is being a CCP as good as being a RN?

[goodgrief]

We were talking yesterday in paramedic class, and someone mentioned that it would only be an extra 8 classes (1 year) to get our R.N after graduating Paramedic.

Now I have NO NO NO NO NO NO wish to EVER be a nurse (shivering at the thought), I am not knocking nurses it is just not what I want. However I do want to be on a heli one day, and I wonder if it would be a wise move since I could still practice as a Paramedic with a R.N license,

Do you think, down the road, I would better off to be a Critical Care RN then just a CC paramedic, employment wise?

Of course all this depends on if I make it through medic school alive.

 

[Veneficus]

We were talking yesterday in paramedic class, and someone mentioned that it would only be an extra 8 classes (1 year) to get our R.N after graduating Paramedic.

Now I have NO NO NO NO NO NO wish to EVER be a nurse (shivering at the thought), I am not knocking nurses it is just not what I want. However I do want to be on a heli one day, and I wonder if it would be a wise move since I could still practice as a Paramedic with a R.N license,

Do you think, down the road, I would better off to be a Critical Care RN then just a CC paramedic, employment wise?

Of course all this depends on if I make it through medic school alive.

Employment wise, get your RN.

Before you completely discount "wanting" to be an RN, I encourage you to spend some time with a CC or Flight RN, you might find they are a lot closer to paramedics then you may have given them credit for.

 

[bbledsoe]

Ccp

If I had my way it would be. But the EMS profession seems to fight increased education at every turn. It is a daily battle. Frustrating...

 

[Shishkabob]

Dr Bledsoe!!!!!!!!!!!!!!!




GG... something you might want to look in to is Respiratory Therapy, since you want to be on a helo. In my experience, flight medics are in control of the airway, and many flight medics that I know also have their RT (some have RN). Get your RT as that can help if you decide field medicine isn't for you either.

 

[goodgrief]

That is why I dont want to be a nurse, I want to be in the field, not in a hospital.

Thanks for the thoughts, Im all for higher education, one of the reasons I was against the RN route was it will push back my bachelors.

And I agree with you on the fighting at every turn with education, I just wrote a paper on why having an assoiciates should be a requirement to be a paramedic in the US.

Im going to talk to the school and see what is in the details, and go from there.

thanks yall

 

[abckidsmom]

RN, Paramedic is such a flexible combination that I recommend it to everyone who asks me for education advice. You can work in so many healthcare settings, doing SO many different jobs.

CCP is kind of a joke. Without daily experience providing critical care, the numbers are just fluff that you barely understand.

 

[Akulahawk]

Employment wise, get your RN.

Before you completely discount "wanting" to be an RN, I encourage you to spend some time with a CC or Flight RN, you might find they are a lot closer to paramedics then you may have given them credit for.

I'd say that Critical Care Transport RN's and Flight RN's are a LOT closer to Paramedic than you might think. Critical Care RN's and ED RN's can (and do) function more autonomously than other RN personnel, but they generally still have someone available to back them up right there, a shout away at most. CCT/Flight RN personnel, during transport, must think more like a Paramedic.

All of the flight programs that I'm familiar with prefer to hire RNs that have field experience (especially as a medic) because it's far easier to train them than it is to take a Hospital-only CCRN and train them for the field. One Chief Flight Nurse flat out stated that it takes them 6 times longer to train the Hospital-Only RN.

 

[Akulahawk]

As to Critical Care Paramedic - I agree with Dr. Bledsoe. The two should be equivalent, and getting them that way is possible. Just not likely at this point in time. Making the minimum entry educational level for Paramedic be the Associate's Degree is just the start. You'd still have to provide for significant levels of clinical experiences during the education and allow for on-going refresher training in those clinical areas. What's going to be especially difficult would be getting Paramedics authorized to provide care in any Critical Care area, especially as they're not RN's and RN's may see that as an encroachment on "their" scope and jobs.

 

[usalsfyre]

...especially as they're not RN's and RN's may see that as an encroachment on "their" scope and jobs.

What REALLY burns my rear about this is they have no problem encroaching on physician's teritory with the DNP program and demands they be treated as equals because "they're doctors too". Yet anyone with approprite education tries to work in their area of specialty and they start screaming.

 

[usalsfyre]

We were talking yesterday in paramedic class, and someone mentioned that it would only be an extra 8 classes (1 year) to get our R.N after graduating Paramedic.

Now I have NO NO NO NO NO NO wish to EVER be a nurse (shivering at the thought), I am not knocking nurses it is just not what I want. However I do want to be on a heli one day, and I wonder if it would be a wise move since I could still practice as a Paramedic with a R.N license,

Do you think, down the road, I would better off to be a Critical Care RN then just a CC paramedic, employment wise?

Of course all this depends on if I make it through medic school alive.

