PHRN transfer to EMT-P in other states?

[Summit]

I believe he was referring to the 39% of RNs who hold BSNs compared to the percentage of medics who hold a bachelor degree which while not 0% is much much lower. I would be surprised if 39% of medics nationwide held a degree of any kind.

I was referring specifically to the number of medics who hold a bachelors in paramedicine or equivalent at entry into practice versus the number of RNs who hold a bachelors in nursing at entry into practice. That is essentially 0% to 39%.

I am not speaking about the highest degree achieved outside of the profession. We all know there are plenty of medics and nurses with degrees outside their field.

We could step it down to associates or higher in the field at entry to practice, then you have 96% for nurses vs what for paramedics nationwide?

 

[truetiger]

Lets look at what the BSN degree adds as far as direct patient care education.....not much. These were listed under "nursing major" for a RN to BSN program. http://www.centralmethodist.edu/cges/_docs/majorminors/nursing.pdf
AH316 Data Analysis for Nursing Practice (3)
AH330 Business Concepts in Health Care/Case Management (3)
NU300 Adaptation Nursing Model (2)
NU301 Physical Assessment (2)
NU303 Research in Nursing (3)
NU315 APA Formatting and Library Databases (1)
NU320 Adaptation Nursing in the Community (4)
NU325 History/Trends in Nursing (3)
NU450 Integrated Concepts on Adaptation Nursing (6) NU455 Professional Issues, Leadership, and Management (3)

I see only 2 hours pertaining to direct patient care.

 

[Shishkabob]

Lets look at what the BSN degree adds as far as direct patient care education.....not much.... I see only 2 hours pertaining to direct patient care.

Or ADNs and their "Well I had pre-reqs too!" Sweet, you can do a spreadsheet! Guess what, I can RSI.

 

[Summit]

The best numbers I could find for Paramedic graduates are from a 2008 study (that quotes a 2005 study):

<1 year certificate program: 75.4%
1-2 year certificate program: 14.8%
Associates Degree program: 9.2%

http://www.ems.gov/pdf/EMSWorkforceReport_June2008.pdf (Warning 152 page PDF!)

I’m sure the Associates numbers are higher now. As far as the highest degree of any nature, I could only find this 2006 statistic about EMS INSTRUCTORS:

"EMS educators reported the following was their highest level of education: 11.6% High School/GED, 38.5% Some College, 20.9% Associate Degree, 21.3% Bachelor’s Degree, 7.8% Graduate Degree. Overall, EMS instructors have similar educational credentials to the students that they are teaching." (Note that this statistic includes physicians, PAs, RNs, and RTs who are EMS educators.)

Nursing professors all have at least a Masters degree. But what is the educational distribution of nurses?

In 2008, 49% of working RNs had acquired a BSN, nursing related bachelors, or graduate nursing degree. 13.2% of RNs had a graduate degree in nursing or a related field. Only 13.3% of working RNs did not have a nursing related degree. I’m certain the BSN+ holders are well over 50% BSN today; the profession’s goal is 80% by 2020.

37.1% of RN students between 2005 and 2008 had a degree in another field, 40% in a health related field, and the majority were bachelors or above. About 9% of RN students were employed in EMS prior to school.

http://www.thefutureofnursing.org/sites/default/files/RN Nurse Population.pdf (Warning! 359 page PDF!)

Or ADNs and their "Well I had pre-reqs too!" Sweet, you can do a spreadsheet! Guess what, I can RSI.

Hey, it is all about skills, right?

But, let us just say that the same amount of time in spent in the program teaching paramedics and nurses. Who can you teach at a higher level?

A vo-tech EMT with a year on the street taught by educators that are statistically unlikely to have a 4 year degree?

Or how about when doctoral/masters prepared professors get to spend "the same amount of time" teaching a student who walked in the door with*:
College A&P with lab
College Chemistry with lab
Microbiology with lab
Biology with lab
Pathophysiology
Psychology
Sociology
Human Growth and Development
College Algebra
English Composition
Statistics
15 semester credits of other stuff, which probably includes a class in Micorsoft Excel too!!!!!!!!!!!!!!!!!!!

*Prereq list from a typical AACN or NLN accredited BSN program

That still doesn't mean the RN can magically be a paramedic. It does mean that the BSN RN has a foundation of general and medical education that will allow them to bridge relatively easily (as opposed to bridging from the other direction).

PS I don't like ACICS.
PPS BSN for initial licensure vs RN-BSN is a whole other thread. If you want, I'll happily link you to the RNs arguing about it at length.

