PHRN transfer to EMT-P in other states?

[Summit]

And how many nurses have experience with the same exact things before they're out in the workforce and taught it? Your point proves nothing.

Because Paramedics can't do that stuff? Because Paramedics are somehow unable to learn on the job the same way nurses are? Ok...

Nurses don't know anything until they're taught it. Same as Paramedics. Same as every other provider. Quit acting like nurses are an exception.

Hey, its all about the skills and that's just OJT! Why do people go to medic school. Medics don't know anything until they are taught, so why not just give EMTs OJT?

The interventional radiologist and the cardiologist don't want an OJT trained technician. If they did, then they would train paramedics for the cath lab!

The difference is the broad collegiate foundation that nurses receive in both medical and general education from graduate prepared professors vs paramedic technical training from peers. I pointed this out, as did veneficus.

It is clear that you don't have any regard for the merits of a liberal arts education, so my words mean nothing to you. Perhaps this reality will mean something: If paramedicine was a bachelors-as-entry-to-practice, as it is in other countries, this thread wouldn't exist, I'd be a paramedic, and maybe pay would be equal!

I deal with a wider variety of providers at a wider variety of locations than someone that works in a single facility, typically at a single place, like you do. No? There are crappy facilities with crappy people, there are great facilities with great people.

When you assume...
I work at one hospital, volunteer at two ems agencies, teach for an ems agency and a school, interact with another ems agency and another hospital. There are great and crappy providers of all persuasions, but I don't go out of my way to point out the negatives experience with one type.

As a new EMT, I had a crappy opinion of nurses for a year or two because that was the attitude of my first EMS mentors, and some people on this forum. I spouted the same crap I see here still: nurses only follow orders, nurses don't know how to care for critical patients or handle emergencies, yada yada yada. I didn't know any better until another job where I worked closely with nurses.

At the same time I came to understand the limitations of EMS education and professional progression. If EMS was set up as a profession like nursing, or like EMS in other countries, I never would have gone to nursing school.

 

[Aidey]

Lets keep this from descending purely into nurses vs paramedics ok?

 

[Shishkabob]

but I don't go out of my way to point out the negatives experience with one type.

When we're discussing just one type, you want me to bring up experiences totally unrelated to the discussion at hand?

I spouted the same crap I see here still: nurses only follow orders, nurses don't know how to care for critical patients or handle emergencies, yada yada yada

I don't spout that off because I know that's not (all) true*. I spout off personal experiences, but alas even that isn't good enough for you. Can't be a general, can't be specific. Guess we're just supposed to not say anything, huh?





*Actually, it is: Nurses only follow orders, just like medics. Certain nurses can't care for ciritical patients, just like certain medics can't care for the chronically ill. Etc etc etc. But you're the one generalizing, not me.

 

[ExpatMedic0]

Ok... I've had my fun with the nurses. I will never see completely eye to eye with everyone on "the other side."
I think however we all agree there should be a bridge for both sides, for the medic if its a state which requires at least an AAS then the medic should hold that but still be allowed to bridge (which already exist in many states) However, nurses should have to do the same unless the RN has 1100 clock hours in "Pre-Hospital Emergencies" that meets something like the DOT and NREMT course curriculum. Nursing school and Paramedic school are two different things, two different jobs, with 2 different goals. A Paramedic is not only a specialist in Emergencies, but emergencies that happen outside of a hospital.

 

[Veneficus]

Ok... I've had my fun with the nurses. I will never see completely eye to eye with everyone on "the other side."
I think however we all agree there should be a bridge for both sides, for the medic if its a state which requires at least an AAS then the medic should hold that but still be allowed to bridge (which already exist in many states) However, nurses should have to do the same unless the RN has 1100 clock hours in "Pre-Hospital Emergencies" that meets something like the DOT and NREMT course curriculum. Nursing school and Paramedic school are two different things, two different jobs, with 2 different goals. A Paramedic is not only a specialist in Emergencies, but emergencies that happen outside of a hospital.

I think 1100 is a bit much considering paramedics do not have such hours. Like I said in the other thread, other healthcare providers do not need to hear the basic anatomy, physiology, and pathophys that is part of that 1100 hours.

 

[ExpatMedic0]

I think 1100 is a bit much considering paramedics do not have such hours. Like I said in the other thread, other healthcare providers do not need to hear the basic anatomy, physiology, and pathophys that is part of that 1100 hours.

