Right track?

TraumaSurfer · Dec 21, 2013

You are messing up your goal of being a flight nurse.

1. You have a job at a Trauma Center. Chances are that hospital will hire you when you complete your BSN. Thus, you won't spend 2 years as an unemployed new grad RN especially if you have an ADN.

2. Most of the NE is going with BSN and have a goal for their states to be "BSN in 10". Many flight programs want BSN degreed RNs. People might tell you it doesn't matter whether you have a BSN or ADN and maybe it didn't 20 years ago. But, it will be at least 5 - 6 years before you become an RN with an ADN by the route you are taking. A lot can change and it probably won't be to lessen the requirements to be an RN.

http://nursing.connectwithmhs.org/wp-content/uploads/2013/04/CC-041213-BSN_Legislating-entry-into-practice_Tina-Barnes3.pdf

3. You will need at least 3 to 5 years of ICU experience as an RN. Many hospitals are now Magnet and want BSN degreed RNs for their ICUs.

4. You need to prepare for the future and not just a quick cert right now. Your long range plans to be a Flight RN requires several years of preparation as a NURSE. Those who have said "the ADN has always been good enough" are finding themselves left out when there are hundreds of applicants who have gone the distance.

5. Where are you going to work as a Paramedic? Very few EMS jobs are going to be flexible enough for you to go to nursing school or at least not for the first year or two.

6. If your goal is to be a flight NURSE, skimping or taking shortcuts for nursing school is not going to benefit you. The bridge programs also just cut you some slack on a couple of classes but sometimes the material missed in those classes can be vital in bringing the whole process together.

Also, is it a university or a community college which is offering the bridge program? Universities usually offer Bachelors and higher...not ADNs.

7. It is a lot easier to go from RN to Paramedic than it is Paramedic to RN. There are programs which allow RNs to take 2 weeks of additional training and take the Paramedic exam. Some states allow the RN to just challenge the test if they have ACLS and couple other weekend certs. There are RNs who teach the Paramedic classes at some colleges and universities.

8. Trying to compare CCRN and the CCEMT is a total joke. To take the CCRN you need over a year of actual work experience in an ICU as an RN. There are also separate CCRN exams for the different ages groups which you will need over a year of work experience in each unit to take the exam. The CCEMT is a 2 week merit badge teaching very watered down introductory level critical care overviews. If you are lucky the might take one day to give you a walk through of an ICU. Some Paramedic schools even tack this course on (at a very high cost) as a selling point for their new grads who have ZERO experience as a Paramedic since there are no prerequisites for the CCEMT.

9. To be a Flight RN, it does not matter if you have 30 years of experience as a Paramedic. To be a flight RN you will still need to meet all the requirements which may include BSN and still have 3 - 5 years of work experience as an RN in critical care. They do not just automatically move you to the next seat. A Flight RN brings critical care knowledge and skills to the team which are highly specialized and not something which can be learned in a weekend cert class.

10. Following through with #9, it is easier to teach a few skills like intubation and central line placement to someone who has advanced education and who has already worked in the lCUs with these procedures and devices than it is to take someone who has very little exposure to these lines and tubes and the only critical care knowledge is from the CCEMT which again does not really teach anything about critical care nor give the necessary experience.

11. As an RN (with a BSN) you may have the opportunity to work in many ICUs such as Neuro, Cardiac, CV, Pedi and neonatal. All of which would be great for making you a better Flight RN. As a Paramedic you can not work in any of these ICUs except as a tech to assist the RNs.

12. While you are going off to be a Paramedic and trying to gain work experience as one, remember the prerequisites you took to get into nursing school have a time limit. You may need to retake most of the math and science classes.

If you are looking for shortcuts, just scrap the goal of being an RN. Go to Paramedic school. Earn as many weekend merit badges as you can. Work a couple years on an ambulance if you can find one which does emergency response. Then you can apply as a Flight Paramedic and work with an RN who has lots of critical care experience.

kvromero11 · Dec 21, 2013

TraumaSurfer,

I think you misinterpeted. I am currently enrolled in a BSN program I only have four more prereqs to do -, and am half done my paramedic program.. I am enrolled in a UNIVERSITY. The ADN is offered through a community college.

Here the flight paramedics and nurses are expected to perform the same set of skills at the same competency. They are equals. In medic school you are already taught how to intubate (I did my first one 2 days ago). The helicopters here cannot even take off unless a medic is on board and working. The only difference is you need 3 years minimum as a critical care nurse, and 5 years at a busy 9-1-1 service.

And I think it's just as bad going RN-medic bridge as apposed to Medic-RN. You miss the critical thinking and problem solving that goes into being a medic.

I plan on getting my BSN eventually, I just was wondering if it would be smart to get my ADN in a year then bridge to my BSN. While working in the ICU gaining experience.

The service I am taking my medic course through offers perdiem spots 8, 12, 16 and they always have shifts available. My work schedule in not a real issue. All my credits won't expire.

I dont want this to turn into a debate whether being a nurse is better than a medic. I feel like you dont respect what goes into being a medic. Airway/cardiac specialist and quick descision maker without a doc writting every order for you. I want both, and I think getting my medic will do nothing but help.

TraumaSurfer · Dec 21, 2013

Silver Surfer,
I think you misinterpeted. I am currently enrolled in a BSN program-, and am half done my paramedic program. I only have four more prereqs to do. I am enrolled in a UNIVERSITY. The ADN is offered through a community college. Here the flight paramedics and nurses are expected to perform the same set of skills at the same competency. They are equals. In medic school you are already taught how to intubate (I did my first one 2 days ago). I plan on getting my BSN eventually, I just was wondering if it would be smart to get my ADN in a year then bridge to my BSN. The service I am taking my medic course through offers perdiem spots 8, 12, 16 and they always have shifts available. My work schedule in not a real issue.

