I have a similar problem. I just passed the national registry and am now a NREMT-P. I've been an LVN working in and out of ER's and ICU's for about 14 years. I was trained as a EMT-B in the Army but always worked as a nurse. I have no box time other than school, which makes me really nervous. I know what I'm doing, I'm not (as) worried about cardiac or medical issues but I'm concerned about the trauma patients. In the ER we have "medical control" beside us directing things, but out in BFE your it. When I have a pt in my ER working them is second nature, but pre-hospital is a whole new world for me. I'm applying for my state cert (Texas) so I can start working some PRN at one of two of the local 911 services. Any suggestions to my dilemma other than jumping in feet first?