# Are Medics Esentially RNs In rigs



## drose (Dec 15, 2012)

I've heard this a lot, friends always tell me that Medics are basically RNs In riggs. If not, what's the difference?


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## STXmedic (Dec 15, 2012)

No. 

Can't type a lot right now though. So that is all.


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## Akulahawk (Dec 15, 2012)

The short answer is, no. Paramedics aren't Nurses on the road. In particular, they don't usually have the pathophysiology knowledge that nurses have, not the general pharmacology knowledge that nurses have, and don't have to do time management in the same way that nurses do. 

On top of the difference in education, Paramedics and Nurses have a different mission in their professional lives. Their thought processes are also accordingly different. They share quite a few skills, however the reason for the application of those skills varies. 

So, no, Paramedics aren't like nurses on the road. They're very much a different type of care provider. Nurses aren't like Paramedics in the hospital either, and they'd have a difficult time adapting to the speed of things that happen on the street. 

They are two different types of providers that are used in two different areas of care. Apples and Oranges.


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## Joe (Dec 15, 2012)

When will people stop with these? First it was ambulances are the same as the er and now medics are rn's... some people wonder why we make 11$ an hour. Not a personal shot at drose but your friend needs some help


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## VFlutter (Dec 15, 2012)

I'll try to keep it simple. Are you new to the health care field? I would suggest maybe shadowing a RN for the day (Which most hospitals allow) to get a better understanding of what they actually do. RNs/Medics tend to have very little understanding of each others field . I would also point out that floor/ICU/ER nursing are all very different fields in themselves. Most EMS personal only have experience interacting with ER RNs.


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## drose (Dec 15, 2012)

Chase said:


> I'll try to keep it simple. Are you new to the health care field? I would suggest maybe shadowing a RN for the day (Which most hospitals allow) to get a better understanding of what they actually do. RNs/Medics tend to have very little understanding of each others field . I would also point out that floor/ICU/ER nursing are all very different fields in themselves. Most EMS personal only have experience interacting with ER RNs.



Sorry for disappointing you haha, and yeah I am very new to the health care field.


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## VFlutter (Dec 15, 2012)

drose said:


> Sorry for disappointing you haha, and yeah I am very new to the health care field.



We have all been there and when you first start out the various health care professions can be confusing. Just don't let that guy tell you he is the same as a doctor in the back of an ambulance:beerchug: Also, you will see that they RN vs Medic debate can get pretty intense on this forum.


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## drose (Dec 15, 2012)

Chase said:


> We have all been there and when you first start out the various health care professions can be confusing. Just don't let that guy tell you he is the same as a doctor in the back of an ambulance:beerchug: Also, you will see that they RN vs Medic debate can get pretty intense on this forum.



Alright thanks, and wow just realized from your reply, do you have a BSN degree?


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## VFlutter (Dec 15, 2012)

drose said:


> Alright thanks, and wow just realized from your reply, do you have a BSN degree?



Just graduated today actually


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## drose (Dec 15, 2012)

Chase said:


> Just graduated today actually



Oh okay cool congrats man


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## medic417 (Dec 15, 2012)

No!!!  Paramedics are much better than an RN, they are closer to being a doctor.


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## Veneficus (Dec 15, 2012)

medic417 said:


> No!!!  Paramedics are much better than an RN, they are closer to being a doctor.



You just like to stir the pot don't you


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## systemet (Dec 15, 2012)

I'll be the dissenting voice and suggest that paramedics and RNs actually both have a lot in common. Both are non-physician providers with relatively short educational programs performing acts delegated by a physician.

Sure, each profession brings its own perspective to a given situation, and some nursing roles veer far away from a typical paramedic's work - but tell me there's not some similarity between a paramedic and an ICU or ER nurse.  In plenty of European countries EMS is a subspecialty of nursing. It sounds like, in some states, RN's are doing a lot of the flight work.


