# Paramedic or LPN???



## RunnerD1987 (May 1, 2019)

Hey hey!!!
Question is in the title ^

I have worked in healthcare since I was in my early 20s and now 31 going on 32 in a few months.
I never really had any goal or career path until maybe 4 years ago. Did receive my Bachelors Degree when I was 25. I tried for nursing I did the prereqs and was averaging around a B+ with my nursing GPA.

Right now nursing isn't playing out I have been rejected at least 4 times from a program and withdrew from a program ($60K for a 2 year RN program) for financial reasons.

I am looking for a change up in careers to break out of the monotony of what I have been doing for almost 8 to 9 years at 3 different facilities.
Looking for work that can match my current pay, work closer to home, and have better hours. Right now working 5 variable 8 hour shifts a week with a 60 to 80 minute drive one way burns you out.

I would go the LPN route but the programs in the area are expensive around $30,000 to $40,000. The medic route cost about $10,000 to $12,000 and they make same pay as an LPN. The only downside more job opportunities in my area for LPNs.

Was thinking I could get my medic be in the field for 4 to 6 years. Eventually work on retaking my prereqs shortly after the wife goes back & finishes up her LPN to RN bridge program.

Just curious on medics who went back for their RN. Any pros or cons? What do to you think was your biggest barrier? Did you feel strapped and stressed managing class with work?

Appreciate the feedback.


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## CCCSD (May 1, 2019)

Why are you going to a private college for nursing? That’s a waste of money.


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## joshrunkle35 (May 1, 2019)

LPN programs are about $3,000. Not $30,000. 

Also, if you already have a bachelor’s degree, you should consider a second degree accelerated BSN to become an RN. They are usually 1-2 years.


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## DrParasite (May 1, 2019)

What do you do now?  do you work full time?  what is your current title?

you have a BS; as Josh said, look at BS -> BSN programs.  40k for an LPN is pretty pricy; 60k for an RN is even moreso.  are there any other options in your area?

I know several medics who took the excelsior program to get their RN.  Most are happy, did the program part time, and were successful in their transition.  Others didn't complete the program, and are still on a truck.


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## RunnerD1987 (May 1, 2019)

joshrunkle35 said:


> LPN programs are about $3,000. Not $30,000.
> 
> Also, if you already have a bachelor’s degree, you should consider a second degree accelerated BSN to become an RN. They are usually 1-2 years.



In our State they run $30K to $40K reason it is a deterrent for me. Though Medics and LPNs make around $20 to $30 an hour depending on where you are working in the State.

Accelerated wouldn't work for the reason I need to work 24 to 32 hours a week. Right now for the next two year's I can't drop from full time for health insurance.


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## joshrunkle35 (May 1, 2019)

RunnerD1987 said:


> In our State they run $30K to $40K reason it is a deterrent for me. Though Medics and LPNs make around $20 to $30 an hour depending on where you are working in the State.
> 
> Accelerated wouldn't work for the reason I need to work 24 to 32 hours a week. Right now for the next two year's I can't drop from full time for health insurance.



I work 60-70 hours a week between 3 jobs, have kids and a pregnant wife to take care of and I’m in an accelerated nursing program. It’s only a year or two of your life. It’s not permanent. I’m sure you could make it work if you choose.


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## RunnerD1987 (May 1, 2019)

^^^ Psych Tech. Pay varies by location in the State. So do requirements and skills you can do.

For my current job you need a Bachelors degree or Masters degree. You do phlebotomy, EEGs, blood sugars, vitals, facilitate groups, interview/chart on patients, and few other things.


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## RunnerD1987 (May 1, 2019)

From what I hear only 1 program is doable to work in. Rest are full time a week and about 12 to 18 months. Some make you sign a contract to not work more than 16 hours a week. I feel if I could work nights it would be doable. That's why I was thinking go the Medic route. Could make the same making now, work close to home, work nights, and work 2 to 3 times a week that way can go take an accelerated program down the road.

The cost is up there. Looking at around $20K for the least expensive and $60K for the most expensive.


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## RunnerD1987 (May 1, 2019)

joshrunkle35 said:


> I work 60-70 hours a week between 3 jobs, have kids and a pregnant wife to take care of and I’m in an accelerated nursing program. It’s only a year or two of your life. It’s not permanent. I’m sure you could make it work if you choose.


How is your class schedule?


CCCSD said:


> Why are you going to a private college for nursing? That’s a waste of money.


Yah yah dropped out before being accepted. Just too hard to swing financially. They hook you in because they are part time and acceptance isn't a lottery it's based off points.


