# Paramedic vs. RN



## villagegirl127 (Aug 6, 2009)

I am curious to know what the difference is in salaries of a parmedic and an RN?  I am starting EMT Basic in a couple of weeks, than working as an EMT until I start paramedic training.  I waiver between taking the paramedic classes or going for the RN degree.  The paramedic classes are more accomodating than the RN classes, (I am a single mom), and the paramedic class would be paid for by the private ambulance that I work for.  Also, there are no prerequisites required for the paramedic program.  The RN program is full of prerequisites that will take me 1 year to obtain.  Just wondering if anyone faced a similar decision and if they can give me some facts/advice?


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## motomedic (Aug 6, 2009)

I would say all in all RN makes more. but many things play into it. Company. experience. benefits. retirement. etc. Im not sure how things work out there this is from what I know out in CA. either one is going to be a blast. good luck!


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## Ridryder911 (Aug 6, 2009)

If your are asking salaries on either, your going into it for the wrong reason. Both of the pay sucks... 

As described I know of Paramedics barely making over minimum wages as well as some making more than many RN's. RN's salary maybe more pre hour but with crunches lately, overtime and benefits have dropped drastically as well as decreasing staff at this time. 

Truthfully, most of the hospitals I have seen are on freezes at this time. Yes, usually it runs courses like this periodically but many are attempting to enter the health care field strictly for personal monetary gains and that they are going to be dissapointed with the pay vs. the workload. 

One can make as much money doing other jobs with less education, hours standing on your feet and not working every holiday and night shift. It is more a personal calling and internal dedication to provide care to the sick and injured in both careers and professions. Sad that it is not rewarded per financial gains but it is true....

R/r 911


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## 46Young (Aug 6, 2009)

I faced a somewhat similar scenario when my daughter was born. My wife was unemployed, and my salary as an EMT in Queens NY was barely enough to cover the bills. Nursing is a much safer, established career than that of a medic. There are many avenues for advancement and specialization. RN's are well compansated in the greater NY area. Nursing grads were in high demand back then ('05), you could pretty much write your own ticket back then. 

That would have taken me a few years and way more money than I was prepared to lay out. The paramedic program on the other hand, was 13 months without any pre reqs and only 6 grand, which was tax deductible. My employer was more than accomidating with my schedule. Class was two 8 hour days with 16-24 hours of clinicals weekly. Upon graduation, I upgraded to medic at my FT job, and took a per diem position shortly thereafter. I earned back the 6 grand in no time.

I also considered that I could go municipal third service EMS (I briefly considered FDNY EMS) TSEMS elsewhere, or fire based EMS where a few others from my job left for. Any of these would be secure, and offer a pension. A pension is vitally important nowadays. You want to be secure when you retire. 

Bottom line, you're behind the 8-ball financially being a single mom. If your job is willing to pay for school, it would be in you and your child's best interest to go the medic route. You probably can't afford to tool around with school for three years or more. 

What does your job ask for in return for paying for school?


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## 8jimi8 (Aug 7, 2009)

you can get a 2 year nursing degree, fast, especially if you already have some credits.

in Austin, starting medics make 42,000-45,000 i think with a 48000 cap.

Starting nurses are making 21/hour plus shift differentials.

with some experience its not hard to make way more than that


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## marineman (Aug 7, 2009)

I recommend you stay with whatever you're doing now. Like rid mentioned if the first question you have is about money you're in it for the wrong reasons. The other deciding factor that you mention is the length of time involved in school, for now the medic program is much faster but do you feel that less than a year of 2 days a week will prepare you to be on your own responsible for the patient, you will notice that some of us are trying to move EMS forward including increased educational standards. Someone entering EMS because it's the shortest path to a medical career will not sit well with many here. I truly hope and expect that within the next 5-10 years an associates will be the required minimum to operate as a medic.


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## villagegirl127 (Aug 7, 2009)

46 young thank you so much for your honest answer and 
8jimi8 thank you for the stats.  To answer your question, the position requires 1 year service as EMT and I am not sure how long they request for paramedic once they pay for the schooling.  (They are very well respected around here and have a great rep. and I would be proud to work with them).  They also have a TON of continuing ed. classes, so the education doesn't have to end.  

As far as the other responses - first of all, my reasons for wanting a career as an EMT and/or Paramedic are HUGE - you don't know me and have no idea what brought me to wanting to be an EMT/Paramedic or possibly an RN.  Second, maybe you have, or once did have, the option to not worry about how much money you will make in a career, or how much time you would invest in obtaining that degree/certificate - LUCKY YOU! I however don't have that luxury and never have.


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## SanDiegoEmt7 (Aug 7, 2009)

I agree with villager.  If you know that you want to work in healthcare, I don't see the problem with picking a subsection of healthcare that has better pay/benefits.  Right now I believe RNs generally make better money than paramedics by a large margin.  There is no shame in weighing the choices based on all aspects of job description, which includes pay.  

I know many nurses in CA, making just under 100k a year, and they don't live in the expensive areas like SF, LA, SD, so their income actually allows them a comfortable lifestyle.  Private medics in my area, on the other hand, start at 12.50/hr.  Definitely something to consider.


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## DrankTheKoolaid (Aug 7, 2009)

*re*

Taking into account your personal situation and the current state of the economy, i would suggest pursuing your initial intention of becoming a medic especially if someone else is flipping the bill.  Then as time goes on and your life allows start taking all the RN-Medic degree pre-req courses.  Even if you dont end up with a degree in either these classes will only make you a stronger medic in the long run.


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## Ridryder911 (Aug 7, 2009)

villagegirl127 said:


> As far as the other responses - first of all, my reasons for wanting a career as an EMT and/or Paramedic are HUGE - you don't know me and have no idea what brought me to wanting to be an EMT/Paramedic or possibly an RN.  Second, maybe you have, or once did have, the option to not worry about how much money you will make in a career, or how much time you would invest in obtaining that degree/certificate - LUCKY YOU! I however don't have that luxury and never have.





I can only base what I read and the first statement was about money and the discussion followed that trend. I hope you look carefully as more and more are leaving the nursing profession after 3-5 years. The average age of a  RN is 49 years old. There is a reason.. Yes, it is a great profession for those that want and have an ambition to do it. If one chooses it for monetary gains, they will be greatly disappointed as well as their patients. 

