EMS/Nursing vs. Firefighting

[Shishkabob]

How so? Medics only have to deal with one pt at a time. Nurses can be covering two, three, up to nine or more in some cases. Even if we're running non-stop, we can at least hold a signal for a few minutes to open the cooler and have a meal.

On the other hand, they also have virtually unlimited resources and help.


It's not uncommon for there to be only 2-4 EMS on scene for a code, whilst in a hospital, 10+ is common. They also, generally, have all the experts and equipment they could ever need to manage their acute patients. Us? Not so much.



It's silly to compare the two, because each has their own kind of busy / difficulties about them.

 

[46Young]

On the other hand, they also have virtually unlimited resources and help.


It's not uncommon for there to be only 2-4 EMS on scene for a code, whilst in a hospital, 10+ is common.

They also, generally, have all the experts and equipment they could ever need to manage their acute patients. Us? Not so much.



It's silly to compare the two, because each has their own kind of busy / hardness about them.

True, it is apples to oranges to an extent. Still, the nurse in a busy hospital will be doing some work related task nearly every moment they're on the clock. We get a breather when driving between calls, we can hold signals, take extra time to write a report, catch naps or surf the net if the call volume dies down, etc. The nurse may have more help for a code, but how many codes are we running? At my busiest back in NY, I might see an average of 1 working code per shift. All we're really doing is CPR, a line, airway, work the monitior, and push some drugs. We can work the code for 20-30 minutes and then call it, and not even need to move the pt. We do more physical work, but I'm willing to bet that the mental demands of the nurse far exceeds ours. Even when we're running our tails off, how tough do we really have it? We can only run one call at a time.

 

[Indy]

How so? Medics only have to deal with one pt at a time. Nurses can be covering two, three, up to nine or more in some cases. Even if we're running non-stop, we can at least hold a signal for a few minutes to open the cooler and have a meal.

Which one is more stressful? Paramedic or Nursing? I for one vote medic. In EMS, the pay is terrible. My sister makes over $70k a year, and she's only in her 4th year of nursing. Paramedic pay with that many years on around here tops $38,000 if you're lucky, and doesn't increase much as years go on. So stress wise, yes paramedics have a harder and more stressful job than nurses IMO.

Also consider working conditions. Nurses during the winter are in a nice, warm and safe environment, and in the summer they have cooled buildings. EMS goes out on MVIs and other outdoor calls in 20 degree weather, in the rain, sleet, snow, thunderstorms, etc.

Nurses also work knowing they have a doctor who can help them with anything at any time. If a paramedic gets stuck, he/she has to call a supervisor who is probably 5-10 minutes away, even when responding code.

 

[TransportJockey]

I'm kinda curious why medics really should make any more money than they already do? Simple supply and demand there. The market in most places is oversaturated with all EMS personnel. That combined with the higher required education means that RNs usually command higher pay.

 

[Shishkabob]

I'm kinda curious why medics really should make any more money than they already do? Simple supply and demand there. The market in most places is oversaturated with all EMS personnel. That combined with the higher required education means that RNs usually command higher pay.

There is no reason why a medic should make half as much as an RN with equivalent education and responsibilities. None.

 

[TransportJockey]

There is no reason why a medic should make half as much as an RN with equivalent education and responsibilities. None.

No, there isn't. If education at least was equivalent I'd say you've got a point. But with most EMS services not putting any premium on education and hiring out at the lowest pay they can and still having lots of applicants, they see no need to increase it.

Although you can find places that are different. You have, I believe, and I have to an extent down here. But then again, I make about the same pay as our ED nurses here in the county

 

[Shishkabob]

The education (I'll I'll catch flak on this from some here) IS equivalent, in my opinion, on what our job actually is. The difference is what we are educated in.

A Paramedic IS emergency medicine. Do we lack in non-acute medicine, minor disease processes and things of that nature? Sure... but an OB/GYN nurse lacks in cardiology, a med/surg nurse lacks in pediatric care, a respiratory therapist lacks in trauma care, etc etc.