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## joshrunkle35 (May 1, 2019)

RunnerD1987 said:


> How is your class schedule?



I’m in a Graduate Entry Option Family Nurse Practitioner program at OSU. This means that I complete RN and FNP simultaneously (sort of). 

The RN portion is 5 semesters (Summer, Autumn, Spring, Summer, Autumn), however, I am completing additional nurse practitioner classes at the same time (The non-clinical classes like advanced pathophysiology, advanced pharmacology, Evidence Based Research, Quality Improvement and Informatics, etc). I typically do 3 days a week from about 4am-midnight and then I’m free 4 days a week to work. 

Honestly, time-wise, accelerated nursing is still way easier than Paramedic school was. My nursing school is about 50-60 hours/week. Paramedic was 60-90 hours/week (I did a 9 month program instead of 1 year).

ETA: I have completed 1 year in my nursing program


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## RunnerD1987 (May 1, 2019)

Sounds like the reverse here. Medic school is only 3 days a week 8 hours (Clinical's and internship are in Round 2 & 3). Clinical's are twice a week with class once a week. Then internship is 3 12's.

The accelerated nursing programs in my State usually are 5 days a week with 8 to 10 hours of class and clinical's. With exception of one program that only meets 3 to 4 times a week.


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## joshrunkle35 (May 1, 2019)

RunnerD1987 said:


> Sounds like the reverse here. Medic school is only 3 days a week 8 hours (Clinical's and internship are in Round 2 & 3). Clinical's are twice a week with class once a week. Then internship is 3 12's.
> 
> The accelerated nursing programs in my State usually are 5 days a week with 8 to 10 hours of class and clinical's. With exception of one program that only meets 3 to 4 times a week.



Yeah, but I don’t think you’re factoring in homework. In nursing school, you have a week to read a chapter. In paramedic school, you have a week to read 5-10 chapters plus 2-3 supplemental books.


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## RunnerD1987 (May 1, 2019)

joshrunkle35 said:


> Yeah, but I don’t think you’re factoring in homework. In nursing school, you have a week to read a chapter. In paramedic school, you have a week to read 5-10 chapters plus 2-3 supplemental books.


That is very true cramming a lot in a short time period!

The medic program looking at has AP1 completed in 7 weeks. Then AP II in another 7 weeks. While in conjunction with 25 weeks of Paramedicine.

I also have to figure out how to balance work. Because right now 5 days on 8 hr shifts sometimes longer with an hour each way commute from home and area schools be about 30. I am hoping work might put me on 2 16's 7 to 1130 and 8 700 to 330 or 300 to 1130. So I have 5 days free a week.


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## VFlutter (May 1, 2019)

Are we talking California? What state are LPNs making $30/hr? I barely ever see LPNs outside of home health, LTAC, Dr offices, etc. Not sure there job market is all that great in most areas.


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## RunnerD1987 (May 1, 2019)

VFlutter said:


> Are we talking California? What state are LPNs making $30/hr? I barely ever see LPNs outside of home health, LTAC, Dr offices, etc. Not sure there job market is all that great in most areas.


Average $24 to $28. Wife has been on for 3 yrs with her job with differential making around $28 an hr at the nursing home. Her per diem job made around $21 to $22 an hour.


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## CCCSD (May 1, 2019)

He’s not in CA, we have plenty of colleges that have nursing programs. No mandate to attend private for profit.


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## RunnerD1987 (May 2, 2019)

Thinking if I can lead a full time night gig in the hospital close to home will go straight in for nursing.

If not have to see if work can condense my hours. Then if so decide to go the Medic or LPN route then RN.


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## rujero (May 2, 2019)

My 2 year associate degree RN program at a community college cost me about $14k. By working between 36 and 44 hours per week as an RN , I made $71k my first year. I know a lot of LPNs and many are fantastic nurses, but they are always expressing frustration over being relegated to the sub-acute care setting with 20+ patient to nurse ratios, working under the direction of an RN for much less money, and without the credentials to pursue many continuing education opportunities and certifications such as CEN or CCRN or other common interests of those coming from the pre-hospital setting. I think it largely depends on what your ideal working environment is. I tutor a student from the South who was working as a Basic and she relocated to attend the same program I did. She will pursue her BSN after she starts working in the ER setting as an RN.

EDIT: I worked three 8 hour overnight shifts a week while in the program. I was blessed to be able to move back in with some family to reduce the cost of rent. I sold my car to eliminate the payment and bought one that was 10+ years old with 165k miles.