As one that has both licenses (and have been both >20 years), I can assure you that those "great" high dollar RN jobs out there are difficult to find and more and more hospitals are on a freeze. When things do change (as they will) it will still take some time to build back up to the need. Also, watch nursing programs decrease the number allowed into the program. Unlike EMS they monitor demand and needs, to protect their profession. 

R/r 911


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## MrBrown (Aug 7, 2009)

A BScN is probably a much safer career step but do you want to be doing nursing or do you want to be a Paramedic?  The two are run parallel but are also quite different.


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## abckidsmom (Aug 7, 2009)

I am an RN as well as a paramedic.  Back before we had kids, I gave up my nursing career because I longed to be back in the streets.  I got to where I hated every minute I spent in the STICU that I worked in, even though it was a fast-paced, busy unit.  I just preferred being a medic.

Now, with kids to support, I view my nursing license as part of my life insurance on my husband.  If something happens that I have to go back to work, I'd cheerfully suck it up and go be a nurse, because that's where the money is.  

I have a friend who just started as a new grad nurse making the same hourly rate I make at my PT job after 15 years in EMS.  Hmmm.  Plus she gets shift differentials on top of that.

The money's in nursing, but the job isn't nearly as fun as working in EMS, not for me, anyway.


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## usafmedic45 (Aug 8, 2009)

I agree with the sentiment that if you're going into it based upon the paycheck _or _choosing between fields for solely that reason, you're setting yourself up to be miserable in the long run.  

However, here is the information for an average sized hospital in central Indiana that I work at (I asked one of my friends who works in our HR office today).  These are averages based on a full time (36 hour work week) position and vary with experience, shift and time with the facility:
-Med/Surg RN:  ~$25-30/hour
-ER RN: ~$26-30/hour
-ICU RN: ~$28-32/hour (none of the nurses in our ICU were direct hired into the ICU so that skews the pay scale a little bit) 
-RT (just for comparison...this is what I make as a relatively new hire, not an average of our department): $28.70/hour on weekend night shift (my normal shift); $24.60/hour on weekday nights, and $21.00/hour on the rare occasions I pick up a day shift.  It's not a bad gig and an RT's workload at most hospitals is generally considerably less than the RNs (although some people work at hospital where the RTs are BUSIER than the nurses), especially on night shift.  This is based upon experience from a wide variety of hospitals (from a Level I trauma center all the way down to a 25-bed critical access hospital in rural Michigan).   You can make more money by working travel (temp staffing) assignments and I know a couple of therapists who clear almost $100K a year doing this although I should state both of them have specialized as neonatal ICU therapists and therefore demand a higher premium (in some places, such experience can be an almost "name your price" sort of bargaining chip for travelers).  

Our education requirements are comparable and the only thing that is lacking (relatively speaking compared to nurses) in most hospitals is the opportunity to advance in the "chain of command" since you really are locked into one of two departments (RT and sleep) without additional training and qualifications (RN, ultrasound, etc).  Honestly, if you are looking for a pretty good career involving in-hospital care and want to make decent to good money, you should look at respiratory therapy as well.  Feel free to PM me if you have any questions.  If I can't answer them, I can pass you along to some colleagues of mine who are very well regarded in the field who can give help you.


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## villagegirl127 (Aug 8, 2009)

Thank you all for giving me the info.  I have to weigh the options, but I am thinking paramedic is the way I am going to go.  I'm not in it for the money (I know I won't get rich), but I do need to know that I can keep a roof over my head and feed my kids.  My plan is to finish the medic training and just continue to learn and take classes...than I can take it from there.


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## syd (Aug 8, 2009)

I don't know if you are thinking about getting both degrees... but, there is usually a RN to EMT-P track at some colleges, while there is usually no P to RN track (that I know of). If someone was thinking about both degrees, it seems easier to do RN first, then EMT-P. Just something to think about...


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## Level1pedstech (Aug 8, 2009)

I have been pondering this question myself for the last few months. I live in Washington which I have heard will soon be following Oregon's lead and making the paramedic program a two year degree. I have discussed this with former ER techs who are now ER RN's and they all say if its going to be a two year program either way then go RN and challenge the medic test at a latter date. Money is for sure better as an RN and the schedules tend to be better. I know of a few RN's that work as medics with both paid and volunteer agencies and they seem to be very happy having it both ways.

 I do realize the negatives as well as the positives with both programs, RN schools are full and competition is fierce, first year RN's can have trouble getting in the ER door but the last few of my fellow techs that finished RN school are now working in our ER, having an established relationship with your facility of choice is a big plus. One year medic programs are still available in WA but the wages starting after school are low for the most part and I really don't like the restrictive nature of some agencies protocols and field SOP's. There are plenty of things to consider before making a decision either way.


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## DV_EMT (Aug 8, 2009)

In Central California:


RX Tech (Retail) - 15.00
RX Tech (Hospital) - 20.00
RX Tech (Compounding/IV's) -17.00 (ish)

EMT-B - 8.00-9.00
EMT-P - 12.50-13.00

LVN (Hospital) - 15.00-25.00
RN/BSN (Hospital) - 35.00


Just a comparison of all the fields that I KNOW how much they make... this is subject to change.... 

**please note that this is a very expensive area to live in and therefore there is inflation of salary


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## daedalus (Aug 8, 2009)

Wow. I know a few RNs in private hospitals around LA, they are making 50+/hr with lots of opportunities for overtime and great benefits. These people all have BSNs and have all the certs. Unlike EMS, hospitals actually pay you more monthly to carry ACLS, PALS, NRP, MICN, CEN etc. 
Paramedics on the other hand make very little.


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## That_Guy (Aug 8, 2009)

Sticking to the threads title, Paramedic vs RN.

Getting the pay stuff out of the way (not a concern of mine) What do you ladies and gents think about the scope of practice between an Registered Nurse, and a Paramedic?

I've heard a lot, that once you get your ASN, and aquire the NCLEX-RN, you can challenge the NREMT-P. Are the skills between the two really that similiar?

Do you think one may compliment the other? (Being skilled as a Paramedic, at the same time being skilled as a Registered Nurse, Pre-Hospital, and Post Hospital Medical Skills. Or experiences working in both capacities?

