RN-to-Paramedic Bridge

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Specializes in Trauma ICU, Peds ICU.

I know there is an older thread (circa 2003-2005) on this topic, but I'm looking for more current information as some of the programs mentioned therein no longer exist (i.e. Creighton).

So, does anyone know of any currently active RN-to-Paramedic programs in the United States? I'm already aware of those at Hartford Hospital and Jefferson College of Health Sciences.

Thanks.

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Specializes in ED, Critical Care Transport.

Mike,

Try looking at Creighton again, their next Paramedic Certification Course for Healthcare Providers is being offered Oct 11-22, 2010. You can sit for the national registry once the program is completed. You have to have your EMT-B (as well as your RN) for this 2 week program but they also offer a 1 week RN to EMT program. (I am taking the Sept 12-18th one)

I don't know what state you are in but in the state of Florida once an RN has their EMT-B they can challenge the Paramedic certification exam without attending Paramedic school.

Hope this helps.

CaraMiaRN

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Specializes in Pediatric Critical Care.

Mike,

Please let me know what you find out...Im very interested in doing this as well...

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Mike, are you still in California? If so, you can hook up with the MICN program which may then be able to direct you to where you can get the needed 40 ALS patient contacts. After that, you just get an endorsement from the EMS Authority to take the NREMT. In California the MICN will be valuable to expand into EMS for more career opportunites. You also won't need to become a FF but can still work for a FD or a county/state EMS system with the MICN.

http://www.emsa.ca.gov/paramedic/files/FAQ.doc

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Specializes in Critical Care, Emergency Medicine, Flight.

does a Flight Nurse have to be a medic to work in flight?

-im looking into flight nursing (once i have my RN license & icu/ed time under my belt of course), i already have my EMT-B

do you know if its the same in IL for an RN/EMT-B to challenge the medic state test?

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I believe IL still has the PHRN credential.

Some states mandate the Paramedic cert for RNs and for some it is the employer's preference. However, it will generally be the RN license that your will function under. It can become confusing if you try to mix the scope of practice for both licenses. States that have their own prehospital credential for RNs generally will not have this problem.

It will also depend on the type of Flight program you work for. If the service does mostly scene response, the Paramedic may be required. However, again, it will be more for the additional training like any other "specialty cert". In some areas the RN will complete the Paramedic cert with the NREMT course and may not even need to become licensed by the state. Every state is different when you get into EMS issues since it is a very fragmented field when it comes to the many certs and licenses. If the service is primarily IFT or critical care transport, they want the RN to be well equipped with experience in the ICUs and the credentials/certifications that pertain to the nursing profession.

If you do need the get the Paramedic after you get your RN and your state doesn't have a challenge or RN prehospital credential, find a community college that will accept your sciences and allow you to just do the core courses. You really shouldn't have to go through a watered down A&P or Pharamacology course if you have had the regular classes in your nursing program.

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Specializes in Critical Care, Emergency Medicine, Flight.
I believe IL still has the PHRN credential.

Some states mandate the Paramedic cert for RNs and for some it is the employer's preference. However, it will generally be the RN license that your will function under. It can become confusing if you try to mix the scope of practice for both licenses. States that have their own prehospital credential for RNs generally will not have this problem.

It will also depend on the type of Flight program you work for. If the service does mostly scene response, the Paramedic may be required. However, again, it will be more for the additional training like any other "specialty cert". In some areas the RN will complete the Paramedic cert with the NREMT course and may not even need to become licensed by the state. Every state is different when you get into EMS issues since it is a very fragmented field when it comes to the many certs and licenses. If the service is primarily IFT or critical care transport, they want the RN to be well equipped with experience in the ICUs and the credentials/certifications that pertain to the nursing profession.

If you do need the get the Paramedic after you get your RN and your state doesn't have a challenge or RN prehospital credential, find a community college that will accept your sciences and allow you to just do the core courses. You really shouldn't have to go through a watered down A&P or Pharamacology course if you have had the regular classes in your nursing program.

yeah IL still has the PHRN cred.

i totally agree..that they should just allow you to take the meat of the course, well actually, now that i think of it, the one major skill(in the field) medics have over RNs is they can intubate right?.. i mean nurses start iv's, push drugs, cardiac monitoring (12 leads etc) right?

i may have left something out.

thanks for the info :)

