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I agree that paramedics are trained for the "Out of hospital environment" or field work, and RNs are trained for the hospital environment. However, a RN is not necessarily better than a Paramedic and a Paramedic is not better than an RN. I have two full time careers; one as a fire department firefighting Paramedic, and another as an Emergency Dept Registered Nurse. Therefore, I also get to perform and observe both areas of health care. I would rather have a Paramedic provide care to me in the field, and I simultaneously would prefer the care of an RN in the hospital. I have responded to many emergencies where a clueless RN was on scene freaking out, not knowing what to do. Most RNs do not experience emergency situations outside of the cushy hospital and therefore, they often are no better than an untrained bystander on scene. On the RN side of the issue, I get to experience and do so much more in my ER than I ever do in the field and I am a much better paramedic because of my RN experience. I am also a better RN because of my Paramedic experience as well and will not spaz out the way a few other nurses do during a crisis.

I am pretty sure it is a HIPPA violation to give a patient's SSN to police without a warrent.

Taking, or (Measuring) an individual's blood pressure is a basic skill not a treatment. Your can purchase cheap machines to measure BP at many stores, and these machine do not receive regular calibration either. Therefore, I cannot perceive how measuring someone's blood pressure is an issue. The difficulty would arise when one attempts to provide health care advice related to blood pressure.

I wish you the best in your career and life QueensNurse. It seems that the ED, while initially exciting, will eventually progress to being a repetitive task for those of us new to the emergency department.

Sorry about my post concerning my new ED job. I thought I followed the correct process to send the e-mail directly to LunahRN, but obviously I failed. Ooops, my bad

LunahRN, I have to tell you that I have watched for your post since I decided years ago to obtain my RN through Excelsior College. Along with the fact that you were a paramedic obtaining your RN through Excelsior also has provided me a little extra motivation and encouragement along the way. Well now I have my RN degree and Tennessee RN license. I had an interview yesterday and to my utter disbelief, was offered a night **** position after an interview by the ED's DON and four night shift charge / head nurses with a large ED here in the Memphis region. I am still in shock because the day before the interview, I spoke to the ED Manger by telephone and she informed me rightly so, that I had a few strikes against me in trying to land a job as a new RN. One strike is that I will stay working with my fire department which works 24 hour shifts. The second strike is the lack of a clinical process with Excelsior College. Despite my belief that I could not possibly get a position in the ER, I decided to give the meeting with the ED manager a try with the hope to at least get some professional advice. When I arrived for my appointment, I overheard the ED Manager tell her secretary that as a result of a couple of pressing issues that just occurred, she would not be able to do the interview, but instead, another nurse would do the interview. After hearing this statement, it just reinforced my belief that I was just out of luck. A few minutes later, a nurse walks up and introduces himself as the Director of Nursing for all of this particular hospital system’s emergency departments. I just knew that this interview with the big man of the ED would be the death of any chance I had. The ED’s DON sat me down and asked a few easy questions about my experience and expectations. After he completed his portion of the interview, the four night shift’s head nurses come in to interview me as well. When they walked in, they all sat down to form a crescent shape around me. They were the predators and I was their prey. Again I thought, “Here comes the real grilling.” However, those nurses including the director were some of the most pleasant people I have ever met. After the four night shift nurses completed asking me their questions, the DON returned and told me that the night nurses recommended that he hire me! As I type this page, I am still in shock. I think I should ask my wife to slap me to make sure I am awake. It will be tough to work two full time jobs. One being 24-hour shifts at the fire department and the other 12 hour nights in the ED, but I am motivated to make this work for at least a year, until I can prove myself and then change my status to part time. The eventual part time status I want will only be so I can wok the ED schedule around my fire department schedule a little better. I also see you have your CEN, which I have been studying for as well. I plan to take the CEN in about three months. I am so psyched that I am already unable to sleep throughout the night without awakening to the thought of how will I do, or will I be a good ED nurse. Onward I go. I will now be able to post my thoughts and try to help other new emergency nurses as they ask questions on this site. Thanks for the motivation

Hello Brian, I have applied for a few positions at St. Francis as well as Baptist and Methodist systems. I basically would take what ever position I could get, because my view is beggars cant be picky. I also realize that no matter what position I start in as an RN, I have a tremendous amount to learn. I believe the Cardiac floor would be a great area to work in and would appreciate the assistance. Thank You Sir!

Thanks for all of your advice.

