# R.N challenging medic in FL: What needs to be done?



## jedirye (Oct 19, 2008)

I am curious on what needs to be done if you are an R.N. and would like to challenge the medic test? Thanks!

-rye


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## reaper (Oct 19, 2008)

You must go through EMT school and get your cert. Then you contact the state and setup to challenge the Paramedic test.

They want you to have your EMT so you have an idea of the different skills used on the streets.

I for one, would at least also do some ride alongs with an ALS unit. Also, hit the OR and learn intubation.


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## Ridryder911 (Oct 19, 2008)

It depends upon the state you live in. NREMT used to allow one to challenge the Paramedic test as well as many states stills allow RN with documented educational courses to. 

Personally, I would not advise one to do such. Even though their are several similarities, I give the same advice to a Paramedic wanting to challenge or accelerate through nursing, *IT IS NOT THE SAME PROFESSION*! 

Yeah, one might pass the test...so? This does not ensure one is able to function at that level.


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## reaper (Oct 19, 2008)

As Rid stated, you will have a hard time crossing over. What I said about needing EMT, is for the State of FL. I do not know how others handle it.


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## VentMedic (Oct 19, 2008)

Ridryder911 said:


> It depends upon the state you live in. NREMT used to allow one to challenge the Paramedic test as well as many states stills allow RN with documented educational courses to.
> 
> Personally, I would not advise one to do such. Even though their are several similarities, I give the same advice to a Paramedic wanting to challenge or accelerate through nursing, *IT IS NOT THE SAME PROFESSION*!
> 
> Yeah, one might pass the test...so? This does not ensure one is able to function at that level.


 
While I agree with you about education Rid and both fields are very different, 50% of Florida's Paramedic programs are medic mills with 700 hours of training just geared to pass the exam. Until the state finally underlined the part about an ALS engine NOT being an ambulance (dah!) that qualifies for clinicals, that was where the majority of ride time was done in some counties. 

If the RN is getting the Paramedic for a flight job, where there is still an old law on Florida's books about scene response requirements, the challenge is not a bad idea. The RN can usually very easily pick up 5 intubations with ED/OR arrangements and the medical director of the flight program may assist in the training for other advanced skills which even the Paramedic program is barely teaching or most EMS agencies are not allowing such chest tubes and central lines. Many of the Flight programs rely heavily on interfacility transport so the RN's skills from ICU are of the most value. Also, for most scene responses the ground crews usually have the patient extricated and packaged.

Since RNs have more sciences and a solid general education, I am still supporting the 100 - 200 hour bridge to be the more practical solution in Florida and other states such as that for the MICN or PHRN. 

However, if the RN is challenging to work primarily on a truck that does scene response, I would say go through the program just to see if the "culture" is what you want and to pick up some additional information that might be beneficial somewhere down the road. 

http://www.doh.state.fl.us/mqa/emt-paramedic/emt-lic-requirements.html#Initial

There are times when I see how bringing other professionals that have a solid educational foundation in some medical discipline into the world of EMS can be a beneficial eye opener. Many Paramedics never know what RNs are truly capable of until they partner with one on a flight or specialty program.


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## triemal04 (Oct 19, 2008)

Ventmedic-

We've gone around about this before I think, but I'm curious about something:  why does a RN need to become a paramedic to work on a helicopter in Florida, or am I misreading what you wrote?  I can't imagine there isn't such a thing as a Flight Nurse in Florida, and if there is, why not just work under that title and not bother becoming a paramedic?


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## VentMedic (Oct 19, 2008)

http://www.leg.state.fl.us/statutes....HTM&Title=->2005->Ch0401->Section 25#0401.25


> b) Each permitted advanced life support ambulance not specifically exempted from this part, when transporting a person who is sick, injured, wounded, incapacitated, or helpless, must be occupied by at least two persons: one who is a certified paramedic or licensed physician; and one who is a certified emergency medical technician, certified paramedic, or licensed physician who also meets the requirements of s. 401.281 for drivers. The person with the highest medical certifications shall be in charge of patient care. This paragraph does not apply to interfacility transfers governed by s. 401.252(1).


 

This applies only to scene response. It does not apply to interfacility or speicalty. Florida Hospital's flight team is RN/RRT and no Paramedic but they only do interfacilty. 