I've been hearing a lot about PHRNs (Pre-Hospital Registered Nurse) working with some FDs in and around WA. both RN, and Paramedic certified medical professionals. I've also heard that Flight Medics, and Flight Nurses work side by side in literal sinc. Anyone have any expire on this?


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## That_Guy (Aug 8, 2009)

DV_EMT said:


> In Central California:
> 
> 
> RX Tech (Retail) - 15.00
> ...



In WA, an Paramedic makes around $18-22 an hour. EMT-B, you'll never see one outside a FD. so I've never heard of anything regarding the hourly pay. but they make a min of $50K per year if fulltime. (or $40K, it depends completely on the department) pretty much the same as LPNs and RNs. with exception RNs in my area of WA. can make anywhere from $18 to $86 per hour depending soly on their specializations. aka, persuing education beyond the "basic" Registered Nurse. Flight Nurses make almost $65k per year (just like Flight Medics, depending on hospital) if you're a Emergency Room, Critical Care, and Ultrasound/Electro Kardio Gram qualified. you're talking almost $74K per year. With Surgical Technologist, and Phlebotemy certifications on top of the above mentioned, you're a $104K per year asset. (they can throw you anywhere needed, and can double up with a surgical procedure on the spot, and use specialized equipment. In other words, you save them from having to hire 4+ more people)

For Nursing, all the Nurses I know (been talking extensively to quite a few, as well as Paramedics) the more specialized training you get into/persue (with your own money, fyi) and the more specialized skills you have vs generic RN. The better, and higher your pay is going to be. Like a Nurse Anesthesiologist (although you need to have an MSN to get that specialty) makes roughly $270K per year average in WA. one at Harborview I've questioned quite a bit, she makes $285K per year, because she has more than aneastisology certifications. She's ER, and Surgical Tech qualified as well, Surgical Tech certification saves her hospital from hiring one. (so they get 4 people int he operating room VS 6, because another Nurse on her surgical team is Surgical Technologist qualified as well, giving her an additional $15K per year, vs having to spend $45K per year for an employee on payroll)


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## 8jimi8 (Aug 9, 2009)

Sorry to be so blunt, but what you are saying doesn't really make that much sense.  An RN doesn't need a phlebotomy certification.  Hospitals don't hire 1 person to replace a team.  I can see where having some specialties earns you extra pay, but it really sounds like you got carried away....  --->   <----  I left that space there in case you need room to correct me...


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## VentMedic (Aug 9, 2009)

RNs have a strong national and specialty support associations. They have mobility and can move easily from one area to another as permanent and temporary or travel assignments. Education is valued and the opportunities to obtain additional education are almost limitless. The wages can range from $20 - $75/hr for the staff RN even without CRNA or NP if one is willing to be mobile or seek out various employment situations and make oneself marketable. 

For nursing, their specialty certs take much longer than just a weekend or week long course. Usually the certifications such as wound care and CCRN require 1 -2 years of experience in addition to extra education as well as the certification exam. A few will allow you to test for the exam but nursing is a difficult profession to bluff your way through. Thus, memorizing just enough to pass a test will not get you very far. 

Here are examples of the many specialties in nursing and the associations that offer support along with education. 
http://www.nursingworld.org/EspeciallyForYou/Links/SpecialtyNursing.aspx

As far as ACLS, NRP, PALS or whatever, these are usually required certs for RNs or whatever professional if they are working in a certain area. If you don't have the necessary "basic" certs, which is what these are, you probably won't be allowed to even apply for that specialty area in some hospitals. If a specialty department accepts you for a training program, they don't want to waste time teaching you these certs which are very easy to obtain. But, these certs are also controversial and some hospitals recognize they actually don't measure one's ability or knowledge and prefer to conduct their own inhouse training programs. 

Right now several older and experienced RNs have re-entered the work force filling many positions. However, this will be temporary and they will probably leave once whatever economic instability that occurred in their lives stabilize. There are still travel and temp assignments although not as plentiful. The most notable decline is the number of strikes, especially in CA, that have been called this year. The unions are laying low. Even BART in San Francisco came to an agreement for their contract to prevent a strike. 

Since nursing is competitive now, hospitals are looking for those with higher education. They like to see discipline, dedication and determination which getting a 4 year degree does demonstrate. The applicant will also be around 21 - 23 y/o instead of 19 if they entered nursing school right out of hospital.


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## daedalus (Aug 9, 2009)

Adding to what VentMedic has said, an RN license typically requires college pre-requisite classes usually including sciences and humanities. The ADN programs are usually at least three years when you count the time spent getting the needed classes on top of the standard two year nursing program. As such, the ADN is far more rigorous than a simple AA degree. 

As of now in California and almost every other state, Paramedic licensure only requires you to complete a state approved program. There are no mandatory degrees or even pre-req classes to be sure the paramedic student possess the academic ability, science foundation, and commitment to practice. 

As much as it pains me to say, the RN program is far more academically superior to paramedic programs, which may be only three months long in some areas. Obviously this is a cancerous lesion which brings all of us down and must be excised quickly if we are to shape up. 

This is not even going into the comparisons of wages, collegial atmosphere, treatment from employers, opportunities for advancement, etc. The RN outranks us in every one of the above. 

Personally, I have lost the desire to continue to try and change minds in my current job and in school. I desire the company of people who think they are worth more than a 120 hour cert. I may not even practice as a paramedic if it obstructs the finishing of my undergrad degree in any way. I went into this planning on staying in EMS, only to realize that medicine is who I really am as I walk down the halls of UCLA watching the residents do rounds, as I am pushing the gurney to bring some person back home because couldn't find a family member to drive them.

This change in heart has occurred over the last few weeks. I had a few run ins with upper management of my private ambulance company where I tirelessly argued for patient care and advocacy only to be shot down every time. Every private company is the same, and I have no desire to go to the fire service (who are I respect very much). I also despise the low level expectations of us in my paramedic school. At this point, I strongly urge academically or professionally motivated people who want to practice good medicine, to step away from EMS. It is filled with idiots who argue tirelessly about skills like pulse ox or glucometers when they should be advocating for their profession and the patient. It is filled with idiots who think nothing more of themselves than to go get a 120 hour cert and call themselves health professionals. I cannot stand the culture or the attitudes or the egos, and i implore the young to find their full potential somewhere else. Hopefully the public will wise up soon and we can start staffing ambulances with professionals from the hospital like RNs, RRTs, PAs, Emergency Medicine residents, etc.