-r


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## RunnerD1987 (May 2, 2019)

rujero said:


> My 2 year associate degree RN program at a community college cost me about $14k. By working between 36 and 44 hours per week as an RN , I made $71k my first year. I know a lot of LPNs and many are fantastic nurses, but they are always expressing frustration over being relegated to the sub-acute care setting with 20+ patient to nurse ratios, working under the direction of an RN for much less money, and without the credentials to pursue many continuing education opportunities and certifications such as CEN or CCRN or other common interests of those coming from the pre-hospital setting. I think it largely depends on what your ideal working environment is. I tutor a student from the South who was working as a Basic and she relocated to attend the same program I did. She will pursue her BSN after she starts working in the ER setting as an RN.
> 
> EDIT: I worked three 8 hour overnight shifts a week while in the program. I was blessed to be able to move back in with some family to reduce the cost of rent. I sold my car to eliminate the payment and bought one that was 10+ years old with 165k miles.
> 
> -r


Will say my goal is to get my RN.

However, do feel to get to Point B might have to go from Point A to Point B.

Right now make about $22 to $24 an hour. Leaving where I work will drop down to $15 to $18 an hour. With my current DTI make about $15 an hour. Now if I can pay down my debt $15 to $18 would make that hourly pay manageable.

The thing is to go back to RN school though I will need to find a night gig I feel. So that's why I was thinking work nights in a job close to home in my current field, as an EMT, LPN or Medic where it is 32 to 36 hours a week.


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## joshrunkle35 (May 2, 2019)

RunnerD1987 said:


> Will say my goal is to get my RN.
> 
> However, do feel to get to Point B might have to go from Point A to Point B.
> 
> ...



As someone who has done EMT, Paramedic and is now in nursing school, in my opinion, if it is at all possible, you should go straight to a 2nd degree BSN program. Yeah, it’ll be 1-2 hard years with very little sleep if you also work 40 hrs/week, but then you’ll be done. 

Also, a lot of schools pay tuition if you work for their hospital system. So, you could make $14/hr as a CNA/PCA/PCT, but then you get free tuition. Most of my class at OSU does that. The loss in wages is worth the free tuition.


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## Peak (May 2, 2019)

RN is going to be the best value for money as well as have the best career flexibility and growth for the vast majority compared to LPN or medic. I would search out RN programs at public schools, and keep in mind that what school you went to has little bearing on your hireability.

LPNs are largely working in nursing homes, home health, and little else. Most of the clinic jobs LPNs used to work are being filled with MAs. 

I don't think that starting a program with the end goal of LPN makes a whole lot of sense. There are few LPN programs anyway, and most now are through private schools that are very expensive. I get that life happens or that some people have specific circumstances that make this a good option, but I wouldn't generally recommend it. I'm am a bit biased as don't really like adult nursing and that is most of what LPNs work in now. 

Paramedic is a good option if you want to work in EMS. Very few nurses will ever work in EMS, and it is incredibly difficulty to onto CCT/HEMS. I wouldn't use nursing as a way to work in EMS. The options for paramedics in a clinical setting are pretty limited outside of EMS (and are often restricted far below that of nursing in most settings like EDs). Without a push towards at least a baccalaureate requirement I doubt we will really be seeing any development of a real advanced practice paramedic role like in some other countries. 

The nice thing about nursing is that I currently work in EDs and inpatient critical care, but if I wanted to do something lower stress I could easily do it. If I had a significant medical issue I could still work telephone triage or some other desk job. I can pursue advanced practice, or if I loose my mind I could do management (gag).

I worked full time through nursing school, so I definitely think it is doable. I think the stress of the nursing school shenanigans far exceeded the stress of time management.


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## FiremanMike (May 3, 2019)

LPN is just not worth it.

My wife has been an LPN for 10 years, we've struggled to find time to send her to RN school.  The job outlook is terrible, the job itself sucks, and the pay sucks.  

The question should be RN vs paramedic, which is more complicated.  EMS is fun, but not forever.  RN/BSN opens up so many different career paths.


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## RunnerD1987 (May 3, 2019)

FiremanMike said:


> LPN is just not worth it.
> 
> My wife has been an LPN for 10 years, we've struggled to find time to send her to RN school.  The job outlook is terrible, the job itself sucks, and the pay sucks.
> 
> The question should be RN vs paramedic, which is more complicated.  EMS is fun, but not forever.  RN/BSN opens up so many different career paths.


