Paramedic/RN

[Jwade]

I think I can let this post speak for itself...A look into the curriculum would prove this wrong...

I believe there are seven or so flight programs in Michigan, Kzoo switched to RN/RN some time ago, and the couple in Mid Mich are making motions that way..That is not a debate here though..Maybe I should have said most instead of a lot in my post......

Probably N-Flight and the St. Joes will be the last two..

At any rate, there is more to a BSN education that stats and management, and I cant remember finance being part of it....pre-requisites are more science oriented with additional emphasis on evidence based medicine, pharmacology, chemistry, etc...I think the programs make you a better thinking and more well rounded Nurse. Understanding the process a little better. But I am biased for sure..I guess if increased knowledge and education about interventions, outcomes, and critical thinking doesnt provide better patient care, then I am way off base to prefer the BSN model..

Go for the BSN then the medic.. It will make you more marketable at least...

CC,

If KZOO has switched completely to dual RN, then I stand corrected. I have an MD friend who flew with them not too long ago. I also called my contacts up in Saginaw after reading your post, you won't see dual RN any time in the near future up there either!. But, as you said, we are not debating this.

Now, as far as your Biased BSN opinion, I think it is strictly that, Biased and more than likely the programs you speak of would likely fall into the statistical outlier category. As CHBARE stated, I cannot imagine what other hard science classes or clinical rotations in a BSN program that are not covered in any standard traditional ADN program. If that were the case, you would probably see more BSN's with minor's in a particular science related field. The overwhelming majority above ADN classes in a BSN program are VERY BASIC MGT related, leadership, community health, etc......Again, some programs might provide for further ICU rotations etc.... but this is definitely not the norm.

Again, if your comparing apples to apples, Take the BSN, if your comparing oranges to apples, I would take the oranges!

Respectfully,

JW

[ccmedoc]

Noted...

[VentMedic]

JW,

You have a Paramedic cert with an MBA. What was your 4 year degree in?

The classes that make up the RN - BSN transition prepares the nurse for a broader spetrum of nursing for the future such as community health and research. Too few get a very limited view of medicine as a whole to know how systems work and what their role can be for the future. Also the additional research and writing can only improve skills that are necessary for day to day life.

If you haven't noticed by some of the posts on the forums, that readin' and writin' stuff can come in handy. The better you are at it the better your presentation may be as a professional in your reports and other forms of communication.

Fifth, a BSN really does not provide much more education in the way of patient care, a few VERY BASIC management classes, maybe a stats class or finance....I would still hire a 10 year ADN ICU nurse over a 3 year BSN ANY day of the week!

Respectfully,

JW

As a manager or owner of a Flight company I can see where the ADN RN would be to your liking. If they haven't started a higher degree after 10 years they probably won't so you will not have to worry about working around a college schedule or be concerned they might ask for education perks. They also know their options as an ADN are very limited especially if other flight teams want a BSN. Even some ICUs now prefer a BSN degree especially since they do have a large selection of qualified nurses despite a "shortage". Thus, the ADN RN will not be as likely to argue about salary and safety concerns if flight is something they really want to do. A BSN RN with 3 years of critical care experience knows they have several options and can be upwardly mobile in their careers.

Edited January 8, 2010 by VentMedic

[Jwade]

JW,

You have a Paramedic cert with an MBA. What was your 4 year degree in?

The classes that make up the RN - BSN transition prepares the nurse for a broader spetrum of nursing for the future such as community health and research. Too few get a very limited view of medicine as a whole to know how systems work and what their role can be for the future. Also the additional research and writing can only improve skills that are necessary for day to day life.

If you haven't noticed by some of the posts on the forums, that readin' and writin' stuff can come in handy. The better you are at it the better your presentation may be as a professional in your reports and other forms of communication.

As a manager or owner of a Flight company I can see where the ADN RN would be to your liking. If they haven't started a higher degree after 10 years they probably won't so you will not have to worry about working around a college schedule or be concerned they might ask for education perks. They also know their options as an ADN are very limited especially if other flight teams want a BSN. Even some ICUs now prefer a BSN degree especially since they do have a large selection of qualified nurses despite a "shortage". Thus, the ADN RN will not be as likely to argue about salary and safety concerns if flight is something they really want to do. A BSN RN with 3 years of critical care experience knows they have several options and can be upwardly mobile in their careers.

