There are no RNs working ground 911 in California, and very few cases of RNs actually becoming Paramedics through the loophole you are talking about. For an RN to become a paramedic, s/he would have to demonstrate to the EMS agency that her program taught to the objectives of the national curriculum for paramedics. I know of exactly zero nursing schools that do such. They would also have to have the psychomotor skills of back-boarding and intubation and the like taught to them, and demonstrate proof of this. My own mother openly admits that RNs almost never intubate in any setting, and that they are not taught a thing about it. I have no idea who is going to teach them to do so and provide them with documentation of such that is acceptable to Cal EMS. As well, I highly doubt there is an employer who will hire you even if you are did somehow become a paramedic by using your RN cert and I doubt if my area's medical director would even accredit you to practice. It just doesn't happen.
Backboarding? You do know that some hospitals do all sorts of spinal surgeries which requires nurses to move the patient in a variety of cautious ways besides just with a backboard.
What other roles do MICNs play in the county EMS systems? Their education levels are put to better use than on a ground ambulance with very limited protocols.
Not that there is much pride to it but the MICNs also teach the LAFD flight team.
How many flight or specialty nurses do you know? Do you know how extensive their protocols and "skills" lists are? Do you know how many emergencies they respond to and the level of expertise it takes to get a severely injured patient a long distance back to the appropriate hospital or to stabilize a patient at scene that the ground EMS can not?
Since EMS in California is primarily Fire Based, the RN would get the Paramedic patch and become a Fire Fighter. You may never know they were an RN.
Yes, the state of California has made this acceptable in their statutes. They might actually raise the standard in the FDs. However, I would see it as a waste of a good medical education but if they want to be a fire paramedic, so be it. I do know of several fire medics that actually were RNs first but switched for the hours, benefits and security of the FD. This is in both FL and CA.
Some RNs, usually the MICNs, do challenge the Paramedic exam just to see what all the fuss is about since so many Paramedics complain about how hard it is. Few have any desire to actually work as a Paramedic and most will not get their state license.
It is more advantageous for the RN or RRT (in some states) to remain with that title and not work under a Paramedic license. Again, you can look at CA and how limited the Paramedics scope of practice is even on CCT. But then, some RNs may actually welcome only having 21 meds to know in the entire scope instead of 210+ for just one shift.
In CA, there is also little opportunity for Paramedics in HEMS except for the LAFD and medicine is not really their focus or strong point. But then, there is little to no opportunity for them in CCT either. In FL, many of the Paramedics trying to pass themselves off as "CCEMT-Ps" shouldn't be anywhere near a CCT. But unlike most nurses, some Paramedics don't know what they don't know.
Again, nurses know that their education is JUST a foundation and the beginning of their career. They will receive more education and training in their specialization. If your mother has only been a med-surg RN, then she may not have known all of the opportunities out there for nurses. Once one has a good educational foundation, it is not much of a stretch to gain "skills". If it is to be part of their job description, an RN can get into an OR, NICU, PICU, ICU or ED for intubation training easier than most Paramedic students. Our flight and specialty transport nurses have no problem getting at least 25 live intubations before going at it on their own as well as maintaining their "skills". As well, L&D nurses also have not problem finding babies to intubate.
If a nurse works in the ICU setting, he/she had better know a lot about intubation even if they are not doing the actual "skill". They are the ones pushing the RSI or whatever meds and assisting the RRT or MD. Our ICU nurses are very well educated and trained for working in a critical care environment. No, we would not ask or expect a med-surg nurse to do the same things.
Paramedics are taught to the "medical model" (according to Dr. Bledsoe) and are trained in differential diagnosis and initial management.
Nurses also make these same decisions in the ICUs, Rapid Response Teams and code teams. Even med-surg nurses must make certain differential diagnosis to initiate care. They can not be put on hold or wait 2 hours for a doctor to call back. They are trained to intiate whatever care is necessary or at least identify the need for a Rapid Response team. They also must be educated to the many labs or diagnostics available to point them in the correct direction since a higher level of care and expectation is on their judgement. Paramedics must make a differential diagnosis in order to figure out which protocol or recipe to choose. If you look at the majority of Paramedic protocols, almost all start with the same initial treatments. By the time the Paramedic gets to the fork in the road, med control can advise the Paramedic on the rest of the treatment.
