# Paramedic school vs Nursing school



## beaucait (Feb 19, 2016)

Which do you think would be better? I am almost licensed as an EMT, and love it already, but just got accepted into nursing school. What are some pros and cons to each?


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## STXmedic (Feb 19, 2016)

Getting your RN/BSN will offer better pay and far more opportunities. I love being a paramedic, but burnout is high, hours are long, and typically pay is low. 

As others will say, these are different jobs. Shadow both and see what you prefer. But as fair warning, the lights and sirens being "cool" and the adrenaline rush fades. It can still be a rewarding job, but EMS is not as high-speed as o gets made out to be.


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## Gurby (Feb 19, 2016)

Do you want to be a nurse, a paramedic, or something else?


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## beaucait (Feb 19, 2016)

Both!


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## Ewok Jerky (Feb 19, 2016)

Go to nursing school, challenge paramedic.


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## beaucait (Feb 19, 2016)

Ewok Jerky said:


> Go to nursing school, challenge paramedic.


What if I went to nursing school, and then became a paramedic?


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## Gurby (Feb 19, 2016)

Caitlin Demers said:


> What if I went to nursing school, and then became a paramedic?



That's what he's suggesting.  As a nurse with some experience, you can take a 2-week course and then take the test to become a registered paramedic.  This route seems like the clear best choice for someone in your situation, who isn't dead set on one or the other.  It's much easier to do it this way than the other way around.


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## Chimpie (Feb 19, 2016)

That's what he's saying. Get your RN, challenge the medic test, that way you'll have both. You can work, or just become a medic or a nurse, whichever.


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## CALEMT (Feb 19, 2016)

Like Gruby and Chimpie have already pointed out, thats what Ewok is suggesting. Personally if you want to do both, shoot for your RN/BSN. You can work part time as an EMT while going through nursing school. Make a little income, get a little experience. Its a win-win if you can pull it off. Then when you're a RN you can challenge for your medic card/cert./whatever.


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## beaucait (Feb 19, 2016)

I see what you mean. I thought he was being funny...  I didn't even know that was an option. 


Ewok Jerky said:


> Go to nursing school, challenge paramedic.


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## medichopeful (Feb 20, 2016)

Go to nursing school first.  Better pay, more opportunities, and (most importantly), you get to wear professional pajamas.  Depending on the specialty you choose in nursing, you might be treating more really sick patients in a day than most paramedics treat in a week or more, which will make you a much stronger EMS provider.

If you're still interested in paramedic school afterwards, it will be easier with your nursing education.  You can either challenge the exam (in some places), or go through paramedic school (which is what I'm doing).


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## beaucait (Feb 20, 2016)

I would love to go through paramedic school I think it would be fun


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## Tigger (Feb 20, 2016)

Paramedic school pretty much pigeon holes you if that's your only post high school education. I am very happy I went and got a bachelors before I went to p-school, at least I have something to fall back on if being a paramedic doesn't work out.


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## DestinyNicole (Feb 20, 2016)

Go to nursing school.. More money, more options (you can be a EMS specific type nurse) LOL do the same thing as a medic for 3x the $$$$$$.....There's a reason they have bridges from Medic to Nursing and not vice versa! Good luck either way


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## StCEMT (Feb 20, 2016)

Medic school is fun with some suck mixed in for good measure. That being said, once you are a nurse I doubt you want to deal with all the class hours, clinical days, etc. you would have to do for medic school. Challenge it, best of both worlds.


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## SpecialK (Feb 21, 2016)

You will probably find, as certainly is the case in Australasia, the Paramedic degree and Nursing degree are made up of many of the same papers, at least in first year  There may also be the option, as in Australia, of doing a double degree.


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## Carlos Danger (Feb 21, 2016)

SpecialK said:


> You will probably find, as certainly is the case in Australasia, the Paramedic degree and Nursing degree are made up of many of the same papers, at least in first year  There may also be the option, as in Australia, of doing a double degree.



It isn't like that in the US. The two educational tracks are _completely_ different.


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## beaucait (Feb 21, 2016)

Remi said:


> It isn't like that in the US. The two educational tracks are _completely_ different.


I know which doesn't make sense. I wish they were hand in hand.


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## Chewy20 (Feb 21, 2016)

Listen to everyone on here. Don't pass up an RN school offer. Sadly EMS jobs for the most part are a joke, and paid as such.

Get your RN, then take the paramedic test if you still feel the need to do so.


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## COmedic17 (Feb 21, 2016)

DestinyNicole said:


> There's a reason they have bridges from Medic to Nursing and not vice versa!


^ No. 

While I agree BSN is the way to go, there are definitely programs for paramedic to RN. They are just a bit longer then vise versa.


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## chaz90 (Feb 21, 2016)

I cannot fathom why every single time this question comes up in these forums we immediately shoot down the potential EMS career aspirations of anyone who asks. There's eating your young, and then there's eliminating your future generation while they are still fetuses and ensuring you are the last of a breed at the brink of extinction.

Realism is great as is looking at both careers with an open mind, but are we really all so disillusioned that we can't even recommend a two year educational commitment for someone who is potentially interested?

Everyone has their own opinions reflective of their life, their area, and their job. There are benefits and of course cons to either path. Overall, I agree that nursing certainly gives more career flexibility and better long term job prospects, but there is absolutely nothing wrong with pursuing a career in EMS. 

Locally, I earn the same per hour as my RN roommate who works at a local hospital. I have a better schedule, better benefits, better job security, educational assistance, a more defined path for advancement, and a fully funded non contributory pension. Additionally, I get way more vacation, and only have to use 48 hours of paid vacation to get 12 days off in a row. I also think my time at work is much more enjoyable, at least from my perspective. I have a lot of autonomy to do what I want, work in a station, run only ALS 911 calls, and often sleep for the majority of my night shifts, none of which is possible as an RN working in a hospital. For a bit of perspective, we currently have 4 active RNs who are choosing to work at or department as a paramedic instead of getting a nursing job. To be fair, we also have several former medics who have left to work as RNs. 

I understand that modern nursing is a very fulfilling career and there are certainly many components of advanced practice nursing and non standard jobs that are very appealing to me. I would wither and die as a floor nurse though. There's a lot to be said for "just get through the hoops of nursing school" and then following those opportunities, but I don't regret going through paramedic school for a moment. Happiness matters, and for me, paramedicine is what I want to do at this stage of my life.


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## Qulevrius (Feb 21, 2016)

chaz90 said:


> Locally, I earn the same per hour as my RN roommate who works at a local hospital. I have a better schedule, better benefits, better job security, educational assistance, a more defined path for advancement, and a fully funded non contributory pension. Additionally, I get way more vacation, and only have to use 48 hours of paid vacation to get 12 days off in a row. I also think my time at work is much more enjoyable, at least from my perspective. I have a lot of autonomy to do what I want, work in a station, run only ALS 911 calls, and often sleep for the majority of my night shifts, none of which is possible as an RN working in a hospital. For a bit of perspective, we currently have 4 active RNs who are choosing to work at or department as a paramedic instead of getting a nursing job. To be fair, we also have several former medics who have left to work as RNs.



As much as I agree with you that EMS is not such a bad thing to do for a living, I think people are trying to give a general advice that will shoot for most, as opposed to your specific setting. Granted and I haven't seen a whole lot of EMS outside of my immediate surroundings (namely LACo & Ventura Co), what you describe will absolutely not fly anywhere around here. And I suspect that it won't fly in a whole lot of other places, too.



chaz90 said:


> I would wither and die as a floor nurse though.