VENT,

Let me start by correcting you. I have both, license and certification!

As I think you well know, Paramedics are LICENSED in the state of Michigan and others.

Second, It drives me absolutely crazy when people start throwing the licensure versus certification argument around with their limited knowledge. Having taken a few semesters of graduate level business law, criminal law, and healthcare law, the Case Law and courts have shown no distinction between licensure and certification. Without either one, an individual such as you or me does not partake in the taking care of others. This whole stupid debate was started by RN's trying to protect their EGO's and Turf.....

Seriously, they make people who cut your hair have a license!

Third, My undergrads are in Physiology and Business Management, My Masters Degrees are an MBA and soon to be completed MHA. Not sure where you are going with that.

Fourth, I do believe i said the BSN classes include community health and so forth. I agree with everything else you said about the BSN, although I have my doubts about how many BSN's could show me how to do a statistical research analysis.

My point was that a BSN nurse does not provide an education any more suited for taking care of patients straight out of school than a traditional ADN program. Again, I realize there are statistical outliers, however, we never base any decisions on an outlier!

I disagree completely with your last paragraph. My liking over a 10 year ICU ADN nurse versus a 3 year BSN nurse is obvious, based strictly on experience. If I am hiring for a clinical position, then 9 out of 10 I am taking the experience versus 3 years...( Assuming all other things are equal)...It has nothing to do from the business side of the equation.

Most Respectfully,

JW

(edited for a spelling error)

Edited January 8, 2010 by Jwade

[fireflymedic]

I'm with JWade on all things considered experience speaks far greater than any piece of paper ever will. I would want a partner with more experience any day to help deal with the funky transport drugs you might see, and some of the conditions you deal with very little prehospital. Good ICU experience is vital to a good team. That being said, there very much is still a place, and I think will be a place for a long time for paramedics in the flight environment. Even if they go with dual RN's - most likely some prehospital experience will still be experienced as you cannot take someone from the hospital environment, and throw them with a critical scene situation and expect them to function well. It's an adaption process. Not to say they can't do it, but RN is focused towards hospital care which is great for IFT's and Paramedic focus towards scene and prehospital care. Both have their place and function within the team. Don't forget that when you're having your peeing match over RN vs Medic. One is not better than the other, it's just different.

[VentMedic]

I'm with JWade on all things considered experience speaks far greater than any piece of paper ever will. I would want a partner with more experience any day to help deal with the funky transport drugs you might see, and some of the conditions you deal with very little prehospital. Good ICU experience is vital to a good team. That being said, there very much is still a place, and I think will be a place for a long time for paramedics in the flight environment. Even if they go with dual RN's - most likely some prehospital experience will still be experienced as you cannot take someone from the hospital environment, and throw them with a critical scene situation and expect them to function well. It's an adaption process. Not to say they can't do it, but RN is focused towards hospital care which is great for IFT's and Paramedic focus towards scene and prehospital care. Both have their place and function within the team. Don't forget that when you're having your peeing match over RN vs Medic. One is not better than the other, it's just different.

But working someplace for 10 years may not necessarily equate to someone "experienced". Some people may just exist in a job for 10 years and decide to get a flight job because they need a change and especially if all they need is an ADN. If the requirements were any higher they probably wouldn't put forth the effort. However, if someone has done their homework to find out that a BSN is preferred and then works their butt off in the best ICUs trying to learn all they can to get a job they have set their goals for, I would find that to be the best candidate.

You are also stereotyping the RN. One thing about RNs is that many are capable of adapting to most situations since they may be required to float t/o the hospital or between hospitals. Some are also tossed on an ambulance at a moment's notice if the pateint is beyond the scope of a Paramedic. Right or wrong they make the best of it and most with then demand additional trasining The training for a Paramedic is not really that extensive either in material or time but yet some are expected to function on their own after just a day or two of orientation. This may be coming with no previous medical experience except for the required EMT-Basic experience which doesn't prepare one very well for medical issues or doing lead on a quality ALS truck.