For me the question is which one will allow me to work closer to home (Both LPN and Medic), offer the same pay I make (LPN & Medic), offer the best hours (Both have possibility of staying extra hours and being mandated). Plus with LPN don't know much about Medics is that there is a lot of places that offer Baylor shifts where we live and 11p to 7a openings. From the wife not a fan of nights just due to the fact of working nights. Said the shift was the best when she picked up because you rarely stay past your shift. The only downside is you have 50 to 60 patients usually to take care of at night. With Medic school program is the most cost effective program.


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## FiremanMike (May 3, 2019)

RunnerD1987 said:


> For me the question is which one will allow me to work closer to home (Both LPN and Medic), offer the same pay I make (LPN & Medic), offer the best hours (Both have possibility of staying extra hours and being mandated). Plus with LPN don't know much about Medics is that there is a lot of places that offer Baylor shifts where we live and 11p to 7a openings. From the wife not a fan of nights just due to the fact of working nights. Said the shift was the best when she picked up because you rarely stay past your shift. The only downside is you have 50 to 60 patients usually to take care of at night. With Medic school program is the most cost effective program.



Are you saying there's LPN jobs but not RN jobs in your area?

My wife and I were both suckered with the "it's less time in school, less tuition, and we can get working in NURSING so much quicker, plus... she can go back to RN school as soon as feasible".  The reality is that she desperately wishes she could go back in time and take the extra year to get her RN, which would allow her to make LITERALLY double what she's making now and have INFINITELY more job opportunities.

Here - LPNs are relegated to MA work in doctors offices or passing pills in nursing homes.  There are occasional "cool" LPN jobs but they are few and far between and hard to get..

If you really want to go the LPN route, that's fine - but please go into it with the full knowledge of what you're getting into and not the recruitment poster..


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## Peak (May 3, 2019)

RunnerD1987 said:


> The only downside is you have 50 to 60 patients usually to take care of at night.



You have literally one minute per patient per hour to assess, give any order treatments and meds, verify and ensure the safety of orders, and document. How is that safe? Why would this ever be appealing?

If my options were 60 patients in a nursing home or EMS I would choose EMS every time.


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## RunnerD1987 (May 3, 2019)

FiremanMike said:


> Are you saying there's LPN jobs but not RN jobs in your area?
> 
> My wife and I were both suckered with the "it's less time in school, less tuition, and we can get working in NURSING so much quicker, plus... she can go back to RN school as soon as feasible".  The reality is that she desperately wishes she could go back in time and take the extra year to get her RN, which would allow her to make LITERALLY double what she's making now and have INFINITELY more job opportunities.
> 
> ...


I am in a rock and a hard place.
Dropping full time now working 32 hours I'll see a drop of pay from $1600 biweekly to $1050 biweekly. With my debt $1050 is what I make now with debt and the 400 miles I travel to work.

If I leave my job get a night hospital gig closer to home I will make less pay. Using my 403 and PTO money from work can reduce my debtand with less miles on the road will break even with my current monthly income after debt is factored in or slightly more a month.

Game plan is from March of next year to September of next year if unable to find a night gig have to decide between LPN or Medic route to get to my RN.

Also was thinking so where the Wife and I are moving to in CT there is 8 hospitals less than 20 miles or less away. 5 that are 30 miles or less away. So there are a few areas to look for work. The town moving to hope to volly for their organization. Their ambulance company has ALS assistance from Medics next town over. The Medics are one of 3 in the State that are Hospital Based. So was hoping could make connections. Maybe find an EMT gig with them and get my Medic license can work with them while getting my BSN. The Medic program interested in works in the same classrooms and labs as the Nursing students interested in obtaining my BSN from.

Do appreciate the feedback.


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## FiremanMike (May 3, 2019)

RunnerD1987 said:


> Game plan is from March of next year to September of next year if unable to find a night gig have to decide between LPN or Medic route to get to my RN.



If you are doing the LPN or medic merely as an intermediary step to RN, then the answer is LPN (if you really truly can't go straight to RN).

Medic to RN is a convoluted path and nowhere near as clean as LPN to RN.

To reiterate my opinion based on what I've seen with my wife, taking any intermediary step instead of just driving straight through to RN is a waste of time and money.


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## RunnerD1987 (May 3, 2019)

FiremanMike said:


> If you are doing the LPN or medic merely as an intermediary step to RN, then the answer is LPN (if you really truly can't go straight to RN).
> 
> Medic to RN is a convoluted path and nowhere near as clean as LPN to RN.
> 
> To reiterate my opinion based on what I've seen with my wife, taking any intermediary step instead of just driving straight through to RN is a waste of time and money.


True true
As you know New England is expensive. If I have to pay $40,000 for education instead of $30,000 not a huge loss. Path may be longer.

