Lpn vs medic school

[usalsfyre]

I don't think anyone here or the nurses with the certification are attempting to "fill the role" of the Medic. Both the Medic and the Nurse bring a different aspect of health into the picture, PHRN is giving the nurse more training to function in a pre-hospital environment, not replace a Paramedic. Usually, these nurses have ER and ICU experience as well, thought that was worth mentioning.

In most cases that is EXACTLY what a PHRN would do, replace a paramedic. I may bring a different perspective into the ED, yet I'm not allowed to replace an RN.

Like I said, it's not about nurses personally...

 

[joeshmoe]

Why shouldn't someone challenge an exam? I looked through a CNA textbook and it seems that the position only requires certification for legal purposes. There's nothing in there that necessitates instruction.

Aerin-Sol

My state CNA written exam was a joke. I could have possibly passed the exam without even having taken the class, using common sense alone.

However the practical exam was another matter. It was pretty much on par with the NREMT practical exams for EMT basics, only with even more mindless memorization of steps. Many of the RNs who conduct CNA state exams are test nazis that see themselves as the last line of defense against incompetent aides who will get out there and make RNs jobs a living hell by spreading infection like wildfire, as a result they will fail people for the most petty of reasons, and expect EVERY step to be flawlessly executed. I passed my CNA exam the first time, but MOST of my class failed it, despite the fact most of them were also going on to RN school or were already enrolled, and the fact my CNA instructor went over the skill stations with us verbatim the last few classes.

Where I used to work they would hire people who had passed a CNA class but were still awaiting their test date, but had to stop that because so many new hires ended up failing their state practical exam lol.

 

[Katy]

In most cases that is EXACTLY what a PHRN would do, replace a paramedic. I may bring a different perspective into the ED, yet I'm not allowed to replace an RN.

Like I said, it's not about nurses personally...

Well, like I said, I can only speak from my experience, but if that is the case in some places then that's pathetic. I know many Paramedics who work in the ED, that doesn't mean they are nurses. I know a few Nurses who work in the Ambulance, doesn't mean they are Paramedics.

 

[JPINFV]

Which, let's face it is as complete and utter bushwa as most EMS educational programs.

True, to an extent. In a physician, for example, is challenging the paramedic exam (which the only reasons I can think of is for "street cred" and staffing concerns (having 2 medics on the ambulance)), then the preceptorship is to acquaint the physician with the environment, whereas a student needs to be acquainted to both the environment and the medicine.

 

[Akulahawk]

I have quoted a LOT of posts...

In nursing school students learn little about a lot, they have a very generalized education on human anatomy and physiology, as well as interventions and specialities. Now, when one graduates from nursing school, he or she can choose a speciality that holds interest to them, and with a very generalized education it would be fairly easy or not too difficult to adapt to that specific environment.
Now, when one enters a Paramedic program, they are already setting themselves up to work in a specialized field, pre-hospital emergency care. Now, when one graduates that program, there main knowledge revolves around cardiology, airway, and emergency interventions. It is very difficult for one who has gone to school for such a specialized field to adapt to a whole different concept of thinking. Not saying it can't be done, but in relation RN's get far more generalized education making them more adaptable to field specialization, while Paramedics essentially graduate school with an already set speciality. Or at least, thats how I view it. ^_^

RN's do learn a little bit about a lot of different areas... and follow-on "orientation" teaches them to function in that particular field. Paramedics learn a LOT about a little bit. When they graduate, they're (ideally) almost completely ready to function in the field with little additional training.

I'm still not sure how this in any way justifies the PHRN credential.

I don't see that either...

Then I guess I don't understand your question, like any other certification and credential, it accounts for a specialized field of nursing.

Nursing school does not prepare the Nurse for field work.

What your saying is that RNs should be allowed to fill a role where a provider already exist that is educated in that specialty.

So should we start using RNs to do PT or shoot Xrays next? Surely we could just give them some training and make up a credential....

I think that's exactly what Happy is saying...

I don't think anyone here or the nurses with the certification are attempting to "fill the role" of the Medic. Both the Medic and the Nurse bring a different aspect of health into the picture, PHRN is giving the nurse more training to function in a pre-hospital environment, not replace a Paramedic. Usually, these nurses have ER and ICU experience as well, thought that was worth mentioning.

In most cases that is EXACTLY what a PHRN would do, replace a paramedic. I may bring a different perspective into the ED, yet I'm not allowed to replace an RN.

Like I said, it's not about nurses personally...

Like usalsfyre says: the PHRN usually does replace the Paramedic. The places that I've heard of that use the PHRN has them functioning in exactly the same role as a Paramedic, using the same protocols. Some places require a Nurse to get a PHRN credential to function in the role of a Critical Care Transport RN on a ground ambulance.

Well, like I said, I can only speak from my experience, but if that is the case in some places then that's pathetic. I know many Paramedics who work in the ED, that doesn't mean they are nurses. I know a few Nurses who work in the Ambulance, doesn't mean they are Paramedics.