Edited January 8, 2010 by VentMedic

[Jwade]

But working someplace for 10 years may not necessarily equate to someone "experienced". Some people may just exist in a job for 10 years and decide to get a flight job because they need a change and especially if all they need is an ADN. If the requirements were any higher they probably wouldn't put forth the effort. However, if someone has done their homework to find out that a BSN is preferred and then works their butt off in the best ICUs trying to learn all they can to get a job they have set their goals for, I would find that to be the best candidate.

You are also stereotyping the RN. One thing about RNs is that many are capable of adapting to most situations since they may be required to float t/o the hospital or between hospitals. Some are also tossed on an ambulance at a moment's notice if the pateint is beyond the scope of a Paramedic. Right or wrong they make the best of it and most with then demand additional trasining The training for a Paramedic is not really that extensive either in material or time but yet some are expected to function on their own after just a day or two of orientation. This may be coming with no previous medical experience except for the required EMT-Basic experience which doesn't prepare one very well for medical issues or doing lead on a quality ALS truck.

Vent,

You are killing me here...LOL....

Agreed some people just exist for 10 years.....HOWEVER, this is where someone such as myself who understands the business side of things and has extensive knowledge in business management would be able to " WEED OUT" those " Just Exist" people during the application review process and at the furthest during the interview process. So, they would never make it on to my team to begin with!

This is where a lot of Nurse Managers fail because they do not have the advanced business education from which to base sound hiring and business practices! Their very basic MGT classes in the BSN program are not sufficient by any means.

Again, I am all for education, and to get back on the OP questions, follow your heart, it does NOT matter how much education you have if you hate your job! I have friends who went to law school, passed the bar, and now went to med school, and one took up being a fly-fishing guide! Follow your heart!

Respectfully,

JW

[fireflymedic]

You cannot possibly tell me that taking an RN from a hospital environment onto a scene with no experience in dealing with the differences there makes them perfectly adapted to the scene environment. I'm sorry, but the occasional jump on a truck when you have a skill that a medic's not familiar with or allowed to do due to protocols doesn't qualify them as ready for prehospital environment. If that was the case, then heck, let's just do away with paramedics and let RN's run the world. It's just like taking a medic and putting them in the ER - yeah, they can do it, and may do well at it, but it's a different environment, and having some hospital experience is helpful. That's why even if you are a medic in this area, most require you to go get your CNA to work in an ER so you have a concept of the differences. Both can adapt to another environment quite well - and I'm not saying a nurse can't. I know many float between floors as needed or even do the travel nursing thing at different hospitals. But I don't think it's out of the expectation to ask them to have some prehospital experience as at least a basic to understand teh differences out there. As I said - both have their place and work well together. It's not one is better than the other - a well versed critical care medic can be a huge assest to a program and the same qualifications apply. Obviously Nellie Nurse from Community Hospital that doesn't do much is going to be no more qualified than Peter Paramedic who works only transport ALS. However, you put a skilled ICU RN (ADN or BSN regardless)- give them prehospital experience, and take a knowledgeable critical care medic and put him in the ER for experience, and you've got a damn good team that one would be hard pressed to beat IMHO. Just something to chew over.

[VentMedic]

You cannot possibly tell me that taking an RN from a hospital environment onto a scene with no experience in dealing with the differences there makes them perfectly adapted to the scene environment. I'm sorry, but the occasional jump on a truck when you have a skill that a medic's not familiar with or allowed to do due to protocols doesn't qualify them as ready for prehospital environment. If that was the case, then heck, let's just do away with paramedics and let RN's run the world. It's just like taking a medic and putting them in the ER - yeah, they can do it, and may do well at it, but it's a different environment, and having some hospital experience is helpful. That's why even if you are a medic in this area, most require you to go get your CNA to work in an ER so you have a concept of the differences. Both can adapt to another environment quite well - and I'm not saying a nurse can't. I know many float between floors as needed or even do the travel nursing thing at different hospitals. But I don't think it's out of the expectation to ask them to have some prehospital experience as at least a basic to understand teh differences out there. As I said - both have their place and work well together. It's not one is better than the other - a well versed critical care medic can be a huge assest to a program and the same qualifications apply. Obviously Nellie Nurse from Community Hospital that doesn't do much is going to be no more qualified than Peter Paramedic who works only transport ALS. However, you put a skilled ICU RN (ADN or BSN regardless)- give them prehospital experience, and take a knowledgeable critical care medic and put him in the ER for experience, and you've got a damn good team that one would be hard pressed to beat IMHO. Just something to chew over.