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## medic417 (Dec 15, 2012)

Veneficus said:


> You just like to stir the pot don't you



Who me? Never!-_-


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## VFlutter (Dec 15, 2012)

systemet said:


> Both are non-physician *providers with relatively short educational programs* performing acts delegated by a physician.



Say what? :blink:


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## mycrofft (Dec 15, 2012)

Nurses can fill a wide variety of jobs in a wide variety of settings. Paramedics get a pale translucent complexion from being stuck (shackled) in the back of modular ambulances all day long.:lol:


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## NYMedic828 (Dec 15, 2012)

systemet said:


> *I'll be the dissenting voice and suggest that paramedics and RNs actually both have a lot in common. Both are non-physician providers with relatively short educational programs performing acts delegated by a physician.*








Paramedics are way more trained/educated than nurses. h34r:


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## Anonymous (Dec 15, 2012)

Chase said:


> Just graduated today actually



Congratulations!


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## systemet (Dec 16, 2012)

Chase said:


> Say what? :blink:



Paramedic: 2-3 years if you include EMT.
RN: 3-4 years
M.D. (FM) : 8-10 years.
M.D. (EM) : 10 - 12 years
M.D. ( random obscure specialty + dual boarded + journeyman plumber) 57.6 years.

And so forth...

Obviously educational time varies with location, but as much as both would probably like to deny it, they're closer to one another than either is to being a physician.

edit :Also, while I now feel like a bit of a douche, congratulations!


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## JPINFV (Dec 16, 2012)

systemet said:


> M.D. (FM) : 8-10 years.
> M.D. (EM) : 10 - 12 years




Family medicine: 3 year residency. 
Emergency medicine 3-4 years depending on the program (heard more than once it being described as a 3.5 year residency and, alternatively, the 4th year being the "$200,000 mistake").


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## sir.shocksalot (Dec 16, 2012)

systemet said:


> Both are non-physician providers with relatively short educational programs performing acts delegated by a physician.


Actually, I agree. However the typical paramedic holds a certificate, the typical nurse holds an associates degree (and a BSN is becoming more common, and currently I think it's the unofficial minimum for entry into the profession these days).


systemet said:


> but tell me there's not some similarity between a paramedic and an ICU or ER nurse.  In plenty of European countries EMS is a subspecialty of nursing. It sounds like, in some states, RN's are doing a lot of the flight work.


Actually I think ICU nurses are very distant from what we do in EMS, I think the typical paramedic, including myself, is very uncomfortable with many of the things going on with patients in an ICU. Multiple drips, vents, wound vacs, chest tubes, IABP, blood products, etc etc. Many of these things fall way outside the normal paramedic's scope of practice, even many CCT paramedics aren't able to transport these things without a nurse present.

As far as flight nurses go, I actually think having a paramedic on the helicopter is silly. There are so many paramedics that become nurses that you would think there would be enough nurses with paramedic experience that they shouldn't bother hiring paramedics. I'm starting to think that paramedics are only on the helicopter because they are a cheap extra pair of hands. I have seen some flight teams when they are on inter-facility flights take an RRT instead of a medic. I would hate to be a flight medic honestly... every flight that goes out goes with a nurse, but not always a paramedic.

The ER, however, is a different story, I think paramedics could do a lot of an ER nurses job without much extra training. Starting IVs, putting in foleys, and giving some of the medications are all currently in paramedic scope, and I don't think it'd be a stretch to replace at least half of the ER nurses with medics. Although I think some states have minimum nurse to patient ratio laws, plus nurses really don't want to lose their jobs to medics who are often $20,000/yr cheaper. 


systemet said:


> Paramedic: 2-3 years if you include EMT.
> RN: 3-4 years
> M.D. (FM) : 8-10 years.
> M.D. (EM) : 10 - 12 years
> ...


Completely agree, if we just want to count straight educational time. In fact an AAS in Paramedicine and an ADN are very similar to each other, I think the ADN just has pathophysiology, human growth and development, and nutrition that separates it from most paramedic degrees. But how many Paramedics have an AAS vs how many nurses have an ADN? How many paramedics have bachelors degrees in their field?

