in the AC for CT dye, for example), reassess the lungs, get all the different labs (do I need a lactate or blood cultures, or just a rainbow), is there urine output commensurate with the amt of fluids going in, etc. etc. etc. The whats and whys are just as important as the hows. The treatment algorithms aren't as clear cut.

I think you'll do fine if you are open to new ways of looking at things, a different slant on the same things. Elephants look very different fore and aft!

Your quip about arrogance is at times spot on. A different situation, our ED was requiring paramedic training for ED techs, and brought in some experienced paramedics. One had such trouble accepting the limitations of a tech as opposed to the autonomy in the field, he protested "if I can't practice medicine what am I doing here?" Ah, you CAN'T practice medicine! He had a very unrealistic view of roles and scopes. My friend the medic-to-RN did fine, the medic-tech quit. It is up to you which attitude you bring with you. From your post, I suspect you'll do fine. :)