RN vs RT

[chbare]

Were the second semester clincals flexible, or were they set days, such as every Tu/Thu, or could it be Mon/Fri one week, and Tu/Wed the next?

How many hours per week, on average, were you spending on nursing clinicals? Were the hours flexible, or fixed?

A five week ventilator course, huh? It makes the three hour inservice I had seem paltry in comparison. Ventmedic has mentioned that a medic needs to have, at the bare minimum, a two year medic degree to even be able to absorb and thrive in the IFT arena, let alone CC or flight. I see her point. My medic program barely even touched on vents. I had to get up to speed once in the field.

My nursing clinical experience was not flexible. We had practicum on Tuesday and Wednesday. We had 16 hours of practicum a week and another 4-8 hours of pre-clinical work per week. The exception was labor and delivery where we were on call and had to continue the rotation until we did a delivery.

My RT clinical experience will not be flexible either. We have practicum on Monday and Wednesday, with the exception of the summer session which is about 10 hours a day for five days a week from what I have been told.

Vent pretty much nailed the other concepts and would be a better resource if you consider the RRT route. I would not suggest settling for CRT if somebody tries to persuade you to take the shorter route. With increased competition and focus on critical and special care, the role of the CRT in many places is going away. Go RN or RRT and if you have a BS program close by and get accepted take the opportunity. I wish there was a BS program in my area.

Take care,

chbare.

[VentMedic]

Vent pretty much nailed the other concepts and would be a better resource if you consider the RRT route. I would not suggest settling for CRT if somebody tries to persuade you to take the shorter route. With increased competition and focus on critical and special care, the role of the CRT in many places is going away. Go RN or RRT and if you have a BS program close by and get accepted take the opportunity. I wish there was a BS program in my area.

Take care,

chbare.

Florida and a few other states do have separate licenses with some differences in scope. CRTs don't always get to work the ICUs or do any of the "fun things" nor are they accepted to transport or ECMO programs. Rumor has it that California might finally do the right thing and only license RRTs. That would be great since CA was well known for its RT mills in the 80s and early 90s.

If the legislation is passed that the AARC has been working on, the Bachelors program will become more prominent.

The RT profession didn't wait for a mandate that they had to get a college degree in their profession. The RTs and employers just starting accepting it as the norm long before the legislation was passed for the 2 year degree. It was sorta common sense to see where a "cert" was not enough in the ICU just like the LVN. Now the 4 year degree is going the same route as more people are getting it to stay qualified in this job market.

[46Young]

You could definately do the PRN gig in nursing in almost any specialty, however I cannot speak intelligently of the RRT field. All of the RRT's I work with on the neo team are full-time, but Vent would be a great resource for that particular question. the problem isn't so much of working when convenient, but more getting to that level. As chbare states, the education is a full time one, regardless of the field. Excelsior will not prepare you for the field clinically, they expect you to come prepared. Nor does their program adequately provide the delineation from medicine and a strong foundation of the nursing process. That is the reason why many State's are thinking twice about licensing their graduates and why a good number of Paramedic's fail the CPNE. Even in an articulating students or transition program, you have to dedicate the time for class, skills, and clinicals.

Can you get creative with your schedule? Sure! Will it take its toll after a while? Probably! I'm working fulltime at two jobs plus taking a 12 semester hour load. Quite honestly, it is kicking my a$$. But I have the determination to see it through this time. Having communicated with you in multiple threads elsewhere, I could see you getting it done as you have a passion and motivation to succeed. I'd say do it!

In reference to working in the flight environment, I would strongly recommend becoming familiar with the height / weight restrictions of the agencies you are interested in. Many have a 220 - 225# weight restriction wet, meaning with suit / equipment / helmet / etc. Many also have height limitations as some of the smaller single engine airframes are not so accomodating to you taller types! I know I was tight in a Bell 206 and I'm only 5'7"!

Thanks for the words of encouragement! I remember doing several IFT txp's back in the day to LaGuardia airport to deliver a pt for fixed wing txp (I'm not sure what model) and thinking that it was really tight in there. I've heard varying accounts as to what acceptable height/weight limits are.

I'm not considering going Excelsior for RN. It's the equivalent of a medic mill, from what I've heard.

That 5 week ventilator course just introduces you to what a ventilator is. The following semesters apply what you learned from that course to the courses for introduction to critical medicine and bring it all together later. You will also get a semester of specialty ventilation/critical care theory for Peds and a semester for neonatal. As well some programs may have electives in HBO, Cath Lab and ECHO. I did all three because I just couldn't get enough. I also repeated Cath Lab later when I did my B.S. in CardioPulmonary just to see how another center known for caths did it with technology. The first was in the 80s were we still did all the calculations and manual drawings.

