Paramedic/RN

[Dustdevil]

Here in Arizona, there are very long wait lists for nursing school due to the lack of qualified Nursing instructors.

I think that is almost pandemic in the US, and has been for awhile. Sad, but it perpetuates a shortage, which is good for wages, lol.

I started nursing school right before the Gulf War, and my class got interrupted for a full year because of the number of instructors who got deployed.

[spenac]

Its funny how many ads from the community college I see for RN's to make extra money teaching part time. Seems nursing has some of the same issues as EMS and Tom, Dick, or Harry can teach.

[chbare]

Its funny how many ads from the community college I see for RN's to make extra money teaching part time. Seems nursing has some of the same issues as EMS and Tom, Dick, or Harry can teach.

In some cases, yes. The thread was looking like it could go into nursing erotica land, and I wanted to emphasize the fact that the profession of nursing is far from sorted. While this does not excuse EMS, I also wanted to point out some of the major issues facing my profession.

Take care,

chbare.

[spenac]

In some cases, yes. The thread was looking like it could go into nursing erotica land, and I wanted to emphasize the fact that the profession of nursing is far from sorted. While this does not excuse EMS, I also wanted to point out some of the major issues facing my profession.

Take care,

chbare.

I appreciate it. At times it gets old hearing we suc and they rule. We know we need to advance and are disorganized.

[Jwade]

I applaud nursing for having high educational standards for the educators. I personally feel that EMS is lagging because it has not set the bar higher for its instructors to become educators. Once education becomes more visible to the students, an example is set rather than "look at the cool things Bubba has done and he only had 4 months of trainin'". For RT, I am really impressed at the support for education but then after having all the other health professions looking down their noses at the RTs in the 80s when the tech mills tried to ruin the profession, it is nice to see this profession emerge stronger than the weakest link. Unfortunately, EMS is still catering to the weakest links.

RT combines the best of two worlds; technology and health care. For those who love gadgets and taking the human body to extremes with technology, it is a fascinating career. However, Physical Therapy ranks up there in gadgets and a fascinating profession with many different opportunities as well as being one of the better paid with sign-on bonuses that make even the RNs drool.

Vent,

My cousin is a PT in Michigan and her program was a Masters in Science. I am pretty sure just about all PT programs are all Graduate level now? We could take a lesson from these guys and the Pharm people i think!

JW

[VentMedic]

Vent,

My cousin is a PT in Michigan and her program was a Masters in Science. I am pretty sure just about all PT programs are all Graduate level now? We could take a lesson from these guys and the Pharm people i think!

JW

There's also the DPT, Doctor of Phyical Therapy which is 3 years in length post Bachelor's. Let's not forget the SLPs, Speech Language Pathologists, which is now a Masters. I believe that is true for OTs as well and anything less is an assistant. Athletic Trainers are a minimum of a Bachelor's with a Masters preferred. Exercise Phyiologists have a Masters. Dieticians have a Masters with some heavy Chemistry and math prerequisites.

Edited January 10, 2010 by VentMedic

[ccmedoc]

In some cases, yes. The thread was looking like it could go into nursing erotica land, and I wanted to emphasize the fact that the profession of nursing is far from sorted. While this does not excuse EMS, I also wanted to point out some of the major issues facing my profession.

Take care,

chbare.

True, true, true...It seems that nursing is pushing through to get the DNP as a preferred track, while at the same time not having the resources to adequately educate at the BS or even ADN level. I have even heard talk about the CC level colleges offering a BSN.

1/3 of the students from the last BSN class in the University I am affiliated with are not even planning on staying in nursing or nursing education. They seem to prefer the BSN as a launch pad to anesthesia. This contributes the educator shortage for sure; but comparing salaries, who can blame them.

I appreciate it. At times it gets old hearing we suc and they rule. We know we need to advance and are disorganized.

I think it is prudent to get our own house in order before putting these statements forth. If I gave this impression, I apologize. As easy as it is to pick the shortcomings of EMS education, Nursing is far from being a model of efficiency..