Your experience may be a little weak in the area of prehospital and interfacility transport then. Most of the Paramedics I've ever heard of working in the ED as Paramedics work in the hospital's ambulance service and are seconded to the ED for additional help there. Otherwise, they're used as ED Technicians, not as a Paramedic in a Paramedic role. Nurses that work the ambulance typically are there doing strictly CCT transport and don't normally get involved in the 911 system. Incidentally, California (for example) requires that there be at least 2 EMT's onboard each ambulance. An RN, even if certified as MICN, does not meet that requirement, so most CCT ambulances have 2 EMT's and an RN on-board. Now if the RN is also certified as an EMT, that would qualify as the 2nd EMT... Flight programs are handled differently. If they weren't... weight could/would quickly become an issue.

 

[Katy]

I have quoted a LOT of posts...

RN's do learn a little bit about a lot of different areas... and follow-on "orientation" teaches them to function in that particular field. Paramedics learn a LOT about a little bit. When they graduate, they're (ideally) almost completely ready to function in the field with little additional training.

This is basically what I just stated.

I don't see that either...

Nursing school does not prepare the Nurse for field work.

I think that's exactly what Happy is saying...

I know it doesn't, this is exactly why they prefer ICU/ER experience and must get additional certifications. And no, it isn't. Read my posts, a PHRN does not replace a Paramedic. I never said it did, never will.

Like usalsfyre says: the PHRN usually does replace the Paramedic. The places that I've heard of that use the PHRN has them functioning in exactly the same role as a Paramedic, using the same protocols. Some places require a Nurse to get a PHRN credential to function in the role of a Critical Care Transport RN on a ground ambulance.

Not from my experience and the people I know, hence why I said "from my experience."

Your experience may be a little weak in the area of prehospital and interfacility transport then. Most of the Paramedics I've ever heard of working in the ED as Paramedics work in the hospital's ambulance service and are seconded to the ED for additional help there. Otherwise, they're used as ED Technicians, not as a Paramedic in a Paramedic role. Nurses that work the ambulance typically are there doing strictly CCT transport and don't normally get involved in the 911 system. Incidentally, California (for example) requires that there be at least 2 EMT's onboard each ambulance. An RN, even if certified as MICN, does not meet that requirement, so most CCT ambulances have 2 EMT's and an RN on-board. Now if the RN is also certified as an EMT, that would qualify as the 2nd EMT... Flight programs are handled differently. If they weren't... weight could/would quickly become an issue.

It is, but where I lack in that area I pick up in others. They do work in the hospitals as techs, which is why I said a Nurse isn't a Paramedic in an ambulance, a Paramedic isn't a nurse in an ED. They aren't used in a Paramedic role because the Paramedic role wasn't designed for in-hospital treatment, or so the reason of the director at a local hospital I know.
But, I"m not going to debate on this further, it is far off-topic.

 

[Akulahawk]

True, to an extent. In a physician, for example, is challenging the paramedic exam (which the only reasons I can think of is for "street cred" and staffing concerns (having 2 medics on the ambulance)), then the preceptorship is to acquaint the physician with the environment, whereas a student needs to be acquainted to both the environment and the medicine.

The main issue, IMHO, would be for staffing. For instance here in California, Title 22 doesn't appear to make any exceptions for non-EMT licensed/certified personnel to staff an ambulance. In effect, a physician or RN licensed persons can't be counted as crew members unless they're also certified/licensed as some level of EMT. For instance, an RN could get an EMT cert and work with an EMT driver and that would be kosher from a crew standpoint. Same with a Physician wanting to (or having to) work on an ambulance.

 

[8jimi8]

What your saying is that RNs should be allowed to fill a role where a provider already exist that is educated in that specialty.

So should we start using RNs to do PT or shoot Xrays next? Surely we could just give them some training and make up a credential....

Don't forget that all of those professions you listed have their roots in nursing. It used to be a nurse pushing all of those buttons, before it was a specialist.


Nurses replacing paramedics?... Well I'm picking up the medic card so no emts will cry if I take their job...


Everyone here knows WHY a nurse can replace an EMT and it is diametrically opposed to why a paramedic can't replace a nurse.



E. D. U. C. A. T. I. O. N. ( or the perception of what each one learns/ how much time was put into it.)


Happy, RN/LPN may not be hired under a lower license. Example: tech earns RN while working in a hospital... Once tech receives license::: poof! no job!


And a side note: ONLY, get your LPN if you plan on workin at an LTAC/Rehab/nursing home. Most LPNs around the country have been offered to upgrade their license or stop working in the hospital.

LPN is a waste of time if you want to be an RN. It is also a waste of time if you want to be a paramedic.

I've seen people work fulltime through both RN and Paramedic school as well.

There is no reason to stop halfway to your RN unless you just can't handle the coursework.

 

[Handsome Robb]

Off topic question, why in the blazes do we as a profession support the PHRN certification? Do you see RNs jumping to support an In-Hospital Paramedic certification?

Please understand this is not sniping at RNs, it's simply the thought we should be protecting our area of practice.

I'm agreeing with this.

Separate environments, separate responsibilities, separate education. Don't try to mix the two.