Couldn't agree more. But for the places I've been around and know about, it's being miserable as RN/ER Tech with decent wages, or a happy medic/EMT with miserable pay. And the latter will eventually turn a happy medic/EMT into a depressed burnout, unless the said person gets up and leaves for greener pastures. So in my opinion, a better advice would be one that addresses a specific state/county vs a general 'do this/don't do that'.


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## STXmedic (Feb 21, 2016)

Chaz, don't forget that your system is a stellar system that is very rare to find and just as hard to get into. 99% of EMS systems are nothing like where you work. I also get paid very well and have stellar benefits. But regionally (and for the most part the whole state), if you don't work for my system, you start at 15/hr and if you stay for that same system for 10+ years, you might make it to 23/hr. Benefits are crap. Vacation is crap. On the flip side, every hospital here (we have 19 in town) starts their nurses between $25-$45, and most with pretty decent benefits.

As I said, I love being a paramedic. I lucked out ending up where I am, but I'm not blind to the fact that it's average at best, but often straight up sucks elsewhere else. I see where you're coming from; EMS can't keep running good people off. But until the system changes, I can't in good conscience push someone away from what is in almost every instance a smarter long-term move to come see how they like EMS- where if you're willing to move all over the country, there's a small chance in scoring one of the few stellar jobs. And while it's only two-ish years education, it will likely be considerably longer to make the switch while they realize it's not all sunshine and rainbows, then manage to find a way to go back to school part time, while being an adult happens with bills and kids and everything else. If you have both options on the table early, it would be stupid in my opinion to pick the lesser of the two options just to "check it out".

*If this was hard to follow, I apologize. It was written in haste.*


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## gotbeerz001 (Feb 21, 2016)

Go Fire. 

Just kidding; BSN like everyone else said.


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## beaucait (Feb 22, 2016)

STXmedic said:


> But regionally (and for the most part the whole state), if you don't work for my system, you start at 15/hr and if you stay for that same system for 10+ years, you might make it to 23/hr. Benefits are crap. Vacation is crap. On the flip side, every hospital here (we have 19 in town) starts their nurses between $25-$45, and most with pretty decent benefits.


In my state, starting as a paramedic you make 15$ an hour. As an EMT I'm not sure how much you start making. I can tell you though, I am taking a decrease in pay to get a job as an EMT because it definitely makes me way happier. I have never been happier then the two times I went on the truck. Laughs and good times every second. I would pass up nursing school to have a job like that all the time.


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## COmedic17 (Feb 22, 2016)

Caitlin Demers said:


> I have never been happier then the two times I went on the truck. Laughs and good times every second. I would pass up nursing school to have a job like that all the time.



Maybe it was like that those two times. But it's not "laughs and good times every second" all the time, as you stated. There is a much darker side to it as well.


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## Chewy20 (Feb 22, 2016)

Caitlin Demers said:


> In my state, starting as a paramedic you make 15$ an hour. As an EMT I'm not sure how much you start making. I can tell you though, I am taking a decrease in pay to get a job as an EMT because it definitely makes me way happier. I have never been happier then the two times I went on the truck. Laughs and good times every second. I would pass up nursing school to have a job like that all the time.



You cannot base a career off of two rideouts you have done. Glad you liked it, but be realistic.


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## Qulevrius (Feb 22, 2016)

Caitlin Demers said:


> In my state, starting as a paramedic you make 15$ an hour. As an EMT I'm not sure how much you start making. I can tell you though, I am taking a decrease in pay to get a job as an EMT because it definitely makes me way happier. I have never been happier then the two times I went on the truck. Laughs and good times every second. I would pass up nursing school to have a job like that all the time.



If they start medics off $15/hr then the EMTs will start @ $11/hr or lower. And, as others pointed out, you'll stop being starry eyed about EMS once you actually start working.


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## nightmoves123 (Feb 22, 2016)

It is easier to go from RN to Paramedic in terms of education... Im sure you are aware how difficult it is to get into nursing school. Do your nursing, and if you still have a passion for EMS then you can chop and change between the two.

Most 'service' jobs are 90% boredom and 10% action. If you're lucky anyways. Good luck


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## beaucait (Feb 22, 2016)

I know I have to be realistic about it. I really enjoyed helping patients, that's the 'good times' I meant. I know there will be alot of situations that make the job seem unfavorable, but it is what you make of it in the end. Am I right?


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## Chewy20 (Feb 22, 2016)

Caitlin Demers said:


> I know I have to be realistic about it. I really enjoyed helping patients, that's the 'good times' I meant. I know there will be alot of situations that make the job seem unfavorable, but it is what you make of it in the end. Am I right?



Yeah until you can't afford to take a vacation or pay your bills lol. If you're willing to move to different parts of the country there are some gigs you can EMS a career and have some room for advancement. That is the minority, and that's the point people are trying to make. With nursing you can move anywhere in the country and know that you can make a living. 

At the end of the day, it's a job. And it needs to be able to put food on the table and keep the family happy.


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## gotbeerz001 (Feb 22, 2016)

Caitlin Demers said:


> I know I have to be realistic about it. I really enjoyed helping patients, that's the 'good times' I meant. I know there will be alot of situations that make the job seem unfavorable, but it is what you make of it in the end. Am I right?


No. Not really. 
You will find that at private companies, management often seems to work against all your best efforts to provide care due to concerns over profitability; any attempt to push back can jeopardize your ability to move forward. 

Most people get to a point where their ability to have a good day is because they have a good partner and have decided that they cannot "fix" the system but rather must just embrace the suck and try to find a few nuggets of positivity to keep going.... Or commit suicide because of their life choices. #projectgreen

Sound fun?

While I hear that nursing is not all roses, the end product is much more tenable and financially beneficial for those in it.


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## STXmedic (Feb 22, 2016)

Does nursing not help people too?...


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## Carlos Danger (Feb 22, 2016)

You don't hear much about the downsides of nursing. Bedside nursing is actually a really tough job. In fact, every nursing job I've had was generally much harder work than my EMS jobs.

Pay for RN's is still decent (considerably better than for paramedics) in most places, but it definitely isn't as good as it used to be, and benefits and general working conditions seem to be on the decline, at least from what I've seen. The trends are definitely not favorable.

The only area where nursing clearly blows away EMS without question is opportunities to do different things. That's important to some people (it was to me), but to many it isn't.

Overall, it looks to me like the gap between the two is closing. If you can find a good paying job as a paramedic (they are out there, as chaz90 and STXmedic can attest) and you are pretty confident that it's what you want to do for good, then I don't think nursing is necessarily better.


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## NomadicMedic (Feb 22, 2016)

chaz90 said:


> I cannot fathom why every single time this question comes up in these forums we immediately shoot down the potential EMS career aspirations of anyone who asks. There's eating your young, and then there's eliminating your future generation while they are still fetuses and ensuring you are the last of a breed at the brink of extinction.
> 
> Realism is great as is looking at both careers with an open mind, but are we really all so disillusioned that we can't even recommend a two year educational commitment for someone who is potentially interested?
> 
> ...



Slow clap.


