Paramedic or Nurse?

[zzrider]

Now I'm probably jumping the gun here since I'm only in the midst of my EMT-B training at present, but it's in my nature to always be looking ahead to what's next. That said, I'm currently pondering what direction to go once I've got my B cert and have spent some time in the field.

I am contemplating two options, assuming I like the field and can handle the work: go on to Paramedic, or go the RN route. Both are pretty much the same in terms of educational commitment - I can get an AS in either (if I went EMT-P, I'd probably go for the AS rather than the cert alone), with RN being somewhat more expensive. I am already working on prereq courses that would be useful for either - I'm taking Soc now, and will be taking A&P I over the summer.

This being an EMT forum, I expect most answers to be biased towards the EMT-P route, but I'm wondering if anyone else has pondered this choice and how you made your decision.

From what I have seen, RN jobs seems to be somewhat more plentiful and pay better, but I'm not sure how a middle-aged guy would be received in that field.

So... any thoughts on RN vs. EMT-P as the next step after EMT-B?

 

[Shishkabob]

The answer is simple: What do you want to do? Heck, no one says you can't do both. I know FF/P's who during their 48, work PRN as an RN at the ED.



Yes, RNs tend to make more, but it also depends on where you work and where you're located.

 

[VentMedic]

From what I have seen, RN jobs seems to be somewhat more plentiful and pay better, but I'm not sure how a middle-aged guy would be received in that field.

You would probably be rec'd better than in a Paramedic program with 18 year olds only wanting to get on with the FD and have very little interest in patient care.

It all depends on what you want to do. If you want the opportunity to work in many different patient care areas including emergency medicine, then the RN would be the way to go. If you want prehospital medicine to be your focus, then the Paramedic would be best.

 

[VentMedic]

The answer is simple: What do you want to do? Heck, no one says you can't do both. I know FF/P's who during their 48, work PRN as an RN at the ED.

But at 48 years old one might have a difficult time getting on with a paid FD depending on how good your physical condition is.

He would also have to consider this if his area is largely fire based EMS or if he is willing to relocate to an area where it is not.

 

[wyoskibum]

If I had it to do over, I would go to Nursing school instead of Paramedic school. More job options and better pay.

 

[trevor1189]

I was told to go to nursing school then challenge the NREMT-P. Not sure of the process of that, but I was told it can be done.

Also that way you can work and make good money as an RN and take field shifts as a medic as you like.

However, not really interested in being a nurse, so I decided just to go for the AAS degree in Paramedic Technology and then go for the B.S. in EMS later on as like.

 

[LucidResq]

Even if the educational requirements are similar on paper, sometimes, bear in mind that most quality nursing programs are EXTREMELY competitive. You probably won't be considered with anything less than a 3.5 GPA in my area. Paramedic programs usually aren't. Also, there is a shift in nursing education to the Bachelor's level... it may become the minimum standard in the future. This will likely not be the case with paramedicine education.

 

[LucidResq]

Oh and believe me, you'll be fine as a middle-aged male. It would probably surprise you how many men go into nursing, and older men at that. Definitely not the majority, but they're out there for sure. My best friend is in nursing school and she can tell you that she's sick of the estrogen flood. Hell, I'm just finishing up my pre-requisites and there's so many women I'm getting a little crazy.

 

[VentMedic]

I was told to go to nursing school then challenge the NREMT-P. Not sure of the process of that, but I was told it can be done.

Also that way you can work and make good money as an RN and take field shifts as a medic as you like.

In PA, the RNs have their own prehospital credential - PHRN.

 

[Akulahawk]

To the OP: If you're at a point where you can go either way, I'd say look towards doing Nursing. The prereq's should be very similar to what the Paramedic AS program (and other allied health professions too) would want. Either way, get your Gen Ed stuff out of the way FIRST. This way you only need to concentrate on doing the program coursework and not having to find a way to get any co-requisites, other GE, or whatever coursework done while you're in the program... or even AFTER you complete the program.

Basically, you whichever way you go, take lots of good GE classes... and if you're not selected for either program initially, take other classes that might be prereq's for other fields too. Make sure you keep your GPA up though. Nursing School can be VERY competitive.

