Nurses vs EMT/Paramedics in EMS

[harold1981]

In my country a choice has to be made whether to continue with a nurse-based ambulanceservice or to start with a EMT/paramedic-based EMS-system. Can anyone give me good arguments why EMT/paramedics would be better than nurses (with ED or ICU-background)?

 

[TransportJockey]

I'd say go with the Nurses unless you are planning on having your medics trained to the level of medics in places like Australia or New Zealand. The system we have in the US is very flawed and I'd say do not go with anything like it.

 

[adamjh3]

CCT/RN will pay way better than any Paramedic job.

 

[RCashRN]

i dont know where you live, but i think pre-hospital treatment is for EMT's/paramedics and not nurses. nurses aren't (usually) geared for the initial, acute onset treatment... we're geared more for the stabilization and focused care, initiation of longer-term care. you take your typical ER nurse, or even more so ICU nurse, and set them down in the middle of a multi-vehicle accident and they're gonna freak out and/or freeze up. even being halfway through my testing i can tell you the first few chaotic scenes i go to, i dont know how i'm going to handle it. paramedics are trained for it from the onset where nurses arent.

 

[TransportJockey]

It was thought over at the city that the OP is in Holland. Where their EMS is run by CCRNs

 

[RCashRN]

It was thought over at the city that the OP is in Holland. Where their EMS is run by CCRNs

hmm wow. i would think a CEN would be better suited than a CCRN, unless the CEN's and lumped in with the CCRN's. things are surely much different there, but i just dont see most nurses as being able to handle a mass-casualty incident without some degree of difficulty. not initially, anyway... i'm sure it would get better over time... but green medic vs. green nurse... i'd rather have the green medic at a MCI.

 

[Shishkabob]

Depends wholly on the education.


If they are all educated the same, there is no reason one or the other can't work in the hospital or pre-hospital setting... it's just what they're used to.

Generally it does take a different set of skills / mentality to work in the field then in the ER. It tends to be up to the person and not the education that makes that determination though.

 

[8jimi8]

i dont know where you live, but i think pre-hospital treatment is for EMT's/paramedics and not nurses. nurses aren't (usually) geared for the initial, acute onset treatment... we're geared more for the stabilization and focused care, initiation of longer-term care. you take your typical ER nurse, or even more so ICU nurse, and set them down in the middle of a multi-vehicle accident and they're gonna freak out and/or freeze up. even being halfway through my testing i can tell you the first few chaotic scenes i go to, i dont know how i'm going to handle it. paramedics are trained for it from the onset where nurses arent.

And this is exactly why I am taking a paramedic course rather than challenging.

 

[TransportJockey]

hmm wow. i would think a CEN would be better suited than a CCRN, unless the CEN's and lumped in with the CCRN's. things are surely much different there, but i just dont see most nurses as being able to handle a mass-casualty incident without some degree of difficulty. not initially, anyway... i'm sure it would get better over time... but green medic vs. green nurse... i'd rather have the green medic at a MCI.

A lot of the CCRNs I know at the hospital I worked at started as CENs, so it might be something similar there

 

[8jimi8]

however I would like to add to the conversation.

If the RN has been properly trained and has practiced alongside other emergency workers such as fire crews / other EMS, they can do just as good of a job as a paramedic (NOTE I SAID WITH MORE TRAINING)

You see for me, I have the educational background to understand and incorporate new procedures; however the reciprocal jump from EMT to RN, I don't feel would be an equivalent conversion... (based on what I have seen of two different EMT programs ... my basic and my intermediate)

Perhaps when i take Paramedic 2 (a different program altogether from where I have been studying) I will see a more stringent educational basis, being that this will be from a very well reputed land based program.

When you get down to it, the didactic material is less than what I received as a nurse, just a few different skills. The priniciples are the same ABCs, eliminate life threats, prioritization of a rapid transport to a facility with definitive care.

 

[RCashRN]

And this is exactly why I am taking a paramedic course rather than challenging.

wish i could've afforded that option, but couldn't. fortunately, the EMS service that serves the hospital i work at is one of the tops services in the state... if they'll hire me, i plan on doing lots of ride time and learning before jumping into being primary "P" on the truck.