As Dr. Bledsoe noted, they should be, but they're not. It is entirely possible to elevate your knowledge of care beyond what a typical RN knows, but currently there is no way to recognize that over a 10 week medic mill wonder.

 

[Shishkabob]

What REALLY burns my rear about this is they have no problem encroaching on physician's teritory with the DNP program and demands they be treated as equals because "they're doctors too". Yet anyone with approprite education tries to work in their area of specialty and they start screaming.

*cough* Community Paramedics *cough*

 

[TransportJockey]

*cough* Community Paramedics *cough*

Wake County and... Crap I can't remember what service that Chris Montera from EMS Garage works for, but anyways. Both of those services are trialing the Community Paramedicine program and it seems to be bringing in good results. I hope it can find widespread acceptance, especially since you find very few RNs willing to do public health. It makes sense that Paramedics take over that role, but then we'd have to find somethign other than Emergency Medical Services to call ourselves, and I know a lot of whackers that will oppose that

 

[Shishkabob]

Crap I can't remember what service that Chris Montera from EMS Garage works fo

Eagle County Ambulance District



Also, MedStar here in Fort Worth is doing Advanced Practice Paramedics... same thing just a different name. They still send CCPs with extra education out to minimize frequent fliers. They also send the APPs to all cardiac arrests and things of that nature.

 

[Veneficus]

What REALLY burns my rear about this is they have no problem encroaching on physician's teritory with the DNP program and demands they be treated as equals because "they're doctors too". Yet anyone with approprite education tries to work in their area of specialty and they start screaming.

At one point I got upset over the idea of a DNP, but then I saw what their curriculum is and how they function.

They are simply people who want to play doctor. They have neither the science education nor the ability.

They are very much nurses in all respects, they know what to do as long as the patient fits easily into a protocol but identifiying patients who are anything but textbook and treating outside the cookbook protocols they use is so completely beyond them I no longer feel threatened.

They can get any degree they like, but they will never live up to "doctors" until they go to medical school.

In the meanwhile, only the people in the US will buy into the bull of people making up their own standards to be called doctor when they lack the ability commitment, or drive to do what it takes to put MD or DO after their name.

Best of luck to them, and more luck to their patients who get swindled by their ignorance and deception.

 

[WTEngel]

Critical Care Specialties

Whether you go the RN route, the CCP route or the FP-C route, you will have to put in at least 3 - 5 years of intense practical experience before you really have any business getting into flight or critical care transport. That's just my $0.02.

So, you can put in 3-5 years in a busy 911 rig doing all sorts of field work, or you can take another year or so in school and then spend 3-5 years in an ICU, ER, or both....making literally two or three times the salary.

The most unfortunate fact of the entire matter is that the rising stars in EMS always tend to leave the field to pursue better paying option with an expanded scope of practice (i.e. PA, RN, Med school, etc.)

As had been mentioned before, the route to gaining the respect that so many of us feel we deserve will come from education and professionalization of our industry. This will be a direct result of requiring Associate's degrees at a minimum, and then getting 4 year schools to offer Bachelor's and Graduate programs. If EMS were to copy any one thing from nursing as a profession, it would be their road map to professionalization of their industry. Do you think nursing became a high demand, excellent paying profession by some stroke of luck?

Anyway, sorry to hijack the thread a bit...but seeing Bledsoe's remarks encouraged me to weigh in on the issue.

My two bits...go get your RN. as others have mentioned, you would be surprised at how intense working in an ICU or ER can be, and that experience comes in very valuable when you make your move to flight.

TE

 

[EMSLaw]

Much like with paramedics, states have widely differing protocols on how they allow advanced practice nurses to function. The fact of the matter is that if you want a plenary license to practice medicine, you have to go to medical school.

Law isn't that different, by the way. While the AMA has been jealous in protecting their profession by limiting the number of medical schools, the ABA hasn't done the same with law schools. On the other hand, lawyers face much less encroachment into their practice areas than doctors do.

Nurses are the most common targets of the whole "they want to be called doctor" thing, but the ongoing increase in training standards for health professions (which is a good thing) has lead to lots of non-MD doctors out there. Pharmacy, physical therapy, even chiropractic. I suppose I would expect such people to be very forthright about the fact that they /aren't/ my physician, even if they are entitled to the title "doctor." Just like I'd hope that advanced practice paramedics would have something more along the lines of a master's degree than an associates if they're going to be out there prescribing medications, even under protocols (which, at that level, necessarily leave some room for the practitioner's clinical judgment).

And since I've got a doctorate, and there are plenty of ethics opinions saying I can use it...

I'm Dr. EMSLaw, from the legal department...

 

[Veneficus]

First glad to see you are back posting.

I'm Dr. EMSLaw, from the legal department...