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## Akulahawk (Feb 23, 2016)

nightmoves123 said:


> *It is easier to go from RN to Paramedic in terms of education*... Im sure you are aware how difficult it is to get into nursing school. Do your nursing, and if you still have a passion for EMS then you can chop and change between the two.
> 
> Most 'service' jobs are 90% boredom and 10% action. If you're lucky anyways. Good luck


It's very much easier to go from RN to Paramedic than vice versa, primarily due to the prerequisites necessary for entry to Nursing School vs Paramedic School. Quite honestly, if you did all the typical RN prerequisites and then did P school, you'd find that P school really isn't all that hard. You'll know the deeper "why" behind the things we do instead of a relatively basic "why." That, combined with your knowledge of things Paramedic, will usually make it much easier to apply what you know to real-world patients. 

I went through P school through an odd route. I earned my Bachelors in Sports Med first, became an EMT and then went to Paramedic School. By the time I was done, I only truly learned a few new things as much of the rest was already known at a much more in-depth level. It's fair to say that I rarely cracked the book for P school. Nursing school was far more involved. That being said, since I'd already had a very in-depth education, I found RN school to be reasonably easy and I passed the NCLEX the first time, minimum questions to pass. 

I'm not saying _you_ should go the way I did, OP, but consider that patient assessment is patient assessment, regardless of where you learned it. One of the more difficult things for RNs to do is transition to an "I'm it" mentality and learn the typical protocols that we learn in P school. Once they "get it" the nurses that go medic do just fine. My goal wasn't to become an RN. That evolved over time. Had I wanted to be both a Paramedic and an RN from the outset, I would have gone RN first and then challenged the P exam. I was unmarried at the time as well, so I probably would have looked for an RN job for the $$$ part of it and then also a PRN Paramedic job to complement things.

One minor bit of caution: earn your BSN soon, if you're going RN. This is because the job market for nurses is still heavily in the employer's favor. The BSN will usually get you a look by a hiring manager long before you get looked at if all you have is an ADN. Once that pendulum swings back to the Nurse's favor, it won't matter as much, but you'll still have more opportunities compared to most ADN grads. 

Don't think of doing RN and then P as a lesser way to do it, think of it as more of a cheaper way to reach your goal of earning both.


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## Run with scissors (Feb 23, 2016)

Every one is saying to go RN,  but people are having a hard time getting jobs after RN school. A friend of mine just graduated RN school and her and 3 friends have applied to every local hospital. No one will even touch them without a BSN.  She just got accepted into a residency program for nurses 250 miles away at OU Medical (in another state).

My cousin is a medic in oklahoma city for amr. And makes 50k/year.  While my friend works at OU in Oklahoma city now making 47k/year doing the residency program. 

If you ask me. Your safer with the paramedic route. At least you know there will always be a job for you.


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## Akulahawk (Feb 23, 2016)

Run with scissors said:


> Every one is saying to go RN,  but people are having a hard time getting jobs after RN school. A friend of mine just graduated RN school and her and 3 friends have applied to every local hospital. No one will even touch them without a BSN.  She just got accepted into a residency program for nurses 250 miles away at OU Medical (in another state).
> 
> My cousin is a medic in oklahoma city for amr. And makes 50k/year.  While my friend works at OU in Oklahoma city now making 47k/year doing the residency program.
> 
> If you ask me. *Your safer with the paramedic route. At least you know there will always be a job for you*.


Nursing job availability is cyclical. I've seen a couple cycles of this. As a Paramedic while there may be relatively easy job prospects, your pay may not be all that great. Around my area, only the FD medics approach my pay as an RN. The "private" folks earn about 1/2 of my hourly wage at best. Still, having a job beats no job. All of my classmates found jobs (and we're all ADN grads) within a year of graduation. I wanted to be an ED RN so it took me a little longer than most. About 1/2 of my classmates had jobs well within 6 months of graduation, if not sooner. You just might have to be willing to "settle" for whatever you can find OR travel a bit to get the specialty of your choice. I'm an ED RN and (only one of a couple from my class) and I had to go 2 hours away to find that job. I'm now rapidly approaching the point where I should be fairly competitive for ED jobs closer to home...

My "full" recommendation for going both RN and Paramedic is to do Nursing School, take an EMT course between the Spring and Fall Semesters at school and when you're done with RN school, find a Paramedic School that will do the transition course and arrange for you to do your field time. Then you can get licensed as a Paramedic also and you'll be free to pursue either job and that should be a LOT cheaper than going to Paramedic School and then through RN school... even if you did a Paramedic-RN transition course. 

If I end up staying at my current job for a couple more years, I might just see about getting on one of the local FD's as a PRN Paramedic. Sure the pay will be lower but I'll be allowed to intubate again and do EJ IV sticks.


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## Run with scissors (Feb 23, 2016)

Yeah, in my area. Amr starts off at 40k/year fresh outta medic school. With 2 years exp its 45k after 4 years its 48k then 50k after 5 years.  Plus they give bonus pay for like hazmat and extra certs. 

40k is big ballin where I live. Not much I wouldn't do for that type of money.


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## gotbeerz001 (Feb 23, 2016)

Run with scissors said:


> Every one is saying to go RN,  but people are having a hard time getting jobs after RN school. A friend of mine just graduated RN school and her and 3 friends have applied to every local hospital. No one will even touch them without a BSN.  She just got accepted into a residency program for nurses 250 miles away at OU Medical (in another state).
> 
> My cousin is a medic in oklahoma city for amr. And makes 50k/year.  While my friend works at OU in Oklahoma city now making 47k/year doing the residency program.
> 
> If you ask me. Your safer with the paramedic route. At least you know there will always be a job for you.


We all pretty much said to get a BSN.

Buddy of mine in SoCal graduated with his BSN 6 weeks ago and started a job yesterday.


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## Akulahawk (Feb 23, 2016)

Run with scissors said:


> Yeah, in my area. Amr starts off at 40k/year fresh outta medic school. With 2 years exp its 45k after 4 years its 48k then 50k after 5 years.  Plus they give bonus pay for like hazmat and extra certs.
> 
> 40k is big ballin where I live. Not much I wouldn't do for that type of money.


I'm going to compare something for you... I don't work for anywhere near good pay as a nurse in the area. In fact, I make about $8 less than the average. My starting annual salary was "only" about 74k and I just received a slight bump in my base pay (I'm still at the bottom) and now gross around $81k. The lowest annual salary where I live brings in around $89k. SoCal is a very tight market for nurses, lots of them and few spots. Down there they can expect a salary between $52k and $59k. That's starting... and no OT figured in this, with 36 hrs/week for 12 hour shifts. If I worked a 40 hr work week at my current hourly wage, I'd make just around $90k/year gross. 

Generally speaking, you have to be a firefighter to approach or exceed what I make. Incidentally, around here, even the firefighter base salary doesn't approach this, though once they're OK to accept OT shifts, it becomes very easy to blast well past my salary. Just 15 years ago there were some Firefighters, not AO's or Captains, that made >$100k/yr....


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## beaucait (Feb 23, 2016)

A lot of people end up running 2 or 3 jobs just to support themselves. My instructor does shifts on the weekend as a paramedic, and also controls all of the education in the whole system.


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## Chewy20 (Feb 23, 2016)

Caitlin Demers said:


> A lot of people end up running 2 or 3 jobs just to support themselves. My instructor does shifts on the weekend as a paramedic, and also controls all of the education in the whole system.



Shouldn't have to work more than one job to make ends meet. Jus sayin.


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## Summit (Feb 23, 2016)

One of the hospitals I work at just raised the pay for a new BSN to 72K, before night and weekend differential. New Paramedics in the area are making $15-18/hr...


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## Akulahawk (Feb 23, 2016)

Summit said:


> One of the hospitals I work at just raised the pay for a new BSN to 72K, before night and weekend differential. New Paramedics in the area are making $15-18/hr...