It is difficult to have a flexible schedule because the clinicals may actually be monitored by physicians along with the clinical educators. Most of my classes, especially ath the B.S. level, were taught by physicians.

Nursing of course can have more opportunities but the RRT can have many also. I can travel on short or long assignments in any state I care to get a license in. I have also worked PRN as an RRT most of my career as a FT Paramedic. For specialty programs such as Neonatal, they did require a serious commitment especially if you wanted to work at a higher level of competency and be on transport.

RT is a very active profession politically when it comes to lobbying for benefits for the patient and the therapists. The benefits for the patient includes home care payments from medicare for extended services. By that, whatever benefits the patient gets it helps the RRTs' future. But, the patient is always emphasized first which the profession took notes from NPs, PTs and PAs in that areas. They didn't use the "me, me, me" approach and have managed to make great strides in the past 20+ years.

The biggest thing against the Excelsior program is the clinicals. You really need to know basic nursing skills and time management. Few RNs precepting you will want to talk you through gait management and the various lines when there are so many other things to learn about the facility. The clinicals also allow you to network for a decent job.

Points noted. Cardiovascular and airway/respiratory are the systems that I took the most personal interest throughout the medic program, and I continue to hold that interest. I think that I would be happier as a RRT vs an RN. It's going to come down to being able to free up the requisite time. Taking a LOA from Fairfax isn't an option. I suppose that with major increases in educational standards, completing any of the major degrees in the healthcare field demand a full time effort, and are not particularly accomodating to those with an existing FT career/job. It seems more geared towards the young individual who may be living at home and can afford not to work, or work PT at the most. Not that it's not doable otherwise, it'll just require me to be creative.

Medic to RN bridge programs were created to accomodate the working professional, but were apparently designed poorly, leaving much to be desired. One shouldn't have to be brought up to speed when doing clinicals due to poor prep either.

I understand where you're going with the "pt first" emphasis.

[Dustdevil]

I'm not considering going Excelsior for RN. It's the equivalent of a medic mill, from what I've heard.

Not even close. A medic mill at least teaches you something, even if it's not much. Excelsior teaches you nothing. Zero. Zip. Zilch. Zed. Nada. Nyet. All they do is validate what you have somehow managed to learn (or fake) on your own.

To compare Excelsior to a medic mill is to insult both them and the medic mills.

Edited October 7, 2009 by Dustdevil

[46Young]

I totally encourage your pursuit of either RN or RRT degree. Either will open up many possibilities and avenues.

I would discourage you from thinking about trying to get a job in the flight arena per diem. I don't know of any flight program that would hire someone without previous flight experience for a per diem position. If they did I would be looking at a different program. People who have already worked full-time in flight are ok to go to per diem but it is not a position that you should be starting and learning about in a per diem position. You will also need 3-5 years of critical care experience as either an RN or RRT or good 911 ground experience as a paramedic before you should even consider a flight position.

When you say you are looking at retiring at age 55 is that just the fire service or working altogether?

I wasn't sure if there was a market for PT flight RN's/medics.

I got on at Fairfax at age 32. I'm currently 33. Normal service retirement is at either 25 years of service at 2.8% (approx 72% of average three highest earning years minus OY), or age 55, whichever comes first. One can work in excess of 25 years to increase the multiplier, resulting in a near 100% yearly payout. I plan to work a total of 23 years, which will occur when I'm 55, and then do three more years in the DROP, to maximize my retirement.

I would keep an eye out at Montgomery College's website over the next few years as they are doing a lot in the way of a paramedic program and since they have a pretty good nursing program they might offer a bridge. The nursing school is located in Takoma Park, Maryland, which can be a little bit of a hike from Fairfax (not sure where you live). I'll shoot an e-mail to the program directors over there and see what they are thinking in ways of a bridge course. Montgomery College does however have a great Fire Science degree with one of the classes taught (last I heard) by our Chief Richard Bowers. The fire science course I took through there, equivalent to Officer I, met about once a month and almost all of the work was online. We had a career MCFRS member go through the course.

Something to look into.

I can not speak much to RN vs RT but I am a full time nursing student and just school alone (20 credits) is really kicking my butt some days. I just pulled an all nighter and I wish I could say it was my first of the semester. We have one woman in our class who works full time as an ED tech and she is barely scraping by with passing grades. It may just be the program I am in, but something to consider. A full time schedule anywhere is the equivalent to a full time job in my opinion and depending on your social life, may be hard to keep up and still do well.

Best of luck to you and don't hesitate to PM me if you have any questions about MC's programs. I know both of their department heads and they are fantastic people and paramedic volunteers in Montgomery County.