Only concern is the Hospital is one of 3 stand alone hospital's in the State. If they do get bought out wondering how it will effect working at that hospital. They are the only ambulance service for the town and surrounding 2 towns. Pay is around $28 an hour. Believe AP1 & 2 can be used towards nursing prerequisites.


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## Bishop2047 (May 5, 2019)

Any chance this hospital has set a precedent of assisting LPNs who wished to upgrade to RNs? This should certainly factor into your choice, as I doubt any would consider a Medic to RN tuition reimbursement.

I have a poor understanding of LPNs job opportunities in the states (from Canada where LPNs work anywhere that RNs are) but I understand it varies dramatically by state.


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## Carlos Danger (May 6, 2019)

I haven’t read all the replies here. Bottom line is that despite similarities in the length of the required initial education, LPN and paramedic are about as different roles as you can imagine. 

Either one will provide you with plenty of employment options. Either one will pay the bills. Do whichever one you think you’ll like better, and/or moves you more in the direction of your ultimate career goals.


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## johnrsemt (May 7, 2019)

Co-worker worked 48 hours straight at FT job, 24-36 hours a week at PT job (at hospital), both as a medic while doing RN in 5 semesters FT;  he graduated; and is now working 48 hours straight as a medic and 36 hours as a RN/medic.  making around $150K


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## Summit (May 7, 2019)

johnrsemt said:


> Co-worker worked 48 hours straight at FT job, 24-36 hours a week at PT job (at hospital), both as a medic while doing RN in 5 semesters FT;  he graduated; and is now working 48 hours straight as a medic and 36 hours as a RN/medic.  making around $150K


Because one guy managed to survive with no life and a potentially dangerous work schedule doesn't mean others can or should be encouraged.


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## Carlos Danger (May 7, 2019)

johnrsemt said:


> Co-worker worked 48 hours straight at FT job, 24-36 hours a week at PT job (at hospital), both as a medic while doing RN in 5 semesters FT;  he graduated; and is now working 48 hours straight as a medic and 36 hours as a RN/medic.  making around $150K


That’s a crappy way to live, and it’s not even good money for how much he works.


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## Summit (May 8, 2019)

If you want to make 150K with an OT adjusted averaged wage of $32/hr you gotta work 72hr/wk (valued at 88hr). 2 days off aren't 2 days off if you spend one recovering from the 48 and the other doing basic life maintenance after 3x12 before going in for the next 48.


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## Akulahawk (May 9, 2019)

Considering the costs of going RN vs LPN vs Paramedic, it might be cheaper in the long run to move to another area to both work and go to school. I am both an RN and a Paramedic. I make far more as an RN than I do as a Paramedic. The LPN/LVN has been greatly pushed out of acute care and, as stated above, LPN and Paramedic are very different. Where I went to school, the LVN program was 3 semesters long, 10 units/semester. The RN program was 4 Semesters long and 12 units/semester. It's not really that much longer of an investment in your time to do RN. 

Also, if you're having to commute 400 miles to your job, you might want to reconsider your job. That eats into your income very quickly. You'll have to do the math. A job that pays less but is closer to home may actually net you a greater income.

Summit is also very much correct in that if you're working so much that you only get a couple days off per week (and you're doing 12's), you really won't have much of a "life" as you'll be recovering on day 6 and tending to home needs on day 7. You'll pretty much be tired all the time. I've been there.

My advice: keep applying to RN school. Eventually you'll get in. It took me 4 years, but I kept at it. Yes, I applied to nursing schools for 8 straight semesters. I got in, I worked (and studied) my tail off, and I just started my 5th year in the ED.


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## RunnerD1987 (May 9, 2019)

Akulahawk said:


> Considering the costs of going RN vs LPN vs Paramedic, it might be cheaper in the long run to move to another area to both work and go to school. I am both an RN and a Paramedic. I make far more as an RN than I do as a Paramedic. The LPN/LVN has been greatly pushed out of acute care and, as stated above, LPN and Paramedic are very different. Where I went to school, the LVN program was 3 semesters long, 10 units/semester. The RN program was 4 Semesters long and 12 units/semester. It's not really that much longer of an investment in your time to do RN.
> 
> Also, if you're having to commute 400 miles to your job, you might want to reconsider your job. That eats into your income very quickly. You'll have to do the math. A job that pays less but is closer to home may actually net you a greater income.
> 
> ...


Love my job and the people I work with!

With us moving closer to family will add an extra 60 miles a week to my commute which I feel will eventually burn me out.

Just gotta stick it out for a year for the newborn and get my finances in order. See where things go from there.


