Question on combined BSN/RN, EMT-P training

FiremedicMike, BSN, RN, EMT-P · Jun 20, 2022

There are RN to paramedic bridge courses which are much less painful than paramedic to RN bridge courses.

If you're going for maximum efficiency, then getting RN first, then EMT-B (req'd for EMT-P), then RN to medic bridge course is likely your cleanest route.

That said, you need to consider what you truly want out your career to look like. Knowing whether your vision is full time nursing/part time EMS, full time EMS/part time nursing, or full time MICU/HEMS work kinda helps move this discussion forward..

ChrisC99 · Sep 13, 2022

On 6/20/2022 at 4:01 PM, FiremedicMike said:

There are RN to paramedic bridge courses which are much less painful than paramedic to RN bridge courses.

If you're going for maximum efficiency, then getting RN first, then EMT-B (req'd for EMT-P), then RN to medic bridge course is likely your cleanest route.

That said, you need to consider what you truly want out your career to look like. Knowing whether your vision is full time nursing/part time EMS, full time EMS/part time nursing, or full time MICU/HEMS work kinda helps move this discussion forward..

I appreciate all of that guidance, thank you so much! So, I actually have an extensive background as a career researcher - and more recently I've wanted to become involved in direct patient care as well. I'm at a juncture now where I can continue contributing to research work through consulting/advising, so both the training and subsequent EMS/clinical hours would need to work around my advisory duties at that time. But that won't be a major issue since these appointments will be remote and won't likely take more than 10hrs per week at most.

My personal preference for patient care would primarily be in out-of-facility work - rescuing patients in the field and treating/stabilizing them for transport. Obviously that's the focus of EMS work, the ceiling position of which would be an EMT-P.

However, I would also like to have the option to treat general patients in underserved sites - homeless shelters, rural tribal lands etc. An RN would have a vastly broader scope for generalized treatment options in these settings. There would also be a later option to advance down the NP route for added scope and practice autonomy (depending on the state, CA will be allowing full NP autonomy in 2023) which wouldn't be an option with an EMS background. And of course comparative salary is also a major consideration; anyone in the field is well aware of the challenges of making a livable wage in even advanced positions in the EMS field at a majority of US sites.

In the US system the only qualification short of an emergency physician that would allow for options in both field emergency and homeless/tribal population general care would appear to be in HEMS/flight nursing; I am informed that even MICU for nurses is strictly inter-facility transport, never field rescue.

But as you correctly state, flight nurse positions are highly competitive and require years of ICU nursing experience at minimum, so this ultimate goal would be a long way off. So during the intervening period, the only option I can see for serving both roles would be as a combined EMT/RN.

Would you agree based on your experience in the field?

FiremedicMike, BSN, RN, EMT-P · Sep 16, 2022

On 9/13/2022 at 6:06 PM, ChrisC99 said:

I appreciate all of that guidance, thank you so much! So, I actually have an extensive background as a career researcher - and more recently I've wanted to become involved in direct patient care as well. I'm at a juncture now where I can continue contributing to research work through consulting/advising, so both the training and subsequent EMS/clinical hours would need to work around my advisory duties at that time. But that won't be a major issue since these appointments will be remote and won't likely take more than 10hrs per week at most.

My personal preference for patient care would primarily be in out-of-facility work - rescuing patients in the field and treating/stabilizing them for transport. Obviously that's the focus of EMS work, the ceiling position of which would be an EMT-P.

However, I would also like to have the option to treat general patients in underserved sites - homeless shelters, rural tribal lands etc. An RN would have a vastly broader scope for generalized treatment options in these settings. There would also be a later option to advance down the NP route for added scope and practice autonomy (depending on the state, CA will be allowing full NP autonomy in 2023) which wouldn't be an option with an EMS background. And of course comparative salary is also a major consideration; anyone in the field is well aware of the challenges of making a livable wage in even advanced positions in the EMS field at a majority of US sites.

In the US system the only qualification short of an emergency physician that would allow for options in both field emergency and homeless/tribal population general care would appear to be in HEMS/flight nursing; I am informed that even MICU for nurses is strictly inter-facility transport, never field rescue.

But as you correctly state, flight nurse positions are highly competitive and require years of ICU nursing experience at minimum, so this ultimate goal would be a long way off. So during the intervening period, the only option I can see for serving both roles would be as a combined EMT/RN.

Would you agree based on your experience in the field?

I think you’re trying to merge two very different fields of healthcare.

With everything you’ve said, I think you should get your RN, work in a clinic in an underserved area, then find an RN to emt bridge and volunteer for the local EMS squad out there. Spend a year or two doing that and then see where your heart tells you to go.