Paramedic school vs Nursing school

[Akulahawk]

Yeah, in my area. Amr starts off at 40k/year fresh outta medic school. With 2 years exp its 45k after 4 years its 48k then 50k after 5 years. Plus they give bonus pay for like hazmat and extra certs.

40k is big ballin where I live. Not much I wouldn't do for that type of money.

I'm going to compare something for you... I don't work for anywhere near good pay as a nurse in the area. In fact, I make about $8 less than the average. My starting annual salary was "only" about 74k and I just received a slight bump in my base pay (I'm still at the bottom) and now gross around $81k. The lowest annual salary where I live brings in around $89k. SoCal is a very tight market for nurses, lots of them and few spots. Down there they can expect a salary between $52k and $59k. That's starting... and no OT figured in this, with 36 hrs/week for 12 hour shifts. If I worked a 40 hr work week at my current hourly wage, I'd make just around $90k/year gross.

Generally speaking, you have to be a firefighter to approach or exceed what I make. Incidentally, around here, even the firefighter base salary doesn't approach this, though once they're OK to accept OT shifts, it becomes very easy to blast well past my salary. Just 15 years ago there were some Firefighters, not AO's or Captains, that made >$100k/yr....

 

[beaucait]

A lot of people end up running 2 or 3 jobs just to support themselves. My instructor does shifts on the weekend as a paramedic, and also controls all of the education in the whole system.

 

[Chewy20]

A lot of people end up running 2 or 3 jobs just to support themselves. My instructor does shifts on the weekend as a paramedic, and also controls all of the education in the whole system.

Shouldn't have to work more than one job to make ends meet. Jus sayin.

 

[Summit]

One of the hospitals I work at just raised the pay for a new BSN to 72K, before night and weekend differential. New Paramedics in the area are making $15-18/hr...

 

[Akulahawk]

One of the hospitals I work at just raised the pay for a new BSN to 72K, before night and weekend differential. New Paramedics in the area are making $15-18/hr...

This is why we're suggesting that if someone is considering nursing school vs paramedic school, we suggest nursing school. It's just plain tough to make it on $15-18/hr unless you're very good at budgeting and/or you've got someone else also making about that much in your household.

Is nursing school hard? Yes. Is Paramedic school hard? Yes. In terms of difficulty, they're about the same. The thought process behind the two are very different though. Why then do nurses have a "better" education than Paramedics? Simple. They have extensive, college-level prerequisites. In short, the "generic" nurse has a broader education in human anatomy, physiology, psychology, growth & development, nutrition, research, and the like than the "generic" paramedic does at the first day of formal schooling.

 

[Tigger]

I cannot fathom why every single time this question comes up in these forums we immediately shoot down the potential EMS career aspirations of anyone who asks. There's eating your young, and then there's eliminating your future generation while they are still fetuses and ensuring you are the last of a breed at the brink of extinction.

Realism is great as is looking at both careers with an open mind, but are we really all so disillusioned that we can't even recommend a two year educational commitment for someone who is potentially interested?

Everyone has their own opinions reflective of their life, their area, and their job. There are benefits and of course cons to either path. Overall, I agree that nursing certainly gives more career flexibility and better long term job prospects, but there is absolutely nothing wrong with pursuing a career in EMS.

Locally, I earn the same per hour as my RN roommate who works at a local hospital. I have a better schedule, better benefits, better job security, educational assistance, a more defined path for advancement, and a fully funded non contributory pension. Additionally, I get way more vacation, and only have to use 48 hours of paid vacation to get 12 days off in a row. I also think my time at work is much more enjoyable, at least from my perspective. I have a lot of autonomy to do what I want, work in a station, run only ALS 911 calls, and often sleep for the majority of my night shifts, none of which is possible as an RN working in a hospital. For a bit of perspective, we currently have 4 active RNs who are choosing to work at or department as a paramedic instead of getting a nursing job. To be fair, we also have several former medics who have left to work as RNs.