Good to see you back, Vent. One day I hope to be your colleague.


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## rhan101277 (Aug 9, 2009)

Here in Mississippi, entry into Paramedic school requires real college A&P I w/labs and A&P II w/labs.  Although you can take A&P to as a co-req.  I have seen lots of other states this way as well.

Some of the medic mills have a A&P


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## Ridryder911 (Aug 9, 2009)

That_Guy said:


> Sticking to the threads title, Paramedic vs RN.
> 
> Getting the pay stuff out of the way (not a concern of mine) What do you ladies and gents think about the scope of practice between an Registered Nurse, and a Paramedic?
> 
> ...



The two professions are totally separate and have verily little in common. The same as a a x-ray tech and RT have in common. The methodologies and philosophies are nothing similar, thus why I am always surprised by those that attempt to judge and compare the two professions.

The scope of practice is as well different due to the job itself is different. Not less or more, just different. So many want to acclaim that nurses require orders to do anything, when in reality so do all of those in EMS. Albeit that most have standing orders disguised as protocols, they still have to have orders alike the RN which most hospitals have in place for the area they work in. 

The education of nursing is much more traditional. Alike other formal education routes, they have a standardized curriculum but it is NOT objective based unlike that of EMS. Something the new EMS Standards is attempting to accomplish but will have a hard time, since the majority of EMS Instructors are not educated enough to teach as in developing lesson plans and having a full understanding of adult education. Where as in nursing the minimal to teach RN is a graduate degree to a doctorate, even the LPN instructor requires a BSN to MSN level. A far cry from those that teach EMS where the most requires is a GED and a 39 hour EMS Instructor course. 

Nursing of course has been around for decades and they take that role very seriously. I have found nursing also police their profession much better than those within EMS. Sure we can all point poor nurses, but in general and per numbers compare this to the number of poor providers within EMS. Personal behavior such as substance abuse is much more watched and patient complaints is taken much more seriously.... in general much more professional. 

Ironically I have yet heard any nurse complain of taking any science courses or witnessed two week nursing classes. Even now the accelerated and on-line type are being scrutinized and many states not allowing them altogether or requiring additional classes, even though that person has passed the RN license. That does not mean that they may practice within a specific state. 

Truthfully, I love EMS but I respect nursing. I am beginning to miss nursing. The problems of nursing is that administration takes advantage of the profession. I believe nursing is much harder and wearing than EMS. Yes, in EMS we all have bad days.. difficult patients that are hard to deal with but remember where you dropped them off? The nurse does not just have the one but two or three more just alike them and they will have to provide care for hours not minutes to them. 

Paramedics can gain the same respect, money and professionalism if they choose to do so. The problem is that the majority want it without the work and sacrifices. They much rather take a 10 month program without any basic sciences, no academic courses associated with the profession. Then they still whine and complain that they have so much to study; even though the majority of the schools still utilize a one textbook philosophy. How ludicrous! 
The skills can be similar but from a total different approach. Suctioning is suctioning, but there is NO reference to prehospital care or even emergency care. In my opinion, nurses should NOT be able to challenge the Paramedic test the curriculum does NOT cover the material needed nor the role or function of the Paramedic. Alike a Paramedic should not be able to challenge the RN test without proper education. There are very few states that recognize PHRN and there is a reason for that. I and some others are developing a RN to Paramedic bridge program. Yes, there are some areas that they will be able obtain credit and challenge but there are areas that they will have to have as much education and skill monitoring as those just entering EMS. I had heard that the NREMT allowed RN to challenge but have since abolished that practice. 

You will not find volunteer nursing alike that in EMS. To replace or subsitute the role of a professional nurse. Yes, you will find those that will volunteer their services but to replace the role of a needed professional nurse...no. I have seen nurses raise money to fund a full time nurse or those associated with missionary missions that entered that professionally. Again, the nurse realizes the need of professionalism. Even communities that are rural, small and so forth; you will always find a RN in the hospital, nursing home and they will be compensated for their services. Not to do so, would be an insult not just to the person but the profession. 

Anyone entering either one of the professions should do so because that it is the role they want to do. It should be more of a calling than just a job. If you are doing either for just financial reasons, you will not last long and will be unhappy until you quit and move on. 

Just remember though, nursing is a diverse profession. Critical care and emergency, as well as flight nursing is just one area that is nursing. In reality many nurses have the opinion those that work in those areas as we do in EMS about nursing home nurses. The general nursing programs does *NOT* prepare or teach any specific areas regarding critical care or emergency. You will NOT ever find a question regarding such on any NCLEX test in regards to critical care/emergency due to it is a speciality. Again, the focus is in general nursing: medical surgical, obstetrics, labor and delivery, psychiatric, community health and pediatrics. 

R/r 911


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## usafmedic45 (Aug 9, 2009)

> Good to see you back, Vent.



+1....we may not always agree on everything, but your posts are usually pretty insightful and when on a technical or clinical matter are so frequently spot on that it's a cold day in Hell when you don't hit the target you were aiming for.  Good to see you posting again.


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## VentMedic (Aug 9, 2009)

Nurses that enter a specialty area to transport outside of a hospital are also held to higher standards for education (with a BSN preferred), experience and training. The Paramedic is still slow to understand this and will often show up at a flight program stating "I've worked for PDQ transport for 3 years and I have ACLS, PALS" and a couple of other weekend certs. The thought process behind the requirements for the job is usually missing. 

It truly takes about 6 - 10 years for a nurse to achieve the necessary experience and education requirements to raise a transport to a critical care level. Thus, RNs are generally not needed to do "ALS" but are vital to the transport world as a nurse with critical care experience. They do not strive to be Paramedic-like or doctor-like. They know they are nurses practicing in a different environment with a scope of practice specific to it. This includes all the many specialties for the RN on transport. It can be Flight -scene and/or IFT, Neo, Pedi, ECMO, Cardiac or whatever. Too many Paramedics claim to be like a nurse when applying for some transport or ED jobs but fail to have established or recognized their identity as a Paramedic. They get overcome with comparing the two professions' similarities that they miss the differences and uniqueness.