A brand new nurse will NEVER know more than a brand new Paramedic in cardiology, trauma, and emergency medicine. The only nurses that can compare to medics in that knowledge ARE ER and ICU nurses, and it can fluctuate in who knows more in what... yet we make half as much as they do. That's screwed up, regardless of any perceived overabundance.

 

[JPINFV]

A brand new nurse will NEVER know more than a brand new Paramedic in cardiology, trauma, and emergency medicine. The only nurses that can compare to medics in that knowledge ARE ER and ICU nurses, and it can fluctuate in who knows more in what... yet we make half as much as they do. That's screwed up, regardless of any perceived overabundance.

So, what you're saying is that a paramedic is useless outside of emergency medicine whereas a nurse has a skill set that's useful in multiple departments? Would you feel comfortable with the brand new medic following a similar orientation/new nurse program (to make it fair) taking the place of an RN in the emergency department? Are cardiology, trauma, and emergency medicine the only three fields that matter? In terms of trauma, and surgery in general, how much training do paramedics receive for post surgical wound care and the like, or is it really an apples to oranges comparison?

 

[Shishkabob]

And I point you back to this

Do we lack in non-acute medicine, minor disease processes and things of that nature? Sure

As is oft stated, nursing education is generalistic, but lacks in depth in many things just as much as Paramedicine lacks in breadth. How much training does the average non-ER nurse receive in acute care? How about the average OB/GYN nurse in trauma surgery? Adult ICU nurse in pediatric cancer treatment? Public health nurse in respiratory care?



Why is it so bad that Paramedics specialize in a subset, but not nurses?



If our job was to provide post-surgical wound care, I'd be inclinced to agree that we were lacking, but it's not our job, and whilst it'd be beneficial to be more generalistic in that fashion as many of our calls are NOT true emergency medicine, I can also see why it typically (I said typically, not always) not included.


The education of Paramedics should, and often does, mirror that of an ER RN in emergency medicine. They just learn a lot more in the theories of the non-emergency aspects that show up in the ER too, as we should strive for.

Would you feel comfortable with the brand new medic following a similar orientation/new nurse program (to make it fair) taking the place of an RN in the emergency department? Are cardiology, trauma, and emergency medicine the only three fields that matter?

Actually having spent the time I did in ERs and trauma departments, and meeting the new nurses that work there, actually yes, I would feel comfortable. Especially for the trauma specific areas. No reason they can't.

 

[TransportJockey]

The education (I'll I'll catch flak on this from some here) IS equivalent, in my opinion, on what our job actually is. The difference is what we are educated in.

A Paramedic IS emergency medicine. Do we lack in non-acute medicine, minor disease processes and things of that nature? Sure... but an OB/GYN nurse lacks in cardiology, a med/surg nurse lacks in pediatric care, a respiratory therapist lacks in trauma care, etc etc.


A brand new nurse will NEVER know more than a brand new Paramedic in cardiology, trauma, and emergency medicine. The only nurses that can compare to medics in that knowledge ARE ER and ICU nurses, and it can fluctuate in who knows more in what... yet we make half as much as they do. That's screwed up, regardless of any perceived overabundance.

I agree with you for the most part, but nurses still have more knowledge base to build on. My biggest complaint with EMS education is that EMT-Bs and EMT-Is are definitely undereducated. And medics are to a degree as well. I'd love to see an AAS a requirement for medic, as I've said in the past. Oregon seems to do pretty well with that as a requirment, and NM has been talking about moving in that direction. If we had a more solid base of knowledge I would agree with you 100%.

 

[Shishkabob]

So I have no knowledge base to build on either? My knowledge is confined to JUST acute care, and the pathphys, anatomy, physiology, pediatrics, geriatrics and pharmacology, no matter how little or much, cannot be built on?