 

[zzrider]

Thanks for all the advice, guys. I have seen how competitive nursing school programs can be to get in to - my wife is doing it now. She's been working as a hospital lab tech for years, but is now going back for RN. She finished her prereq stuff last year and will be starting the actual program this fall, assuming she gets in. It seems pretty certain that she'll get in - she got straight A's in all her prereq stuff and has many years of health care experience, both of which are heavily weighted for admissions.

At this point I'm leaning towards the RN route, and I like the idea of getting an EMT-P also. I'll have to investigate that further at a later date. In the meantime I'm going to keep working on general prereq coursework that will be needed for either.

A couple years ago I never would have imagined that I'd be back in school at 43 looking to do something completely different. But so far, I'm really liking it! Feels good; feels like I'm actually alive again.

 

[Jon]

I was told to go to nursing school then challenge the NREMT-P. Not sure of the process of that, but I was told it can be done.

Also that way you can work and make good money as an RN and take field shifts as a medic as you like.

However, not really interested in being a nurse, so I decided just to go for the AAS degree in Paramedic Technology and then go for the B.S. in EMS later on as like.

In PA, the RNs have their own prehospital credential - PHRN.

Both of you are right. Since PA uses the NREMT-P as their state Paramedic exam, a PHRN candidate must take the NREMT-P exams (written and practical) to become a PA state PHRN. HOWEVER, if you don't complete a paramedic program, you JUST become a PHRN, and don't get the NREMT-P. Same deal with prehosptial physicians, and in the near future, physician extenders. They'll all wear the "Health Professional" patch, and have at least the Paramedic scope of practice... but they'd need to go though a Paramedic class to be able to be a NREMT-P.
Figured I'd throw this out there to make sure no one got confused.

 

[VentMedic]

Both of you are right. Since PA uses the NREMT-P as their state Paramedic exam, a PHRN candidate must take the NREMT-P exams (written and practical) to become a PA state PHRN. HOWEVER, if you don't complete a paramedic program, you JUST become a PHRN, and don't get the NREMT-P. Same deal with prehosptial physicians, and in the near future, physician extenders. They'll all wear the "Health Professional" patch, and have at least the Paramedic scope of practice... but they'd need to go though a Paramedic class to be able to be a NREMT-P.
Figured I'd throw this out there to make sure no one got confused.

Why would they want a Paramedic patch if they have the PHRN?

In most states RNs can do everything a Paramedic can under their own scope which is creates less license conflict. Our RNs would be very frustrated if they were limited to the Paramedic scope of practice and I can't imagine how the RNs in California would feel if they had to function with a Paramedic scope on Flight or CCT. Yes, if the RN wants to become a Fire Medic, then he/she should get the Paramedic and ONLY be an RN on Flight, CCT or in the hospital settings....not on the fire truck.

 

[firecoins]

radiation therapist

 

[46Young]

Here's the deal, if you can get into a 2 year RN school, then choose that. It'll take you the same amount of time to complete as an EMS AAS. You can then quickly challenge for the medic card through whatever tech school. Do that, and then you can take that card to a community college and receive 36-40 credits or so for an EMS AAS if you want. You'll have more than enough classes for that degree, and you'll maybe have to do one or two core classes to complete the degree.

Now you can have your cake and eat it too.

For any medical profession, I personally see it as more financially beneficial to get the entry level degree, such as a 2 year for the RN, and then go for the bachelor's while earning a paycheck. Otherwise, you're spending four years wihtout any significant earning potential, instead of only two. As far as an RN, maybe an exception to this would be someone who wants to be a flight RN. This requires 3-5 years in critical care, and only a BSN qualifies for that position. In that case, going right to BSN would allow one to realize their goal that much sooner. Otherwise, it's better to get the entry degree, and get the next two while gainfully employed.

After you have both your medic and RN, I would choose a BSN over an EMS BA. Four year EMS graduates aren't compensated all that great in comparison, and most positions that someone with an EMS BA would qualify for would also go to a BSN.

Here's a link to Charleston County's employment page (it may be obsolete in the coming weeks as the position gets filled):

https://jobsweb.charlestoncounty.org/hronline/public/vacancylisting.aspx

Here you have the position of Assistant Emergency Services Director for Charleston County EMS. Here's the qualifications:

Minimum Education - A Bachelors Degree from an accredited University in EMS, Business, Health or a related field
Minimum Qualification - 10 years of progressive management experience of a 911 EMS provider or other health care administration.