When anyone, Paramedic or RN, is looking at obtaining specialty certifications, they should see what the requirements are which will also be what employers are looking at. If all of the certs just involved taking a test or sitting through a short lecture, they may only be "paper" certs. 

These certs for nursing are also like the flight cert for the Paramedic. They essentially only require a nursing license. The CTRN is also impressive in appearance but like a CCEMT-P cert, it may not hold much credibility in reality. In many states, the Paramedic is also just another "cert" that RNs can add to their name by exam. There is also a new "paper" exam, C-NPT, that is coming out this fall which is open to RNs, RRTs and Paramedics for Neo/Pedi transport. 

http://admin.ena.org/bcen/

C-NPT
http://www.nccwebsite.org/Certification/Exam-detail.aspx?eid=26


> No practice experience is required but it is recommended that for the best possibility for successfully completing the credentialing process is that you have a minimum of two years of experience.





Other RN certifications, such as the CCRN by the AACN, require documented clinical experience.
http://www.aacn.org/WD/Certifications/content/ccrn.pcms?menu=Certification#Eligibility

Wound care is another specialty that requires documented experience and additional education.

One also has to not confuse the certs obtained for professional advancement and those that are credentials recognized by states. The CTRN or CFRN are professional achievement certs while in some states the PHRN and MICN are credentials recognized by the state. This is similar to the CCP that is recognized as a credential by about 5 states for the Paramedic but the CCEMT-P may be handed out by various companies to achieve CCT designation with the training ranging from 2 hours to 2 years. 

Florida, as have other states, has also taken to specifically defining their specialty transport personnel (RN, RRT, Paramedic) requirements such as Neonatal in their statutes. 

This is from a recent suggestion for revision of the statutes.



> (c) All references to "patients" and "BLS and ALS procedures" shall be understood as referring to
> "neonates" and "neonatal advanced life support procedures" respectively;​


Previous terminology had gotten bogged down with "ALS" and "BLS" since it was written in the EMS statutes to where it ignored the concept of medicine and the patient care. 
​


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## 8jimi8 (Aug 9, 2009)

Ridryder911 said:


> You will NOT ever find a question regarding such on any NCLEX test in regards to critical care/emergency due to it is a speciality.  *Again, the focus is in general nursing: medical surgical, obstetrics, labor and delivery, psychiatric, community health and pediatrics.*
> 
> R/r 911



Rid, I want to disagree without disclosing information, but I was given several emergency procedure and many emergency situation type questions on my recent NCLEX.

This is information that was covered in my last semester of school, but I'm not sure that I would have prioritized some of these correctly without having had emergency medical training. 


I do agree with the bolded portion.  That is the focus of the test. It could also be for my part, that some of these other types of questions were pilot questions.


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## That_Guy (Aug 9, 2009)

*The maturity on this thread is outstanding.*

At first, I was expecting a lot, if not all of you getting seriously egotistical, or "butt hurt" for asking on your opinions, and picking your brains on this single topic.

I've learned a great deal. Thank you personally to each and everyone of you. 

Personally, later in life I hope to be a BSN, and Paramedic on weekends (or at least an "EMT") and work for a FD part-time (since majority of departments require 24 hours per month. some require 48 per month, no biggy) 

But both RN, and Paramedic are certifications, and training I wish to undergo.

Do any of you think NCLEX-RN, and NREMT-P may compliment one another? (Knowing medical skills on "both sides of the fence") 

I personally don't care about how lucrative one is from the other, just both fields are what I want. And later hopefully Medical School for an MD. (Having both the professions knowledge, would give me a greater incite towards how those "Under me" work, go through, and I'd know the full abilities of what that Nurse, or Paramedic can do)

Ultimately I need a BSN to even apply to Medical School. EMT-P Bridge Program from RN is most likely what I"ll be doing. Personally I think it's not so good, that a Paramedic would do work on an injured pt. and a Nurse take over, and not fully know the approach, and what the paramedic did prior to the nurse taking over. (So a much easier transition between the Paramedic, and the Registered Nurse) But that's just me.

Both are professions I hope to master, at least somewhat. Emergency, and Critical Care are both certifications I hope to earn.

And regarding the question on the Phlebotomy. It gives the Nurse another scope of practice, so instead of having to go through two people to help a patient, the Nurse can just do it. which frees up the full-time phlebotemists job, which kills two birds with one stone so to speak.

The way it was described to me, the particular Nurse I was speaking of, had told me in Providence, where she works, because she's in Critical Care, (or was, she told me she moved to another department, can't remember which) and Phlebotemy work is one of the things she does on the side of her job when not doing a rotation. And her Surgical Technologist Certification, when a CCU patient goes "under" she's immediately a member of the surgical team, because she's there on the spot and qualified. And they have another RN (on call) to take over her shift until her position in the surgical room is no longer needed. 

Another reason why her phlebotomy cert saves the Hospital money, is because she does the phlebotomy for the CCU (she did anyways) so they don't need another phlebotomist to cover CCU department. Another way it kills two birds with one stone, and saves Province $XX,000 per year from having to hire a Phlebotomist to cover the CCUs samples.

Harborview does similiar. If they've got an RN who's qualified with an EKG, and Ultrasound, that Nurse will double up as a Ultrasound/EKG Med Tech. when not doing rounds. which saves Harborview $XX,000 in hiring an EKG/Ultrasound Tech who only has the EKG/Ultrasound Tech certifications.

Which gives the RN a bit of the chunk. Because of having specialty skills that save the hospital money.


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## abckidsmom (Aug 9, 2009)

syd said:


> I don't know if you are thinking about getting both degrees... but, there is usually a RN to EMT-P track at some colleges, while there is usually no P to RN track (that I know of). If someone was thinking about both degrees, it seems easier to do RN first, then EMT-P. Just something to think about...





We have a P to RN track at our local CC.  3 semesters.


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## Ridryder911 (Aug 9, 2009)

8jimi8 said:


> Rid, I want to disagree without disclosing information, but I was given several emergency procedure and many emergency situation type questions on my recent NCLEX.
> 
> This is information that was covered in my last semester of school, but I'm not sure that I would have prioritized some of these correctly without having had emergency medical training.
> 
> ...



I agree that these were probably pilot questions then, as in agreement with the ENA and other sub-speciality emergency and critical care is not part of the standard curriculum. Questions in regard of CPR and similar questions have been asked. 