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## MackTheKnife (Jun 16, 2019)

DrParasite said:


> What do you do now?  do you work full time?  what is your current title?
> 
> you have a BS; as Josh said, look at BS -> BSN programs.  40k for an LPN is pretty pricy; 60k for an RN is even moreso.  are there any other options in your area?
> 
> I know several medics who took the excelsior program to get their RN.  Most are happy, did the program part time, and were successful in their transition.  Others didn't complete the program, and are still on a truck.


Excelsior is a good option, except in California. Not accepted. Not sure if there are other states.


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## MackTheKnife (Jun 16, 2019)

RunnerD1987 said:


> I am in a rock and a hard place.
> Dropping full time now working 32 hours I'll see a drop of pay from $1600 biweekly to $1050 biweekly. With my debt $1050 is what I make now with debt and the 400 miles I travel to work.
> 
> If I leave my job get a night hospital gig closer to home I will make less pay. Using my 403 and PTO money from work can reduce my debtand with less miles on the road will break even with my current monthly income after debt is factored in or slightly more a month.
> ...


You keep mentioning debt. It sounds like a major factor. Reduce/eliminate your debt, then make the change. And go EMS or RN, not LPN.


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## SandpitMedic (Jul 5, 2019)

Akulahawk said:


> Considering the costs of going RN vs LPN vs Paramedic, it might be cheaper in the long run to move to another area to both work and go to school. I am both an RN and a Paramedic. I make far more as an RN than I do as a Paramedic. The LPN/LVN has been greatly pushed out of acute care and, as stated above, LPN and Paramedic are very different. Where I went to school, the LVN program was 3 semesters long, 10 units/semester. The RN program was 4 Semesters long and 12 units/semester. It's not really that much longer of an investment in your time to do RN.
> 
> Also, if you're having to commute 400 miles to your job, you might want to reconsider your job. That eats into your income very quickly. You'll have to do the math. A job that pays less but is closer to home may actually net you a greater income.
> 
> ...


I love a good success story.

Why anyone would bother with an LPN is beyond me. It’s a step, not a destination...An unnecessary step if you ask me, but to each their own.


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## akflightmedic (Jul 7, 2019)

johnrsemt said:


> Co-worker worked 48 hours straight at FT job, 24-36 hours a week at PT job (at hospital), both as a medic while doing RN in 5 semesters FT;  he graduated; and is now working 48 hours straight as a medic and 36 hours as a RN/medic.  making around $150K




Nothing like averaging $34 an hour for no life....


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## joshrunkle35 (Jul 7, 2019)

SandpitMedic said:


> I love a good success story.
> 
> Why anyone would bother with an LPN is beyond me. It’s a step, not a destination...An unnecessary step if you ask me, but to each their own.



Someone once told me that no one should be able to be an EMT or LPN longer than 5 years. As brutally harsh as that is, I don’t disagree with it.


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## SandpitMedic (Jul 8, 2019)

joshrunkle35 said:


> Someone once told me that no one should be able to be an EMT or LPN longer than 5 years. As brutally harsh as that is, I don’t disagree with it.


Can we make it 3 years?!


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## akflightmedic (Jul 8, 2019)

There is strategy in being an EMT....just for a stroll down memory lane, early in my career I was partnered with an older guy close to retirement who was a damn good EMT, he knew so much and was able to help guide me, despite being only an EMT. Then I learned he was a Paramedic for nearly 20+ years, however he let it intentionally lapse and he had kept his EMT current. This was his retirement plan from the county. He had already maxed out in pay, he was old and tired of being in charge, and with his seniority he could go to any of the 15 stations he wanted, and pretty much do darn near anything he wanted. LOL

So basically, his final 3 years with the County, he just cruised...into retirement.


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## joshrunkle35 (Jul 8, 2019)

akflightmedic said:


> There is strategy in being an EMT....just for a stroll down memory lane, early in my career I was partnered with an older guy close to retirement who was a damn good EMT, he knew so much and was able to help guide me, despite being only an EMT. Then I learned he was a Paramedic for nearly 20+ years, however he let it intentionally lapse and he had kept his EMT current. This was his retirement plan from the county. He had already maxed out in pay, he was old and tired of being in charge, and with his seniority he could go to any of the 15 stations he wanted, and pretty much do darn near anything he wanted. LOL
> 
> So basically, his final 3 years with the County, he just cruised...into retirement.



I legit work with 3 guys who have done that exact same thing.


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## MackTheKnife (Jul 8, 2019)

joshrunkle35 said:


> Someone once told me that no one should be able to be an EMT or LPN longer than 5 years. As brutally harsh as that is, I don’t disagree with it.