I understand that modern nursing is a very fulfilling career and there are certainly many components of advanced practice nursing and non standard jobs that are very appealing to me. I would wither and die as a floor nurse though. There's a lot to be said for "just get through the hoops of nursing school" and then following those opportunities, but I don't regret going through paramedic school for a moment. Happiness matters, and for me, paramedicine is what I want to do at this stage of my life.

Thank you.

Paramedics and nurses do not do the same things. I am tired of the forced comparison between the two fields. Two jobs with two different educational slants that focus on different goals. And there is nothing wrong with that. Yet we insist on comparing the two and I just cannot figure out why that is.

 

[STXmedic]

Thank you.

Paramedics and nurses do not do the same things. I am tired of the forced comparison between the two fields. Two jobs with two different educational slants that focus on different goals. And there is nothing wrong with that. Yet we insist on comparing the two and I just cannot figure out why that is.

When nursing is compared to paramedicine, many medics picture ER/ICU nursing. Other than us driving an ambulance and having to hang out in people's smelly, cockroach-infested houses, and nurses having longer times with the patients, what's the difference? We both practice medicine under standing or direct orders of a physician. Some RNs do have a bit less autonomy than a paramedic, but others can be significantly more autonomous. I've never personally worked as a nurse, but my wife is an ICU nurse, and almost all of our friends are nurses either in the ICU or ED- including many who made the switch from paramedic (including my wife). Those that made the switch seem to think it's pretty damn similar; do you have some better insight than they do?

 

[Chewy20]

Thank you.

Paramedics and nurses do not do the same things. I am tired of the forced comparison between the two fields. Two jobs with two different educational slants that focus on different goals. And there is nothing wrong with that. Yet we insist on comparing the two and I just cannot figure out why that is.

What are the different goals?

 

[Tigger]

What are the different goals?

The more time I spend in the ED, the more I realize that patient care is carried out by the nursing staff. But even in a high functioning ED, the doctor is still the one calling the shots, and a good nursing team implements that super efficiently while also filling in the smaller details that the doc missed.

Meanwhile for us on the ambulance, we make and implement our own plans. This is not a dig on nursing. I have no doubt that ED RNs require minimal direction, but that's not their educational goal it seems.

 

[SpecialK]

Broadly, a Registered Nurse treats people whereas a Doctor (or for the matter, a Paramedic) focusses on disease.

For example, pneumonia might be the patient's diagnosis. The doctor comes along and prescribes antibiotics appropriate for the situation and other medications (or whatever). The Registered Nurse is going to focus on ensuring the patient understands the necessity of adequate tidal volume and cough, getting them up and out of bed as early as possible, doing breathing exercises etc i.e. about helping them understand the impact of the disease they have and what they can do to restore their health as best they can from it. Physiotherapist might come along once the Nurse has gotten the patient up and ot of bed and do more physiotherapy-specific things with them.

This is a very broad example specific to a particular situation; but in general the difference is a Registered Nurse is not as concerned with making a medical diagnosis and determining medical treatment, that is the medics job. They must understand various elements of medicine but do not have the breadth and length of diagnostic training because it is not required. There is some of the same clinical decision making overlap between medicine, nursing and paramedic - for example titration of intravenous morphine (whether it is prescribed by a doctor or administered under a standing order by paramedics).

As a Registered Nurse on a medical ward or in ED, ICU or CCU you are going to learn far more due to exposure and constant collegial contact with a range of health professionals than you ever would as a Paramedic.

If it sounds like I know what I am talking about it's because I did some nursing in my younger days. Some of the best people I worked with were ICU nurses who ave long forgotten more than I'll ever know.

 

[Summit]

The more time I spend in the ED, the more I realize that patient care is carried out by the nursing staff. But even in a high functioning ED, the doctor is still the one calling the shots, and a good nursing team implements that super efficiently while also filling in the smaller details that the doc missed.