This is why we're suggesting that if someone is considering nursing school vs paramedic school, we suggest nursing school. It's just plain tough to make it on $15-18/hr unless you're very good at budgeting and/or you've got someone else also making about that much in your household. 

Is nursing school hard? Yes. Is Paramedic school hard? Yes. In terms of difficulty, they're about the same. The thought process behind the two are very different though. Why then do nurses have a "better" education than Paramedics? Simple. They have extensive, college-level prerequisites. In short, the "generic" nurse has a broader education in human anatomy, physiology, psychology, growth & development, nutrition, research, and the like than the "generic" paramedic does at the first day of formal schooling.


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## Tigger (Feb 24, 2016)

chaz90 said:


> I cannot fathom why every single time this question comes up in these forums we immediately shoot down the potential EMS career aspirations of anyone who asks. There's eating your young, and then there's eliminating your future generation while they are still fetuses and ensuring you are the last of a breed at the brink of extinction.
> 
> Realism is great as is looking at both careers with an open mind, but are we really all so disillusioned that we can't even recommend a two year educational commitment for someone who is potentially interested?
> 
> ...



Thank you. 

Paramedics and nurses do not do the same things. I am tired of the forced comparison between the two fields. Two jobs with two different educational slants that focus on different goals. And there is nothing wrong with that. Yet we insist on comparing the two and I just cannot figure out why that is.


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## STXmedic (Feb 24, 2016)

Tigger said:


> Thank you.
> 
> Paramedics and nurses do not do the same things. I am tired of the forced comparison between the two fields. Two jobs with two different educational slants that focus on different goals. And there is nothing wrong with that. Yet we insist on comparing the two and I just cannot figure out why that is.


When nursing is compared to paramedicine, many medics picture ER/ICU nursing. Other than us driving an ambulance and having to hang out in people's smelly, cockroach-infested houses, and nurses having longer times with the patients, what's the difference? We both practice medicine under standing or direct orders of a physician. Some RNs do have a bit less autonomy than a paramedic, but others can be significantly more autonomous. I've never personally worked as a nurse, but my wife is an ICU nurse, and almost all of our friends are nurses either in the ICU or ED- including many who made the switch from paramedic (including my wife). Those that made the switch seem to think it's pretty damn similar; do you have some better insight than they do?


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## Chewy20 (Feb 24, 2016)

Tigger said:


> Thank you.
> 
> Paramedics and nurses do not do the same things. I am tired of the forced comparison between the two fields. Two jobs with two different educational slants that focus on different goals. And there is nothing wrong with that. Yet we insist on comparing the two and I just cannot figure out why that is.



What are the different goals?


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## Tigger (Feb 26, 2016)

Chewy20 said:


> What are the different goals?


The more time I spend in the ED, the more I realize that patient care is carried out by the nursing staff. But even in a high functioning ED, the doctor is still the one calling the shots, and a good nursing team implements that super efficiently while also filling in the smaller details that the doc missed.

Meanwhile for us on the ambulance, we make and implement our own plans. This is not a dig on nursing. I have no doubt that ED RNs require minimal direction, but that's not their educational goal it seems.


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## SpecialK (Feb 26, 2016)

Broadly, a Registered Nurse treats _people _whereas a Doctor (or for the matter, a Paramedic) focusses on _disease.  
_
For example, pneumonia might be the patient's diagnosis.  The doctor comes along and prescribes antibiotics appropriate for the situation and other medications (or whatever).  The Registered Nurse is going to focus on ensuring the patient understands the necessity of adequate tidal volume and cough, getting them up and out of bed as early as possible, doing breathing exercises etc  i.e. about helping them understand the impact of the disease they have and what they can do to restore their health as best they can from it.  Physiotherapist might come along once the Nurse has gotten the patient up and ot of bed and do more physiotherapy-specific things with them.  

This is a very broad example specific to a particular situation; but in general the difference is a Registered Nurse is not as concerned with making a medical diagnosis and determining medical treatment, that is the medics job.  They must understand various elements of medicine but do not have the breadth and length of diagnostic training because it is not required.  There is some of the same clinical decision making overlap between medicine, nursing and paramedic - for example titration of intravenous morphine (whether it is prescribed by a doctor or administered under a standing order by paramedics).

As a Registered Nurse on a medical ward or in ED, ICU or CCU you are going to learn far more due to exposure and constant collegial contact with a range of health professionals than you ever would as a Paramedic. 

If it sounds like I know what I am talking about it's because I did some nursing in my younger days.  Some of the best people I worked with were ICU nurses who ave long forgotten more than I'll ever know.


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## Summit (Feb 26, 2016)

Tigger said:


> The more time I spend in the ED, the more I realize that patient care is carried out by the nursing staff. But even in a high functioning ED, the doctor is still the one calling the shots, and a good nursing team implements that super efficiently while also filling in the smaller details that the doc missed.


 I think this depends because there are plenty of EDs where the RNs have a massive standing protocols they can implement with not much more physician involvement than the equivalent of a call to med control (not with the level of indepence a progressive EMS systems offers as that would be silly in an ED, but often with more flexiblity in treatment options). These tend to be highly collaborative care environments too and it is a lot easier for a RN to decide on a modified treatment plan and get it approved than for EMS to deviate from the protocols by calling medical control. The final call falls to the MD. Other EDs operate more like the EMS equivalent of a "mother may I system."



SpecialK said:


> Broadly, a Registered Nurse treats _people _whereas a Doctor (or for the matter, a Paramedic) focusses on _disease. _


I truly detest this line because in the US it is usually parroted as feel good nonsense by academics or RNs who aren't in clinical roles (or lower acuity care) who want to aggrandize RNs reputation or otherwise assuage their insecurities. *I know you don't mean it how they do*, but I still don't quite agree with the middle portion of your statement, especially from the US ICU point of view where understanding the medical treatment and diagnosis in as much detail as possible is of paramount importance.


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## gotbeerz001 (Feb 26, 2016)

SpecialK said:


> Broadly, a Registered Nurse treats _people _whereas a Doctor (or for the matter, a Paramedic) focusses on _disease.
> _


Yeaaaaahhhh, no points for this. Do you also believe that "good EMTs save paramedics"?


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## Carlos Danger (Feb 26, 2016)

SpecialK said:


> Broadly, a Registered Nurse treats _people _whereas a Doctor (or for the matter, a Paramedic) focusses on _disease. _





Summit said:


> I truly detest this line because in the US it is usually parroted as feel good nonsense by academics or RNs who aren't in clinical roles (or lower acuity care) who want to aggrandize RNs reputation or otherwise assuage their insecurities. *I know you don't mean it how they do*, but I still don't quite agree with the middle portion of your statement, especially from the US ICU point of view where understanding the medical treatment and diagnosis in as much detail as possible is of paramount importance.



I haven't heard it put that way in a long time but when I think about it, to me it is a pretty good way to describe what nurses do vs. what physicians do. It's not a complete or perfect explanation of course, but I think it summarizes the essence of the difference in roles as well as any pithy statement can.

As all us nurses know well, we do focus on _care of the *patient*_, rather than just _diagnosis and management of the *disease*_, which is what physicians focus on. Obviously there is some overlap there, and nurses are heavily involved in disease management as well. Being the ones constantly in contact with and assessing the patient and carrying out the medical orders, of course we need to know quite a bit about the relevant pathophysiology and pharmacology, as well.