 

[truetiger]

My paramedic program awarded 40 credit hours, my emt 10. That's 50 hours specifically in one area of medicine. From the ADN program at the local cc, I see they take 58 hours in multiple areas. Having taken ACLS with our local ER nurses, they always need help through the class.

 

[silver]

My paramedic program awarded 40 credit hours, my emt 10. That's 50 hours specifically in one area of medicine. From the ADN program at the local cc, I see they take 58 hours in multiple areas. Having taken ACLS with our local ER nurses, they always need help through the class.

Its important to note that different universities and even different programs award credits differently. For example, I took a class that required 12 hours of service a week on top of the normal class time and was awarded 3 credits, which is the same as all my other classes. Some of my labs, which were all 1 credit were either 2, 3, or 4 hours a week.

Also its important to note that we shouldn't compare apples to oranges. Nurses aren't trained on ACLS until on the job (if even) and don't frequently use the algorithms.

This has essentially come down to each side using moot points.

 

[ExpatMedic0]

 

[Shishkabob]

Also its important to note that we shouldn't compare apples to oranges. Nurses aren't trained on ACLS until on the job (if even) and don't frequently use the algorithms.

Once was privy to a conversation between a couple of cath lab nurses and a nursing student. The nurses stated a new grad had no business being in the cath lab because they "can't read a 4 lead yet, and only doctors can do 12s", and they "Haven't really even done ACLS so they don't know what to do in a code".


I brought up the fact that a new medic, from day one of graduation, could run a code and do a 12 lead.



They didn't like the fact that a medic is not only more qualified, but more suited for the cath lab, than an otherwise equal nurse is.

 

[Summit]

Once was privy to a conversation between a couple of cath lab nurses and a nursing student. The nurses stated a new grad had no business being in the cath lab because they "can't read a 4 lead yet, and only doctors can do 12s", and they "Haven't really even done ACLS so they don't know what to do in a code".


I brought up the fact that a new medic, from day one of graduation, could run a code and do a 12 lead.



They didn't like the fact that a medic is not only more qualified, but more suited for the cath lab, than an otherwise equal nurse is.

Doesn't it seem strange to you that you ONLY run into below average providers? At least those are the only anecdotes you present when concluding that all providers inferior to you. One starts to wonder if it is the photographer and not the subject.

 

[VFlutter]

They didn't like the fact that a medic is not only more qualified, but more suited for the cath lab, than an otherwise equal nurse is.

I think you have just have bad luck with dumb nurses. I have spent a decent amount of time in two seperate cath labs and it was totally different than what you described.

Personally I could perform and interpret 12 leads upon graduation. I also did not feel out of place during codes.

I am not sure why you think a medic is more qualified or better suited for the cath lab. How many medics have adequate experience with IABPs and transvenous pacers?

I am assuming you have spent some time in the Cath lab and realize how involved the RNs are in the procedure.

 

[silver]

I think you have just have bad luck with dumb nurses. I have spent a decent amount of time in two seperate cath labs and it was totally different than what you described.

Personally I could perform and interpret 12 leads upon graduation. I also did not feel out of place during codes.

I am not sure why you think a medic is more qualified or better suited for the cath lab. How many medics have adequate experience with IABPs and transvenous pacers?

I am assuming you have spent some time in the Cath lab and realize how involved the RNs are in the procedure.

Its also important to note that RNs do peri-procedural care in the cath lab. Once in the lab, it is a complex "dance" acting as a circulator. This includes managing the patient, documenting, giving medications, running/setting up non-sterile things (IABPs, pacing, vents etc. as stated), and grabbing things that are needed (and you better have what the physician wants before he/she even asks).

Sure you can run a code better, the medic/nurse will never run it in the cath lab as there is a cardiologist there. Additionally, it is such a minor part of the job of a cath lab nurse. In the extremely busy cath lab I worked in for a summer, we had two codes during daytime hours (and a couple "uh oh we put the patient in VFib" moments that didn't count).

 

[usalsfyre]

Role creep and arguing why RNs are superior for everything is EXACTLY why much of the rest of healthcare looks at the nursing lobby with a critical eye....

Just saying

 

[Veneficus]

Role creep and arguing why RNs are superior for everything is EXACTLY why much of the rest of healthcare looks at the nursing lobby with a critical eye....

Just saying

I must agree with this.

Nursing research is basically nurses claiming what they already do is best. It is even worse than a drug company telling you they conducted research and their new drug is safe and cures all.

Nurses even create awards for places that embrace their position, like the magnet award. (If you think it is about patients or safety, you might want to read with a more critical eye the homepage on who gives it and why)

However, if you notice...