I think this depends because there are plenty of EDs where the RNs have a massive standing protocols they can implement with not much more physician involvement than the equivalent of a call to med control (not with the level of indepence a progressive EMS systems offers as that would be silly in an ED, but often with more flexiblity in treatment options). These tend to be highly collaborative care environments too and it is a lot easier for a RN to decide on a modified treatment plan and get it approved than for EMS to deviate from the protocols by calling medical control. The final call falls to the MD. Other EDs operate more like the EMS equivalent of a "mother may I system."

Broadly, a Registered Nurse treats people whereas a Doctor (or for the matter, a Paramedic) focusses on disease.

I truly detest this line because in the US it is usually parroted as feel good nonsense by academics or RNs who aren't in clinical roles (or lower acuity care) who want to aggrandize RNs reputation or otherwise assuage their insecurities. I know you don't mean it how they do, but I still don't quite agree with the middle portion of your statement, especially from the US ICU point of view where understanding the medical treatment and diagnosis in as much detail as possible is of paramount importance.

 

[gotbeerz001]

Broadly, a Registered Nurse treats people whereas a Doctor (or for the matter, a Paramedic) focusses on disease.

Yeaaaaahhhh, no points for this. Do you also believe that "good EMTs save paramedics"?

 

[Carlos Danger]

Broadly, a Registered Nurse treats people whereas a Doctor (or for the matter, a Paramedic) focusses on disease.

I truly detest this line because in the US it is usually parroted as feel good nonsense by academics or RNs who aren't in clinical roles (or lower acuity care) who want to aggrandize RNs reputation or otherwise assuage their insecurities. I know you don't mean it how they do, but I still don't quite agree with the middle portion of your statement, especially from the US ICU point of view where understanding the medical treatment and diagnosis in as much detail as possible is of paramount importance.

I haven't heard it put that way in a long time but when I think about it, to me it is a pretty good way to describe what nurses do vs. what physicians do. It's not a complete or perfect explanation of course, but I think it summarizes the essence of the difference in roles as well as any pithy statement can.

As all us nurses know well, we do focus on care of the patient, rather than just diagnosis and management of the disease, which is what physicians focus on. Obviously there is some overlap there, and nurses are heavily involved in disease management as well. Being the ones constantly in contact with and assessing the patient and carrying out the medical orders, of course we need to know quite a bit about the relevant pathophysiology and pharmacology, as well.

 

[Bullets]

I would echo everyone else in regards to a BSN, my local hospital system only hires BSN, even for floor spots. I already had a BA so i applied to a BA to BSN bridge and a medic program at the same time. I was accepted to both but found out that the RN school was about to loose its certification, So i went to the paramedic school and am almost finished. I took all the prereqs for nursing school so paramedic school was incredibly easy. The nice thing is all these clinical hours put me in position to meet the requirements for the PA school at the local university, so i am going to go that route.

But EMS is where my heart really is and i think were building something great here. We've been developing an EMT based community medical service where our EMTs go visit new discharges within the community to help reduce readmissions at the ER, we have introduced the Rescue Task Force model to a consortium of local PDs in response to active shooters, we have integrated our senior center and EMS under one department, so our services work hand in hand to deliver better comprehensive care to a large senior community. There are plenty of opportunities in EMS to do new stuff. 6 years ago i would never guess a bachelors of history would lead to having my name on any of that stuff. I could never imagine. I know that as a municipal 911 agency we have a little more money and politicians love to put their names on this kind of stuff but opportunities are out there, you just have to find them

 

[ICUmurse]

So I am a nurse in a high volume trauma ICU at a large level 1 trauma center. I have gone back to get my EMT (I completed a full EMT program) and will be going back to get my Paramedic Cert via a bridge program. The reason I'm doing this is to get field experience to fly. I can tell you from experience that having that ICU experience is very valuable when going through my EMS training. In the ICU you have a large amount of autonomy and work mostly off of protocols (we don't have a physician nearby). On top of that you are regularly titrating drips and working on very unstable patients. You gain a significant understanding physiology. If you become a nurse and then work through a bridge program to Medic you will excel in both areas. The best nurses I've known were both nurses and paramedics with field experience.