That sounds alot better than " I'm Dr. Soandso, and I will be your nurse."

 

[abckidsmom]

At one point I got upset over the idea of a DNP, but then I saw what their curriculum is and how they function.

They are simply people who want to play doctor. They have neither the science education nor the ability.

They are very much nurses in all respects, they know what to do as long as the patient fits easily into a protocol but identifiying patients who are anything but textbook and treating outside the cookbook protocols they use is so completely beyond them I no longer feel threatened.

They can get any degree they like, but they will never live up to "doctors" until they go to medical school.

In the meanwhile, only the people in the US will buy into the bull of people making up their own standards to be called doctor when they lack the ability commitment, or drive to do what it takes to put MD or DO after their name.

Best of luck to them, and more luck to their patients who get swindled by their ignorance and deception.

I understand your resentment of the DNP program (resentment might be too harsh...), but I do see that NPs are a vital part of inexpensive healthcare when everyone "deserves" it. NPs do have enough exam skills to detect when they're out of their league, and I've yet to meet one who doesn't immediately turf the patient out to someone with a clue. Plus, they have enough time in their day to really do the patient education that's going to make a long-term difference in preventative medicine.

There's a place for everyone, I think.

 

[EMSLaw]

That sounds alot better than " I'm Dr. Soandso, and I will be your nurse."

I was under the impression that DNPs were primarily for nurse practitioners. So I guess it would be "I'm Dr. Smith, and I will be your mid-level non-physician practitioner today."

Admittedly, doctorates in Nursing aren't so common yet outside academia, though they're picking up now (I think they'll be required for all new nurse practitioners in NJ within the next five years), but I do have one observation...

When I go into the ERs near us, most rooms have a whiteboard that has the date, and then the names of the people responsible for the room, I guess so the patient knows who to yell for. So, your Tech is Gary, your LPN/CNA is Patti, your RN is Mary, and your physician is Dr. Smith. The line that says PA/NP doesn't say "Dr. Jones." It says, "Betty". I've never seen it say "Dr. Jones." So, at the moment there is still a distinction.

 

[Veneficus]

I understand your resentment of the DNP program (resentment might be too harsh...),.

It is sort of like some guy who was a cook in the navy trying to pass himself off as a SEAL.

All of the NPs that I know make it very plain they are not physicians. Of course they are also nurses who spent a great deal of time being nurses before pursuing an advanced degree so they are well aware of the differences in education.

I think the major problem comes from the ones who go through academia to doctorates and come out that do not realize their limitations.

but I do see that NPs are a vital part of inexpensive healthcare when everyone "deserves" it.

I think everyone deserves a MD/DO. To find out if you can be turfed to a protocol. Not see if you fit the protocol and if it doesn't work you get turfed to a doctor. No patient should ever be shunted to a doctor. They should always be shunted from.

From the economic standpoint, in my experience it doesn't save money. It just adds an extra level with an extra bill. One of the common practices in hospitals now to get extra money out of payers is to have a NP see patients a couple days a week, then have the physician oversee this and bill for both the NP and the Physician.

In all fairness, if the NP is the one managing the Pt. the NP should be the only one getting paid. Physicians are not reimbursed for administration, they are reimbursed for their clinical practice.

NPs do have enough exam skills to detect when they're out of their league, and I've yet to meet one who doesn't immediately turf the patient out to someone with a clue.

It is not the ones that turf people out quickly that really worries me. It is the ones who think they are "doctors" and they can handle it.

I have only met one in person, a "wound care DNP" who didn't recognize early signs of Group A strep infection on a patient because he didn't know that the skin degeneration is by the same mechanism in burns, Strep A, and pemphigus. So he insisted that the patient didn't have an infection and need to be refered to a doctor because there wasn't local redness or tempature increase. In a circulatory compromised pt., early identification of infection has a mch better prognosis than waiting for grossly obvious signs.

The fact is, he didn't know what he was looking at in his field of specialty. I doubt it is a systemic issue, but it really makes me wonder how often it comes up and if the education really is preparing them for the role they envision themselves in.

Plus, they have enough time in their day to really do the patient education that's going to make a long-term difference in preventative medicine..

I think this is a major benefit of the DNP. But it was always part of nursing. Which means that the rank and file nurses are not doing it.

I also think the DNP can make a significant contribution in helping patients comply with their medical treatments.

The issue is when people start wanting to stop focusing in where they do help to pretend to be as capable as somebody else. I am sure you have noticed that on a large scale, nursing has been steadily moving away from its core foundations and principles in order to branch out to other roles. That is great as long as you are still doing what you are supposed to, but I think nursing as a whole in the US is failing at that. Otherwise there would be no need for so many techs. Which also increases the cost of healthcare when you need to hire people to do the original job because the person who was supposed to be doing it is now "branching out."