[VentMedic]

I appreciate it. At times it gets old hearing we suc and they rule. We know we need to advance and are disorganized.

YOU know about some of the weaknesses in EMS but not everyone does or they care to ignor it especially if they already have the benefits of a FD. We've had countless people on the forums, including those that claim to be "CCEMT-P or FP-C" that will say a few hundred hours are adequate to do a few skills.

Do we just not talk about it and pretend the problem does not exist? This has absolutely nothing to do with "they suc more than us" so this whole us against them mentality needs to disappear from EMS. EMS has tried the "we're so different" attitude for too long and has alienated itself. Other professions decided it was easier to play nice...until they got stronger.

When Rid, Dust and I started in EMS, there were already established degree programs in EMS and it was thought that the Paramedic would be THE health care professional of the future. There was not much competition since many of the allied health programs were just starting out or has not started at all. Nursing was still trying to come out of the diploma era. Some of us who got our Associates "because that was the future" and enjoyed the respect of being "physician extenders" by some definition, got to experience a different level of professionalism. Then, greed and ignorance tore apart over 15 years of progress for selfish agendas that had little to do with patient care. Yeah, let's just stop talking about it. Those who are leading the mergers and churning out mediocre medics at a rapid fire pace would rather not hear about educated EMS providers.

Edited January 10, 2010 by VentMedic

[UMSTUDENT]

I'm going to say something kinda inflammatory. This is an educated response, I think. Since it involves the comparison between paramedic education and nursing education let me preface it by saying I have an education beyong basic paramedic training. Many of the deficits I note below I see in others in my field, not neccesarily in my own background. Dust and others are familar with my posting (I've been busy with life and such).

Having been a paramedic for almost three years I am still having a problem finding huge differences between an RN and a well educated paramedic. I came out of school thinking, and truly believing, that there really was a big deficit in certain areas of practice. Outside of the nursing profession's focus on in-hospital processes, I honestly believed they received more in depth training in pharmacology, basic disease processes, and other long term care issues. I've discovered that at the community college (ADN, associates, etc) level that this really isn't the case. I recently had the opportunity to engage in some educational opportunities with nursing students. Some of my newer clinical exposures have led to some newer perspectives as well.

Can someone who is a nurse please educate me on what I'm missing? Yes, there are some differences. Nurses have a detailed knowledge of in-hospital politics and patient progression through the healthcare system. I learn something here on a fairly regular basis, but nothing that couldn't be taught me in less than a week. Yes, I had little exposure regarding wound care. Got me there. Pediatrics? Some differences, but mostly from a developmental aspect.

My largest observation? Nursing and paramedic involves VAST cultural differences in providing care. Paramedics are told every day in school that disease processes are out literally hunting down their patients. They're fed a bunch of BS about the golden hour, rushing from the scene, etc. Every ailment has to be treated immediately with some mind-blowing process? Chest pain? Every patient's going to get PCI. The slightest ST elevation? STEMI (regardless of statistical improbability). Back pain? AAA.

I think a lot of this comes from the lack of prerequisite education that EMS providers get. I bet fully 2/3rds of this nation's paramedics have undergone dubious education in the basic sciences. Microbiology and infectious disease training is lacking in the majority of paramedic programs. Paramedic educators have no real standard to meet and they themselves have little knowledge of in-hospital treatment. Nurses seem to be taught to approach patients from a more cautious diagnostic perspective. For the nurse, diseases are a process. The patient, as a person, should be supported. Disease prevented and monitored. Patient advocacy is better emphasized.

Still, I feel like I encounter at least one nurse a week in my different clinical exposures who is harmful to their patient. Just as the average paramedic is not fit for the hospital setting, many nurses are typically horrible for the urgently sick patient. Lack of basic knowledge regarding ECG analysis (even among the CENs), poor intuition about overall patient condition, lack of decisiveness, acquired clinical practices or assumptions that are false or improper, etc. Minimizing even the obviously sick. Even things that you would assume are privy to nursing expertise like aseptic procedures and general infection control seem to go to the wayside. EXTREMELY poor understanding of patient living conditions or human events that precipitate common ailments. Poor understanding regarding the immediate evolution of emergency conditions.

