Will my EMT experience help get a job as an ER-Nurse?

heinz57 · Sep 28, 2016

Whether the EMT cert will matter will depend a lot on the culture of your ER and EMS along with your own attitude. If it is an Ambulance Driver vs Butt Wiper type of situation, the EMT probably won't help much. If your own attitude goes along with cockiness or hero to save the day that only an EMT could possibly do CPR or know what to do with a broken bone while nurses, especially those with a BSN, would be useless, expect some difficulty if you emphasize your EMT. When being interviewed, managers will want to know what you have experienced as a nurse or in school which will help you fit in.

If you are in California, going through the Paramedic course even though it isn't that long would be a waste of time. It is a short hop to get the Paramedic patch in California after you have your RN license. RNs have a much broader scope of practice than any California Paramedic. It also seems everybody you talk to in that state is a Paramedic including the barista at one of the coffee houses I frequented during a conference. He was waiting to get hired by the fire department but preferred serving coffee over "wiping butts or doing dialysis runs".

torie RN, NRP, CEN · Sep 29, 2016

Whether the EMT cert will matter will depend a lot on the culture of your ER and EMS along with your own attitude. If it is an Ambulance Driver vs Butt Wiper type of situation, the EMT probably won't help much. If your own attitude goes along with cockiness or hero to save the day that only an EMT could possibly do CPR or know what to do with a broken bone while nurses, especially those with a BSN, would be useless, expect some difficulty if you emphasize your EMT. When being interviewed, managers will want to know what you have experienced as a nurse or in school which will help you fit in.
If you are in California, going through the Paramedic course even though it isn't that long would be a waste of time. It is a short hop to get the Paramedic patch in California after you have your RN license. RNs have a much broader scope of practice than any California Paramedic. It also seems everybody you talk to in that state is a Paramedic including the barista at one of the coffee houses I frequented during a conference. He was waiting to get hired by the fire department but preferred serving coffee over "wiping butts or doing dialysis runs".

So California RNs, within the nursing scope of practice, can do surgical crics, administer RSI medications, intubate patients, make the decision to synchronized cardiovert or transcutaneous pace independently without a licensed practitioner giving orders? What? How exciting!

Look, as someone who is a paramedic (first) and a RN, I recommend getting an ER tech job. It'll open your eyes to in-hospital versus pre-hospital. There's a huge difference. The combination of in-hospital experience and pre-hospital experience did two things for me (1) made me a better paramedic, and (2) made me a better nurse. I worked as an ED tech while as a paramedic before and during nursing school. I wouldn't have experienced it any other way.

heinz57 · Sep 29, 2016

So California RNs, within the nursing scope of practice, can do surgical crics, administer RSI medications, intubate patients, make the decision to synchronized cardiovert or transcutaneous pace independently without a licensed practitioner giving orders? What? How exciting!
Look, as someone who is a paramedic (first) and a RN,

I was wondering when somebody would start the "nurses need someone to give them an order to do anything" mess.

Paramedics are not independent medical practitioners. They aren't mid level practitioners (NP, PA) either. They have medical directors (doctors) who write protocols for everything a Paramedic does. Whatever is not in the protocols or even if it is sometimes, a Paramedic must contact their Med Control.

Nurses also work under protocols. This applies to almost ALL nurses working in hospitals. Their protocols will be dependent upon where they work. Critical Care RNs and those on Rapid Response Teams and Code Teams can usually get the party started without a doctor to hold their hands. This includes RSI, medications, intubation and defib or cardioversion. L&D (labor and delivery) nurses also can do their protocols to keep a baby alive. RNs working on HEMS, PICU, NICU and Cardiac Specialty Transport teams have extensive protocols which can definitely surpass a Paramedic in out of hospital care. Many transport teams don't include Paramedics. In California, a lot of CCTs are RN/EMT/EMT.

Spend some time being a nurse first and you will see they do more than wipe butts.

TheSquire, DNP, APRN, NP · Sep 30, 2016

I was wondering when somebody would start the "nurses need someone to give them an order to do anything" mess.

No, they were responding to you minimizing what medics can do skills-wise, which aren't taught in nursing school and even more rarely done in practice by RNs. While orders had something to do with it, medics spend a lot of time functionally (though not legally) independent while still working in scope, to a degree that would scare the pants off most RNs.