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## Bullets (Feb 26, 2016)

I would echo everyone else in regards to a BSN, my local hospital system only hires BSN, even for floor spots. I already had a BA so i applied to a BA to BSN bridge and a medic program at the same time. I was accepted to both but found out that the RN school was about to loose its certification, So i went to the paramedic school and am almost finished. I took all the prereqs for nursing school so paramedic school was incredibly easy. The nice thing is all these clinical hours put me in position to meet the requirements for the PA school at the local university, so i am going to go that route. 

But EMS is where my heart really is and i think were building something great here. We've been developing an EMT based community medical service where our EMTs go visit new discharges within the community to help reduce readmissions at the ER, we have introduced the Rescue Task Force model to a consortium of local PDs in response to active shooters, we have integrated our senior center and EMS under one department, so our services work hand in hand to deliver better comprehensive care to a large senior community.  There are plenty of opportunities in EMS to do new stuff. 6 years ago i would never guess a bachelors of history would lead to having my name on any of that stuff. I could never imagine. I know that as a municipal 911 agency we have a little more money and politicians love to put their names on this kind of stuff but opportunities are out there, you just have to find them


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## ICUmurse (Feb 26, 2016)

So I am a nurse in a high volume trauma ICU at a large level 1 trauma center. I have gone back to get my EMT (I completed a full EMT program) and will be going back to get my Paramedic Cert via a bridge program. The reason I'm doing this is to get field experience to fly. I can tell you from experience that having that ICU experience is very valuable when going through my EMS training. In the ICU you have a large amount of autonomy and work mostly off of protocols (we don't have a physician nearby). On top of that you are regularly titrating drips and working on very unstable patients. You gain a significant understanding physiology. If you become a nurse and then work through a bridge program to Medic you will excel in both areas. The best nurses I've known were both nurses and paramedics with field experience.


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## medicaltransient (Feb 26, 2016)

Nurse, better pay better hours. I like the work I do but I regret being a paramedic.


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## SpecialK (Feb 26, 2016)

gotshirtz001 said:


> Yeaaaaahhhh, no points for this. Do you also believe that "good EMTs save paramedics"?



What do you mean?



Remi said:


> As all us nurses know well, we do focus on _care of the *patient*_, rather than just _diagnosis and management of the *disease*_, which is what physicians focus on. Obviously there is some overlap there, and nurses are heavily involved in disease management as well. Being the ones constantly in contact with and assessing the patient and carrying out the medical orders, of course we need to know quite a bit about the relevant pathophysiology and pharmacology, as well.



Yes, I very much agree.



ICUmurse said:


> In the ICU you have a large amount of autonomy and work mostly off of protocols (we don't have a physician nearby)



Now that is different.  Our large tertiary ICUs are staffed by a Consultant Intensivist until at least 2300 each day and there will always be a Senior ICM Registrar as well, and they are really not physically allowed to leave the unit. Isn't that the entire point of an ICU? To have expert medical and nursing staff readily available?


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## ICUmurse (Feb 26, 2016)

> Now that is different.  Our large tertiary ICUs are staffed by a Consultant Intensivist until at least 2300 each day and there will always be a Senior ICM Registrar as well, and they are really not physically allowed to leave the unit. Isn't that the entire point of an ICU? To have expert medical and nursing staff readily available?



We have an ICU doctor in house, however he/she is covering 4 different ICUs that make up 60 plus ICU beds and any pulmonary step down patients in the hospital. Due to this we have a large amount of autonomy. I know this is not this way everywhere. I have even seen some units staff an ICU trained NP in the unit for a 12 hour shift and you have to go to them to get an order to start a foley. My point was simply that having that core critical care training is very helpful in EMS. If you've been able to stabilize a multitrauma pt that is on pressors, sedation, paralytics, CRRT, ICP monitor, etc for 12 hours...when you're alone in the back of a flipped car trying to RSI someone it'll just make you stronger.


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## EOPFD (Feb 26, 2016)

DestinyNicole said:


> Go to nursing school.. More money, more options (you can be a EMS specific type nurse) LOL do the same thing as a medic for 3x the $$$$$$.....There's a reason they have bridges from Medic to Nursing and not vice versa! Good luck either way


I am currently enrolled in medic school in NY
Do you know any medic to RN bridge programs?


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## Tigger (Feb 27, 2016)

STXmedic said:


> When nursing is compared to paramedicine, many medics picture ER/ICU nursing. Other than us driving an ambulance and having to hang out in people's smelly, cockroach-infested houses, and nurses having longer times with the patients, what's the difference? We both practice medicine under standing or direct orders of a physician. Some RNs do have a bit less autonomy than a paramedic, but others can be significantly more autonomous. I've never personally worked as a nurse, but my wife is an ICU nurse, and almost all of our friends are nurses either in the ICU or ED- including many who made the switch from paramedic (including my wife). Those that made the switch seem to think it's pretty damn similar; do you have some better insight than they do?


I don't doubt that many nurses are more than capable of managing their patients nearly autonomously. It seems to me though that the goal of a paramedic education is to be more targeted. I think my program casts a much wider net in terms of education on diseases that we encounter than most, but at the end of the day we are taught to perform treatments that are realistic for our environment. The nursing education (at base) to me appears to provide a much better foundation, but most ED nurses have told me that they feel useless for the first year in the ED until they can get some OTJ training that is specific to their role. Our education is specific to our role and while I know I have a lot to learn once I finish, at the very least I could function on my own at the completion of the program. 

I guess that's what I mean by different goals. I have nothing against nursing but think that that sort of track isn't for me. I want to know what will make a direct impact on my care, and a very broad curriculum isn't necessarily practical for EMS. There's a limit to what we can do, let's make sure we're awesome at that.


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## Summit (Feb 27, 2016)

Tigger I agree with that differentiation. Paramedics are trained as emergency specialists. RNs (and MDs) are educated as generalists and then they specialize. That is why it is hard for paramedics to bridge to other professions without nearly the same investment as starting from scratch. It is why nursing is such a broad field and easy to switch specialties. But many don't have an interest in the broad portions of the generalist foundation that don't apply to their special interest and don't want to then spend time specializing. For those folks the targeted education of paramedics is very appealing.


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## Lal (Feb 8, 2020)

Nursing school was easy for me but I went in 2002    I now work as an EMT, I was one semester of clinicals away when I realized I would go crazy under the thumb of 10 bosses, behind brick walls 40+hours a week so I got a non-clinical BS instead.  I prefer fieldwork even if it's hard.  Paramedic school is hard because of the level they want you to be practicing when you leave.  Nursing school is more of an overview...and a good three months of my clinicals were wasted on dumb things like cleaning rooms and changing bedpans (hopefully their are programs out there that don't waste time on dumb crap like this). We use urinals and bedpans in an ambulance but we never had to train to use them because it's not rocket science. From what I understand Medic school is intense the entire time...your going to start off doing big things right away so you better be ready there is also a lot you are expected to memorize and learn on your own (interpreting 12 leads is boring to me but some people love it).   Some Medic schools are only 12 weeks. If you are talking about the number of diagnostics tools learned,  nurses have way more to learn about (ICU/ER) but they don't typically interpret like Medics do. I have heard most nurses learn the majority of work after starting a job. So now for the cost...obviously Nursing school is the better pay off...thats why you shouldn't waste your money as a medic if your not sure you want to do it.  Get a job as an EMT or ER Tech first than decide. That would be the best route. Medics/EMTs must be good at investigating a problem and getting an initial diagnosis. The information that is provided to the ER shapes care from the moment a report is given (that's been proven). We decide what information to communicate (what is applicable what is not).  We have to investigate the scene/history and we are utilizing this to help form a diagnosis so it's important to be confident in the diagnostics aspects.  We also must control the scene and it can be dangerous. Most times the critical patient goes into the ER to see a huge team of clinical care providers all working with diagnostic tools to get a clearer picture.  In the field, you have to use a lot of instinct and understand human nature, human psychology and the culture of medicine. We also relay that information so the ER/Cath lab etc can be ready for the patient, and its super embarrassing not to mention detrimental if you screw up!  In the ICU nurses work autonomously but have a lot more resources to perform their job. I think the hardest part about Nursing school was the laboratory portion of A&P (btw...what a dumb waste of time...if I wanted to work in a lab studying cultures I would have got a laboratory tech degree).   So Nursing is more to learn and longer (but a lot of its a waste)...Medic is faster paced and high stress. On a side note an Associates are the new minimum for medics this includes all the same prerequisites of Nursing school.  You can obtain certification/licensure but to get any kind of good job you are going to need minimum associates.  Where I work they prefer a Bachelor's....but pay the highest in the State (Starting is $22/23 hour).