What's the compensation? $60,424-$74,256 with 10 years admin experience. Hellllloooo, paramedic crew chiefs, which new medics generally progress to after six months to a year after hire, were getting 45k/yr to start back in '07, with nothing more than a tech cert and a few alphabet cards that everyone has anyway. Only an extra 15-20k/yr for four years of school and ten years of experience? That doesn't sound very appetizing to me.

My point is that if you decide to go beyond two years with your education, go with the BSN vs the EMS BA. You can have any position that the EMS degree would qualify for, and be able to do many other things with that degree as well.

 

[TransportJockey]

As far as an RN, maybe an exception to this would be someone who wants to be a flight RN. This requires 3-5 years in critical care, and only a BSN qualifies for that position. In that case, going right to BSN would allow one to realize their goal that much sooner. Otherwise, it's better to get the entry degree, and get the next two while gainfully employed.

Not always. I know several nurses in ICUs of the... eight? hospitals here in ABQ, including our Lvl 1, who are ADNs. Two of them are flight nurses who PRN on ground transports as medics.

 

[VentMedic]

Not always. I know several nurses in ICUs of the... eight? hospitals here in ABQ, including our Lvl 1, who are ADNs. Two of them are flight nurses who PRN on ground transports as medics.

Any idea about their clinical ladder or how it is used for pay and advancement?

 

[TransportJockey]

Any idea about their clinical ladder or how it is used for pay and advancement?

BSNs are usually quicker advancing to mgmt positions. Charge RNs seem to be split pretty evenly between ADN and BSN on step-down, medsurg and ER. ICUs tend to have about 2/3rd BSN charges. Pay for BSNs is typically a little better than for ADNs. Not entirely sure what you mean by clinical ladder since they are all regarded as RNs

EDIT: And thats just my hospital system which runs 3 of the seven (I miscounted we don't have eight :blush) hospitals in the city.

 

[8jimi8]

It all depends on what you want to do. From my very first clinical day, i knew that med/surg floor nursing was not for me. But I also would have rather gone to paramedic school. I spoke with a firefighter captain who encouraged me to pursue nursing because of the money and the diversity in the field.

Lucid you are wrong. Nursing will never step forward to bachelor's as a minimum. They still have hospital school programs that graduate RNs.

To people who are encouraging the OP to pursue nursing because jobs are widely available, go to allnurses.com and do a search for jobs and new grads. See how many thousands of posts you see of new grads freaking out because they cannot find a job.

The nursing shortage is for experienced nurses, NOT for new graduates. If you are excited by emergency medicine pursue that, otherwise you are going to be in for a long road of doing jobs you don't want to do until you can get into a specialty like critical care or the emergency department.

 

[VentMedic]

BSNs are usually quicker advancing to mgmt positions. Charge RNs seem to be split pretty evenly between ADN and BSN on step-down, medsurg and ER. ICUs tend to have about 2/3rd BSN charges. Pay for BSNs is typically a little better than for ADNs. Not entirely sure what you mean by clinical ladder since they are all regarded as RNs

EDIT: And thats just my hospital system which runs 3 of the seven (I miscounted we don't have eight :blush) hospitals in the city.

Many hospital licensed professionals have clinical ladders that are not necessarily related to being in upper management.

It is a way of giving RNs (RRTs, PTs, OTs etc) a chance to advance in steps to achieve a better pay grade, accepting more responsibility or more promotional opportunities. The steps can be achieved through obtaining more education in the form of a degree and/or more certs. It also can be obtained by cross-training for different units or doing special procedures. As well, one might have to achieve a certain amount of steps on the ladder to qualify for certain units or to do special procedures. Examples would be an ECMO or Specialty Transport. Rarely will these teams accept people who only meet the minimum standards and just exist day to day in their position. The same might go for those doing charge or lead positions and in roles as preceptors. Many RNs also continue to work on the same unit which may even be med-surg but through their educational accomplishments and completing job goals, they may enjoy a higher pay grade as well as bringing more to the care they provide to their patients than those who just exist at minimum.