 

[8jimi8]

what about when your partner needs another EMT-P, isn't it unfair for your to assume that it is ok for you to not be bringing the necessary training to the equation of the partnership?


Please do not take this as an inflammatory personal attack. RCashRN has more experience as an RN than I do... possibly more education as an RN (sorry havent read your profile recently and not sure if you are a BSN).

My goal is to fly as an RN. I know what the industry standards are for minimum entry level into that field. I exactly do not want to be a flight RN with zero scene experience.

Sure it is a financial burden and a burden on so many other parts of my life; however I refuse to show up to do a job without the necessary preparations.


What is the situation in California? I've seen many people talking about RNs riding rigs, is this only for interfacility transport, or is it as 911 EMS?

 

[ExpatMedic0]

Ummm.... Paramedics! thats what we are for. As I have stated before the minimum education level for RN and Paramedic are the same in my state at the community college level. Both require an AAS, all the same basic education classes and science classes, HOWEVER one is trained only for pre-hospital care and emergency's as a Paramedic, the nursing program is completely different with complete different content and overall objectives.

The only problem with Paramedics in the U.S. is that the training and education varys to much from state to state.

 

[ExpatMedic0]

PS: no offense to nurses, there great and do a great job and have a lot of training, more so than paramedics in most states... but I would never let one touch me outside of a hospital in an emergency unless they where a very experienced ED nurse

 

[eveningsky339]

If the RNs are given courses in pre-hospital medicine, sure, they would be better. But paramedics are already trained specifically in that area, so a paramedic system would be simpler and, frankly, more effective.

Can you imagine sticking a nursing home RN on an ambulance? Yeah, no.

 

[adamjh3]

What is the situation in California? I've seen many people talking about RNs riding rigs, is this only for interfacility transport, or is it as 911 EMS?

When I did my Ride-along for my EMT class we did five CCT transfers, we would rendevous with an RN, they'd bring their EKG, drug bag, vent, etc., etc., and drop it in the rig, then they'd handle most of the medical side of the transfer, while we did the lifting and grunt work. I know they can do way more than that, but that's just the scope that I've seen them in in my EXTREMELY limited time in the field.

I'm looking forward to hearing about what else an RN can do in the field, as one of the ones I got the chance of working with definitely got the wheels up in my head turning, thinking that might be the route I want to take.

 

[mycrofft]

Training, speed and money

EMT's (that included Paramedics at the time; still does) were invented here to quickly upgrade the availability in the early Seventies onwards of some sort of improved quality of immediate care and transport.
Fast and economical: EMT/Paramedic.

RN's if trained are capable but you will need to train them up from scratch, mostly. Some you will recruit. Takes longer to do, but you can get a greater depth of knowledge and care.

If you want to essentially do "house calls" and not just prepare and transport, maybe you want nurses, but the expense and time factors will be quite a bit higher. "EMT" and "Nurse" are not different ruings on the same ladder, they are very different here in the USA; being just titles, you can make either what you want of them, given time.

 

[8jimi8]

If the RNs are given courses in pre-hospital medicine, sure, they would be better. But paramedics are already trained specifically in that area, so a paramedic system would be simpler and, frankly, more effective.

Can you imagine sticking a nursing home RN on an ambulance? Yeah, no.

So are you working with LVNs or RNs in your nursing home?

because there is quite a difference.

 

[EMSLaw]

So are you working with LVNs or RNs in your nursing home?

because there is quite a difference.

A difference in the scope of practice, certainly, and the level of responsiblity. A major difference in academic preparation when comparing a BSN- or MSN- prepared RN to an LVN/LPN.

But skills degrade over time, and I think that, rather than the education of the provider in question, is the biggest problem I've seen with nursing home staff. Most of them are hard working and well meaning, but they simply don't spend enough time responding to emergencies to remember (because I'm sure they do know, or did) what they're supposed to do.

 

[John E]

or even...

If the RNs are given courses in pre-hospital medicine, sure, they would be better. But paramedics are already trained specifically in that area, so a paramedic system would be simpler and, frankly, more effective.

Can you imagine sticking a nursing home RN on an ambulance? Yeah, no.

Can you imagine sticking an EMT into a nursing home...?

John E