I suppose your right about that, I forgot some states do not require A&P as a pre-rec. WA state does or at least where I was and Oregon requires(or at least use to) the whole series. I can not comment on every state, but as a national standard you are correct it is part of the 1100 I guess.

 

[EpiEMS]

How about just let RNs bridge if they've taken an EMT course and complete a EMT-P refresher course (and NR, I suppose)? Not a lot of hours there, but it allows for training of core areas, no?

 

[Veneficus]

How about just let RNs bridge if they've taken an EMT course and complete a EMT-P refresher course (and NR, I suppose)? Not a lot of hours there, but it allows for training of core areas, no?

I do not agree.

I think the EMT-B should be a prereq to any bridge.

The 2 things nurses need to bridge are medic skills training and supervised out of hospital clinical time as the primary decision maker.

A refresher will not provide adequete time for skills like intubation, comfort with things like ACLS, familiarity with the medications, or field experience.

I would not advocate for any program that did not include ride time.

I would also add ED time to that if the nurse did not have prior work experience or clinical time in the ED.

I would not accept only ICU time because one of the most important skills is "sick/not sick" and there aren't many "not sick" people in the ICU.

 

[EpiEMS]

I do not agree.

I think the EMT-B should be a prereq to any bridge.

The 2 things nurses need to bridge are medic skills training and supervised out of hospital clinical time as the primary decision maker.

A refresher will not provide adequete time for skills like intubation, comfort with things like ACLS, familiarity with the medications, or field experience.

I would not advocate for any program that did not include ride time.

I would also add ED time to that if the nurse did not have prior work experience or clinical time in the ED.

I would not accept only ICU time because one of the most important skills is "sick/not sick" and there aren't many "not sick" people in the ICU.

I see what you're saying. So, beyond the EMT cert, a Medic bridge program of several hundred hours (including ride time) would be enough?

 

[Veneficus]

I see what you're saying. So, beyond the EMT cert, a Medic bridge program of several hundred hours (including ride time) would be enough?

That is how the math works out:

http://www.emtlife.com/showthread.php?t=33957&highlight=stupid+nurses

 

[EpiEMS]

That is how the math works out:

http://www.emtlife.com/showthread.php?t=33957&highlight=stupid+nurses

Seems fair. (Not that I am either an RN or a medic.)

 

[JPINFV]

Since this thread came up...

There's always a problem when it comes to bridging, and even more so, when it comes to giving straight equilivance. The question is, "How close are the fields?" Just comparing education level and foundation isn't enough. For the nurses, do you think a physician should be able to be hired on to act as a nurse without any additional education or training? After all, a physician is much highly trained and educated than the average nurse. Alternatively, is the practice of medicine and the practice of nursing a significant enough divide that just OTJ training isn't enough?

Similarly, is the divide between paramedicine and nursing facing a similar divide where a formal bridge course should be required to work in EMS?

 

[Handsome Robb]

Since this thread came up...

There's always a problem when it comes to bridging, and even more so, when it comes to giving straight equilivance. The question is, "How close are the fields?" Just comparing education level and foundation isn't enough. For the nurses, do you think a physician should be able to be hired on to act as a nurse without any additional education or training? After all, a physician is much highly trained and educated than the average nurse. Alternatively, is the practice of medicine and the practice of nursing a significant enough divide that just OTJ training isn't enough?

Similarly, is the divide between paramedicine and nursing facing a similar divide where a formal bridge course should be required to work in EMS?

In my opinion, yes.

Having general education plus nursing education either at the ADN or BSN level doesn't qualify you to automatically jump on a truck and act as the ALS provider in charge.

The argument keeps coming up that EMT-B should be sufficient to transition but I personally don't agree.

I know that I have no business challenging the NCLEX, walking into an ER or ICU, tossing on a pair of scrubs and jumping into a nursing roll. They're two different fields. They have their similarities but there has to be a bridge program if you're wanting to transition from one to the other.

I have no issue with a nurse taking an appropriate bridge course with an ALS internship just like any other paramedic student then being allowed to challenge the NREMT-P. I'd argue they need to do OR rotations as well and depending on what kind of nursing they've been doing potentially ER/ICU/CIC rotations as well. If they work in those settings I'd have no problem having experience meet that requirement. With that said, it needs to be a two way street. I'm not advocating that a paramedic be allowed to challenge the NCLEX but why would it be inappropriate for a AAS/BS Paramedic taking a bridge course with some clincals as well then being able to challenge the NCLEX and not be viewed as an "inferior" nurse?

