RN to Paramedic Advice

[EMSnut45, BSN, RN, EMT-P]

i am a new grad rn (6 months in) and work in a very busy tertiary medical icu. i am also a volunteer emt-b at the local firehouse where i have been an active provider for almost 8 years. my passion is ems, and my ultimate career goal is to be a flight nurse. after high school, i decided to persue my goal by first becoming an rn, then becoming a paramedic. becoming a paramedic is both a career and

i'm itching to get back to school... so i'm working on having my nursing courses and (what little) experience i have evaluated to find out what portions of the paramedic program i need to take. the program will start in august, and run 3 days/week for a year. i plan on working my usual 3 days in the icu while attending the paramedic program, then using my paramedic license as a volunteer.

from what i understand, i can "skip" the portions that i am deemed competent, but may attend them if i want to.

i completely understand that there is a huge difference between rn's and paramedics, so i am not taking this lightly. i have no intention of being a half-baked paramedic-- which is why i'm coming here for advice.

i have a few questions:

1. i am afraid that i will miss valuable information by "skipping" portions of the class. would you advise me to sit them out, or attend anyway?

2. i am paranoid that i will have difficulty seperating nurse-thinking from paramedic-thinking. has anyone encountered difficulty with that, or have you developed ways to overcome it?

3. has anyone done an rn-paramedic bridge or just plain gone from rn to paramedic and have any words of wisdom they'd like to share??

thanks a bunch and happy st. patricks day!!

emsnut

[getoverit, BSN, RN, EMT-P]

Congratulations and good luck on the flight thing...great job and it sounds like you've got a good plan for yourself.

As far as the portions of paramedic school that you can opt out of, I wouldn't even think of skipping a whole section but maybe parts of it, e.g. you may feel totally comfortable with 12 leads and coronary anatomy and not need to sit in on all those days but still "audit" some of the class dates. Same with respiratory, if you are comfortable with adventitious breath sounds you don't need to sit in the class and listen to a CD of someone wheezing but there are many parts of respiratory and airway management that are essential to being a good medic and you just don't get that in nursing school. whatever the paramedic program tells you that you are "competent" in, I'd still gauge my attendance in those areas on a day-to-day basis. I respect you for attending a full program instead of some 4 week bridge course and I'm sure your co-workers at the fire house and any future flight jobs you get will feel the same way.

Paramedic vs nursing thinking? Since you started off as a nurse, I think you might have an advantage rather than the other way around. I'm an REMT-P as well as RN and obviously don't mean to insult either discipline at all. My point is I've seen medics feel an irregular pulse, hook up an EKG and see a-fib....then tell the person they are at risk for having a stroke. the patient gets all excited and fearful, asymptomatic and denying complaint but needs to "go get checked out". The medic doesn't realize that the patient has been taking lanoxin and coumadin for years, has no idea what an INR is or even what a TEE might find. Not that the medic CAN'T understand those concepts, they just haven't been exposed to them yet (and of course, this isn't true with all paramedics).

Critical care nursing has more of a "big picture" approach with attention to minute details whereas paramedicine has more of a "what's an immediate life-threat and how much time do I have before we get to the ER?" and remember, as a paramedic, most of your calls will be at the intermediate or basic level. Making things out to be more than they are is a common mistake.

Again, good luck and hope things go well.