RTs, PAs, perfusionists, and all other manner of healthcare provider has a minimum level of education to practice that is sufficent enough for them to defend their position as experts and the most capable.

Paramedics not only do not have this, they do not embrace it, and they don't even have their own biased research to back it up. All they do is spout their gas about how great they are and how everyone else sucks.

So really, why should anyone treat them as experts or equals much less superior?

US medics don't have the education societies all over the world use as a measurable standard for every profession.

US medics do not have an organization that lobbies for them in a money talks BS walks world. (Don't even try to count the coopted NAEMT)

US medics have not embraced evidence based practice, further degrading their expert position.

US medics do not lobby or accept responsibility for their profession. "But my protocol says..." Medical directors are a dime a dozen, demand change. (of course if you do that and something goes wrong, you have nobody to blame but yourself)

US medics focus their training on an incredibly small portion of medicine. Then claim expertise from experience. How would you like your doctor to learn on the job? Your surgeon? Your aesthesiologist? Your Ob/Gyn?

As it stands today, US nurses are more educated ad more qualified to work prehospital than medics.

Medics have nobody to blame but themselves.

For years I have advocated medics need to increase their education. They always say there is nothing in it for them, they don't want to front the money... I have heard it all.

I asked then and I ask now? Is your job worth the investment? Because somebody more educated is poised to take it from you and/or so pigeon hole you in such a small role that you will be lucky to not need food stamps in a few years.

What if a group of people who think advanced edcation is valuable prehospital over your feeble skills, went out and got nusing degrees, and then started to take over EMS by also finding roles as dual providers, using your skills training as the environment specific training?

Because nurses have done so. Look at your leaders, from educators to dare I say? the NREMT?

You claimed you did not need education. You claimed you were just there for emergencies. You claimed it wasn't worth your time and money.

You said I didn't know what I was talking about. That nurse to medic - medic to nurse street is not 2 way. You have nobody to blame but yourself.

"Even a monkey can intubate..."

A curious phrase.

 

[Aidey]

Doesn't it seem strange to you that you ONLY run into below average providers? At least those are the only anecdotes you present when concluding that all providers inferior to you. One starts to wonder if it is the photographer and not the subject.

Not necessarily. If the main local nursing program is sub par it could explain running into a high concentration bad nurses. If that can happen with medic programs, there is no reason it can't happen with nursing programs.

I think you have just have bad luck with dumb nurses. I have spent a decent amount of time in two seperate cath labs and it was totally different than what you described.

Personally I could perform and interpret 12 leads upon graduation. I also did not feel out of place during codes.

I am not sure why you think a medic is more qualified or better suited for the cath lab. How many medics have adequate experience with IABPs and transvenous pacers?

I am assuming you have spent some time in the Cath lab and realize how involved the RNs are in the procedure.

I think your 12 lead ability isn't a widespread thing. To be very blunt, I know EMT Bs with better 12 lead interpretation skills than most ED nurses who have tried to do it.

Anecdote time. A few days ago I brought in a chest pain that was positive for every stereotypical AMI symptom. Her EKG was very very suspicious for a cardiac event, but didn't meet STEMI criteria. The RN INSISTED on seeing it before I went to talk to the MD (who I had spoken to on the phone about this pt). I told her it wasn't a STEMI and I wasn't sure what to call it. She proceeds to say "Well, there is a P wave so we know it is a sinus rhythm. And she has big T waves, so that means she has hyperkalemia. There you go, now we know what it is." :glare::glare::glare: :glare::glare::glare:

 

[usalsfyre]

I must agree with this.

Nursing research is basically nurses claiming what they already do is best. It is even worse than a drug company telling you they conducted research and their new drug is safe and cures all.

Nurses even create awards for places that embrace their position, like the magnet award. (If you think it is about patients or safety, you might want to read with a more critical eye the homepage on who gives it and why)

However, if you notice...

RTs, PAs, perfusionists, and all other manner of healthcare provider has a minimum level of education to practice that is sufficent enough for them to defend their position as experts and the most capable.

Paramedics not only do not have this, they do not embrace it, and they don't even have their own biased research to back it up. All they do is spout their gas about how great they are and how everyone else sucks.

So really, why should anyone treat them as experts or equals much less superior?

US medics don't have the education societies all over the world use as a measurable standard for every profession.

US medics do not have an organization that lobbies for them in a money talks BS walks world. (Don't even try to count the coopted NAEMT)

US medics have not embraced evidence based practice, further degrading their expert position.