 

[JPINFV]

Everyone here knows WHY a nurse can replace an EMT and it is diametrically opposed to why a paramedic can't replace a nurse.

You must have missed the "Of course any paramedic can replace a school nurse" thread.

 

[Katy]

You must have missed the "Of course any paramedic can replace a school nurse" thread.

He must have.

 

[Handsome Robb]

Everyone here knows WHY a nurse can replace an EMT and it is diametrically opposed to why a paramedic can't replace a nurse.

I don't. Please enlighten me.

I understand that nurses have a deeper education, but half of an ADN is G. E. N. E. R. A. L. Education. The rest is Nursing specific. So slap some gen ed on a paramedic and we theoretically have the same level of education.... Just specialized.

I like you Jimi and respect your knowledge and ability as a provider, but get off your high horse about nursing education, please.

 

[8jimi8]

You must have missed the "Of course any paramedic can replace a school nurse" thread.

As someone who has seen the didactic for both programs, I am exempt from that thread.

Practically speaking the only thing a paramedic is missing to be an RN is more disease pathology and clinical time taking care of more than one person for 12 hours at a time.


What is a nurse missing from paramedic school? A class on 12 leads and check-offs on a few invasive procedures.


The education is pretty much the same, but being that you can gain entry into an ambulance with a 120 hour course... Oh and a few decades worth of lobbyists....

....That's why nurses are keeping medics down... The entry level of education and political clout.

 

[8jimi8]

I don't. Please enlighten me.

I understand that nurses have a deeper education, but half of an ADN is G. E. N. E. R. A. L. Education. The rest is Nursing specific. So slap some gen ed on a paramedic and we theoretically have the same level of education.... Just specialized.

I like you Jimi and respect your knowledge and ability as a provider, but get off your high horse about nursing education, please.

Lol... High horse...

You completely missed some of what I wrote.

Go back and keep reading, then maybe you'll realize you aren't upset with me at all. High horse... Lol...

 

[usalsfyre]

As someone who has seen the didactic for both programs, I am exempt from that thread.

Practically speaking the only thing a paramedic is missing to be an RN is more disease pathology and clinical time taking care of more than one person for 12 hours at a time.


What is a nurse missing from paramedic school? A class on 12 leads and check-offs on a few invasive procedures.


The education is pretty much the same, but being that you can gain entry into an ambulance with a 120 hour course... Oh and a few decades worth of lobbyists....

....That's why nurses are keeping medics down... The entry level of education and political clout.

Jimi, I think you kinda see my point. It's not that I don't think there's a subset of nurses who couldn't function effectively in the out-of-hospital acute care environment (indeed many already do) just as I think there's a subset of paramedics who could function effectively in an ED or ICU.

My thought has more to do with protecting whatever small niche we have carved out.

 

[Shishkabob]

I never quite got why some people thought a new grad nurse was more capable of learning OTJ than a Paramedic.

 

[Akulahawk]

Jimi, I think you kinda see my point. It's not that I don't think there's a subset of nurses who couldn't function effectively in the out-of-hospital acute care environment (indeed many already do) just as I think there's a subset of paramedics who could function effectively in an ED or ICU.

My thought has more to do with protecting whatever small niche we have carved out.

No new grad nurse that I know of can function effectively in the ED or ICU without having a fairly extensive orientation to that environment. I would expect that a Paramedic, even though their training is quite specific, would still have to go through a somewhat modified version of the ED or ICU orientation course before they could be ready to function safely in those environments.

While I'd be OK in the prehospital environment, I have no illusions about my ability to function as well in the ED on my own, with my own patients. In that environment, at this point, I'd suck...

 

[Shishkabob]

While I'd be OK in the prehospital environment, I have no illusions about my ability to function as well in the ED on my own, with my own patients. In that environment, at this point, I'd suck...

But the true question is, is that due to your 'lack of education' as a Paramedic, or just like a new grad nurse, lack of experience in that area?



I'm of the firm belief that new grad Paramedics can be as good as (if not better) than new grad nurses in certain areas of the hospital that can benefit from their specialization, like the cath lab.

 

[8jimi8]

No new grad nurse that I know of can function effectively in the ED or ICU without having a fairly extensive orientation to that environment. I would expect that a Paramedic, even though their training is quite specific, would still have to go through a somewhat modified version of the ED or ICU orientation course before they could be ready to function safely in those environments.

While I'd be OK in the prehospital environment, I have no illusions about my ability to function as well in the ED on my own, with my own patients. In that environment, at this point, I'd suck...

6 months would make any paramedic golden, as long as they were willing to go home and read a med/surg book on the different disease pathologies encountered.

As i said previously, the courses are almost exactly the same. What the paramedic would be shocked to find is that most of their invasive procedures would now only be the realm of attendings and their doclings.

 

[jjesusfreak01]

What the paramedic would be shocked to find is that most of their invasive procedures would now only be the realm of attendings and their doclings.

You're telling me you've never seen an RN or ER Tech intubate or do an EJ in the ED??? Not even a crich?