 

[TransportJockey]

Never said you have no knowledge base to build on Just not as broad as a Grad Nurse does to start with. If we made at least some hard sciences a requirement to entry into this field it would go a long way (A&P 1 and 2 w/ labs would be a nice start )

Besides, I just called myself undereducated, so I'm sure as hell not going to say that you have no knowledge base to build on.

 

[Shishkabob]

But you're you, and I'm me, therefor I'm better.

 

[SerumK]

I've got to agree with JTPaint and disagree with Linus.

Linus, I'm not really sure where you get your idea that nurses ON AVERAGE have it easier than paramedics for twice the pay but equal education.

I will say that nurses absolutely have comfier work environments... no rain, wind, snow, etc. Nurses usually have 5 to 9 patients they are responsible for (ICU is more like 1-3, LTC one nurse may have up to 150 patients in some of the disreputable facilities). I could go on and on about these comparisons, largely apples to oranges, but lets focus on pay and education.

The biggest difference is education. Many nursing jobs are BSN minimum or within 1-3 years of hire. There's such a glut of new nurses that even when it isn't the official requirement, a bachelors is what you need unless you have years of experience. Many new RNs are coming in with two bachelors via ABSN programs! At minimum, anywhere, you need an associates degree to be an RN.

EMT-P does NOT require anything but high school + some watered down A&P and trade school classes. (except in OR) Employers do not reward the medics who do have the more thorough education!

RNs have a much more in-depth educational foundation which makes them much more versatile and easier to educate in the long run (interestingly, that is what they found with associate vs bachelors nurses: the associates had an edge for the first 6 months, after that the bachelor foundation proved superior). EDUCATION IS WHY THERE IS A PAY DIFFERENTIAL BETWEEN RN AND EMT-P. Education is also why there is nowhere to go as an EMT-P except management. It is why I chose RN over EMT-P (as the first step).

Still, I've noticed paramedics make only slightly less than nurses. In my local spot, paramedics are making 14-25/hr while nurses are making 22-32/hr (that's for FT, not including built in OT adjustments... if you look at salary its 35-55K for medics and 44-65K for nurses).

BUUUUUUUUUUUT Fire Medics always make a ton more than nonFFmedics, usually equal to what an RN can pull down. Rookie fire medics pull in 45K here MINIMUM which is what a new grad RN makes. And Fire Medics get 24s or 48s instead of what new RNs get: 12 hour rotating shifts (some nights here, some days here) or the night shift.

Lastly, there are presently jobs for paramedics, although FF/Medic jobs are insanely competitive. At least there are those private service jobs. It is not so rosy for RNs. There's a ton of new nurses that have been out of work for more than a year after graduation with no hope in sight, not even in the nursing homes. It's a common topic on nursing forums: "what rural county of what state must I move to in order to get ANY nursing job?" There's many a crying new grad who realizes after their 200th job application gets rejected that the "nursing shortage" was nothing but hype.

 

[brentoli]

A Paramedic IS emergency medicine. Do we lack in non-acute medicine, minor disease processes and things of that nature? Sure... but an OB/GYN nurse lacks in cardiology, a med/surg nurse lacks in pediatric care, a respiratory therapist lacks in trauma care, etc etc.

But a nurse has the educational foundation to transition in to those areas. A nurse doesn't come out of college as a "ER Nurse" or a "L&D Nurse". Rather they come out a nurse, capable of going into any position and learning the specific demands and skill set of that job. If a nurse wants to leave L&D and go to the ER after 5 years can they? Yes. Without question. a couple of months of orientation and boom - you have an ER nurse.

 

[Shishkabob]

So you're telling me a Paramedic can't adapt either? You're telling me Community Paramedicine is a hoax?



What makes you think a Paramedic is completely and totally incapable of transitioning to other areas as well, with the same orientation? What makes a new grad nurse any more capable at working in an ER than a Paramedic with the same educational requirements?




Anyway-- medicine is full of specialized professionals. Respiratory therapist, rad techs, sonographers, etc etc. Why is it so bad that we are specialized in emergency medicine? No one has YET to explain that to me.

