The scope of practice for nursing does not vary as much from state to state. The job description does. A flight or L&D nurse can intubate but a med-surg nurse probably has not need to so it is not in his or her job description. For EMS it seems every state varies in some way including what each provider is called since not all use all of the new NREMT titles. Texas sets its scope of practice as it goes depending on the medical director. California seems to be very limited for scope of practice while in Washington it is broad for Paramedics and even EMTs.
An RN also has the ability to move across the street to another facility to have more autonomy or participate in advanced patient care with additional skills due to an extensive scope of practice by the state. Often EMTs or Paramedics are very limited to their state's scope of practice unless there is special permission obtained through the state by a request of their medical director. The titles EMT and Paramedic do not always follow them into jobs in many health care facilities and is often limited to prehospital as their state certification statutes define. If the titles do follow, they might be limited to only what they can do by their state scope of practice which would then prevent an EMT from performing invasive procedures such as venipuncture of any type and even obtaining a finger stick for. If they left the EMT title outside and went with ER Tech, they might be trained to the full scope of a PCT.
As an off duty Paramedic do you carry intubation equipment, IV equipment, fluids and narcotics routinely on your person? Are the narcotics in a lock box in your car? Is this only in the area covered by your ambulance service or can you take all of this equipment anywhere in the state? If you were to assist your co-workers while you are off duty, great but then are you paid for your time since you would be working under your medical director and do you fill out the PCR? Would you fall under the Good Sam as most healthcare workers do performing "BLS" or would this be listed as volunteer even if you are a paid service? Is this a written duty to act when off duty by your state or county? I guess I should also ask if you are a volunteer Paramedic although the topic here is about salaries. While I know there are volunteer Paramedics I don't know if I would want to advertise it especially if the spouse and kids use the car which might have ALS equipment in it or known to have such stuff in the car.