Before being so quick to argue, perhaps you should look at what someone's saying and who's saying it (torie's a board-certified emergency nurse, not a medic). Rather than clarifying or educating, you just look like an ass.

heinz57 · Sep 30, 2016

No, they were responding to you minimizing what medics can do skills-wise, which aren't taught in nursing school and even more rarely done in practice by RNs. While orders had something to do with it, medics spend a lot of time functionally (though not legally) independent while still working in scope, to a degree that would scare the pants off most RNs.
Before being so quick to argue, perhaps you should look at what someone's saying and who's saying it (torie's a board-certified emergency nurse, not a medic). Rather than clarifying or educating, you just look like an ass.

Do you know that nurses function everyday on transport teams without A DOCTOR looking over their shoulder? They take very tiny babies from one hospital to another on multiple drips and lots of equipment without "have their pants scared off". These are transports which most Paramedics will not be on. Do you actually think there is a doctor sitting at the bedside of every ICU patient telling a nurse what to do at all times? Do you really have such low opinion of nurses?

By your logic, no Paramedic should be doing CCT at all since ventilators, multiple drips, IABPs and LVADs are not taught in Paramedic school. Some schools only do dummie head intubations because they can not get OR time. Did you know that Paramedics in California do not have RSI in their scope of practice? Try looking up a Paramedic's scope of practice. You only have EMT-B behind your name and it seems you have not worked as a nurse where there are actual protocols. Not all nurses need hand holding and are afraid to do transport where functioning "independently" is the norm.

Torie quote

Look, as someone who is a paramedic (first) and a RN,

Torie also has NRP in her screen title. That usually stands for Nationally Registered Paramedic. But good to know she is not a Paramedic. She much have mistyped that statement or I am reading it wrong.

CEN is one of several certifications offered by a private corporation. There is also the Board for Critical Care Transport Paramedic Certification (BCCTPC) which sounds cool but not a state licensing board. TNCC is offered through ENA. New grads have taken the CEN since it does not require experience hoping to improve their resume. It is not that difficult to get and after several years of various certs, most of us don't attach them to our titles.

torie RN, NRP, CEN · Sep 30, 2016

Yes, I am a paramedic. And since you want to bash my CEN certification, I am also a critical care transport/flight RN with one of the most prestigious programs in the country. I got the job after 3 years of nursing, ER experience only. You know what got me the job? My 6 years of paramedic experience.

Since you want to bring up CCT, all transport RNs in my state must have a minimum of EMT-B, preferably paramedic, to be on the CCT since it still governed by the Office of EMS. While BON has allowed CCT/HEMS RNs a much broader scope of practice, it's still protocols. Just like paramedics.

A new graduate paramedic comes out with the critical care skills I outlined above. A new graduate RN does not.

Paramedics and RNs are complementary to each other. Two different professions. Two different sides of the fence. I don't feel a need to personally bash a stranger troll who has obviously been offended by a paramedic sometime during their nursing career and their feelings never recovered.

Best of luck to you.

Socal_EMT · Sep 30, 2016

I swear I wanted to pop some popcorn for this thread

I do appreciate the conversation. Each of you brought a unique perspective to the table.

applesxoranges, BSN, RN · Sep 30, 2016

Well, EMT allowed me to become an ER tech. When I was laid off due to it being a rural ER, I was able to get a job as a unit clerk/paramedic in a larger ER in the company. When I became a nurse, I made the mistake of trying something else but the paramedic experience helped me get a job back in the ER.

My advice is to search for a job now as an ER tech. The EMT cert may help you get into the ER. Work hard and make yourself invaluable to get the references. They may offer you a position in the ER if they like you or you may get a spot elsewhere.

In general, California is notorious for being hard to find a job as a new grad. If you keep yourself more flexible and able to move, you increase your chances of getting a job. Even going out of state.

supakimchee · Oct 7, 2016

So California RNs, within the nursing scope of practice, can do surgical crics, administer RSI medications, intubate patients, make the decision to synchronized cardiovert or transcutaneous pace independently without a licensed practitioner giving orders? What? How exciting!
Look, as someone who is a paramedic (first) and a RN, I recommend getting an ER tech job. It'll open your eyes to in-hospital versus pre-hospital. There's a huge difference. The combination of in-hospital experience and pre-hospital experience did two things for me (1) made me a better paramedic, and (2) made me a better nurse. I worked as an ED tech while as a paramedic before and during nursing school. I wouldn't have experienced it any other way.