But to answer the OP, no. Paramedics are not like nurses in an ambulance. In spite of how similar ER nurses' daily routine looks like a paramedic's, the field of nursing is worlds different than paramedicine. One is not better than the other, some nurses are not suited to being in emergent situations, just like paramedics are not suited for the long-term, holistic care of patients.

As a side note, why do we constantly have to measure penises with nurses? Are we just that insecure with ourselves? See I personally think I'm better than nurses because I don't have the option of working in a SNF. :lol:


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## VFlutter (Dec 16, 2012)

Just a side note. The BSN has essentially become the minimum level of education for New grads at many hospitals, especially magnet/academic hospitals. Having just gone through the new grad HR process I was told that they will go through and interview every BSN applicant before moving on to ADNs (New grads). ADNs with experience still have a chance but are not eligible for any type of charge nurse or management  role and must get their BSN within X number of years. 

by 2015 the BSN is *supposed* to be the minimum entry for RN

Also, ICU RNs typically have 2 patients for 12 hour shifts and step down or med/surg can have anywhere from 4-8 patients. But they do so in a controlled environment with support staff as opposed to the field


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## Bon-Tech (Dec 16, 2012)

Around here 2020 is the date for all RN's to be BSN. At least in major hospitals.


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## silver (Dec 16, 2012)

In a world where college degrees, specifically bachelors, are becoming the norm for entry level jobs, its not like this is groundbreaking or even a challenge for people to obtain. We are at a time where more people are going to college and completing it. As such it would be expected that a BSN becomes a requirement. That being said, it becomes difficult for those already in the workplace to compete.

What is really of concern/interest is why pre-hospital care is so far behind.


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## ExpatMedic0 (Dec 16, 2012)

If it was not for the fact the OP was new to health care, I would vote the title of this thread "troll level 1000" achievement unlocked.


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## boerbull (Dec 16, 2012)

I work in the Netherlands. Here there is a RN on every ambulance. To be an ambulance nurse you first have to build up some clinical experience in a hospital for a few years and specialize in ICU, trauma, CCU or anesthesia. Lately some services also accept military nurses with at least 6 years experience.
I've seen that every specialism brings certain knowledge and experience with it, but everybody has to change their mindset to work in the ems field. Everybody needs an additional 1 year study to be allowed to work independently. 
Here in the Netherlands they like to think that because they are RN and not paramedics they've got more experience and knowledge. I must say I have seen paramedics at work in other countries and I have come to the conclusion that you've got good paramedics and bad ones, but there are also good RN’s and bad ones on the ambulances here. It doesn't make any difference what your diplomas are saying. It is the way that you use your knowledge and skills to give the best care that you can.


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## ExpatMedic0 (Dec 16, 2012)

boerbull said:


> It doesn't make any difference what your diplomas are saying. It is the way that you use your knowledge and skills to give the best care that you can.



That is a good point. There are some amazing Paramedics I have met over the years with a vast amount of knowledge who are excellent providers. Most also took self initiative and acquired an undergraduate degree even though it was not required. Others simply gained the knowledge through self study and experience. 

In the USA its a mixed bag, whats holding us back professionally is the minimum standard is set to low in various ways.
The minimum standard for RN has raised the bar and Paramedicine must do the same 

PS:Over here in Denmark they have had Paramedics (Paramediciner) for only a few years. It is a new concept. Does the Netherlands also staff ambulances with Doctors?


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## boerbull (Dec 16, 2012)

No doctors on the ambulance. What we do have is a number of Mobile Medical teams. These are teams of a anesthetist and a nurse that provides additional skills for the ambulance crews. What we also have is a after hours GP service that is also mobile. If we think that it's not necessarily for a patient to be transported we can ask the GP service to come past and treat a patient at home. During hours we can contact there own family doctor to hand over the patient care.
I must say that this is a system that works here in the Netherlands but I don't think it would work in bigger countries.


