PHRN transfer to EMT-P in other states?

[Dwindlin]

Take the Paramedic school in the state you move to. Problem solved.

Not really sure how many times I've said the same thing about practicing medicine. . .

 

[ExpatMedic0]

First off, Its not this nurses fault the system is this way, that is the way its set up and I wish this person goodluck,I hope we could help. I however, do not agree with the bigger picture here and agree with others regarding the sandbox.

I can see no reason to sit through a 600 hour class taught at a high school level when I have already spent 4 years in college. I know that sounds condescending and arrogant but it is what it is. Do I think I could go out on the streets today with no extra education and function as a medic? Absolutely not. But do I think I need to go through an entire medic program to get what I need?

Last time I checked most of our nations medics programs where well over 1000 hours,mine was about 1500 full time 1.5 years long and worth 50 college credits. Myself and the other Oregon medics had the same pre rec's as associates degree RN's, the only difference was our Paramedic program course work was longer than the RN's and obviously ours focused on Emergencies and Pre-Hospital care. It was also mandatory for us to hold an AAS or higher to be certified in Oregon. Many in my class already had an undergraduate degree. From an international stand point a paramedic going to nursing is taking a step backwards in your career, like losing rank. Only in the U.S. it is not necessarily seen as this. However in my book and opinion it still kind of is ;-)

Please get over yourself, if your such an advocate of education than surely a little extra never hurt anyone right? The right way to do it is to take the paramedic program or at least some kind of bridge for gods sake.
PS: almost everything in your thread made me laugh a loud... GET REAL

 

[VFlutter]

Last time I checked most of our nations medics programs where well over 1000 hours,mine was about 1500 full time 1.5 years long and worth 50 college credits. Myself and the other Oregon medics had the same pre rec's as associates degree RN's, the only difference was our Paramedic program course work was longer than the RN's and obviously ours focused on Emergencies and Pre-Hospital care. It was also mandatory for us to hold an AAS or higher to be certified in Oregon. Many in my class already had an undergraduate degree. From an international stand point a paramedic going to nursing is taking a step backwards in your career, like losing rank. Only in the U.S. it is not necessarily seen as this. However in my book and opinion it still kind of is ;-)

Please get over yourself, if your such an advocate of education than surely a little extra never hurt anyone right? The right way to do it is to take the paramedic program or at least some kind of bridge for gods sake.
PS: almost everything in your thread made me laugh a loud... GET REAL

As far as I know Texas and a few other states still have 600 hour paramedic programs. It is great that some states require an AAS but the majority do not.

50 college credits? That is impressive. Still not even half of a bachelors degree. Hell, my two minors were almost 50 credits.

I have no doubt that international medics are on a much higher level. If I lived in Australia or a similar country I would probably be going that route myself. But we are no where near the standards of other countries. You have your opinion and I have mine, and I don't see either of us changing anytime soon. I am sure its no surprise I have the opposite view of which way is stepping backwards.

I am an advocate for quality education but unfortunately many of the paramedic programs out there do not fit that description.

And again, I have been saying people should go through a bridge program and not just challenge the exam.

What thread are you referring to?

But I will work on getting over myself, just for you. I wouldn't want you laughing out loud too much.

 

[Shishkabob]

I had a long post but it seemed rather mean, so I'll just keep it to a few points;


There are parts of medicine where an otherwise equivilient Paramedic would be a better fit than an RN, but due to tradition and unions, they haven't been able to encroach upon it, such as the cath lab and trauma room.

As far as I know Texas and a few other states still have 600 hour paramedic programs. It is great that some states require an AAS but the majority do not.

Last I checked there are still RN programs that are darn near equal to medic mills.


And minimum =/= norm. Sure, 600 minimum, sad that they exist, but I dare you to go to a single renowned EMS agency and see if you can find any Paramedics that partook in one of those programs. Those graduates go play hose jockey at FDs, nothing more. Just like a lot of the rather scary RNs are held to nursing homes, med/surg and the like. (Disclaimer, not saying if you work in those areas you're bad)

50 college credits? That is impressive. Still not even half of a bachelors degree. Hell, my two minors were almost 50 credits.

Oh yay, your extra year of school taught you theory of being an RN, how to do a spreadsheet and what else? Apples to apples. BSN vs BS in EMS. Not BSN to AAS.