I'm currently living in Garrisonville in Stafford County, just below Quantico. I'm going to meet with the FRD's career development/education coordinator next week and see what we have set up with regional universities/colleges. I'll check out your leads as well, of course. Thanks for that.

I worked FT + an OT shift each week on average while going through my 13 month medic program, which was two 8 hour days per week with 16-24 hours of clinicals, flexible. The material wasn't anything as intensive as the RN or RT curriculum, I'm sure.

The FFM job + OT will keep us comfortable, so completing the Fire Science dergree first may be the best career wise, especially if you're only meeting once a month. Tackling an RT or RN program head on should be easier on a Tech or Lt salary, along with an ample amount of leave available. The RN or RRT licenses interest me greatly, but can be deferred if the curriculum creates too much with my current schedule and relative lack of leave in the bank. If it works out I'll do RN or RT first, but at least I know that I can do the Fire Science degree in a much more career friendly fashion at first. I also want a fallback with RN or RT if I go out on permanent injury, or to segue into FT post retirement.

20 credits is a full plate, I'm sure. Keep up the good work!

I'm having trouble with some of the non-standard acronyms you're using here. Can you define these for me?

FRD

NSLIJ

DROP

WOWOWOOOO

FRD is the Fire rescue Dept, Fairfax County to be specific.

NSLIJ is the North Shore Long Island Jewish Health System. I worked for their Center for EMS, which does both NYC 911 and IFT.

The DROP is the Deferred Retirement Option Plan

http://benefitsattorney.com/modules.php?name=Content&pa=showpage&pid=17

WOWOWOOOO is my work rotation. Each character represents a 24 hour block. W=work, O=off.

Everything clear as mud?

My nursing clinical experience was not flexible. We had practicum on Tuesday and Wednesday. We had 16 hours of practicum a week and another 4-8 hours of pre-clinical work per week. The exception was labor and delivery where we were on call and had to continue the rotation until we did a delivery.

My RT clinical experience will not be flexible either. We have practicum on Monday and Wednesday, with the exception of the summer session which is about 10 hours a day for five days a week from what I have been told.

Vent pretty much nailed the other concepts and would be a better resource if you consider the RRT route. I would not suggest settling for CRT if somebody tries to persuade you to take the shorter route. With increased competition and focus on critical and special care, the role of the CRT in many places is going away. Go RN or RRT and if you have a BS program close by and get accepted take the opportunity. I wish there was a BS program in my area.

Take care,

chbare.

Thanks again. It would have been way easier if I was still working at NSLIJ, where they are willing to accomodate a FT school schedule with a workable shift change, as long as your intended degree would benefit the Health System. I had to go with the FFM position over staying in NY to pursue a degree (or several). This made the most financial sense for my family and I, and I can still fufill my degree aspirations. It'll just be a little more taxing.

Florida and a few other states do have separate licenses with some differences in scope. CRTs don't always get to work the ICUs or do any of the "fun things" nor are they accepted to transport or ECMO programs. Rumor has it that California might finally do the right thing and only license RRTs. That would be great since CA was well known for its RT mills in the 80s and early 90s.

If the legislation is passed that the AARC has been working on, the Bachelors program will become more prominent.

The RT profession didn't wait for a mandate that they had to get a college degree in their profession. The RTs and employers just starting accepting it as the norm long before the legislation was passed for the 2 year degree. It was sorta common sense to see where a "cert" was not enough in the ICU just like the LVN. Now the 4 year degree is going the same route as more people are getting it to stay qualified in this job market.

If I decide to go RT, I'll go all the way. Money won't be a motivating factor in this anyway, so why not take the time to attain the highest level possible?

Not even close. A medic mill at least teaches you something, even if it's not much. Excelsior teaches you nothing. Zero. Zip. Zilch. Zed. Nada. Nyet. All they do is validate what you have somehow managed to learn (or fake) on your own.

To compare Excelsior to a medic mill is to insult both them and the medic mills.

I suspected as much.

[VentMedic]

If I decide to go RT, I'll go all the way. Money won't be a motivating factor in this anyway, so why not take the time to attain the highest level possible?

If you do go for RT, the RRT is the way. After that you may want to specialize.

However, the reasons for obtaining the higher level would be if you have any desire to work in a critical care unit, with ventilators and do transport.

Again, if other states do start to recognize the highest level for licensing, the CRTs will have to upgrade. Right many CRTs have been faced with that to maintain their status in the hospitals. They were given 5 years to meet the 2 year degree requirements and get their RRT as the minimum education standard was raised. The hospitals had not obligation to maintain the lesser educated and credentialed providers in the critical care areas. Within the new few years there will only be the RRT and the differences in education of having either the 2 year or 4 year degree similiar to the options now for RN as the LVN has essentially dropped out of acute care. If the Bills pass as the AARC have planned, the 4 year degree will become more prominent and even expected by the employers. It will then be easy to increase the minimum education requirement for entry into the profession to a Bachelors. That will at least get RT closer to the other allied health professions when it comes to education and recognition with the insurances or medical community.