And, you are correct, the RN will work under the RN license UNLESS specifically hired to be a Paramedic. An example of this is in the FDs. The Fire Medics may have gotten a degree and license as an RN with a 2nd totally separate job in the hospital but will work as a Paramedic on the trucks. A Paramedic with an RN license may also work on Flight as a Paramedic UNTIL he/she can meet the necessary requirements as an RN to qualify for a Flight RN position.


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## triemal04 (Oct 19, 2008)

Helpfull, but I guess my concern is why there is even an option for a challenge; to work transports or on a helicopter a RN just needs to be an RN, albeit with quite a bit of experience.  If they were to challenge to become a paramedic simply to get the position on a helicopter because they lack the ICU time, they'd still be lacking that experience, and the paramedic experience as well, which, hopefully, is required for a flight medic job, so what would be the point.  

I don't know.  Nursing and EMS, while somewhat similar, are two different things.  Just doesn't seem like a good idea.


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## VentMedic (Oct 19, 2008)

triemal04 said:


> Helpfull, but I guess my concern is why there is even an option for a challenge; to work transports or on a helicopter a RN just needs to be an RN, albeit with quite a bit of experience. If they were to challenge to *become a paramedic simply to get the position on a helicopter because they lack the ICU time,* they'd still be lacking that experience, and the paramedic experience as well, which, hopefully, is required for a flight medic job, so what would be the point.
> 
> I don't know. Nursing and EMS, while somewhat similar, are two different things. Just doesn't seem like a good idea.


 
No. It is because of the statute I quoted that wants someone on an ALS truck that does scene response to hold the title of Paramedic. If the truck or helicopter does not do 911, then all is fine and no paramedic is needed. It is just a wording of the statute. In other states, they have changed their wording to include PHRN, MICN etc... Other states such as Washington and California, this is not an issue since Flight RN/RN or RN/RRT crews do scene response.

The RNs are usually more than qualified for the flight positions but one of them still must hold the cert even if in patch only. At the time the statute was written, we did not have that many helicopters flying to the scenes and if they were they were FD based. Now, anyone can bid for the contract and some of the services are excellent with highly educated/skilled staff.

Even for scene response flight, the RN's ICU/ED knowledge is going to be of great value for continued stabilization. The ground crews have done the extrication and initial stabilization (sometimes) or not if waiting for the Flight crew members do RSI etc.


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## triemal04 (Oct 19, 2008)

Huh.  Figured helicopters fell under "speciality" EMS and thus didn't require a paramedic or emt on board.  That's...uh...an interesting statute then.  Wow.  I guess it shouldn't suprise me, coming from Florida, but damn...


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## VentMedic (Oct 19, 2008)

triemal04 said:


> Huh. Figured helicopters fell under "speciality" EMS and thus didn't require a paramedic or emt on board. That's...uh...an interesting statute then. Wow. I guess it shouldn't suprise me, coming from Florida, but damn...


 
Only if they do scene response the statute applies.

Florida Hospital's helicopter falls under specialty and does no scene response. 

http://www.flhosp.org/services/floridaflight1/index.htm

Of course, similar glitches in the statutes allowed state accreditation of medic mills to run amok.


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## jedirye (Oct 20, 2008)

Well I should note, the RN in question is not me. My mom is a registered nurse and has been for years upon years. We both realize the job of a paramedic and RN, although similar, are still horses of different colors. I enjoy quizzing her and having her take my paramedic practice exams with me. She has retained much over the years, especially regarding information I just wouldn't have expected her to know. I would often throw the idea about taking the paramedic test with me, to see if she could pass. She has no desire to work as a paramedic, and loves her nursing job, etc. It was just an idea that, if not much effort was required, would be worth pursuing. However, if she has to take an EMT course, I'm sure she'd rather pass... Thanks for the information, regardless!

-rye


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## VentMedic (Oct 20, 2008)

If she has ED and ICU experience, she would probably do very well on the test provided she doesn't put too much thought into the questions. As I stated before, our medic mills can prep anyone without any type of previous medical education or experience for the test in just a few months. Of course, one can see where that has gotten us. 

Nurses are usually trained to know their limits and liabilities. You will not find a med-surg RN accepting an assignment in ICU taking care of a patient with an IABP. However, you may find Paramedics accepting interfacility transports that have no business doing these types of transports.


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## BossyCow (Oct 20, 2008)

We ran into the R.N./EMT-P snafu when some of the local ER Nurses wanted to do ride alongs on the medic units. Even an ER nurse is not covered for work in the field without an accompanying EMT-B or P. Flight nurse only works in the air. Sometimes the cert is required from a liability standpoint.


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