Heck, pit your PhD as an NP against an MD/DO. Yeah, that's worth a laugh.

 

[NomadicMedic]

Play nice. The discussion is a good one as long as it DOESN'T DEGRADE into personal attacks. Lets keep this civil.

 

[Summit]

I am most curious to hear what the TX EMS board says to the OP?

Last time I checked most of our nations medics programs where well over 1000 hours,mine was about 1500 full time 1.5 years long and worth 50 college credits. Myself and the other Oregon medics had the same pre rec's as associates degree RN's, the only difference was our Paramedic program course work was longer than the RN's and obviously ours focused on Emergencies and Pre-Hospital care. It was also mandatory for us to hold an AAS or higher to be certified in Oregon. Many in my class already had an undergraduate degree.

1. With prereqs, most associates nursing programs are 75-90 credits. BSN programs are 120-130.

2. I applaud OR and KS, the only two states who require associates. Other states don't and will accept NR 600 hour schools either within the state or from out of state. My state has numerous 6 month long paramedic programs with 512-600 classroom hours.

3. Plenty of nurses have degrees in other fields.

From an international stand point a paramedic going to nursing is taking a step backwards in your career, like losing rank. Only in the U.S. it is not necessarily seen as this. However in my book and opinion it still kind of is ;-)

In other nations a paramedic is baccalaureate or masters level education... or EMS is handled by specialized prehospital nurses (or physicians).

In the US nurses are associates minimum and trending towards baccalaureate minimum while Paramedic is, in most of the US, minimum of a GED and a couple hundred hours of vocational school.

That is a sad reality. I say it is sad because it is sad to me. I like prehospital medicine more than critical care, but the career aspect is a problem and the educational/professional state of EMS was going to make it hard for me to make a good career without going Fire and I didn't want to go Fire.

The right way to do it is to take ... at least some kind of bridge

As Linus point out, who has a better understanding of EMS related topics out of school? The Paramedic has better training by far! Nurses are educated as generalists, then they specialize. However, versus a trained specialist, it is far easier for a educated generalist, particularly with experience, to bridge into a specialty with additional education and training.

The PHRN program is a bridge program of sorts.

 

[VFlutter]

I had a long post but it seemed rather mean, so I'll just keep it to a few points;


There are parts of medicine where an otherwise equivilient Paramedic would be a better fit than an RN, but due to tradition and unions, they haven't been able to encroach upon it, such as the cath lab and trauma room.

Last I checked there are still RN programs that are darn near equal to medic mills.


And minimum =/= norm. Sure, 600 minimum, sad that they exist, but I dare you to go to a single renowned EMS agency and see if you can find any Paramedics that partook in one of those programs. Those graduates go play hose jockey at FDs, nothing more. Just like a lot of the rather scary RNs are held to nursing homes, med/surg and the like. (Disclaimer, not saying if you work in those areas you're bad)



Oh yay, your extra year of school taught you theory of being an RN, how to do a spreadsheet and what else? Apples to apples. BSN vs BS in EMS. Not BSN to AAS.

Heck, pit your PhD as an NP against an MD/DO. Yeah, that's worth a laugh.

I can agree for the most part on the first few points.

Actually only one of my BSN classes was nursing theory. The rest was geared toward evidence based medicine, research, and management. But I get your point. Also, my various general education classes are more useful than you would think.

My comment about the quality of paramedic education was more in reference to the core sciences. It's great a lot if programs are finally requiring basic A&P classes but how many require microbiology, patho, or pharmacology? Or even basic biology and chemistry. I am talking about actual college courses with labs not the simplified watered down version out of paramedic textbooks.

I didn't try to compare NP to MD/DO or even DNP to MD. I know some nurses like to try to make that leap but they are two different unique roles. If you want to compare apples to apples and pit NP against PA then that is a different story. But personally I think NP education outside of CRNA/ ACNP isn't anything to brag about.

 

[Trashtruck]

The PHRN's that I know, and used to work with, never tried to pretend to be paramedics, or even EMT's. Yes, they got their PHRN cert, but only because their job required it. They were the first to admit that they had no clue how to do EMS proper, and that if we were to ever 'roll up on something' they'd have no idea where to start or what to do. Now, the PHRN's who actually worked as paramedics either prior to their nursing careers or concurrently, obviously didn't share this trepidation.
I'm a paramedic. I'll be the first to admit that even with a bridge program to nursing, I'd suck at nursing until I had some experience actually working as a nurse. Just because I pass the NCLEX, do my clinical time, and graduate with my ASN or BSN, doesn't make me proficient.
Same for an RN passing NR, doing their ride-time, and acquiring their PHRN.