Advise from Nurse Managers My story I have desired an RN degree for many years but could not attend the traditional nursing programs due to my fire department schedule of 24 hours on duty. Well, a few years ago I met a nurse who had obtained his RN through Excelsior College's self-study program for paramedics and LPNs. After contacting my state board of nursing to ensure they accepted Excelsior grads, I applied and just recently graduated this past November and passed the NCLEX in January 2010. I work ten 24-hour shifts per month at the fire department as a paramedic. Therefore, I have an average of 20 days per month off duty in which I can work as an RN. I do not believe most RNs work 20 days per month, so I assume I have plenty of time to work as a nurse. The problem I seek advice for is that all my applications for part time RN positions in the Memphis, TN area have been summarily rejected. Unsure why because no one sends any feedback, but I believe it is because they all ask for one year of experience. So I ask you, how can I get one year of experience if nurse managers will not give me a chance? I have been under the impression that I would not have any difficulties obtaining an RN job because I have been a paramedic for so long. Apparently I have been incorrect in that assumption. It seems to me that a new RN with Paramedic experience would at least have a little bit better chance of obtaining a job than a new nurse with no patient care experience other than from clinicals. As an extra, I am currently studying for the BCEN exam and should take it in about one month, with the hope that passing the emergency nurse's exam will help me. I would appreciate ANY advice. Thanks in advance for your time

As an 18 year paramedic and new RN; I thank you for your appreciation.

Would this be an intravenouse drip solution?

One of the problems with nursing is that most nurses have no formal training in management, supervision, or how to combine them to be a good leader. Therefore, their reasoning processes involve a lot of trial and error learning, often contamination by friendship and cliques.

It is permissible to have a conscious hypoglycemic patient orally ingest a high glucose drink or paste as a conservative measure to elevate her glucose level. However, you can never administer an oral drink to an unconscious patient, and we all know why.

Yes, both forms of ventricular tachycardia are shockable. For the unconscious patient you defibrillate For the conscious patient, you use synchronized cardioversion For unconscious defibrillation, you shock randomly For conscious synchronized cardioversion, you switch the cardiac monitor to its synchronized mode and it analyzes the patient’s rhythm and delivers a shock right after the R wave of the heart’s cardiac cycle. The monitor does this to reduce the chance of turning the ventricular tachycardia into ventricular fibrillation. Ventricular tachycardia can occur while the patient is alert or unconscious, and much depends on the patient’s ability to tolerate the rapid ventricular rate. Some healthier patients can tolerate the increased rate of ventricular contractions and remain conscious, while others with multiple medical conditions may not be able to tolerate the fast rate and become unconscious due to lack of cerebral perfusion. If the patient is unconscious with ventricular tachycardia, you should defibrillate with 200 jules immediately in an attempt to reset the myocardium’s electrical circuit to a slower rate. If the patient is conscious and stable, then consider providing oxygen, starting an IV, and administering Amiodarone or lidocaine. If the patient is conscious and unstable, then you give oxygen, start an IV and administer Diazepam to sedation the patient prior to shocking using the monitor’s Synchronized cardioversion setting.

Male physicians assist with infant deliveries and as a male RN/ Paramedic, I also have assisted patients with the births of their infants. Just because one is a female most certainly does not prove they know more about deliveries. Most female nurses probably could not explain their own menstrual cycle to you if you asked them to.

The terms manager and supervisors overlap in their meaning. A manager is responsible for how a business is operated. This is done by managing supplies and personnel. To manage personnel, one should be able to supervise their performance on the job A supervisor directs the actions of subordinates and "supervises their actions" to ensure quality and safety. A leader is able to manage and supervise his or her assigned personnel through good interpersonal skills, setting a positive example by sharing in the work load and maintaining a positive, professional approach in one’s appearance, and demeanor

excelsior college is how i obtained my rn. i just passed the nclex-rn ten days ago, so you most certainly can do it.

It seems to me that many people confuse supervision with license. There is a difference A license is an individual's legal permission to practice health care at a particular level based on one's education. A license is not an umbrella for subordinates to work under. They each have their own license that dictates what skills they are allowed to perform. Individuals who work as CNAs, LPNs, RNs should realize that they each have a different level of education and responsibilities. It is not your duty to degrade each other based on educational achievements, because we all have a different story to tell about how we arrived where we are in our life. But we each have various levels of supervisors, managers, directors, or bosses, who are responsible for our supervision. My main career is as a fire department paramedic, and as a Fire Officer. My secondary career is as a new RN with an associate degree. As a paramedic, I am the highest licensed health care provider in my group of four medics on an engine company. The other three are basic EMTs. Just because I am a paramedic, does not relieve the EMTs of their responsibility on an emergency scene. The basic EMTs are required to practice within the legal bounds of their license, just as I am. However, because I have a higher level of training and education than the basic EMTs do, I am responsible for supervising their performance and issuing instructions. As a fire officer, it is my job to supervise my crew. However, I also report to my Battalion Chief, who reports to the Fire Chief, who reports to the City Administrator, who reports to the Mayor, who reports to the citizens. As an RN with an ADN degree, I may eventually be assigned the responsibility of supervising the performance of LPNs, and / or CNAs. But that does not mean they work under my RN license, just as I do not work under the license of a BSN nurse, or work under the license of a physician. I have no problem acknowledging the education another individual has achieved, because all of life is a hierarchy. Health care is a hierarchy of CNA, RN with ADN, RN with BSN, Head Nurse, Nurse Manager, Hospital Administrator, Physician, Surgeon, Board of Directors, State Health Regulatory Commission, and the Federal Government. WE ALL WANT TO FEEL SPECIAL, but we must also realize that there will always be someone more educated or more experienced than we are, and I am glad the world is filled with people smarter than I am. If not, we would be in a terrible mess

