RN/Paramedic on a Rig?

zalan,

i went to medic school first and worked for the last 10 years in the field. 5 years ago i went back to nursing school for my rn. the problem in my area is that as a nurse i make $10 more an hour than as a medic (exception, fulltime ff/medic). lessons learned: i should have went first to nursing school and later taken a bridge to medic (the bridge is 3 weeks from rn to medic vs. medic to rn is at least one year)

• how many rn/paramedics work on a rig? well, i work 40 h in a hospital setting a week and 24-36h as a ff/medic…again the medic is for fun, the hospital job, which still is fun, is for money
  
• is there any advantage to being a rn/paramedic in pre-hospital setting? in my area yes, critical transports but could taken a ccp class
  
• does scope of practice change for any? or become blurry? that’s up to your medical director, what he allows us to do.
  
• in pre-hospital which licensure or certifications are you held to? good question, need to research, however you are in general held to the highest training you have, but also the scope of your practice, state laws…
  
• is there any disadvantage to holding both in pre-hospital? or hospital setting? education is always good , no disadvantage that i have ever encountered, just more ceu's
  

i do not think you can do medic and rn (as and adn) in the same time period as both require a significant commitment in clinical time. again, if i would have to do it again i would first go to rn and then take the bridge program. overall, no regrets…i love being a medic and love being a nurse!

Good questions. yes, there are great advantages to being an RN/EMT-P in a prehospital setting. You have an expanded understanding of disease processes and medications. Also, as a nurse you have more exposure to management of different conditions which can also help to understand the whole process and treatment better. (e.g. a medic hooked up an EKG, saw a-fib and told the patient he was in immediate risk for having a stroke. The patient was taking coumadin, had chronic a-fib for many years. The medic had no idea what the patient's coags were, no echo/ultrasound, etc....he had no idea whether or not the patient was in immediate risk. As a nurse I tried to explain these things to the patient but once they heard "stroke", that was the end of the conversation).

Scope of practice is determined by the state and local medical direction. Unless you're doing critical care transport the scope of practice is the same in most places (I'm not aware of any that are different). It doesn't matter that I'm an RN when I'm working at the fire department, I use the same formulary as all the other medics. You are held to the certification/licensure that your employer requires you to hold.

I don't think there's any real disadvantage to holding both in either setting. there are occasional times where I wish I could place an EJ or pass an ETT when a provider is having difficulty. But 99% of the time there are no disadvantages.

BVFD is right, it would be too much to do both at the same time and getting your RN then bridging to paramedic is an easier path to take than the other way around.

Good luck to you!

Bump

I like following these threads, as I'd like to get prehospital. From others I've read, +1 to what the previous posters have said, with the addition of being told that medics have a more medicine type focus, and nurses have more of a nursing type focus. And +1 to BVFD for knowledge being power!

I meant to say was looking into getting a ASN after getting a Associates of Paramedic Science. Not at the same time.

Do you mean the oil rigs? My husband worked on an oil rig and he saw some pretty serious injuries for which they called a lifeflight helicopter. I've not heard of them having a paramedic/RN onsight - maybe the offshore ones do? Considering how new graduate RN's are being treated nowdays, I would recommend the paramedic route. And if you get hired on a 'rig' they are known for paying really well.

I am an ER RN and would like to get my medic, but there is no RN to Medic program here I would have to take the full course. But right now I think it is more important to get my BSN.

there is a difference in scope of practice. RN's would be held to their highest level of licensure even if not working as an RN.

I meant to say was looking into getting a ASN after getting a Associates of Paramedic Science. Not at the same time.

Go for a BSN if you want to be a nurse. Don't waste time getting two lower degrees. If you don't have the option of getting a BSN, a cert as a Paramedic and a nursing degree would be better. The prerequisites (A&P, Pharmacology) for a nursing degree are also generally higher than the Paramedic and they usually can be used for the Paramedic. Those who take a nursing degree first will have no problem with a Paramedic course later. Those who take a Paramedic course first and then nursing may get hung up on the few cool skills a Paramedic can do and put blinders on to all the detailed tasks which seem trivial to someone who is trained for emergent situations even though they are of great importance to patient care.

Your scope of practice will be limited to what your medical director writes for and in regard to the state statutes. If the medical director only writes for a Paramedic scope of pratice, you will have to follow that but you may also still be held accountable as an RN in a court or by the BON especially when it comes to assessment. The ENA has been addressing this which is why some states now have the Prehospital RN certification so that an RN can work under the license they are expected to be held accountable for.

If you do get both the RN and Paramedic credentials, don't say you are only a nurse for the money. That statement can lead your co-workers to view you as a minimalist who just clocks in and clocks out with very little effort inbetween especially if you also make it known that being a nurse is not your real job. While the money is good, there are many advantages to being an RN. This includes working in the ICUs of various types and many parts of the hospital that most Paramedics might never get the opportunity to see and will not be allowed to work in. You will also be taught many invaluable indepth assessments and the treatments associated from those including all the protocols an RN follows within the hospital.

While there is a great adrenaline rush in EMS and getting the patient to the hospital is an important part of the life saving process, there is also nothing like trying to keep someone alive for 12 hours who has multiple drips and pieces of technology attached with much data to be sorted through.

Also, many who went the RN path first find that when they get into the challenges of critical care medicine and the opportunites that exist for them, they forget about becoming a Paramedic. This is especially true if they get onto one of the specialty teams. Even going into Clinical Nurse Specialist or Advance Practice has many rewards. But, if you are still very young the Paramedic route probably attracts you now. There are also many, many other health care professions that are rewarding but are rarely thought about by those in EMS. We have several Paramedics who became Physical Therapists and Athletic Trainers. One of the PTs I work with who got his doctorate in PT was inspired by the rehab patients he transported on routine calls. Two other Paramedics who became PTs were into body building and physical fitness. They were later able to use their new career with the FDs to design fitness programs. Another Paramedic realized how little he know about sports injuries after watching the Athletic Trainers work while he was sitting coverage at football games. Another got his BS in radiation medicine after his mother had breast cancer. One Paramedic became a Respiratory Therapist after his child had a near drowing experience and he saw what their role was in advanced life support including ECMO. Another got his Nuclear Med cert after doing a few routine transports and learned what great money they made.

Lots of opportunities but it really depends on your goals which you may not have even realized what they are yet.