Lemon00

I was in EMS for several years prior to becoming a nurse. I now work in the ER. Although, I know you are coming from a good place, some of your points seem a little bias. They could be good points but you are treading on thin ice with some of them... The weight one... leave that off. It sounds VERY offensive. Everyone knows they should take care of themselves. It's their choice to do it or not. You should take into account how certain aspects of working as a EMS professional can lend to poor weight management. First of all they are usually in a vehicle and only have a short time to eat, making it easy to eat convinces/fast food on a regular basis. They have short bursts of activity followed by sitting in a vehicle for prolonged periods. Two, about the IVs.... I'm wondering if you have ever started an IV in a moving vehicle. While I agree with what you said, I hope you have an understanding of the difficult and unique challenges of EMS. You seem to have the attitude I encountered many many times in my career and still see today, an attitude of "the high and mighty nurse" a good paramedic does what you do, except in the back of an ambulance traveling at high rates of speed with no one to back them up. Some nurses complain because the Paramedic doesn't have an EKG, large bore IV, meds given, a detailed head to toe assessment, and past medical history when they had a travel time of 8 minutes. Thing is most of the time... they do have all of that but when they don't... they'll get eye rolling and snarky remarks from the nurse. Its wrong. Maybe it would also be good for you as the ER nurse to ride a few times with them and learn a few things yourself.

I could have wrote this myself. I am a year in and I still feel overwhelmed at times. I think every one does from time to time. Sometimes, the ER is just overwhelming. Many nights when I'm driving home I question whether the ER is for me. That being said my coworkers are supportive and I can definitely hold my own in a true emergency. I was a Paramedic for several years prior to becoming a nurse but its like you said... The time management and charting is the hardest part of my job. I just wanted to let you know, you aren't alone and it does get better!

I've faced this situation myself fortunately for me the community I lived in was very unique; in that we are accustomed to "the work comes first" because we all lived/worked on a penitentiary. There was no question when they call... you go. So, there were a few people (the usual babysitters) that did an AMAZING job keeping the children, but you still feel like you're abandoning them. When duty called we all had a role and no one questioned, we just did it. We have been through hurricanes (like Katrina, Rita, Gustav) also inmate escapes and last year faced a major flood, all were we worked almost 'round the clock and 7 days a week until everything was "restored" or at least functional. It's hard when both parents work in public service because when there is a public emergency you both are called for duty. No one (employers/coworkers) wants to hear " but I have kids". I know exactly how you felt waiting for the call. Now that I am "on the outside" I have often wondered what it will be like (because now I lack the support system but still have the duty to respond) It is inevitable that we will be hit by another hurricane so I am trying to prepare now and formulate a plan, but options are limited. I don't think it ever gets easier to put your family second to someone elses but that is what we do as public servants. Whether it's the demanding schedule or like this case the literal choice between one's own family or helping others; we sacrifice so much "for the greater good" I just wish people recognized that sacrifice a little more.

I believe the certification is the same whether it be EMT-Basic or paramedic, when you get out of the military. I'm a paramedic and I have worked with EMTs trained in the service. As a Paramedic you get no special placement or consideration in nursing school unless you go through Excelsior,as you mentioned, Excelsior has its downfalls and it's worse for Paramedics than for LPNs. For example in Louisiana if you transition from LPN they honoryour degree, if you are a paramedic they don't and you have to work in another state for 6 months then file for reciprocity.

mmm333 - Your post is spot on. Thank you sharing your knowledge of the subject and more than that thank you for being an advocate for medics that are struggling just to make that transition without starting completely over.You are right it's not too much to ask for people to take the initiative and goback to school, and to go beyond entry level nursing you need more formal education not just field experience. I also don't think it's too much to ask that Paramedic's getadvanced placement (which they don't in the programs in my area) The Excelsiorprogram was my best option but many states still make it difficult to get a job after graduating from their program. Mississippi is the closest state thathonors the program and recently I noticed on many of the posted position theysay “must have graduated from a non-online nursing program” so it looks like things aregetting tougher not easier. I guess we need more people advocating for us. If Icould just get an interview I know I could shine but so far it’s not looking good.

I am a Paramedic (that worked in a prison with a military type structure and expanded duties/ scope) transitioning into the Registered Nurse role. Many of you have commented that the job is different; I can say that working on an ambulance presents different challenges than working in a hospital. Starting an I.V in the back of an ambulance going down the highway or working a cardiac arrest with just you and your partner can be exceptionally nerve racking add the environment of a combat situation or in my case being in a dormitory surrounded by 70-90 murderers and rapist, you do have a very different "job". But, those skills should be considered when a person is taking the next step to become an RN. Where I worked we have an ambulance fleet and Paramedics run the ED/triage unit, I was responsible for advanced head-to-toe assessments, acquiring and reading ECGs, determining the need for x-rays, preparing (NO PREMIXED bags) infusions from amiodarone to zosyn then delivering them with no infusion pump just good old fashioned calculated drip rates, I treated everything from ingrown toenails to pediatric cardiac arrest. We treated inmates and officers and the surrounding community much like the corpsman do in the field. The thing that is the most different from what I did and what I have learned in my nursing program is the psychological aspect of healing. The nurse's role as the person supporting the patient emotionally, I feel that part of the job comes pretty naturally for most that love their joband enjoy helping people. Other than that much of it is the same (at an entry nursing level). I am frustrated right now because I can't even get a job as a patient care assistant (or the like). I'm looking to transition into the hospital setting (since I've moved to another part of the state) until I take NCLEX-RN. I can't even "test out" and become a CNA or LPN. I'm just stuck unless I want to work on an ambulance. I am in the Excelsior College nursing program because I would not have gotten any consideration/advanced placement for my accredited paramedic program and would have started in the same position as someone with no experience, had I enrolled in a traditional Nursing Program. It is very frustrating because now I have to go out of state to work, and then apply for reciprocity because my state doesn't honor the Excelsior program (because there is no "clinical" portion). I can say from this perspective it is a very hard pill to swallow when you are used to doing so much but you can't even find a job changing beds and helping with ADLs. I'm not sure what the solution should be and I realize that every Paramedic has not functioned in the role that I have (or been trained in an accredited program)but there should be consideration for those that have, like me and many corpsmen. *Let me say, I don't think the standards should be lowered* Maybe just schools have advanced placement or reduced clinical time for these situations or employers be more willing to consider hiring these people even though they don't have the specific cert (like CNA) for a job, in which the level of"skill" is within their training and scope of practice.