It's not EMS where some argue for the lowest common denominator or cert of 120 hours. When you manage an ICU ventilator and critical patient, just showing you have the knowledge for "certified" is no longer enough.

Of course nursing is now going through some of the same considerations for its profession as we are now seeing more BSNs especially in ICUs and specialties with that now being the lowest education level in some areas.

Edited October 7, 2009 by VentMedic

[46Young]

If you do go for RT, the RRT is the way. After that you may want to specialize.

However, the reasons for obtaining the higher level would be if you have any desire to work in a critical care unit, with ventilators and do transport.

Again, if other states do start to recognize the highest level for licensing, the CRTs will have to upgrade. Right many CRTs have been faced with that to maintain their status in the hospitals. They were given 5 years to meet the 2 year degree requirements and get their RRT as the minimum education standard was raised. The hospitals had not obligation to maintain the lesser educated and credentialed providers in the critical care areas. Within the new few years there will only be the RRT and the differences in education of having either the 2 year or 4 year degree similiar to the options now for RN as the LVN has essentially dropped out of acute care. If the Bills pass as the AARC have planned, the 4 year degree will become more prominent and even expected by the employers. It will then be easy to increase the minimum education requirement for entry into the profession to a Bachelors. That will at least get RT closer to the other allied health professions when it comes to education and recognition with the insurances or medical community.

It's not EMS where some argue for the lowest common denominator or cert of 120 hours. When you manage an ICU ventilator and critical patient, just showing you have the knowledge for "certified" is no longer enough.

Of course nursing is now going through some of the same considerations for its profession as we are now seeing more BSNs in ICUs and specialties with that now being the lowest education level in some areas.

A few questions

What are the educational requirements for a CRT vs a RRT?

Is it eaiser (schedule wise) to upgrade from CRT to RRT rather than go right to RRT?

Would going from CRT to RRT result in a poorer educational experience than going straight to RRT?

I understand that RRT may soon become the National standard, so this may be irrelevant. I don't plan on doing it piecemeal, but if I go out on permanent disability due to an on the job injury or whatever, I may need to start work ASAP, so then and only then I would consider going CRT at first.

Did you complete your degree while still employed as a firemedic? If so, what were your time management strategies?

Thoughts from anyone on this?

http://staging.nvcc.edu/medical/health/nursing/forms/Online%20Nursing%20Program%20Information%20Handout%20For%20Students%20Entering%20Spring%202008%20-%207-07.pdf

[VentMedic]

A few questions

What are the educational requirements for a CRT vs a RRT?

Is it eaiser (schedule wise) to upgrade from CRT to RRT rather than go right to RRT?

Would going from CRT to RRT result in a poorer educational experience than going straight to RRT?

I understand that RRT may soon become the National standard, so this may be irrelevant. I don't plan on doing it piecemeal, but if I go out on permanent disability due to an on the job injury or whatever, I may need to start work ASAP, so then and only then I would consider going CRT at first.

Did you complete your degree while still employed as a firemedic? If so, what were your time management strategies?

Now that the entry for RT is a 2 year degree there is no difference in education. There are just two very different tests that must be taken; CRT and then RRT.

Since RT had the 1 year tech with the credential CRTT and then CRT as the profession was preparing for the education change for several years, there were and are still many "technicians' that got grandfathered. As they become fewer in number and as the states start to recognize just the RRT, there will be a push to combine the information into one huge examine and just have the entry credential at RRT. The profession doesn't want to alienate some of the older original techs but eventually there will be no choice as change must move forward.

The CRT covers mostly the technical aspects of the job and emphasizes basic knowledge of equipment and theory of the equiment such as venturi principles.

The RRT deals with clinical data and application of theory to hemodynamics and disease processes. The RRT is a 2 part test with clinical simulations being one part. Some do both parts of the RRT on the same day and some do 2 days.

Yes I was still with the FD. However, I also has a 2 year degree as a Paramedic from 1979, a few years before I got hired with the FD. It was still a 2 year course even though I had the prequisites done but it was a couple less classes each semester. This was before the mega mergers and the FDs at that time did support education by allowing some trading of hours.

The nursing program:

The better online programs keep you at the same pace with your other classmates for the diadetic. Clinicals should still be in the same time frame as some of the classes or close to it. There also should be no scrimping on the clinical hours and a good program should have no less than 1000 hours for just the clinicals.