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## CCCSD (Feb 8, 2020)

You missed the reason scut work is taught in Nursing school. I think you made a wise choice not finishing as you seem to think that you know more than what Florence Nightingale was teaching about patient care...

You May want to check that God Complex.


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## CALEMT (Feb 8, 2020)

I'm pretty sure I lost brain cells just reading that post and I can't afford to lose anymore... because... firefighter paramedic...

But in all seriousness you must be an absolute joy to work with.


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## SandpitMedic (Feb 8, 2020)

I’ve spent my entire career not knowing what a herp-derper was and looking for one. Today I found one. Thanks, Lal.


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## Summit (Feb 8, 2020)




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## medichopeful (Feb 8, 2020)

Lal said:


> Nursing school was easy for me but I went in 2002    I now work as an EMT, I was one semester of clinicals away when I realized I would go crazy under the thumb of 10 bosses, behind brick walls 40+hours a week so I got a non-clinical BS instead.  I prefer fieldwork even if it's hard.  Paramedic school is hard because of the level they want you to be practicing when you leave.  Nursing school is more of an overview...and a good three months of my clinicals were wasted on dumb things like cleaning rooms and changing bedpans (hopefully their are programs out there that don't waste time on dumb crap like this). We use urinals and bedpans in an ambulance but we never had to train to use them because it's not rocket science. From what I understand Medic school is intense the entire time...your going to start off doing big things right away so you better be ready there is also a lot you are expected to memorize and learn on your own (interpreting 12 leads is boring to me but some people love it).   Some Medic schools are only 12 weeks. If you are talking about the number of diagnostics tools learned,  nurses have way more to learn about (ICU/ER) but they don't typically interpret like Medics do. I have heard most nurses learn the majority of work after starting a job. So now for the cost...obviously Nursing school is the better pay off...thats why you shouldn't waste your money as a medic if your not sure you want to do it.  Get a job as an EMT or ER Tech first than decide. That would be the best route. Medics/EMTs must be good at investigating a problem and getting an initial diagnosis. The information that is provided to the ER shapes care from the moment a report is given (that's been proven). We decide what information to communicate (what is applicable what is not).  We have to investigate the scene/history and we are utilizing this to help form a diagnosis so it's important to be confident in the diagnostics aspects.  We also must control the scene and it can be dangerous. Most times the critical patient goes into the ER to see a huge team of clinical care providers all working with diagnostic tools to get a clearer picture.  In the field, you have to use a lot of instinct and understand human nature, human psychology and the culture of medicine. We also relay that information so the ER/Cath lab etc can be ready for the patient, and its super embarrassing not to mention detrimental if you screw up!  In the ICU nurses work autonomously but have a lot more resources to perform their job. I think the hardest part about Nursing school was the laboratory portion of A&P (btw...what a dumb waste of time...if I wanted to work in a lab studying cultures I would have got a laboratory tech degree).   So Nursing is more to learn and longer (but a lot of its a waste)...Medic is faster paced and high stress. On a side note an Associates are the new minimum for medics this includes all the same prerequisites of Nursing school.  You can obtain certification/licensure but to get any kind of good job you are going to need minimum associates.  Where I work they prefer a Bachelor's....but pay the highest in the State (Starting is $22/23 hour).



Just out of curiosity, did you leave nursing school before taking a basic English class?

You are correct that nursing school is not difficult.  However, paramedic school is not difficult either.  

Speaking from experience, I can say that both EMS and nursing shapes patient care.  You seem to be giving a lot of credit to EMS, while taking away a lot from nursing.  And unfortunately, you don't really seem qualified to speak on the subject.


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## akflightmedic (Feb 9, 2020)

Lal said:


> Nursing school was easy for me but I went in 2002    I now work as an EMT, I was one semester of clinicals away when I realized I would go crazy under the thumb of 10 bosses, behind brick walls 40+hours a week so I got a non-clinical BS instead.



"No One DOR's their final week!..." LOL, could not resist the O&G '82 movie reference...anyways, that is quite odd you would just not finish that final semester based on inaccurate information. So close to having a RN degree, yet tossing it to the side based on flawed perceptions. Methinks there is more to the story (there always is...), however that was way back in 2002, so recall may be a bit fuzzy these days. That's cool...however, what is not cool is the level and amount of disinformation you spew without even A) being a RN or B) not even being a Paramedic. So sadly, you do not know what you do not know. And THAT is more embarrassing for us, the Medical Professionals. You might be embarrassed some day, right now, not so much due to the safety of the Ivory Tower. 




Lal said:


> I prefer fieldwork even if it's hard.  Paramedic school is hard because of the level they want you to be practicing when you leave.  Nursing school is more of an overview...and a good three months of my clinicals were wasted on dumb things like cleaning rooms and changing bedpans (hopefully their are programs out there that don't waste time on dumb crap like this). We use urinals and bedpans in an ambulance but we never had to train to use them because it's not rocket science. From what I understand Medic school is intense the entire time...your going to start off doing big things right away so you better be ready there is also a lot you are expected to memorize and learn on your own (interpreting 12 leads is boring to me but some people love it).



Paramedic school really is not that hard, the caveat being that the school itself is the unknown. So YOU, as a non-paramedic are speaking about how paramedic school is hard. Interesting, and how many have you attended in order to make this assessment and draw a comparison? You could be in a school which hammers the fundamentals, strong A&P, Bio/Micro, etc and then relates all that body science to the skills and tasks you will perform, or you could be in a program that teaches "if you see X then give one brown box every 3-5mins...". Personally, I strongly advocate for degree/community college paramedic programs simply in an effort to collectively boost the EMS profession as a whole. 

All that I said above about Paramedic programs also applies to Nursing programs. My experience has been complete opposite of your claim. If you were stuck cleaning rooms, changing bedpans, emptying urinals for three months, either your program needs an overhaul or that is simply the level your preceptors deemed you capable of. Regardless, those dumb skills are actually essential to nursing. Why? Knowing the patient's bowel habits, knowing their amounts of waste, color, smell, consistency, etc...are all extremely relevant to a host of conditions and are often good indicators of ongoing care or treatment. Dealing with patient's bowel movements are also a level of intensity that some may not be able to handle and interacting with a patient, questioning them about their elimination, maintaining rapport and overcoming their discomfort and your own is essential to nursing care. You are developing communication, assessment and diagnostic skills...all with a bedpan full of poo. Crazy right?