Not true, IMAO (In My Arrogant Opinion). Prior Proper Planning Prevents Piss Poor Performance! LOL! Seriously, anyone going LPN needs to have their head examined. They are being weeded out. As an RN, I've seen Super Nurses that are LPNs being shown the door. They can't do admission assessments, plans-of-care, push IV meds (yet they can hang drips!). But an LPN can bridge to RN, as can a medic. And then in the magic world of RN Narnia, you can change jobs/disciplines every couple of years with no harm, no foul.


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## DrParasite (Jul 26, 2019)

joshrunkle35 said:


> Someone once told me that no one should be able to be an EMT or LPN longer than 5 years. As brutally harsh as that is, I don’t disagree with it.


Why?  I did medic school after 15 years as an EMT.... my current job (which I started a few years after, and doesn't involve an ambulance) doesn't require me to be a paramedic, doesn't allow me to practice as a paramedic, and being a paramedic doesn't give me any more $$$$, but requires me to still have my EMT, as its a requirement of the job. So what benefit does a paramedic certification bring to me?

So tell me again why no one should be an EMT for longer than 5 year?  Or more accurately, if someone is doing a good job as an EMT (or LPN for that matter), and has no inclination to obtain the additional education needed for the increase in pay, why should that be held against them?


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## Woodtownemt (Jul 26, 2019)

DrParasite said:


> Why?  I did medic school after 15 years as an EMT.... my current job (which I started a few years after, and doesn't involve an ambulance) doesn't require me to be a paramedic, doesn't allow me to practice as a paramedic, and being a paramedic doesn't give me any more $$$$, but requires me to still have my EMT, as its a requirement of the job. So what benefit does a paramedic certification bring to me?
> 
> So tell me again why no one should be an EMT for longer than 5 year?  Or more accurately, if someone is doing a good job as an EMT (or LPN for that matter), and has no inclination to obtain the additional education needed for the increase in pay, why should that be held against them?




+1. I totally agree. Sometimes people get caught up in going to the next step because the social perception of having to go from point A to point B is expected. 

When I was in the field I always felt that I was expected to get my P-card. The reaction from others once they found out I was still an EMT after more than 4 years (at the time) always was, "oh cool you're in ...." a) medic school or b) nursing school. 

In the end I had ask myself the hard questions and realized that EMS wasn't where I honestly saw myself. Even though sometimes i thought it was. Once you're honest with yourself and could care less what other people think your life should be according to THEIR life's outlook it's a no brainer. 

So now when I see those old school EMT still rolling in through ER doors I appreciate their decision a lot more.


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## MackTheKnife (Jul 26, 2019)

DrParasite said:


> Why?  I did medic school after 15 years as an EMT.... my current job (which I started a few years after, and doesn't involve an ambulance) doesn't require me to be a paramedic, doesn't allow me to practice as a paramedic, and being a paramedic doesn't give me any more $$$$, but requires me to still have my EMT, as its a requirement of the job. So what benefit does a paramedic certification bring to me?
> 
> So tell me again why no one should be an EMT for longer than 5 year?  Or more accurately, if someone is doing a good job as an EMT (or LPN for that matter), and has no inclination to obtain the additional education needed for the increase in pay, why should that be held against them?


*So what benefit does a paramedic certification bring to me?  *In your specific case, no benefit. In the general sense,  it provides for, in the field or ED, operating at an advanced level. But, I agree, no one HAS to move up to medic. In a relative analogy, a large portion of our CNAs have no desire to go to nursing school. They are happy where they are.   And we're talking multiple years, some decades.
*if someone is doing a good job as an EMT (or LPN for that matter), and has no inclination to obtain the additional education needed for the increase in pay, why should that be held against them?  *Agree again with you. Not moving up should NOT be held against anyone.  However, in the case of the LPN, specifically here in Florida, in my opinion you NEED to get your RN.  At my hospital where I receive my health care, they have started getting rid of nearly all of the LPNs. It used to be I'd go see my Primary Care provider and an LPN would take my vitals and place me in the exam room. Now it's a Medical Assistant. In the Specialty Clinics, an LPN used to do intakes. Now it's an RN. At my former place of employment, I walked in one day and the LPNs were GONE. All of them. LPNs couldn't do everything an RN could and RNs had to not only take care of their assigned patients, but also the take care of  certain aspects of patient care for the LPN. And we didn't get extra pay for the extra work. The hospital (part of the biggest chain worldwide) just plain got rid of them.