I know within the past recent years some nursing programs are attempting to specialize but again complaints from the medical institutions that focusing upon one area is not producing a well rounded nurse. 

R/r 911


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## VentMedic (Aug 9, 2009)

That_Guy said:


> But both RN, and Paramedic are certifications, and training I wish to undergo.
> 
> Do any of you think NCLEX-RN, and NREMT-P may compliment one another? (Knowing medical skills on "both sides of the fence")
> 
> ...


 
You seem to be confusing tech certs with licensed scope of practice and specialty certifications for the licensed. 

A nurse, RT or Radiology Technologist do not have to get a phlebotomy or IV cert to perform those procedures since that is within their scope of practice and they can do a competency with the hospital. Nor do nurses have to go through the Surgical Tech program which is for entry level non-licensed people to obtain a cert which is not a license for them. RNs go through their own training programs which are often offered through a preceptorship at the hospital. The same for ICU/CCU RNs. They apply to a training program and may spend a few weeks in the classroom with other nurses and then will be with a preceptor for the next 6 months to 1 year in an ICU. 

Recovering OR patients is part of the ICU/CCU RN's job description in most hospitals so it is not "extra" or even that special. No nurse will take a 75% cut in pay to be a phlebotomist or OR tech not will a hospital pay RN wages to perform a skill that can be done by someone else for 1/3 the cost. However, most RNs are responsible for their own EKGs and phlebotomy to save on hiring more nonlicensed personnel. The other option is to have PCTs (advanced CNAs) do these procedures. 

You may also be looking at doing more skills as a nurse without ancillary staff from a Paramedic perspective where you have one patient. Doing all of your own procedures works well when you only have a couple of patients or in states such as CA where the nurse patient ratio is fixed. However, it does not work well in areas where a critical care nurse might have 3 patients, a med-surg RN have 10 -15 patients and an ED RN who might have as many as 10 patients at one time and see well over 30 - 40 in a shift. EKGs, drawing blood and taking it to the lab may not be wise or safe as it takes time away from tasks that a licensed person should be doing. While it is good for the RN to be able to do these skills, it is not always appropriate or possible. 

RNs specialize can under their license and scope of practice to add most skills. Intubation, central lines and inserting chest tubes are also under their scope of practice which they can perform once they are trained for the appropriate specialty such as transport of some type or L&D.

There are some areas now that do require a specific certification in that field. Ultrasound is one of those but often the RN can use his/her education in conjunction with the required training to meet the requirements for that certification. RTs also do this for US and CVT certifications. 



> Personally I think it's not so good, that a Paramedic would do work on an injured pt. and a Nurse take over, and not fully know the approach, and what the paramedic did prior to the nurse taking over. (So a much easier transition between the Paramedic, and the Registered Nurse) But that's just me.


 
In many areas the Paramedic training gives them very little A&P and pathophysiology. Thus, when you already have that from the nursing program as well as exposure to probably over 100 patients in the nursing program instead of just a few in Paramedic clinicals, patient care will be very easy for you going from nursing to Paramedic. As well, what a Paramedic does in the field you will do in the ED. Actually, as an RN you will start to think about the critical care medicine part rather than what protocols have been initiated in the field which will be very similar to what the ED will do in the first steps. Intubation will be slightly different as different technology and tubes may be used since inhospital infection will be a major concern. However, it is often very difficult for RNs to endure the Paramedic program in some areas if they have a solid education and critical care experience. Thus, the reason for a short bridge or challenge program for those that qualify. You won't find very many RNs or RRTs that have gone through the entire Paramedic program once they achieved their primary license of RN or RRT. I seriously wish I could have done the RRT first before my Paramedic as it would have saved me a couple years of college and would have given me more critical thinking abilities to perform the "skills" necessary for being a Paramedic.

Of course the argument you will hear from RNs that do transport is that getting a Paramedic cert is not necessary, and I agree, since they do have access to the same training or actually higher since it is based on their educational foundation and can have a more more extensive scope. As well, when an RN is in training for a transport position, getting advanced procedures such as ETI is rarely an issue.


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## NJmicP (Aug 22, 2009)

I have My A.A.S in Paramedic Science from Hudson County College in NJ. 

http://www.hccc.edu/innerContent.aspx?menu_id=380&id=518

this also includes 800 hours of clinical time in the : OR, ER, PEDS, Cardiac cath, ICU, CCU, Respiratory, OB. 

Im a NREMT-P which means i can go to 38 out of 50 states and get reciprocity. in New Jersey we give RSI, IV/IO,Morphine and other Narcs, Nebs, CPAP, Tridil drips,ACLS Drugs, intubations, we are also doing other stuff such as hypothermic rescuscitation. I can say with the training i have recieved that I have definitely saved some lives.  My advice, if your not dedicated to EMS, dont do it.


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## harkj (Aug 22, 2009)

i say best of both worlds go get your medic since its easier and then go get your RN i dont know about there but here there is fast track medic which is 12 mths all together then the fast track medic to RN which is also a year that way while your getting your RN you can still bring home a nice check working at a medic plus there are alot of jobs that you can get with both


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## medic_texas (Aug 22, 2009)

On one hand, paramedic school is easy to get into and the classes are family friendly.  But the job on the other hand, 24 hour shifts (most places) and the need for a 2nd job is very family or kid friendly.  I speak from experience and these were a couple reasons why I went to nursing school.  

A few other big reasons were the lack of advancement and opportunities as a paramedic.  If you want to advance, you have to either become a nurse or head towards PA or med school (assuming you want to stay in the medical field).  As a nurse, there are many advancements.  Management, administration, CRNA, nurse practitioner, PICC teams (those usually pay well), flight nursing (making more than the paramedic), PA school (most PA pre-reqs are nursing pre-reqs), and travel nursing.  

I don't regret getting my paramedic and working as a paramedic but I think becoming a nurse was a far better decision.