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## Veneficus (Dec 16, 2012)

systemet said:


> M.D. ( random obscure specialty + dual boarded + journeyman plumber) 57.6 years.



Actually, I don't know about the journeyman plumber, but the dual specialty of anesthesia and general surgery is only 10 more years after med school, for a total of 18-20.

With my already near 20 years of school, I see it as 1/2 way done


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## STXmedic (Dec 16, 2012)

sir.shocksalot said:


> As a side note, why do we constantly have to measure penises with nurses? Are we just that insecure with ourselves?


Coincidentally, Chase is one of the few nurses that we can actually measure penises with.... h34r:


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## VFlutter (Dec 16, 2012)

PoeticInjustice said:


> Coincidentally, Chase is one of the few nurses that we can actually measure penises with.... h34r:
> View attachment 1353



Hahaha that might have to be in my signature


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## STXmedic (Dec 16, 2012)

Chase said:


> Hahaha that might have to be in my signature



 :rofl:


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## systemet (Dec 16, 2012)

JPINFV said:


> Family medicine: 3 year residency.
> Emergency medicine 3-4 years depending on the program (heard more than once it being described as a 3.5 year residency and, alternatively, the 4th year being the "$200,000 mistake").



Here it's 2 and 5 years respectively.   I didn't realise that it was different in the US.


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## drose (Dec 16, 2012)

schulz said:


> If it was not for the fact the OP was new to health care, I would vote the title of this thread "troll level 1000" achievement unlocked.



Should've never created this thread.


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## VFlutter (Dec 16, 2012)

drose said:


> Should've never created this thread.



It is not a bad question, for people new to the healthcare field the two roles appear to be very similar. It is the "A Medic is a (RN/MD/God) in the back of an ambulance" mentality that tends to get a lot of people fired up. I know that was not the intention of your post but I think that is how many people took it. But asking about the difference between the two is totally understandable.


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## sir.shocksalot (Dec 16, 2012)

drose said:


> Should've never created this thread.


I'll agree with chase, I don't think it's a bad question, it just tends to get people fired up. I think dealing with just ER nurses and SNF nurses for the most part really makes us look at nursing in a very one dimensional way. We watch SNF nurses really make a mess of things and then we take the pt to the ER and watch as the nurse has to go run off to ask the physician if they can give Zofran. I think a lot of providers forget that there is far more to nursing than just what we see on a daily basis.

During paramedic school one of my favorite clinicals was in the ICU, we had two patients and I don't think we ever stopped running around. Also watching this nurse really analyze what is going on with the patient with not just a physical exam, but interpreting labs, imaging studies, etc and making judgement calls from that was really impressive and eye-opening. We only talked to a doc twice and once was because the patient appeared to be having a stroke.

Now if we can just get nurses to spend some time with us so that they don't see us as just ambulance drivers... Of course that would be the day of either the raisin rodeo or the drunk deliveries.


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## JPINFV (Dec 16, 2012)

Chase said:


> It is not a bad question, for people new to the healthcare field the two roles appear to be very similar. It is the "A Medic is a (RN/MD/God) in the back of an ambulance" mentality that tends to get a lot of people fired up. I know that was not the intention of your post but I think that is how many people took it. But asking about the difference between the two is totally understandable.


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## ExpatMedic0 (Dec 16, 2012)

JPINFV said:


>



Pretty sure that's on some EMT,s t shirt somewhere


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## drose (Dec 16, 2012)

JPINFV said:


>



Haha wow sarcasm through the roof on this thread.


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## Akulahawk (Dec 16, 2012)

Chase said:


> Just graduated today actually


Congratulations! I just noticed the change in your signature as well. Good work!


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## VFlutter (Dec 16, 2012)

Akulahawk said:


> Congratulations! I just noticed the change in your signature as well. Good work!



Thank you. I'm usually not into the whole
Alphabet soup signature but I couldn't resist haha how much longer do you have?