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## joshrunkle35 (Jul 26, 2019)

Woodtownemt said:


> +1. I totally agree. Sometimes people get caught up in going to the next step because the social perception of having to go from point A to point B is expected.
> 
> When I was in the field I always felt that I was expected to get my P-card. The reaction from others once they found out I was still an EMT after more than 4 years (at the time) always was, "oh cool you're in ...." a) medic school or b) nursing school.
> 
> ...



I don’t view it as a social expectation but rather as an ethical one. If you have people who rely on you for their care, you should continue to improve yourself and develop clinical expertise. This means continuing on to board certifications or areas of subspecialty within your field. There aren’t really any areas of clinical expertise at the EMT or LPN levels, so remaining at such a level for an extended period demonstrates stagnation of clinical development and should be an automatic ticket out of practice.

ETA: WEMT and EMT-T are subspecialties at the EMT level, but EMS isn’t the primary field and patient care isn’t typically the primary job.


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## MackTheKnife (Jul 26, 2019)

If EMS would get their sh*t together, this disjointed mess would slowly go away. The whole public, private, mixed public/private, etc. responders. Requiring a degree or not, NREMT gets you a license or every state like NCLEX-RN does, and ... whether or not to have just medics and no EMTs. NOTE: I'm not advocating the latter. Just a discussion point.


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## Carlos Danger (Jul 26, 2019)

joshrunkle35 said:


> I don’t view it as a social expectation but rather as an ethical one. If you have people who rely on you for their care, you should continue to improve yourself and develop clinical expertise. This means continuing on to board certifications or areas of subspecialty within your field. There aren’t really any areas of clinical expertise at the EMT or LPN levels, so remaining at such a level for an extended period demonstrates stagnation of clinical development and should be an automatic ticket out of practice.
> 
> ETA: WEMT and EMT-T are subspecialties at the EMT level, but EMS isn’t the primary field and patient care isn’t typically the primary job.



It is _unethical_ to remain an EMT or LPN for more than a few years because those fields don't provide subspecialty training or board certifications?  

I don't even know how to respond to that. That is easily the dumbest thing I've read on the internet lately, which is saying quite a bit.


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## Summit (Jul 27, 2019)

joshrunkle35 said:


> I don’t view it as a social expectation but rather as an ethical one. If you have people who rely on you for their care, you should continue to improve yourself and develop clinical expertise. This means continuing on to board certifications or areas of subspecialty within your field. There aren’t really any areas of clinical expertise at the EMT or LPN levels, so remaining at such a level for an extended period demonstrates stagnation of clinical development and should be an automatic ticket out of practice.
> 
> ETA: WEMT and EMT-T are subspecialties at the EMT level, but EMS isn’t the primary field and patient care isn’t typically the primary job.


Some of the best people, professionally and personally, I've met in my entire life are CNAs who have remained at that level for 15 years because they were made for it. I dare you to call them unethical to their face.


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## DrParasite (Jul 29, 2019)

The more I think about it, the more I think my response might have been too black and white.  Had circumstances in my past been differently, I likely would have ended up becoming a medic in Jersey City (and probably crossed into Newark or MONOC on my days off like many others) in 2005 with a major drinking problem, and been completely miserable with life.... Looking back, I'm very glad that didn't happen.

Let me modify the statement from @joshrunkle35 and let me know if it sounds better:



> If EMS is to be your full time career, than no one should be able to be an EMT for longer than 6 years; you need to go to paramedic school if you want to be seen as a knowledgeable and competent EMS provider.  The same goes for LPN; if you are still an LPN after 5 years, which doesn't permit you do do all the things an RN can do, than there is a problem, and it's time for your to rethink your career.
> 
> As brutally harsh as that is, I don’t disagree with it.


Especially now that I live in an All ALS system, where BLS ambulances are unheard of (and the overall EMS care isn't that much better TBH, esp since the medics spend soooo much time dealing with BLS patients), if you want to be anything more than on the ambulance, you need to have a paramedic certification.  It's just the nature of the system, not that the paramedic cert makes you any more qualified in many cases.

With all the part time EMS providers, or people who have an EMT cert yet EMS isn't their primary focus (every firefighter in the US, I'm looking at you, or cops who have an EMT cert yet they have never actually been on an ambulance), or volunteer providers (which is an entirely different rabbit-hole that I don't want to go down) it's both unreasonable and absurd to say that they should have to go to paramedic school, when they have no desire to, and would only make for a poor providers, especially if they stopped learning new things once they got their P card.

But if this is going to be your long term career, that you are going to spend 10+ years doing, and you want to be an EMS professional, than you should take the plunge and demonstrate that you can practice at the highest level of prehospital care.


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