 

[Akulahawk]

Something that should also be pointed out is that while generally nursing has the Associate's Degree as the minimum educational level, I dare say that there still are RN programs that do NOT result in a degree being awarded. One such program is California's LVN->RN (30 unit option). Sacramento State, having a BSN program, has such a program that does not result in the LVN->RN grad getting the RN if they take the 30 unit option instead of going for the BSN.

 

[Summit]

^indeed, 4% of RN programs are not degree granting, 39% are BSN, and 57% are associate level (2007). There are a growing number on ELMN programs where graduates receive an MSN and sit for RN licensure. Many ADN RNs immediately enroll in BSN completion programs.

I wonder what % of new paramedics graduate from an associates in paramedicine program?

Also, there are non-degree PA programs and associate degree PA programs in some states. I bet they argue about these versus MS programs on the PA forums. Over on the nursing forums, the ADN vs BSN threads earned their own subforum.

 

[VFlutter]

^indeed, 4% of RN programs are not degree granting, 39% are BSN, and 57% are associate level (2007).

I can't find more recent data but I am willing to bet those numbers have changed in the past few years. There is a huge push for RNs to go back for their BSN as well as an increase in BSN program enrollment. The few diploma programs that I know of have closed and there is currently only one program left in my state. With more hospitals applying for magnet status in the next few years I am guessing we will see a shift in the BSNs favor.

 

[MrJones]

^indeed, 4% of RN programs are not degree granting, 39% are BSN, and 57% are associate level (2007).

And I dare say that we're being short-sighted if we don't advocate and support initiatives that result a relatively equal breakdown in paramedic education.

As a start.

 

[ExpatMedic0]

Phrn

As far as I know Texas and a few other states still have 600 hour paramedic programs. It is great that some states require an AAS but the majority do not.

50 college credits? That is impressive. Still not even half of a bachelors degree. Hell, my two minors were almost 50 credits.

Yes, which is more than the RN program at the same college. That was just the medic program, specifically, I also had all the same pre rec's such as A&P, Bio, Chem, ect.

While where patting each other on the back, I guess Ill pat myself on the back for my psychology minor also and the Bachelors degree I am 2 semesters away from completing.

Also the fact you bring up a 600 hour program which is not accredited nor eligible for national registry as a Paramedic is interesting since I could bring up existing diploma nurse schools which still exists and also certain online RN programs. I could further indulge in the fact that ADN, BSN, and even some Diploma RN's are hold the same RN licence. Just as my pending Bachelors in Paramedicine grants me no higher of a certification as a Paramedic. If we are judging an entire profession based on its weakest links then we have to judge nursing on Diploma nurses, even if only %4 of those still exist, Also the fact almost every community college offers an associate's in the subject which more RN's hold than a BSN.

I respect nurses and what they do for a living, one of my best friends is a nurse, but our jobs are absolutely nothing alike. From a professional standpoint she respects me and I pay her the same respect.

The only "beef" I hold with nursing is as a profession they do like to play in everyone else sandbox, there unions and representation interfere with EMS sometimes, along with the ego some of them display on this forum and in the ED (but that is more of a personal matter)

ANYWAY: This topic should been locked long ago IMO. The OP came here seeking information (regardless of anyone's opinion) That information was given to the OP and everything was accomplished.

Whats been discussed is nothing new, in fact its a broken record on this forum... yes we all agree the minimum national education standard for EMS should be raised, and yes there are some crappy medic mills out there(just as there are some crappy RN ones) and there also some good ones(15 off the top of my head that offer bachelors degree), and others which offer no degree but have 3000-4000 hours of EMS specific education/training which are still pretty good IMO(I.E. medic 1)

 

[Veneficus]

Advice to the OP and the broken record

Call the state board of EMS where you are going. Tell them of your credentials and ask them what you have to do to be a paramedic in their state.

As I know, only a handful of states have PHRN designations. But many others permit RN to medic bridge programs. Still some permit testing out of Medic entirely.

