I have a lot of questions, so please bare with me! I don't want to offend anyone, or do say anything really dumb XD.
I am just about to start my senior year of high school, I received my CNA certification and am a certified EMS- First Responder during my junior year. This coming year, I will be taking EMT-Basic.
My ultimate goal is to work in the ER.
This is where my dilemma is!
I don't want to be a doctor, that's for sure! However, I want to do the most that I can in the emergency room, meaning in terms of skills and scope of practice!
I was wondering about just going on to be a Paramedic, and working in the ER. Does a Paramedic do the same skills as a trauma nurse? Like, are they equal in what they can do?
And, it's only an extra year of schooling, since I have my EMT-Basic certification.
Or do I just need to go into nursing as a registered nurse? Do I get to go directly into the ER, or do I have to work until I get enough experience to go into it?
Or do I get both Paramedic and RN, and get to go into the ER?
Sorry with all the questions! I really need to start making decisions soon, and I really really want the answers to be as detailed as possible, answering all my questions.
Not true in NJ. An MICN is simply an RN who is working in the role of a paramedic. No difference in scope whatsoever.
An RN can work in an ICU and gain critical care experience as well as many other units and specialty teams.
I believe a Paramedic in NJ is limited to prehospital or sometimes the ED in hospital based situations and can not function in the same duties as an RN in the ICU.
There will be many IFT critical care patients which are beyond the scope of practice of a Paramedic or knowledge and the ICU experience of the RN will be very useful.
In California, most of the CCT and Flight programs are staffed by RNs. The MICN is also used for base hospitals for online communications with EMS.
And shouldn't experience as an RN be better for me, rather than BSN education?
The education will help you better understand the experience.
Also, doing clinicals as a CNA is vastly different than having 15 to 20 patients to care for by yourself with the RN busy overseeing 15 - 30 patients in long term. Even in the hosptial our CNAs rarely sit for even a break and may have 15 patients every shift when staffing is good. They also take a lot of abuse from patients and even other health care professionals.
Well, that's the thing. After taking EMS First Responder, I knew as soon as we did the MCI and Skills Testing, that I absolutely loved Trauma.
And when I did clinicals for CNA, I absolutely loved working in the nursing home with people.
So Trauma Nursing was a nice balance of the two, I thought.
The reality of Trauma is much, much different than you get in MCI training. It's at the same time much more complicated and simple than in training. Trauma in person, out in the field is an ugly, messy affair. I have met many an EMT that thinks they love that aspect of things only to realize that the day-to-day life is far different, so much so that they're unable to function when push comes to shove.
You might find out after working a while as a CNA that you like working with people but you dislike the job.
When it comes to working in the ED, an EMT may have a greater scope there than in the field while a Paramedic may have a more restrictive scope than in the field. Some places use Paramedics in their full scope in the ED while in others they're basically little more than gophers.
You should do your "homework" about that. It may very well be that EMT training is all that is needed to work in the local ED. If your end goal is to be a Trauma RN, you might find that getting Paramedic training is overkill for what you'll need and an expensive detour in terms of time and pocketbook.
Keep looking at what you want to do and find a way to get there. Just try to avoid unnecessary delays.
i put some of my responses in red in-line to address some points.
in my state paramedics do clinical rotations in the er during their schooling, but if they do get hired in the er they work as er techs as their scope of practice is limited to field/ambulance/mobile icu(medic rig) under the direction of an ed physician. medics cannot intubate, start iv's, administer medications, defibrillate, or any other acls/als skill once care is transferred from the ems to the ed team.
do be careful about this generalization. while paramedics function under medical supervision, it may not be the ed md that they answer to. they may answer to their own service's medical director or the county's medical director.
paramedic does not equal trauma nurse/ed nurse.
very true and the reverse is also true.
my sister earned her emt-b in nursing school. when she graduated with her bsn & started working in pediatrics she was recruited for a pediatric ed (her emt cert was reciprocal) and they paid for her msn, pals, and micn (mobile intensive care nurse) so she was on the pediatric critical care transport team.
micn has a greater scope of practice than a paramedic. they have critical care experience and can manage invasive critical care equipment such as arterial lines and are used for inter-facility transfers of critical care patients to specialty hospitals.
an micn's scope in the prehospital environment can vary pretty widely. some places they're limited to what a paramedic's scope.
rn's in many states can challenge the paramedic certification preferably with experience (i.e. a new grad may be declined permission to challenge the paramedic certification).
this is usually true. an rn generally can challenge the paramedic's license/certification but may be required to complete additional education or field time. here in california, an rn can challenge but they generally have to take a paramedic refresher course, sit for the nremtp exam and complete a 480 hour internship. the idea behind the internship requirement is to teach the rn/emtp the things that will ensure safety while out in the field. it is these things that aren't taught in rn school.