Just for :censored::censored::censored::censored:s and giggles I did the math on my education hours the other day.
With EMT-B, I, and P I'm sitting at 1950 hours of prehospital education (EMT-B was 200, EMT-I was 250 and Medic was 1500), not including the smattering of general education classes I've taken at the CC and University level. Where does that fall when compared to nurses? I'd be willing to bet that it's just as much if not more than most ADN programs. Add in the prerequisite general education and sciences BSNs are required and I'm sure we're just about dead even. My google-fu is failing me when I try to find out total clock ours for ADN and BSN, just keep getting the credit hour requirements.

I just don't understand how nurses think they can challenge our exam then can run the show...every nurse that's every done a ride along with me for either EMT class or for fun has told me they were completely lost on scene as to what was going on and how to manage things. Now this is anecdotal but I think it's a pretty solid example. All of this can be fixed with an appropriate bridge course but thinking they can just jump in the ring and box is disrespectful, in my opinion.

 

[VFlutter]

Just for :censored::censored::censored::censored:s and giggles I did the math on my education hours the other day.
With EMT-B, I, and P I'm sitting at 1950 hours of prehospital education (EMT-B was 200, EMT-I was 250 and Medic was 1500), not including the smattering of general education classes I've taken at the CC and University level. Where does that fall when compared to nurses? I'd be willing to bet that it's just as much if not more than most ADN programs. Add in the prerequisite general education and sciences BSNs are required and I'm sure we're just about dead even. My google-fu is failing me when I try to find out total clock ours for ADN and BSN, just keep getting the credit hour requirements.

Eh, adding in the EMT-I is a little redundant since you could have gone right from EMT-B to EMT-P and it does not add anything that was not covered during your paramedic course. That would be like me going from CNA to LPN then BSN and claiming that I had more education then other BSNs because of the hours from the CNA and LPN when in reality all of that was covered in the BSN program. More experience maybe but education no.

My BSN was ~ 125 credit hours. According to google 1 credit hour = 18 class hours so that would come out to 2,250 hours.

But comparing straight hours is worthless. You can not compare vocational hours to college credit hours.

200 hours of EMT-B is not equal to 200 hours of university course work.

My science labs alone add up to over 200 hours.

1 hour of sitting in an EMT class learning about how blood flows through the heart is not equal to 1 hour of anatomy lab dissecting a heart.

I just don't understand how nurses think they can challenge our exam then can run the show...every nurse that's every done a ride along with me for either EMT class or for fun has told me they were completely lost on scene as to what was going on and how to manage things. Now this is anecdotal but I think it's a pretty solid example. All of this can be fixed with an appropriate bridge course but thinking they can just jump in the ring and box is disrespectful, in my opinion.

While some may argue differently it seems that many of the RNs that come to this site, including me, do not hold the view that we can challenge the exam and jump right on the truck. The majority are looking for some type of bridge program and usually are seeking Flight or CCT jobs. Even my arrogant self will admit that I could not jump on the truck today and function as an independent paramedic. But I am confident it would not take me much to get there, definitely not an entire paramedic program.

 

[VFlutter]

As far as prerequisites go here is my school's requirents

Minimum 3.0 cumulative undergraduate GPA
Minimum of 54 credit hours in the following prerequisite courses:
Anatomy and Physiology I with lab* †
Anatomy and Physiology II with lab* †
Microbiology with lab* †
Human Growth and Development (across the lifespan) †
Nutrition †
Statistics †
Ethics
College Algebra
English Composition I
English Composition II
Introduction to Sociology
General Psychology
History or Political Science
Biology, Chemistry, Genetics, or Physics
General Elective
Humanities Elective
Social Science Elective

54 credit hours is the bare minimum but many will have more before getting accepted. I think i had 66

 

[Handsome Robb]

Eh, adding in the EMT-I is a little redundant since you could have gone right from EMT-B to EMT-P and it does not add anything that was not covered during your paramedic course. That would be like me going from CNA to LPN then BSN and claiming that I had more education then other BSNs because of the hours from the CNA and LPN when in reality all of that was covered in the BSN program. More experience maybe but education no.