There is a local university here that has a Medic to RN bridge course,

Nope. I didn't misunderstand you.

Why would you dump the BSN program for an ADN when you are already halfway finished.

Having the same "skillset" such as intubation is not the same as having the critical care knowledge and background. There the RNs and Paramedics are NOT equals. Learning to stick a tube down someone throat is just a small part of the equation. EMT-Basics can also intubate in some states. Maintaining that tube with multiple drips and devices are another. If you want to just compare skills, the RN wins without a question and with ICU education and experience. If an RN works on a Specialty team like pedi or neonatal, they may be the primary intubators for their unit. They may need 20 intubations a year for each age group to maintain competency. Plus, they already have the knowledge of the medications required for intubation and know what to do with the patient once they are intubated to keep that tube. Patients don't just lay there quietly without any meds or life support until extubation. There are also all the other acute care issues which must be addressed and this is for the entire shift along with at least 1 - 2 other patients to care for at the same time who might be critical in the ICU. Once they are on transport, they are able to do their jobs just like they were in the ICU.

kvromero11 · Dec 21, 2013

Can you go back and read my post I edited I made it a bit more clear.

kvromero11 · Dec 21, 2013

By the way the NREMT teaches you all the medications for RSI. Ketamine, ROCs, Sucs you name it. Here in Maine only CRNAs and lifeflight nurses can only intubate. I can manage an intubated patient right now. PIFT transfers also involve dealing with equipment and lines in such.

TraumaSurfer · Dec 21, 2013

Not turning it into a nurse vs medic argument.

By the time you have finished with all the Paramedic stuff and you go through the ADN program your hospital will have gotten its Magnet status. How do you think you are going to get the necessary ICU experience in the ICUs if you can not get hired by one?

You miss the critical thinking and problem solving that goes into being a medic.

You actually think RNs don't have critical thinking skills? Now that is insulting. Talk about no respect.

Airway/cardiac specialist and quick descision maker without a doc writting every order for you.

Did you know that Paramedics function by protocols which are DIRECT WRITTEN ORDERS for everything a Paramedic does and must have direct contact with med control for anything which is not in their protocols or exceeds them? A Paramedic is also limited by their state's scope of practice. An RN has a very broad state scope of practice.

Who has been advising you? There are reasons why some of us left EMS to move into the ICUs. Why do you think more Paramedics go on to be RNs than RNs to Paramedics?

Right now you don't know what you don't know and it sounds like a Paramedic is talking down the nurses and telling you education is BS while skills rule.

TraumaSurfer · Dec 21, 2013

By the way the NREMT teaches you all the medications for RSI. Ketamine, ROCs, Sucs you name it. Here in Maine only CRNAs and lifeflight nurses can only intubate. I can manage an intubated patient right now. PIFT transfers also involve dealing with equipment and lines in such.

The NREMT teaches you nothing. It is merely a certification testing agency used by the states and some states don't use it for testing.

NREMT - National Registry of Emergency Medical Technicians

Right now several states do not allow for RSI per state protocols by Paramedics.

How do you manage an intubated patient? What drips do you use for sedation, pain and BP management? What ventilator? What settings for all the different disease processes?

kvromero11 · Dec 21, 2013

I mean just like the street smarts that go into it. Scene safety what meds to use without someone ordering it, interpreting EKGs activating cath labs. Stuff like that. Remembering the protocols.I And again, I dont believe my hospital will be anywhere near magnet status. We still have RN managers here with ADN (not right). I plan to be graduated from nursing school in. Again I am not saying that one is better than the other. You just sounded like you were saying being a medic holds no value.

TraumaSurfer · Dec 21, 2013

Are you sure about only CRNAs and lifeflight RNs intubating?

NPs, RNs and RTs who work on specialty (neonatal, pediatric) also intubate in your state.

kvromero11 · Dec 21, 2013

Yeah that maybe, I know RTs can depending who they work for. At my hospital they have to do at least 10 a year or go to the OR if they are unable to get 10 tubes. I guess RNs can I have never heard of one doing so. I know here they page lifelight, respiratory or anesthesia

http://www.maine.gov/boardofnursing/questions/questions_rn.html#endotracheal

TraumaSurfer · Dec 21, 2013

I dont believe my hospital will be anywhere near magnet status.

Have you looked at the BON website lately or looked at the goals for your hospital? If you are the Level 2 trauma center mentioned, I think changes are coming in the near future because of the low rating on the scores accumulated for safety and mortality. If they can not prove change is in the plan, accreditation and CMS funding can be lost.

I mean just like the street smarts that go into it. Scene safety what meds to use without someone ordering it, interpreting EKGs activating cath labs. Stuff like that. Remembering the protocols.I And again, I dont believe my hospital will be anywhere near magnet status. We still have RN managers here with ADN (not right). I plan to be graduated from nursing school in. Again I am not saying that one is better than the other. .

What used to be in the past is not true for the future. Just because you know of an ADN who is a manager now does not mean he or she would get that same position today or at any other hospital.

BSN is also not only for management. This is now becoming the requirement for bedside RNs. Right now in the US, more than half of all RNs hold a BSN or higher.

You just sounded like you were saying being a medic holds no value.

Medics hold value but not in critical care without extensive training and education. But, they are still lacking in actual bedside critical care experience.

I mean just like the street smarts that go into it. Scene safety what meds to use without someone ordering it, interpreting EKGs activating cath labs.

"Street smarts"? Now I know you have been talking to a Paramedic who down plays education. Without proper education you don't get proficient with street smarts. Most of scene safety is commonsense. RNs now must take safety, hazmat and personal safety education in many hospitals. If you work on a helicopter, the RN is given the safety training yearly just like a flight Paramedic.