And let's not forget, that although these are very "basic" skills and seemingly a waste of time, it is a good reminder that no matter what level of RN you obtain, if you are in the clinical setting...you WILL continue to clean rooms, clean patients, and empty bedpans or urinals throughout your career, especially in the ICU setting, but almost always on Med Surg or LTC. Yep, there are CNA,s however they are not always available and you advocating for your patient will do what needs to be done. Sad you missed this lesson a la Miyagi style (another 80s reference).

You then state in Medic school you start off doing big things right away...not really. You most likely revisit the basics, then learn new knowledge and skills, then start applying. Again, I ask, how do you know the intensity level? "Learn on your own"...technically in any prrofession, whether it be plumbing, electrical, Paramedic, RN, whatever...there is learning on your own. There ALWAYS should be learning on your own with your initial education and then ongoing throughout your career. Unsure what you are trying to prove or disprove here. Awesome you think 12 leads are boring...that statement alone proves how little you value that information presented from that piece of paper. I hope you are competent interpreting these 12 leads at your EMT level. Typically when one finds something "boring" or unnecessary, it is due to the fact they do not understand what they are seeing, hearing, or assessing...basically, a lack of knowledge so they then dismiss it. 



Lal said:


> Some Medic schools are only 12 weeks. If you are talking about the number of diagnostics tools learned,  nurses have way more to learn about (ICU/ER) but they don't typically interpret like Medics do.



Really? Are you intentionally this ignorant? At what point do you think nurses do not interpret? What are you basing this on?



Lal said:


> I have heard most nurses learn the majority of work after starting a job.



This is one statement of semi-truth. Nurses spend 2-4 years in pursuit of their ADN or BSN, and there is only so much you can teach within that time frame. It is MEDICINE...learning is forever ongoing. So yes, initial education focuses on producing a SAFE, NOVICE Nurse. You do learn a broad scope of the basics and then when you start a job as a Graduate Nurse or if you land in an immediate RN role, you will have a huge learning curve. Some of this is due to the facility having different scope, policy, or procedures. Some of the curve is due to you are now applying all that you know while trying to learn more in a 36 hour a week setting as opposed to the one 12 hour clinical day per week you had while in school (or whatever your program offered).

Guess what? The same statement applies to Paramedics! I learned way more stuff in my first 3 years or so as a Paramedic than I ever did in class. So "we" are not immune to the learning more in the first year process anymore than the next person/profession. Paramedic school gave me the basic knowledge to pull from then I had to see quantity, call after call, to build a data of references to pull from in order to apply or not apply what I had learned.



Lal said:


> So now for the cost...obviously Nursing school is the better pay off...thats why you shouldn't waste your money as a medic if your not sure you want to do it.  Get a job as an EMT or ER Tech first than decide. That would be the best route. Medics/EMTs must be good at investigating a problem and getting an initial diagnosis. The information that is provided to the ER shapes care from the moment a report is given (that's been proven). We decide what information to communicate (what is applicable what is not).  We have to investigate the scene/history and we are utilizing this to help form a diagnosis so it's important to be confident in the diagnostics aspects.



Yes, we will make a field diagnosis in order to decide what to do or not do within our scope. Yes, we provide what we think is relevant in our radio report and then in our face to face handover. However, there have been times where I have dismissed something I thought was insignificant and it was completely relevant to the hospital. Drop your ego dude...medicine is a team sport. And if you think all follow on care is based on your report and assessment, you are mistaken. Each professional/provider who comes into contact with that patient is assessing, info sharing, reshaping the treatment plan. 

Please link me to your sources on the "That's been proven" statement. I would like to independently review these for my own knowledge.


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## akflightmedic (Feb 9, 2020)

Lal said:


> We also must control the scene and it can be dangerous. Most times the critical patient goes into the ER to see a huge team of clinical care providers all working with diagnostic tools to get a clearer picture.



Yes, the scene can be dangerous...ANYWHERE. I have been in just as many hostile and violent situations in an ER as I have in the field. I have seen RNs suddenly get attacked by patients and even friends/family. Everyone needs to maintain situational awareness regardless of career choice. 

Are you saying the clinical care providers are less stellar because they have a team and tools at their disposal whereas you are a hero because you do not? Cause that is how your statement is reading...and it sounds quite asinine. If that was not your intent, ok. 



Lal said:


> In the field, you have to use a lot of instinct and understand human nature, human psychology and the culture of medicine. We also relay that information so the ER/Cath lab etc can be ready for the patient, and its super embarrassing not to mention detrimental if you screw up!



In the field you have to use a LOT of knowledge (obtained in school and ongoing) along with OBJECTIVE date in order to treat your patient. Sure, the subjective has some relevance, but I assure you I am not relying on gut instinct to give a medicine or perform a procedure as that simply will not hold up in any QA process. Has there been times when I had feeling that a patient needed something, I did it and then found something? Absolutely. There have also been just as many non-findings when my "instinct" was telling me to check something. Basically you have to count wins and losses if you want to make a statement like that, and again, this is medicine...if you have a question or concern, you investigate. To me, that is more of a scientific process as opposed to acting on instinct. 

Yes, we will activate cath lab prehospital based on boring 12 leads, we will activate Trauma Alert when indicated. 



Lal said:


> In the ICU nurses work autonomously but have a lot more resources to perform their job. I think the hardest part about Nursing school was the laboratory portion of A&P (btw...what a dumb waste of time...if I wanted to work in a lab studying cultures I would have got a laboratory tech degree).



Resources in what way? And why does ICU have these resources that other floors do not? Not sure what you are trying to explain here because from my experience, the ICU had more equipment for certain patients, however the resources available in the hospital are available to all who need it. Example I am thinking of...I can get a bladder scanner, portable ultrasound, doppler, etc on any floor, any department in my facility. I can order labs when needed, I can consult with a provider. So those are things which would be part of assessing and diagnosing. Now 8 IV pumps and a vent would be ICU, however that is not a resource, that is a tool/s.

Again dismissing the importance of lab/patho/microbiology...reveals how little you know. Understanding micro is majorly important in the care of many types of patients. It really is. I simply do not know how to explain this any further but understanding micro and the labs absolutely guide and dictate the care you provide to many patients. And in many situations/facilities, you as the RN are noticing this and implementing treatment, stopping treatment or knowing it is significant enough to bring to a provider's attention sooner than later.



Lal said:


> So Nursing is more to learn and longer (but a lot of its a waste)...Medic is faster paced and high stress.



I disagree and have addressed this above. And you think Medic is "high stress" whereas Nursing is not? Why are we drawing lines over who has more stress? It is not a badge of honor. 



Lal said:


> On a side note an Associates are the new minimum for medics this includes all the same prerequisites of Nursing school.  You can obtain certification/licensure but to get any kind of good job you are going to need minimum associates.  Where I work they prefer a Bachelor's....but pay the highest in the State (Starting is $22/23 hour).



What state are you in? As far as I know, only two states in the USA require an Associates for paramedic and a third state offers a different title and pays more if you do, (Oregon and Kansas for required and Texas for the Lic v Cert Paramedic). If there are others, I am not aware of them and am happy to be educated on who else does.


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## VFlutter (Feb 9, 2020)

Yeah it is really awesome to be the hero who intubates grandma and saves her life so she can die a week later from VAP/CAUTI because you are too worthless to realize how important basic nursing care is. Solid work.