Yes Sir you are correct! Not only did I program it into my cellular telephone, I also put it into my laptop computer. I still forgot. I know, what a dufuss. Ha, Ha.

You are never wrong in asking another person for advice. However, asking for advice does not necessarily mean you have to follow it exactly. You were absolutely correct in researching your question as soon as you could. Maybe you could consider purchasing a pocket computer and a few nursing programs to download unto it so that you can use it while on duty to provide common protocols and other information. I use Skyscape and PEPID programs as a Paramedic and will soon use them to help me as a new RN. I cannot remember everything, so I must compensate. Now, if only I could figure out how to remember my wife’s birthday and our anniversary, I might live a little longer.

As a Fire Officer / Paramedic, I feel you and your "friends" should be charged for immaturity and stupidity. Do you and your friends not realize how much it cost to send multiple apparatuses to an emergency scene, or how you slow our response to a real incident? With you and your friends displaying such poor judgment, why should you be allowed to function as an RN at this immature stage of your life? Maybe it is best that you wait a year or two to grow up so you can take responsibility for your actions and the type of people you decide to hang around with to have fun. When you go to court, you can take you friends with you so they can admit their stupidity and save you additional grief, if your posted version of the story is true. I really would hate to see your education or future career harmed by such behavior. However, after coming in contact with so many people like “your friends”, in my many years of working in the fire service, I have come to realize that there is no such thing as common sense. As a fire officer, I would definitely file charges against you and / or your friends.

Hello Nurses, I would appreciate your time and effort in providing a description of what pulmonary nursing is actually about. I realize it relates to patients with respiratory related illness such as asthma, COPD, bronchitis, ARDS, or maybe inhalation injuries. However, I would like an example of how pulmonary nursing differentiates from Medical surgical nursing and the depth of knowledge one obtains while functioning as a pulmonary nurse. I am curious because I may apply for a job as a new RN at a hospital here in Memphis, Tennessee that has openings for full time and part time nurses in the pulmonary unit. I am initially interested in the part time position, because my main career is as a fire department firefighter /paramedic, in which I work 24 hour shifts. I work an average of ten 24 - hour shift per month. Therefore, I have an average of 20 days per month in which t I can work as an RN. Although I already have a primary career as a firefighter / paramedic with the fire service, I have desired an RN degree for many years, but could not find a program that worked with my schedule until I learned about the Excelsior College RN program for LPNs and paramedics from an RN I met a few years back. Well, I finally have my RN degree, and I test the NCLEX-RN this Tuesday, January 19, 2010. As soon as I know whether I passed the exam, I will apply online for a posted position. Since there appears to be schedule flexibility in the pulmonary floor, I figure why not give it a try. I want to work in an area of nursing that requires me to understand with greater depth, human physiology and disease processes, and from what I have read on this site, pulmonary nursing would provide and require me to obtain greater knowledge, at least as related to respiratory. Thank you for your information and any advice.

As a guy about to be an RN in two weeks (hopefully), I really enjoyed reading this post. Finally I am able read a brief post as to why you female nurses seem to rant and rave at each other constantly here at All Nurses.com. I have often read various posts on this website just to get a feel of what to expect when I start working part time as a new RN. As a firefighter / paramedic, I mainly work with males, and while we also have our disagreements, I believe we are less emotional and resolve the issue in question sooner than most females. Just to be safe, I think I'll go purchase one of those neat shark chain suits and wear under my scrubs just to keep the claw marks to a minimum.

Please explain what LTC stands for. Thank you

LunahRN, I am a paramedic / firefighter and will graduate from Excelsior College this October 16, 2009. I am currently studying for the NCLEX and CEN. My goal is to work as an ER nurse when I am off duty from the fire department. I would appreciate any advise you have to offer on becoming an ER nurse.