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Just having a Paramedic cert does not guarantee competency in endotracheal intubation. There are some Paramedics who may not have placed a tube for several years. Their Paramedic program may not have been able to hook up with an OR or ED that allows Paramedic students to get live intubations and the field clinicals may be a hit or miss for a chance to intubate. There may be some Paramedic students who graduate never having seen a live intubation except on a video. Some employers will not monitor the intubations by having lax QA/QI nor will there be an opportunity for the Paramedic to perfect some of their skills. In some areas all the FFs and/or EMS personnel are Paramedics which dilutes the chance to perform skills or even very much patient contact. Paramedics on an ALS ambulance that does transport for an ALS FD may be little more than ambulance attendants unfortunately. There are Paramedics who work a routine ALS truck who have not utilized either their intubation, IV insertion skills or have not led a code or emergent situation in several years. Some agencies will have flycars with Paramedics who are trained to do DAI and RSI for the field Paramedics. There are also many EMS agencies that are no longer emphasizing endotracheal intubation and are going to alternative airways such as the King especially in code situations.

A Flight employer may ask a Paramedic candidate "Can you intubate?" The answer may be "yes" for adults, peds and babies but the Paramedic may be referring more to their state scope of practice than if they actually are proficient with intubation. A good Flight program should go through the competencies of any new hire and work on the weaknesses as well as introducing new material and skills.

There are many Flight programs that utilize RN/RN crew configuration. The RN, in some situations, may even have the advantage of obtaining intubations in the hospital setting more than a Paramedic or Paramedic student. Some RNs who have gone through a Paramedic program have been disappointed. The program may state they teach intubation but that does not guarantee they will get an opportunity to do one as each program may vary in their set up or connections. Some RNs are also led to believe central lines and chest tubes are standard material in the Paramedic curriculum with an opportunity to perform these skills. However, it is a rare class if either is actually allowed in a clinical and some programs just skim over them or do not even cover them at all since they have fallen out of favor and may no longer be in a state's scope of practice for Paramedics. However, a Flight program may do their own training of these skills for both the RN and Paramedic. The RN would have the advantage here since CLs and chest tubes are part of their ICU responsibilities for set up and maintenance. Even if they haven't done the actual skill they may have seen many procedures in their 5 years of ICU/ED experience. The 12-lead may also not be taught in all Paramedic programs since only half of the EMS agencies in the U.S. utilize 12-leads. Some that do also rely on machine interpretation or transmit to the hospital for the physician to read.

If you are looking into any Paramedic program whether it is a bridge or traditional, find out what and how each skill set is taught. Find out the credentials of the instructors and their teaching experience or special certs in education. Find out if there will an opportunity to obtain live intubations and how many are expected. Find out what EMS agencies you will will be doing ride time with and a little about their protocols and reputation. Make sure the Paramedic program is accredited by CoAEMSP/CAAHEP. This will be a requirement to take the NREMT in a couple of years. Not all states utilize the NREMT and are essentially ignoring the push for accreditation right now. If you want to move to an NREMT state later, you may be at a disadvantage.

Below is a link to a questionaire sent out to the state EMS boards in 2008 to determine if other professionals are allowed to challenge the Paramedic test or work on an ambulance with their own credential. California is not listed but I posted that info earlier.

http://www.nasemso.org/NewsAndPublications/News/documents/NASEMSOsurvey051208.pdf

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Specializes in Critical Care, Emergency Medicine, Flight.

wow. very nice post.

i agree about the medic=ETT competency.

our ems system here is actually shifting towards using the king airway , when needed. b/c of the issues that arise with intubation, and not getting it on the first try..when time is important.

i was just wondering what the purpose was of a RN having a PM cert, maybe its so they can see ALS care in the field vs just ED/ICU?

who knows.:uhoh3:

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i was just wondering what the purpose was of a RN having a PM cert, maybe its so they can see ALS care in the field vs just ED/ICU?

who knows.:uhoh3:

If you notice on the link I posted earlier, the states all vary. But besides the BON's position on some prehospital issues, the state EMS boards have the most say. They have written to control this area which means flexing their muscle when it comes to nurses entering EMS. Some of the states' stances are actually very insulting to the professional RN. Some states however are seeing this and changing especially for the requirements for Specialty and IFT transports as well as petitioning for their own credentials. ASTNA and ENA (nationally and with each state) are collaborating on establishing more guidelines for new and more up to date state regulation to reflect the needs in EMS.

This article about the ASTNA and ENA may answer some of your questions.

http://www.astna.org/PDF/HOSPENV.pdf

There is one note of interest for EMS. In their desire to have their own profession, some states also wrote their EMS statutes in a way that limited their ability to work in any other environment other than EMS or prehospital with the EMT or Paramedic title.

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Specializes in ED.

here in central florida; polk state college,valencia college, seminole state college

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