If you want to see some of the biggest impacts on modern medicine in regards to infection rates, complications, readmissions, etc look no further than mundane nurse-driven protocols and care.

Probably good you dropped out before clinicals, I doubt that would have went well for you.

Your rationale is idiotic. A BSN, even 2002, is arguably one of the most utilitarian degrees you can obtain and affords you opportunities well beyond the bedside. Management, education, medical sales, research, NP/CRNA, etc there are literally endless possibilities including working in the pre-hospital environment that you so desire.


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## CCCSD (Feb 9, 2020)

Maybe he’s the Gecko 45 of EMTlife...


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## Qulevrius (Feb 9, 2020)

Lal said:


> I think the hardest part about Nursing school was the laboratory portion of A&P (btw...what a dumb waste of time...if I wanted to work in a lab studying cultures I would have got a laboratory tech degree).



If you don’t understand the difference between A&P and micro, I’m not sure how you even gotten past the nursing school prereqs.


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## VentMonkey (Feb 9, 2020)

akflightmedic said:


> "No One DOR's their final week!..."


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## Carlos Danger (Feb 9, 2020)

Lal said:


> Nursing school was easy for me but I went in 2002    I now work as an EMT, I was one semester of clinicals away when I realized I would go crazy under the thumb of 10 bosses, behind brick walls 40+hours a week so I got a non-clinical BS instead.  I prefer fieldwork even if it's hard.  Paramedic school is hard because of the level they want you to be practicing when you leave.  Nursing school is more of an overview...and a good three months of my clinicals were wasted on dumb things like cleaning rooms and changing bedpans (hopefully their are programs out there that don't waste time on dumb crap like this). We use urinals and bedpans in an ambulance but we never had to train to use them because it's not rocket science. From what I understand Medic school is intense the entire time...your going to start off doing big things right away so you better be ready there is also a lot you are expected to memorize and learn on your own (interpreting 12 leads is boring to me but some people love it).   Some Medic schools are only 12 weeks. If you are talking about the number of diagnostics tools learned,  nurses have way more to learn about (ICU/ER) but they don't typically interpret like Medics do. I have heard most nurses learn the majority of work after starting a job. So now for the cost...obviously Nursing school is the better pay off...thats why you shouldn't waste your money as a medic if your not sure you want to do it.  Get a job as an EMT or ER Tech first than decide. That would be the best route. Medics/EMTs must be good at investigating a problem and getting an initial diagnosis. The information that is provided to the ER shapes care from the moment a report is given (that's been proven). We decide what information to communicate (what is applicable what is not).  We have to investigate the scene/history and we are utilizing this to help form a diagnosis so it's important to be confident in the diagnostics aspects.  We also must control the scene and it can be dangerous. Most times the critical patient goes into the ER to see a huge team of clinical care providers all working with diagnostic tools to get a clearer picture.  In the field, you have to use a lot of instinct and understand human nature, human psychology and the culture of medicine. We also relay that information so the ER/Cath lab etc can be ready for the patient, and its super embarrassing not to mention detrimental if you screw up!  In the ICU nurses work autonomously but have a lot more resources to perform their job. I think the hardest part about Nursing school was the laboratory portion of A&P (btw...what a dumb waste of time...if I wanted to work in a lab studying cultures I would have got a laboratory tech degree).   So Nursing is more to learn and longer (but a lot of its a waste)...Medic is faster paced and high stress. On a side note an Associates are the new minimum for medics this includes all the same prerequisites of Nursing school.  You can obtain certification/licensure but to get any kind of good job you are going to need minimum associates.  Where I work they prefer a Bachelor's....but pay the highest in the State (Starting is $22/23 hour).


So……you aren't a paramedic OR a nurse?


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## Akulahawk (Feb 16, 2020)

@Lal - One of the best parts of this forum is that there are many, many people here have levels of experience well beyond that of entry level. There are quite a few people that have responded to this thread AFTER your post that are Paramedics, Nurses, are mid-level providers of one sort or another, or some combination of all three. A lot of us are Bachelor's Prepared, though our BS or BA degrees aren't usually specifically in Paramedicine or Nursing. It appears that you went through some nursing school training and chucked it, that's fine. However, one of your gripes with nursing school is that you spend several months cleaning rooms and changing bedpans. Guess what? That's CNA-level work and that stuff is entirely within the scope of nursing. If you don't know how to do that stuff, you won't be prepared to do total care. That _is_ a thing in nursing. Presently I'm an ED RN. I _do_ total care. It's nice when I have an ED Tech or CNA to assist me with some tasks, but most of the time, it's all me. If you managed to get more than a couple semesters into RN school, you easily could have discovered that nursing is an extremely broad field and there's many ways to be a nurse. 

I'm also a Paramedic. Yes, I did both the traditional way. Both Paramedic and RN schools were relatively easy. That's because of my BS degree in Sports Med. It was far more rigorous than either RN or Paramedic. You, on the other hand, have not completed either RN or Paramedic school, by your own admission, and therefore don't have a firm grasp on either field. Those of us who have done both are in a unique position to give advice as to whether someone should do Paramedic or RN school, or if they want both, how best to accomplish that goal. 

While I'm an ED RN, and haven't been in the field in several years, I guarantee that I'd be just as happy and effective in the back of an ambulance today as I am in my ED. Oh and while I'm thinking about it, those lab classes all built a foundation for the Paramedic I became and the RN I am now. Having a good understanding of A&P seriously helps me figure out what's wrong with my patients. That stuff is so ingrained that I don't even _think_ about it. 

So the point of all this is to simply tell you that you really do have a LOT more to learn and that you really did yourself a disservice when you quit nursing some 18 years ago. You could have been an RN with about 15 years of experience. You could have challenged the NREMTP exam and been a Paramedic of some 15 years by now. You could have then used that experience to go on to yet some other education and become a physician or mid-level practitioner (yes, I know some really dislike that term). Instead you didn't. You became an EMT and apparently stayed there. Sure you have a non-clinical BS degree but it appears that you haven't learned from that experience either. No matter what it is that you do, you need to either challenge yourself to do better or you stagnate. One way you grow and the other stinks. Your choice.


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## joshrunkle35 (Feb 16, 2020)

I have completed Paramedic school and RN. I am currently in a Master’s of Science in Nursing degree. I still work in EMS as a Paramedic/Crew Leader/Shift Supervisor as well as an RN in an ED at a Level I Trauma Center. With 7 years experience in EMS, I make $13/hr without benefits. I am often asked by superiors to have my team do things that are not within our capabilities, blur the lines of ethics or SOGs/protocols or are not within the standard of care or scope of practice for a Paramedic. I am usually the person that takes all of the responsibility and is left holding the bag. As an RN with 6 months experience, I make $34/hr (after shift differential) with amazing benefits. I am provided training and oversight. I am given opportunities to learn, and ultimately, someone else is always on shift to absorb the liability. 

There are endless opportunities for advancement in nursing. You can work from home doing chart reviews for insurance companies. You can testify in trials as a legal nurse consultant. You can work in public health or in a school system. You can teach in a university. You can become an NP, Midwife, CNS, CNL, etc. There are hundreds of sub-specialties in nursing and only 4-5 in EMS (Community Paramedic, Flight Paramedic, Critical Care Paramedic, etc.)

Paramedic school was SIGNIFICANTLY harder for me than RN was. 

Lastly, if you haven’t completed RN and Paramedic schools, your OPINIONS in this thread are just adding noise to the signal/noise ratio.


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