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## Akulahawk (Dec 16, 2012)

*Probably TMI but...*



Chase said:


> Thank you. I'm usually not into the whole
> Alphabet soup signature but I couldn't resist haha how much longer do you have?


I went from about 6 months to ADN to about a year for LVN... followed by more time waiting for a "Career Mobility" option to ADN - about 2.5 -3 years out from now. Believe me, I'd MUCH rather not be having to make that change. I have some time before I commit to that course. If I take a bit of a gamble, I might have a seat in the Fall 2013 2nd Semester, which puts me at about 2 years from now to ADN. 

In short, I went from "is it much further Papa Smurf? Not much further..." to "Is it much further Papa Smurf? YES, IT IS!!!" :angry:

I _really_ just need to get out of my current job and back to being an Active Paramedic, and _that_ won't happen until I'm out of school, for scheduling reasons. At least the VN program will be a LOT easier to mesh with work than going back through the ADN program, and I certainly hope to get to be able to work as an LVN and a Paramedic while waiting for things to start back up again. 

Not quite the timeline I had in mind even as of about a week ago... but it's what I have to work with and transfer to another program isn't a realistic option. If I can find a way to come up with $70k, I might be able to afford to do an ABSN program... Doing it this way preserves my ability to get a BSN from the local 4 year university. And I _will _get that BSN.

I'm just _done_ working Security.


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## Veneficus (Dec 16, 2012)

Chase said:


> Thank you. I'm usually not into the whole
> Alphabet soup signature but I couldn't resist haha how much longer do you have?



sure...sure... next you will be adding BLS, ACLS, PALS, and some other alphabet soup after your name until your post nominal is longer than all the letters in your name.

 :rofl:


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## Fish (Dec 16, 2012)

drose said:


> I've heard this a lot, friends always tell me that Medics are basically RNs In riggs. If not, what's the difference?



The Field of nursing is very broad, your friends are referencing only ER nursing. Which is the CLOSEST thing to us, but it is NOT the same.

RNs and Medics are very different, from Education to Job function to Purpose


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## Akulahawk (Dec 16, 2012)

Veneficus said:


> sure...sure... next you will be adding BLS, ACLS, PALS, and some other alphabet soup after your name until your post nominal is longer than all the letters in your name.
> 
> :rofl:



At one point, my stuff would have looked somewhat like this:

Akulahawk, EMT-P, BS, BLS, ACLS, PALS, PHTLS

Chase's postnomial is probably going to be longer than mine for a few years.


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## Trashtruck (Dec 16, 2012)

JPINFV said:


>



Thank God this has been resurrected!

I've missed it for a while.


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## VFlutter (Dec 16, 2012)

Akulahawk said:


> At one point, my stuff would have looked somewhat like this:
> 
> Akulahawk, EMT-P, BS, BLS, ACLS, PALS, PHTLS
> 
> Chase's postnomial is probably going to be longer than mine for a few years.



I think I will stop at - Chase CRNA, DNAP, B.A.M.F. h34r:


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## usalsfyre (Dec 17, 2012)

Chase said:


> I think I will stop at - Chase CRNA, DNAP, B.A.M.F. h34r:



Anyone who feels to put BAMF as a post-nominal is by my definition, not a BAMF h34r:


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## VFlutter (Dec 17, 2012)

usalsfyre said:


> Anyone who feels to put BAMF as a post-nominal is by my definition, not a BAMF h34r:



:sad:


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## abckidsmom (Dec 17, 2012)

Chase said:


> :sad:



Patpatpat.  I still think you're cool.


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## systemet (Dec 17, 2012)

sir.shocksalot said:


> Actually, I agree. However the typical paramedic holds a certificate, the typical nurse holds an associates degree (and a BSN is becoming more common, and currently I think it's the unofficial minimum for entry into the profession these days).



This is a very reasonable and well-thought out post.  In my region this associate's versus certificate distinction doesn't really exist.  Outside of the US few countries use associate's degrees.  Our RNs are either 3-year diploma educated or 4-year BScN educated.  Our paramedics have a two year diploma on top of a 6 month to one year EMT program.  A very few have a four year Bachelor's degree in EMS.