Agreed, it is redundant but I also worked as an Intermediate so it was something that's required of me. So in that case, take out Intermediate and it drops me to 1700 hours.

My BSN was ~ 125 credit hours. According to google 1 credit hour = 18 class hours so that would come out to 2,250 hours.

Your google-fu is stronger than mine!

But comparing straight hours is worthless. You can not compare vocational hours to college credit hours.

200 hours of EMT-B is not equal to 200 hours of university course work.

My science labs alone add up to over 200 hours.

1 hour of sitting in an EMT class learning about how blood flows through the heart is not equal to 1 hour of anatomy lab dissecting a heart.

This is assuming that every EMS education program is created equally. The minimum standards are low but many schools go past the minimum. I'll admit vocational =/= university level but I will argue that there are Medic programs out there that are taught at a higher level than you would think.

Maybe I'm an exception but my medic school was taught by plenty of instructors with teaching at the CC and University level. Ranging from EMT-Ps, CC-Ps, RNs, NP/CRNAs, PAs all the way up to MDs. Did they all have collegiate level teaching experience? No, but many of them did. My graduation certificate is also issued by a state University. I will agree though that my program is not the norm.

While some may argue differently it seems that many of the RNs that come to this site, including me, do not hold the view that we can challenge the exam and jump right on the truck. The majority are looking for some type of bridge program and usually are seeking Flight or CCT jobs. Even my arrogant self will admit that I could not jump on the truck today and function as an independent paramedic. But I am confident it would not take me much to get there, definitely not an entire paramedic program.

Like I said, I have no problems with a bridge course. The problem I have is the inability for medics with education past a vocational program to bridge into nursing. Even if it isn't a degree related to medicine, why can't a medic with a associates or bachelors with appropriate science prerequisites bridge into nursing?

It just seems like a double standard to me. Maybe I'm just being young and naive though.

 

[VFlutter]

My graduation certificate is also issued by a state University.

So was my EMT-B graduation certificate. I am not sure that really adds to the value. It looks pretty cool though h34r:

Like I said, I have no problems with a bridge course. The problem I have is the inability for medics with education past a vocational program to bridge into nursing. Even if it isn't a degree related to medicine, why can't a medic with a associates or bachelors with appropriate science prerequisites bridge into nursing?

It just seems like a double standard to me. Maybe I'm just being young and naive though.

There are a few Medic to RN programs out there however they are longer than what I would consider a "bridge" program.

I agree there is a double standard. And I am younger and probably more naive then you

 

[Handsome Robb]

So was my EMT-B graduation certificate. I am not sure that really adds to the value. It looks pretty cool though h34r:

Alright, you got me there. Can't really argue with that.

There are a few Medic to RN programs out there however they are longer than what I would consider a "bridge" program.

I agree there is a double standard. And I am younger and probably more naive then you

I, admittedly, don't know what all it would take to make a good medic a good nurse. I also don't know exactly what it would take to make a good nurse a good medic.

Skills is an obvious area. Scene management and operations is another. Delegation, well I'll leave that alone since it blew up the last time it was brought up. Patient packaging as well is an area I think that would need to be covered. ECGs for sure (I know lots of RNs that can read 12s as good if not better than most medics I know just like I know lots of nurses that can't tell you a whole lot about a 12-lead other than "it's sinus..."). I'm sure there are more but those are the ones I can think of off the top of my head.

One question I will ask is how far into "initial" presentation of different illnesses and injuries does nursing school go? I'm sure it's just as much if not more than Paramedic, just asking more than anything.

I've said it a million times before and I'll say it again. I have a lot of respect for nurses and what they do, I don't know half the stuff nurses do. With that said, there's plenty that we do that many nurses aren't aware of. There are plenty of moron paramedics out there but at the same time, there's plenty of moron RNs as well.

 

[STXmedic]

*generic comment intended to stir the pot*

 

[VFlutter]

One question I will ask is how far into "initial" presentation of different illnesses and injuries does nursing school go? I'm sure it's just as much if not more than Paramedic, just asking more than anything.

We studied the whole continuum of a disease including initial presentation not just late or chronic. We only covered the basics of trauma but the medical was very comprehensive.

*generic comment intended to stir the pot*

Do you and your wife have Medic Vs RN debates at the dinner table? I am guessing she wins