RMA vs EMT

**NICU Guy, BSN, RN** · Jun 29, 2017

A Medical Assistant and and EMT are totally different scope of practice. When is the last time you had a trauma patient come into the clinic that you and another Medical assistant had to stabilize by yourselves (no doctors or nurses)? EMT are Emergency Medical Technicians. The key word is "Emergency". They handle emergencies outside of the hospital and clinic.

EMTs can be employed at an ER, but mostly in an ambulance service (pre-hospital). Medical assistants work exclusively in a clinic.

akulahawkRN, ADN, RN, EMT-P · Jun 29, 2017

Probably in terms of pure scope of practice, you probably have a wider scope as an RMA than you likely would as an EMT. Given that I'm not certain where you are in the world, but most EMT personnel only do fairly basic interventions, and would probably more properly be termed "First Aid." Given that you're seeing 4 month programs, I can pretty much nearly guarantee that you'll only learn some fairly basic interventions, most of which you already likely know, with a few "new" skills.

I'm in the US and I became an EMT right about 20 years ago and became a Paramedic 17 years ago. A lot of medical knowledge has changed since then but I've also kept up with these changes as they've evolved. That being said, the very basics of care really haven't changed much and we pretty much all know how to do them.

Here in the US, if I was working as an emergency provider at the EMT level and you called 911, upon arrival at the patient's side, I become responsible for patient care. Yes, I want info from you, but beyond that, if you impede my work, I will get law enforcement to remove you from the scene. I have that legal authority. As a Paramedic, in the field setting, there's only a couple providers that I can take patient care orders from and (most of the time) an RN on scene isn't one of them. Interfacility transports are very different and only under very specific circumstances am I to treat that as a "field call." You, as an RMA, in the US at least, wouldn't "out rank" most EMS providers once they arrive to provide care at your clinic. The physician or other advanced medical provider (like an NP or PA) still would. That being said, even in my role as a Paramedic in my state, I am required to treat NP and PA providers as anybody else trained in first aid. Only physicians are allowed to legally retain and direct patient care (but if they do, they're required to ride in with the patient).

If I were in your shoes, I would seriously look at what the EMT does in your area. If they're able to do 911 (or 999 in some parts of the world) in (relatively) independent practice, things will remain generally fun for a while. If most emergency patients are attended to by some other advanced provider such as a Paramedic or an RN that's specifically trained in prehospital care, you'll basically be just another set of hands that help out and you'll do a lot of driving. That kind of work gets very boring and repetitive very quickly.

Here in California and many other US states, the EMT does a lot of very basic non-emergency medical transports such as taking patients to and from various appointments and facilities. I am also an ED RN and in the last week, I transferred out around 10 or so patients either to home, skilled nursing facility, or to a psychiatric hospital by using non-emergency transport staffed by 2 EMT personnel. I've done that work. It's insanely boring after a while. As a Paramedic I have done both 911 and ICU-ICU level transports where the patient only required a provider with my particular skillset and not that of an ICU-trained RN. California is very restrictive in regards to what medications and equipment I can monitor during those transports but other states are far more relaxed and allow the Paramedic to do most ICU-ICU transports. Those Paramedics do know, and will not exceed, their authorized scope of practice.

Know what you're getting into (especially the compensation) for where you are located. You could be trading one boring job for another (ultimately) boring job that pays less.

adommett27 · Jul 28, 2017

Thank you, that is more the answer I was looking for.