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## Akulahawk (Aug 22, 2009)

medic_texas said:


> On one hand, paramedic school is easy to get into and the classes are family friendly.  But the job on the other hand, 24 hour shifts (most places) and the need for a 2nd job is very family or kid friendly.  I speak from experience and these were a couple reasons why I went to nursing school.
> 
> A few other big reasons were the lack of advancement and opportunities as a paramedic.  If you want to advance, you have to either become a nurse or head towards PA or med school (assuming you want to stay in the medical field).  As a nurse, there are many advancements.  Management, administration, CRNA, *nurse practitioner*, PICC teams (those usually pay well), flight nursing (making more than the paramedic), *PA school* (most PA pre-reqs are nursing pre-reqs), and travel nursing.
> 
> I don't regret getting my paramedic and working as a paramedic but I think becoming a nurse was a far better decision.


Out here in the Sacramento area, the NP and PA programs are one in the same. The student successfully completing that program can be an NP or PA, depending upon whether or not the student was an RN to begin with.


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## VentMedic (Aug 22, 2009)

Akulahawk said:


> Out here in the Sacramento area, the NP and PA programs are one in the same. The student successfully completing that program can be an NP or PA, depending upon whether or not the student was an RN to begin with.


 
That is only for a Family Practice NP.  I find it ironic that a school like UC Davis would still be offering a certificate in either of these programs.  Quite a few have graduated from this program only to find they had difficulty obtaining licensure in other states.   The NP program does require a few extra classes that the PA program does not have.  There is also a 3 year option for NP.  However, the minimum standards for the education of the NP is going to change soon and that program will hopefully raise its requirements also.


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## 46Young (Aug 23, 2009)

abckidsmom said:


> We have a P to RN track at our local CC.  3 semesters.



Okay, let's talk reality for a moment. You're a single mom. You need money. Your job is willing to accomodate you going to medic school. If you skip that in lieu of enrollment in RN school, you'll be struggling financially for several years (I'm assuming your child/children are not teenagers that can do PT work to help), or even more after repaying loans. You can complete the medic program while enjoying an accomodating work schedule. You can now get to work on the 3 semester medic-RN bridge while earning a medic salary. You'll still have your RN in roughly the same amount of time that you would've if you did it instead of medic school. You'll also have your medic cert. you can decide which career you like more, and use the other cert/license to earn side $$$'s. Medic school > medic > RN bridge seems like the most financially/family friendly option in your case.

Going to a traditional RN program would be optimal, but isn't feasible for many working professionals. That's why online and fast track programs exist. Online bridge programs have been villianized repeatedly on this forum, but it's the only option for some. I can understand the requirement for clinical hours, though.


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## Ridryder911 (Aug 23, 2009)

Tow months ago, we had difficulty locating Paramedics and now I have about 5 a week contacting me wanting a job. While many assume it maybe easy to enter or locate nursing jobs, I am seeing it as hard as EMS positions. I have had two Paramedics that have became new RN's wanting to return to EMS due the inability to find nursing jobs. 

In my area, they are restricting the open positions to those that have at least two years experience as a RN. Yes, we are beginning to see a few openings in areas such as orthopedics, swing bed (long term care) (all night shift). 

Most travel and agency nursing requires at the least of two years experience as well. It appears although there maybe a need, the positions are not being made available. 

R/r 911


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## catskills (Aug 23, 2009)

I asked this question to a paramedic in the Hudson Valley who also works as an RN in the ER. He also teaches RN classes. He said that he earns more money as a paramedic versus part time nurse.  It depends on the hospital and employer.


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## VentMedic (Aug 23, 2009)

catskills said:


> I asked this question to a paramedic in the Hudson Valley who also works as an RN in the ER. He also teaches RN classes. He said that he earns more money as a paramedic versus part time nurse. It depends on the hospital and employer.


 
What about the number of hours for each?   While some Paramedics state they make more yearly than RNs, they do have many more hours put in if they are FT.  The RN will be considered FT at 32 or 36 hours per week and still make a decent living.


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## catskills (Aug 23, 2009)

VentMedic said:


> What about the number of hours for each?   While some Paramedics state they make more yearly than RNs, they do have many more hours put in if they are FT.  The RN will be considered FT at 32 or 36 hours per week and still make a decent living.


The comparison was pay per hour without benefits.


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## villagegirl127 (Aug 25, 2009)

46Young said:


> Okay, let's talk reality for a moment. You're a single mom. You need money. Your job is willing to accomodate you going to medic school. If you skip that in lieu of enrollment in RN school, you'll be struggling financially for several years (I'm assuming your child/children are not teenagers that can do PT work to help), or even more after repaying loans. You can complete the medic program while enjoying an accomodating work schedule. You can now get to work on the 3 semester medic-RN bridge while earning a medic salary. You'll still have your RN in roughly the same amount of time that you would've if you did it instead of medic school. You'll also have your medic cert. you can decide which career you like more, and use the other cert/license to earn side $$$'s. Medic school > medic > RN bridge seems like the most financially/family friendly option in your case.
> 
> Going to a traditional RN program would be optimal, but isn't feasible for many working professionals. That's why online and fast track programs exist. Online bridge programs have been villianized repeatedly on this forum, but it's the only option for some. I can understand the requirement for clinical hours, though.



This does make the most sense...Which online program is the best for paramedic to RN bridge?  Also, if you are a medic and go to an RN program do you still need the prerequisites?  I live in upstate NY, I'm not sure if they allow the online bridge program...


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## medic417 (Aug 25, 2009)

villagegirl127 said:


> This does make the most sense...Which online program is the best for paramedic to RN bridge?  Also, if you are a medic and go to an RN program do you still need the prerequisites?  I live in upstate NY, I'm not sure if they allow the online bridge program...



Yes you still have to meet all requirements.  And more and more states are not recognizing the online bridge.  Plus it is cheaper to do it regular school than online.  Also many people are not able to remain focused enough to do an online program  Many start few finish.


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## Scott33 (Aug 25, 2009)

I make more than double as an RN (per hour), than I do as a paramedic.

It has been said many times before - this has a lot to do with education and licensure, rather than the degree of manual skills and training.


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## medic_texas (Aug 25, 2009)

I can't believe people make more per hour as a paramedic than as a RN.  Even as a flight medic I made far less than I made when I was hired as a new nurse.


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## Akulahawk (Aug 25, 2009)

Scott33 said:


> I make more than double as an RN (per hour), than I do as a paramedic.
> 
> It has been said many times before - *this has a lot to do with education and licensure*, rather than the degree of manual skills and training.