Wow! What's with the attitude toward educated RNs? They are improving their profession through applying themselves to get a degree and not settle for a cert or the bare minimum.

Did you also miss what I stated in my post?

Right or wrong they make the best of it and most with then demand additional training

RNs know their limitations and do demand more education/training whereas some Paramedics believe they can do it all with a few hours of training. Thus, we get some very dangerous CCT and Flight teams.

Did you also think I was talking about a nursing home RN or one that works solely in Endoscopy? Did you not see this in my post?

However, if someone has done their homework to find out that a BSN is preferred and then works their butt off in the best ICUs trying to learn all they can to get a job they have set their goals for, I would find that to be the best candidate.

Why does nursing have to make do with their lowest denominator just because it is acceptable in EMS? No other profession is lowing their standards for entry because a few whine.

Vent,

You are killing me here...LOL....

Agreed some people just exist for 10 years.....HOWEVER, this is where someone such as myself who understands the business side of things and has extensive knowledge in business management would be able to " WEED OUT" those " Just Exist" people during the application review process and at the furthest during the interview process. So, they would never make it on to my team to begin with!

This is where a lot of Nurse Managers fail because they do not have the advanced business education from which to base sound hiring and business practices! Their very basic MGT classes in the BSN program are not sufficient by any means.

Again, I am all for education, and to get back on the OP questions, follow your heart, it does NOT matter how much education you have if you hate your job! I have friends who went to law school, passed the bar, and now went to med school, and one took up being a fly-fishing guide! Follow your heart!

Respectfully,

JW

Now I see where you are coming from. Having an MBA, you don't like the fact that RNs can take a few management courses.

Do you own all Flight companies in the U.S. to where you can speak for all of them? Probably not. Why are you defending those that practice the "warm body" interview style? They only give those which are professional a black eye?

Let me start by correcting you. I have both, license and certification!

As I think you well know, Paramedics are LICENSED in the state of Michigan and others.

The Paramedic can be acheived by a "certificate" and then they can apply for a state license. Other health care professions need a degree before they apply for state license. That is the difference and not what your state calls the card that gives you the privilege of practicing in that state.

Edited January 8, 2010 by VentMedic

[fireflymedic]

Wow! What's with the attitude toward educated RNs? They are improving their profession though applying themselves to get a degree and not settle for a cert.

I don't have an attitude towards RN's at all. I respect them for what their capacity is and I will defer to them anyday on something that is above my knowledge. A good ICU nurse is worth their weight in gold without question. I wasn't comparing an ICU nurse in that aspect - I think things came out a bit jumbled lol (what I get for typing tired). If you take an inexperienced person - regardless of medic or RN you are going to have trouble. Both need additional training to work in that environment. There are medics that are improving themselves and not just settling for a cert - I think it's unfair to lump all of us into that assessment. I hold my bachelors degree and worked hard to get it in emergency medicine. I'm continuously working to improve myself every day and always open to learning new things. If someone chooses to limit themselves, that is their own stupidity talking.

RNs know their limitations and do demand more education/training whereas some Paramedics believe they can do it all with a few hours of training. Thus, we get some very dangerous CCT and Flight teams.

In some instances yes - but also there are some questionable RN's that are out there as well. Neither are perfect.

Why does nursing have to make do with their lowest denominator just because it is acceptable in EMS? No other profession is lowing their standards for entry because a few whine.

I'm not saying you should - if you've read very many of my posts you realize that I'm an advocate for expanding EMS education. I think a two year degree should be the starting point. Wouldn't hurt any of us a bit and might do a little weeding if it were tougher to get in. Might have people that want to actually get in and stay in. Ironically though, the shortage in this area isn't the lack of nurses, it's the lack of nurses wanting to do pt care. Tons of them are graduating thinking just because they have a BSN that they'll go straight to management and not have to do the patient care or do like workman's comp that type of thing. It's the ADN's that come out and want to do patient care - that may not be the case everywhere, but I've heard the complaint over and over from nurse recruiters in this area leading to an actual shying away from BSN's. I don't think you should condemn an ADN that's well qualified just because they don't have their bachelors.