you may be able to get a job in the local er as a nurse tech/er tech while in nursing school & with an emt-b. (nurse techs are usually nursing students who have completed nursing 1/fundamentals 1 and mayhave a greater scope of practice than a cna/er tech)
i'm not saying that nurses can't do the prehospital role: they do it all the time. what i am saying is that nurses are not educated for that role unless they specifically seek out that education. not having that education can result in misunderstandings between all providers.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
As a high school student..........Never mind all this debate about MICN and what responsibilities everyone has in their jobs, which vary WIDELY depending on the rules and regulations of the EMS systems and nurse practice acts. There will be plenty of time for that later.....looking backward to develop a plan for forward here are my thoughts. It is just my opinion and everybody has their own opinion. I still think, as I said earlier, to check with yoru local fire department/rescue department and rescue helicopter or critical care transport crew and ask them. Google them for your area or call your local ED. You may have to call back but they will talk with you.
In hind sight, what I know now, in this day and age, knowing I wanted trauma flight........ here's what I would do.....
Whatever school I could get in first would be my first choice.
If it was RN then I would do RN, take NCLEX and immediately enroll for my BSN, using tuition reimbursement and during breaks continue my education to be a paramedic. I would seek employment in an emergency department as a tech and try to absorb all the information I could or work part time on an ambulance to get experience and have money for school while becomming a RN and work as an RN while getting my BSN and paramedic.
If it was a paramedic first I would work as a paramedic gaining experience in emergency care in the field and maybe if I was on a transport rig I would be able to learn about critical care patients from the critical care transport nurse. I would use tuition reimbursement to continue my education to be a nures. I would get My RN and ultimately my BSN quickly as that is the assurance to gaining employment and advancement in the career of my choice.
The common thread of this is get your education and in becomming a nurse.......with the trend in the profession....... a BSN is essential to your sucess as a nurse.....:).
Specializes in Infectious Disease, Neuro, Research.
Esme is right.
I'm a former EMT (KS) and a former Coloradoan (Durango). Given your position, I would go EMT-B, and see about a Wilderness Rescue/medic class, then RN. Wilderness is generally available for $1000 or less, and is in demand in CO.
Your Fire & EMS services frequently have Reserve units- you won't be paid, but you can get all the experience you have time for, while going to school or with a non-provider job. For my personality, the trap was the fun- I loooved trauma, so I never went back to school...until I was 36.
The best bang for your buck:
EMT-B -> employment with tuition reimbursement-> BSN/EMT(keep your cert current, if CO requires EMT/Para licensure to transport.) States vary, so that rider may or may not be available to you, or may be more of a PITA than it is worth.
What if I got for my ASN, the two year nursing program. Then get a job as it, and as I am working to the RN-BSN program.
If you're going to go for RN and you have the option of doing a 4 year BSN program, that would be a good path. If money is an issue, a 2+2 (as I call it) of ADN then transition to BSN may be of value. I'm on that basic path myself as until this year, a 2nd Bachelor's was not an option. It was ADN or nothing. I'll do the ADN to BSN upgrade and since I have a Bachelor's already, all I have to take is the courses for the upgrade.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
What if I got for my ASN, the two year nursing program. Then get a job as it, and as I am working to the RN-BSN program.
That's what I said if you re-read my post.....Whatever school I could get in first would be my first choice.
If it was RN then I would do RN, take NCLEX and immediately enroll for my BSN, using tuition reimbursement and during breaks continue my education to be a paramedic. I would seek employment in an emergency department as a tech and try to absorb all the information I could or work part time on an ambulance to get experience and have money for school while becomming a RN and work as an RN while getting my BSN and paramedic.
If it was a paramedic first I would work as a paramedic gaining experience in emergency care in the field and maybe if I was on a transport rig I would be able to learn about critical care patients from the critical care transport nurse. I would use tuition reimbursement to continue my education to be a nures. I would get My RN and ultimately my BSN quickly as that is the assurance to gaining employment and advancement in the career of my choice.
The common thread of this is get your education and in becomming a nurse.......with the trend in the profession....... a BSN is essential to your sucess as a nurse.....:).
and that's IF and that's a big IF......you get accepted into a program your first try. Nursing is tight right now and new grads are graduating nursing school and are remaining unemployed for 2 years or more or only getting jobs in nursing homes. Just because you graduate, right now, doesn't mean you will be able to find a job. Some hospitals, are right now, stating they are only interviewing BSN candidates. The job market is REALLY tight in nursing and I forsee it to be like this for a while longer.
If you don't get accepted into nursing I would go for the paramedic which still maybe the better begining option overall, considering the job market today. peace
pishoncna
35 Posts
Well, that's the thing. After taking EMS First Responder, I knew as soon as we did the MCI and Skills Testing, that I absolutely loved Trauma.
And when I did clinicals for CNA, I absolutely loved working in the nursing home with people.
So Trauma Nursing was a nice balance of the two, I thought.