 

[Symbolic]

So you're telling me a Paramedic can't adapt either? You're telling me Community Paramedicine is a hoax?



What makes you think a Paramedic is completely and totally incapable of transitioning to other areas as well, with the same orientation? What makes a new grad nurse any more capable at working in an ER than a Paramedic with the same educational requirements?




Anyway-- medicine is full of specialized professionals. Respiratory therapist, rad techs, sonographers, etc etc. Why is it so bad that we are specialized in emergency medicine? No one has YET to explain that to me.

There is definitely nothing but truth in that. It's unfortunate that an 2 extra years of school and a piece of paper are enough to warrant an extra 10 thousand a year. I suppose that's like every other Job though. Its all about that diploma.

But honestly, going from a Medic to a Nurse realistically would take only a year extra of training, if not less.. I'm not trying to undermine the Job, but lets be honest here.

 

[brentoli]

Nope. Just refuting your statement that a L&D nurse can't work in the ER or vice versa.

If you want to be held on the same plane as a nurse the education has to be equal, that comes out to be about 2 years of liberal education and 2 years of trade education. There's not many 4 year EMS programs in the US.

 

[Journey]

So you're telling me a Paramedic can't adapt either? You're telling me Community Paramedicine is a hoax?

What makes you think a Paramedic is completely and totally incapable of transitioning to other areas as well, with the same orientation? What makes a new grad nurse any more capable at working in an ER than a Paramedic with the same educational requirements?

Anyway-- medicine is full of specialized professionals. Respiratory therapist, rad techs, sonographers, etc etc. Why is it so bad that we are specialized in emergency medicine? No one has YET to explain that to me.

By your reasoning, Respiratory Therapists, Radiology Technologists and Sonographers are also the equivalent of a nurse. The difference in these professionals and the Paramedic is that their minimum entry level is a two year degree. For your state of Texas, you only need 600 hours of traiing.

As a specialist trained specifically in Emergency Medicine, you do not have the same core education as a nurse and therefore you are not a nurse or like a nurse.

LVNs can do "community health" and they also have 2x more hours of training than what is required in TX. It does not take that much to do welfare checks and give immunizations. If you are referring to the Wake County system, many of the tasks they do should be standard for most Paramedics such as deciding which hospital to go to. That system also only requires 200 hours extra for training. Add that to your 600 hours and you still only get 800 hours which is about 600 hours less than an LVN.

If you have additional education and still work with those who meet only the minimun 600 hours, you should see why that is very inadequate rather than arguing it is just like a nurse or a Radiology technologist. Those who actually have more education see the difference and argue for the standard to be raised rather than additional titles like "community health Paramedic" be added to a system that has not increased its minimun education requirements. Those who do have the additional education do move on or advance to positions or professions where they are no longer working with medic mill products who continue to argue for the least minimal standards.

 

[Journey]

There is definitely nothing but truth in that. It's unfortunate that an 2 extra years of school and a piece of paper are enough to warrant an extra 10 thousand a year. I suppose that's like every other Job though. Its all about that diploma.

A college degree is considerably different than a certificate issued by a tech school. A tech school also has lower entrance requirements so that almost anyone can enter into a trade.

It is attitudes like yours that keeps the Paramedic from advancing to a two year degree. You see no value in education and you believe all health care professions are as easy as the Paramedic which is an insult to the Paramedic.

But honestly, going from a Medic to a Nurse realistically would take only a year extra of training, if not less.. I'm not trying to undermine the Job, but lets be honest here.

That is true only if you have completed all the prerequisites for entry which includes college level A&P, microbiology, math, chemistry and pharmacology. Very few Paramedic programs require these since trade schools lead the market. All the prerequisites will take you well over 1 year to complete and probably more like one and a half years. These prerequisites are the same for almost any allied health program. If you wanted to be a Radiology Technologist, you would probably need another 2 years of college in addition to the prerequisites. About all the Paramedic cert will get you is the equivalent of 1 semester off a nursing program.