 

[medicaltransient]

Nurse, better pay better hours. I like the work I do but I regret being a paramedic.

 

[SpecialK]

Yeaaaaahhhh, no points for this. Do you also believe that "good EMTs save paramedics"?

What do you mean?

As all us nurses know well, we do focus on care of the patient, rather than just diagnosis and management of the disease, which is what physicians focus on. Obviously there is some overlap there, and nurses are heavily involved in disease management as well. Being the ones constantly in contact with and assessing the patient and carrying out the medical orders, of course we need to know quite a bit about the relevant pathophysiology and pharmacology, as well.

Yes, I very much agree.

In the ICU you have a large amount of autonomy and work mostly off of protocols (we don't have a physician nearby)

Now that is different. Our large tertiary ICUs are staffed by a Consultant Intensivist until at least 2300 each day and there will always be a Senior ICM Registrar as well, and they are really not physically allowed to leave the unit. Isn't that the entire point of an ICU? To have expert medical and nursing staff readily available?

 

[ICUmurse]

Now that is different. Our large tertiary ICUs are staffed by a Consultant Intensivist until at least 2300 each day and there will always be a Senior ICM Registrar as well, and they are really not physically allowed to leave the unit. Isn't that the entire point of an ICU? To have expert medical and nursing staff readily available?

We have an ICU doctor in house, however he/she is covering 4 different ICUs that make up 60 plus ICU beds and any pulmonary step down patients in the hospital. Due to this we have a large amount of autonomy. I know this is not this way everywhere. I have even seen some units staff an ICU trained NP in the unit for a 12 hour shift and you have to go to them to get an order to start a foley. My point was simply that having that core critical care training is very helpful in EMS. If you've been able to stabilize a multitrauma pt that is on pressors, sedation, paralytics, CRRT, ICP monitor, etc for 12 hours...when you're alone in the back of a flipped car trying to RSI someone it'll just make you stronger.

 

[EOPFD]

Go to nursing school.. More money, more options (you can be a EMS specific type nurse) LOL do the same thing as a medic for 3x the $$$$$$.....There's a reason they have bridges from Medic to Nursing and not vice versa! Good luck either way

I am currently enrolled in medic school in NY
Do you know any medic to RN bridge programs?

 

[Tigger]

When nursing is compared to paramedicine, many medics picture ER/ICU nursing. Other than us driving an ambulance and having to hang out in people's smelly, cockroach-infested houses, and nurses having longer times with the patients, what's the difference? We both practice medicine under standing or direct orders of a physician. Some RNs do have a bit less autonomy than a paramedic, but others can be significantly more autonomous. I've never personally worked as a nurse, but my wife is an ICU nurse, and almost all of our friends are nurses either in the ICU or ED- including many who made the switch from paramedic (including my wife). Those that made the switch seem to think it's pretty damn similar; do you have some better insight than they do?

I don't doubt that many nurses are more than capable of managing their patients nearly autonomously. It seems to me though that the goal of a paramedic education is to be more targeted. I think my program casts a much wider net in terms of education on diseases that we encounter than most, but at the end of the day we are taught to perform treatments that are realistic for our environment. The nursing education (at base) to me appears to provide a much better foundation, but most ED nurses have told me that they feel useless for the first year in the ED until they can get some OTJ training that is specific to their role. Our education is specific to our role and while I know I have a lot to learn once I finish, at the very least I could function on my own at the completion of the program.

I guess that's what I mean by different goals. I have nothing against nursing but think that that sort of track isn't for me. I want to know what will make a direct impact on my care, and a very broad curriculum isn't necessarily practical for EMS. There's a limit to what we can do, let's make sure we're awesome at that.