It also has to do with some cultural and political differences as well. RN's (and nurses in general) learned a long time ago that they, as a group, must work together to improve their professional status. They've come a VERY long way in the past 60-70 years. States that require degrees and licensure of Paramedics still have pay differences between the two groups. In my experience, getting Paramedics to work together on pretty much anything in the political arena (it can take legislation to improve some parts of scope of practice) has been about as easy as herding cats. 

In the long run, at least at the Paramedic level, I see no reason why a Paramedic can't have equivalent pay and similar scope of practice as an RN... given the appropriate education and recognition of that education. RN's would be the hospital specialists while Paramedics would be the Transport specialists... and there would be no need to have a CCT-RN as the Paramedics would fill that role competently.

Daring to dream big... and what I think the future for Paramedicine should be all over the United States, not just relatively isolated pockets.


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## bunkie (Aug 25, 2009)

RN's make around 50K a year in the Seattle area from what I can find. No idea what Paramedics make. I'm going for paramedic and plan to get my RN, where I go will depend on where my heart is, not my wallet.


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## medic_texas (Aug 25, 2009)

50k in the Seatle area?  That's a little hard to believe.  Let me do some research  

I was looking at a travel job (which does pay more) and it was around 45/hr in the Oregon, Washington, California area.


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## medic_texas (Aug 25, 2009)

Looks like around 63k according to indeed

Link for RN

http://www.indeed.com/salary/q-RN-l-Seattle,-WA.html

Paramedic is around 44k

Link for medic

http://www.indeed.com/salary?q1=paramedic&l1=seattle+washington


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## bunkie (Aug 25, 2009)

Salary.Com


CB Salary.com
*shrugs* Based on what I've been able to find online, thats the general area.


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## medic_texas (Aug 25, 2009)

So, in your other post you stated they made 50k and in the last post, the 10th percentile makes about 57k (which that is a VERY low percentage of RNs in the Seattle area) and the majority making between 63 and 77k per year.  

Which is it?


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## medic_texas (Aug 25, 2009)

catskills said:


> I asked this question to a paramedic in the Hudson Valley who also works as an RN in the ER. He also teaches RN classes. He said that he earns more money as a paramedic versus part time nurse.  It depends on the hospital and employer.




According to indeed, paramedics make 50k and RN's 73k (8k more a year than my area).  

What does this RN teacher guy do?  Work 4 hours a week as a Nurse?  

Link for RN

http://www.indeed.com/salary?q1=RN&l1=hudson+valley

Link for paramedic

http://www.indeed.com/salary?q1=paramedic&l1=hudson+valley


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## bunkie (Aug 26, 2009)

medic_texas said:


> So, in your other post you stated they made 50k and in the last post, the 10th percentile makes about 57k (which that is a VERY low percentage of RNs in the Seattle area) and the majority making between 63 and 77k per year.
> 
> Which is it?



I tend to roll with low estimates so I used 50K rather they setting a higher estimate without knowing skills/education of others.


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## stephaniejordan0410 (Jun 10, 2010)

That_Guy said:


> In WA, an Paramedic makes around $18-22 an hour. EMT-B, you'll never see one outside a FD. so I've never heard of anything regarding the hourly pay. but they make a min of $50K per year if fulltime. (or $40K, it depends completely on the department) pretty much the same as LPNs and RNs. with exception RNs in my area of WA. can make anywhere from $18 to $86 per hour depending soly on their specializations. aka, persuing education beyond the "basic" Registered Nurse. Flight Nurses make almost $65k per year (just like Flight Medics, depending on hospital) if you're a Emergency Room, Critical Care, and Ultrasound/Electro Kardio Gram qualified. you're talking almost $74K per year. With Surgical Technologist, and Phlebotemy certifications on top of the above mentioned, you're a $104K per year asset. (they can throw you anywhere needed, and can double up with a surgical procedure on the spot, and use specialized equipment. In other words, you save them from having to hire 4+ more people)
> 
> For Nursing, all the Nurses I know (been talking extensively to quite a few, as well as Paramedics) the more specialized training you get into/persue (with your own money, fyi) and the more specialized skills you have vs generic RN. The better, and higher your pay is going to be. Like a Nurse Anesthesiologist (although you need to have an MSN to get that specialty) makes roughly $270K per year average in WA. one at Harborview I've questioned quite a bit, she makes $285K per year, because she has more than aneastisology certifications. She's ER, and Surgical Tech qualified as well, Surgical Tech certification saves her hospital from hiring one. (so they get 4 people int he operating room VS 6, because another Nurse on her surgical team is Surgical Technologist qualified as well, giving her an additional $15K per year, vs having to spend $45K per year for an employee on payroll)




 I live in Washington and was curious as to who the lady who is a surgical tech, ER and aneastisology certifications. If possible I would like to be able to get int oucdh with them to find out all the classes, programs and certifications she has.. thats what i want to do but i have no idea how or where to start!!


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## mycrofft (Jun 11, 2010)

*I have the Post-Retirement Phil Collins Syndrome*

"I don't care anymore".

Nursing offers more than pay. Much wider opportunities than paramedic and fewer opportunities for injury. Unions. Benefits.

In facy I'm trying to get a chance to test back into EMT-B without taking the curriculum. Gimme two weeks with the text and EMTLIFE and I'm good to go.


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## TransportJockey (Jun 11, 2010)

mycrofft said:


> "I don't care anymore".
> 
> Nursing offers more than pay. Much wider opportunities than paramedic and fewer opportunities for injury. Unions. Benefits.
> 
> In facy I'm trying to get a chance to test back into EMT-B without taking the curriculum. Gimme two weeks with the text and EMTLIFE and I'm good to go.



Two whole weeks? 



I'm disapointed in you. It should take you two DAYS


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## catskills (Jun 13, 2010)

jtpaintball70 said:


> Two whole weeks?
> 
> 
> 
> I'm disapointed in you. It should take you two DAYS


Interesting comment.  My experience is that RNs are weak in their EMT-B trauma skills and Pt assessment out in the field.


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## JPINFV (Jun 14, 2010)

catskills said:


> Interesting comment.  My experience is that RNs are weak in their EMT-B trauma skills and Pt assessment out in the field.



My experience is that EMT-Bs are weak at patient assessment period.

Since we want to play this game of measure the medical instrument piece game...


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