Paramedics do not act independently without orders, neither do nurses. If you are carrying out ANY ALS interventions in the field it is under the direction of a licensed physician/MICN or it is part of your Standing Field Treatment Protocols which are orders created by your Medical Director of your EMS agency. As for the surgical/needle crics - this is NOT allowed per LA County EMS protocols, so that's just a jurisdictional thing.

I will agree with you that medics and nurses are complementary. There are things medics can do WITH orders that nurses cannot do and vice versa.

I really don't see a point in bickering amongst ourselves when we're all part of the same team.

heinz57 · Oct 10, 2016

Yes, I am a paramedic. And since you want to bash my CEN certification, I am also a critical care transport/flight RN with one of the most prestigious programs in the country. I got the job after 3 years of nursing, ER experience only. You know what got me the job? My 6 years of paramedic experience.

Okay, so you are a Paramedic. That is what I said and I was NOT the one saying you weren't. This is a quote from TheSquire's post.

look at what someone's saying and who's saying it (torie's a board-certified emergency nurse, not a medic).

There are a lot of prestigious transport programs in the US which also have a lot of RNs on them who function very well well.

Take the CEN for what its worth but when getting extra letters it is important to consider who is providing them.

Since you want to bring up CCT, all transport RNs in my state must have a minimum of EMT-B, preferably paramedic, to be on the CCT since it still governed by the Office of EMS. While BON has allowed CCT/HEMS RNs a much broader scope of practice, it's still protocols. Just like paramedics.
A new graduate paramedic comes out with the critical care skills I outlined above. A new graduate RN does not.

The reason for the "EMT-B" in some states has very little to do with the training but rather the definition of who can ride on an ambulance. This was done by EMS Board Members of that state to keep control of those on an ambulance. In a couple of states it even bled over into specialty teams such as recently in Louisiana until out dated legislation was finally updated. Eventually as more nurses are involved in prehospital medicine with specialty training, more states will also be updating those outdated regulations.

What you described earlier are Paramedic skills for those in many states. The exception is RSI which is not allowed in a few states by Paramedics. "Critical Care" skills for Paramedics on CCT come later when they take a short intro course like UMBC which teaches a little about IABPs, hemodynamics and a few common drips.

Paramedics and RNs are complementary to each other. Two different professions. Two different sides of the fence. I don't feel a need to personally bash a stranger troll who has obviously been offended by a paramedic sometime during their nursing career and their feelings never recovered.
Best of luck to you.

If you read my posts you will find out more information about Paramedics and that I not at all offended by them. However, your posts are biased strongly towards Paramedics. You clearly believe nurses could not possibly be as good as a Paramedic in a critical care situation. In my nearly 40 years of working both in and out of the hospital, I have seen my share of egos which have done very little for the patient. I can only imagine how difficult it is for you to be a team player on any prestigious "team" where both nurses and Paramedics must interact together. Best of luck to those members of that team.

heinz57 · Oct 10, 2016

I swear I wanted to pop some popcorn for this thread
I do appreciate the conversation. Each of you brought a unique perspective to the table.

Good response.

What is a Hemodynamic Cardiopulmonary Tech? Our hospitals have Cardiopulmonary Respiratory Therapists but they get pretty offended by the term "tech".

PG2018 · Oct 15, 2016

So from a totally outside perspective, I didn't find being a paramedic helpful from a process perspective. The ED is typically staffed by anal retentive types, in my experience, focused on throughput while I'm focused on calm. I was a paramedic only for a brief span of time and maintained the cert and skills as a side qualifier for another career field. By the time Id moved onto nursing, I'd forgotten about the nuances of vasopressors and found people weren't really using lidocaine anymore, lol. Defibrillators had changed and ACLS, although current, actually used hypothermia. In summation, I didn't find any of the prior field work to convey well although there was an eight year gap between lapsing of my paramedic certification and work as an ER nurse. Although I like to run and workout, I'm at a point in life where I want to sit at a desk and wear slacks so I didn't like the ER. Had I been 12 years younger and interested in somatic medicine then yes. I'd seen enough trauma at that point that I didn't participate in trauma calls.