I'm a big proponent of a pretty controversial idea. That in reality, the two professions have minimal differences that amount to huge clinical differences. The difference is in easily correctable educational problems. Either A) All paramedics go through nursing school and receive specialty training in EMS OR B ) Paramedic education mimic, or exceed, those differences present in nursing schools and actively compete with the traditional nurse for survival in certain aspects of the healthcare field.

The last is probably unrealistic. I understand the argument that not every nurse wants to bop around in the back of a gut box. BUT, I have always, and still do, believe that the future of our profession is in more definitive in-home care. Prevention and treatment of common medical ailments. The word no one wants to hear: advanced practice. Many steps need to happen. First, our profession has to get out of these certificate programs. Minimal entry has to be an associates degree with some adequate barriers to entry. Meaningful bachelors programs that emphasize research and managerial programs with proven methods. Eventually Masters programs that mimic and exceed the standards practiced in current mid-level practioners. I even foresee no real need to reinvent the wheel. Offer adequately educated paramedics entry into already established professions (NP, PA) with later subspecialty training in in-home diagnosis and training. Of course some technologies will need to advance, but they will in time. We need to be prepared to meet these challenges or be relegated to being replaced or forgotten.

Edited January 15, 2010 by UMSTUDENT

[VentMedic]

I even foresee no real need to reinvent the wheel. Offer adequately educated paramedics entry into already established professions (NP, PA) with later subspecialty training in in-home diagnosis and training. Of course some technologies will need to advance, but they will in time. We need to be prepared to meet these challenges or be relegated to being replaced or forgotten.

So what is stopping more Paramedics from becoming a PA?

If you look at websites for the national associations of the NP and the PA you will see their accomplishments.

As far as the Paramedic vs Nurse with the nurse apparently the loser in your mind, you are comparing only the "well" educated Paramedic to the nurse which is one who has a degree with the prerequisites, correct? You are not comparing all the medic mill grads or the FFs who were forced to be a Paramedic, correct? You do realize that nursing is a vast profession with many different specialities and not all are based around "EMS", correct? Thus a nurse who specializes in chemo patients may not need the same education specialization as the RN in the ED. As well, RNs are very aware of their weaknesses and the need for more training and education when they come out of school. Paramedics believe they have it all mastered and they do in their one area of specialty. They (average) do not have the basis or foundation education to specialize and build upon as nurses do.

Lack of basic knowledge regarding ECG analysis (even among the CENs), poor intuition about overall patient condition, lack of decisiveness, acquired clinical practices or assumptions that are false or improper, etc. Minimizing even the obviously sick.

You do realize this also describes some Paramedics as well.

A) All paramedics go through nursing school and receive specialty training in EMS OR

We already have nurses who go through nursing school and then specialize in EMS. Some even have their own credential in a few states.

B ) Paramedic education mimic, or exceed, those differences present in nursing schools and actively compete with the traditional nurse for survival in certain aspects of the healthcare field.

If you read my earlier post you will see that "been there and done that". Paramedic education was at one time considered above that of an RN with very well established degree programs while the RN was still trying to emerge from the diploma error. Greed and ignorance took over and that concept went to hell by 1990. Nursing and many other professions flew past the Paramedic to establish their own professional standing and recognition. That is something the Paramedic still has not been able to establish because even the word Paramedic is not used by all states and all 50 states have their own defining scope and education for the "Paramedic". Plus, there are many more EMS levels still trying to define themselves. So if EMS does not actually know how to define a Paramedic, how can you adequately compare it to nursing which has a nationally established standard for education and testing? Also the majority of allied health care professions are also well established with high minimum national education standards and testing.

Nursing has already realized some of its weaknesses and it has taken a clue from the other professions which is why many employers seek out the BSN rather than the ADN. EMS still hasn't gotten the message to at least seek out the A.S. degreed Paramedic and many agencies have their own medic mills to crank out Paramedics faster.