Certainly the RNs, on average, have more education, but the gap isn't that big.



> Actually I think ICU nurses are very distant from what we do in EMS, I think the typical paramedic, including myself, is very uncomfortable with many of the things going on with patients in an ICU. Multiple drips, vents, wound vacs, chest tubes, IABP, blood products, etc etc. Many of these things fall way outside the normal paramedic's scope of practice, even many CCT paramedics aren't able to transport these things without a nurse present.



I think the argument that I tried to present (however clumsily), is that paramedicine is not that far removed from nursing, and that it could be considered a subspecialty of nursing -- as it is in some countries.  I picked the examples of RN and ICU nurses because when I talk to these people it seems like we're talking the same language and have a common background.

I'm not trying to argue that they're the same, although I think there's some overlap in these areas.  I'm certainly not comfortable trouble-shooting a balloon-pump, although the couple of times I've had to deal with them I've often had a physician in addition to an ICU nurse.  Chest tubes, arterial lines, and blood products are all things that I've been trained in, even if I haven't had a lot of experience with them recently.  Some of my peers encounter and manage these daily. 

My experience is that there's a tendency for people in EMS to underestimate nursing due to dealing with a large number of people who work outside of acute care, in long-term care settings. 



> As far as flight nurses go, I actually think having a paramedic on the helicopter is silly. There are so many paramedics that become nurses that you would think there would be enough nurses with paramedic experience that they shouldn't bother hiring paramedics. I'm starting to think that paramedics are only on the helicopter because they are a cheap extra pair of hands. I have seen some flight teams when they are on inter-facility flights take an RRT instead of a medic. I would hate to be a flight medic honestly... every flight that goes out goes with a nurse, but not always a paramedic.



The local experience here is different.  Our flights are predominantly paramedic-paramedic or paramedic-EMT, with very few RN spots.  I think this is at detriment to the patient and that these calls should be run paramedic-RN.  A good ICU nurse is worth their weight in gold on a complex interfacility ICU-ICU run, but a paramedic has skills that a flight nurse usually lacks when it comes to scene calls.




> Completely agree, if we just want to count straight educational time. In fact an AAS in Paramedicine and an ADN are very similar to each other, I think the ADN just has pathophysiology, human growth and development, and nutrition that separates it from most paramedic degrees. But how many Paramedics have an AAS vs how many nurses have an ADN? How many paramedics have bachelors degrees in their field?



We don't really have the ADN here.   Our least trained RNs are three years, and as you talked about earlier, its increasingly moving to BScN entry-to-practice.  However, our least trained paramedics are also very close to 3 years, so the gap isn't as big here.  My experience has been that nursing education produces a generalist graduate nurse who then does further training courses to be prepared to work in a given setting, e.g. CCRN.  In contrast, the paramedic is trained to do "one thing", or at best, "a few things", but already has that specialisation, at the expense of a wider perspective on health care.  Paramedic education could definitely be expanded.



> But to answer the OP, no. Paramedics are not like nurses in an ambulance. In spite of how similar ER nurses' daily routine looks like a paramedic's, the field of nursing is worlds different than paramedicine. One is not better than the other, some nurses are not suited to being in emergent situations, just like paramedics are not suited for the long-term, holistic care of patients.



I think this is a great perspective.



> As a side note, why do we constantly have to measure penises with nurses? Are we just that insecure with ourselves?



I think so.

I hope I'm not dragging us back onto track in a thread where everyone has already breathed a sigh of relief that we've moved on.


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## ExpatMedic0 (Dec 18, 2012)

systemet said:


> Our RNs are either 3-year diploma educated or 4-year BScN educated.  Our paramedics have a two year diploma on top of a 6 month to one year EMT program.  A very few have a four year Bachelor's degree in EMS.



Hey System, what country?


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## systemet (Dec 18, 2012)

schulz said:


> Hey System, what country?



pm'd


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