US medics do not lobby or accept responsibility for their profession. "But my protocol says..." Medical directors are a dime a dozen, demand change. (of course if you do that and something goes wrong, you have nobody to blame but yourself)

US medics focus their training on an incredibly small portion of medicine. Then claim expertise from experience. How would you like your doctor to learn on the job? Your surgeon? Your aesthesiologist? Your Ob/Gyn?

As it stands today, US nurses are more educated ad more qualified to work prehospital than medics.

Medics have nobody to blame but themselves.

For years I have advocated medics need to increase their education. They always say there is nothing in it for them, they don't want to front the money... I have heard it all.

I asked then and I ask now? Is your job worth the investment? Because somebody more educated is poised to take it from you and/or so pigeon hole you in such a small role that you will be lucky to not need food stamps in a few years.

What if a group of people who think advanced edcation is valuable prehospital over your feeble skills, went out and got nusing degrees, and then started to take over EMS by also finding roles as dual providers, using your skills training as the environment specific training?

Because nurses have done so. Look at your leaders, from educators to dare I say? the NREMT?

You claimed you did not need education. You claimed you were just there for emergencies. You claimed it wasn't worth your time and money.

You said I didn't know what I was talking about. That nurse to medic - medic to nurse street is not 2 way. You have nobody to blame but yourself.

"Even a monkey can intubate..."

A curious phrase.

Which is why I posted the other tread about educators. Not saying we don't need to change. But simply handing the keys over via "bridge programs" ect isn't what I'm looking for.

 

[Veneficus]

Which is why I posted the other tread about educators. Not saying we don't need to change. But simply handing the keys over via "bridge programs" ect isn't what I'm looking for.

Because of the lack of interest of most EMS providers, that may have been decided for you and them by parties not involving them.

 

[Shishkabob]

How many medics have adequate experience with IABPs and transvenous pacers?

And how many nurses have experience with the same exact things before they're out in the workforce and taught it? Your point proves nothing.

Nurses don't know anything until they're taught it. Same as Paramedics. Same as every other provider. Quit acting like nurses are an exception.


But since we're talking about nurses in an out-of-hospital environment... "How many nurses have adequate experience running a cardiac arrest? Starting IOs? Synchronized cardioversion? Intubation? I can keep going if you'd like.

Doesn't it seem strange to you that you ONLY run into below average providers? At least those are the only anecdotes you present when concluding that all providers inferior to you. One starts to wonder if it is the photographer and not the subject.

The stories are post-worthy because they are the exception, not the norm. I don't post every encounter. Someone has to be at the bottom of their respective class.


I deal with a wider variety of providers at a wider variety of locations than someone that works in a single facility, typically at a single place, like you do. No? There are crappy facilities with crappy people, there are great facilities with great people.

Its also important to note that RNs do peri-procedural care in the cath lab. Once in the lab, it is a complex "dance" acting as a circulator. This includes managing the patient, documenting, giving medications, running/setting up non-sterile things (IABPs, pacing, vents etc. as stated), and grabbing things that are needed (and you better have what the physician wants before he/she even asks).

Because Paramedics can't do that stuff? Because Paramedics are somehow unable to learn on the job the same way nurses are? Ok...

 

[Summit]

Veneficus hits the nail on the head, repeatedly.

Aidey: fair enough

Which is why I posted the other tread about educators. Not saying we don't need to change. But simply handing the keys over via "bridge programs" ect isn't what I'm looking for.

I wouldn't worry. There are far more RNs than medics, but RNs are not lined up out the door for medic bridge programs. Most of them have no interest for are variety of reasons, personal to professional to economic.

 

[Shishkabob]

I wouldn't worry. There are far more RNs than medics, but RNs are not lined up out the door for medic bridge programs. Most of them have no interest for are variety of reasons, personal to professional to economic.

I've yet to meet an RN who earned their medic the correct way that didn't prefer being a medic but work as an RN due to the pay.


Pay being equal, I'm confident more people would prefer working as a medic. It's just more fun (per them)

 

[silver]

Because Paramedics can't do that stuff? Because Paramedics are somehow unable to learn on the job the same way nurses are? Ok...

The documentation, assessment, patient advocacy, and overall continuum of care is drilled into their brains in clinicals.

And let us look at what I was responding to:

Once was privy to a conversation between a couple of cath lab nurses and a nursing student. The nurses stated a new grad had no business being in the cath lab because they "can't read a 4 lead yet, and only doctors can do 12s", and they "Haven't really even done ACLS so they don't know what to do in a code".


I brought up the fact that a new medic, from day one of graduation, could run a code and do a 12 lead.



They didn't like the fact that a medic is not only more qualified, but more suited for the cath lab, than an otherwise equal nurse is.

That's strange, we weren't talking about "on the job training" but who was better suited and more qualified.