The politics of whether this is the best or "true faith" are entirely another matter.

But I would like to speak on the education of the matter for the pages worth of nurse vs. medic (Yet again)

I have been a part of US EMS education for a long time. I have seen every type of program from the CC college degree to the medic mill, and remain active in US EMS education and with educators across the States. (the world is another matter so we will not discuss it here too)

Only a handful of States, and by my count 2 going on 3 require a degree in EMS of any kind. These states are the exception, not the rule. I wish it were different but it is not.

Some community colleges require prerequisites to their EMS programs. Others do not. Most college based programs do not require you to complete their EMS degree to take and become accredited as a paramedic.

Various colleges have tried to unilaterally "raise the bar" on paramedic education, by requiring more intensive programs, with varying levels of success.

While many community colleges bill themselves and are transferable to universities, you must still understand what you are getting into. When I transferred from the CC world to university, I got schooled in a big way, so in the effort of sparing others that pain, let me point something out?

Transferable does not mean equal. I took a biology class in CC, transfered to university, and when I asked for credit, my academic advisor (the only good one I ever had) explained to me that in the interest of my knowledge and goals to repeat the course. After some hard bargaining to get something out of it for me, I ened up in intro to bio for science majors. I thought since I already passed this class a few years prior it would be an easy A. It was not. Infact, I am proud of my "B" in the class, because the prof can count the number of "As he has given out in his career. Today I am better for not taking the easy (and cheaper) way out.

The purpose of the CC and associates degree, is to give you the education you need to minimally function in the job market of a given field. It does not teach you what you need to know in order to be anything but the bottom level. It also does so in a very "this is important for the job/this is theory manner."

Outside of EMS, theory counts! You will constantly be faced with decisions that are outside the "rules." You must know enough to be able to either make a decision or call for help. As it stands, nursing has more ability to make reasonable decisions than EMS providers when looked at on the grand scale.

Where in the country you get your education matters. In the "North" education is focused around a "well rounded" knowledge. Education in the South is far more focused on job speciific. I have been there, I have seen it. Which is better is a matter of endless debate, so let's not get into it.

The average nurse in the US has more basic science education than most paramedics. Just as there is no EMT-Vene level there is no EMT-(Your name here level) being an exception to the rule does not confer your ability on your colleagues or your vocation. It does bring great credit to you. So accept it and quit trying to deflect it as the norm.

Nurses are not all equal to the ED or ICU nurse. In fact, most nurses will never be capable of or desire to operate in those environments. Do not pretend those nurses are the "norm." They are the same exceptional as the up educated paramedic.

Nurses in EMS, like every nurse in every other division of nurses will need job specific training in order to be effective. They do not need to hear A&P, pharm, or any other part of the EMS didactic that they already have superior knowledge in.

Now I know EMS providers don't like to hear this and try to make up all kinds of BS reasons why it is not so. But it is like this. Nursing is an educated profession now. It continues to raise it's own bar. EMS is a vocation trying to keep the bar low. I give you this example to put what you are arguing into perspective.

Let's say you have an engineer, with lots of education and experience in designing bridges. For whatever reason, this engineer wants to weld on bridges. HIs knowledge is far in excess of the average welder, and he just needs the welding credential, not an education in "how bridge building really works."

I just have to comment on the magnet status thing too. Magnet is a self gratifying award from nurses to organizations that suppoort the goals of the nursing lobby for the benefit of nurses. Not the benefits of patient care, safety, efficency, or cost.

 

[ExpatMedic0]

The purpose of the CC and associates degree, is to give you the education you need to minimally function in the job market of a given field. It does not teach you what you need to know in order to be anything but the bottom level. It also does so in a very "this is important for the job/this is theory manner."

I would loosely agree with this statement, and also mention that both career paths offer this education(Associates) option which results in the same medical licence/certification as someone who go's beyond or below.

Unlike say a Physician, Engineer, Lawyer, or even Public Health which you can not just obtain an associate's degree or below in and begin working. When you look at it like this and your comparing "the national mainstream" minimum standards it feels a bit more like comparing apples to oranges to me at the CC level.

 

[SanDiegoEmt7]

I would loosely agree with this statement, and also mention that both career paths offer this education(Associates) option which results in the same medical licence/certification as someone who go's beyond or below.

Unlike say a Physician, Engineer, Lawyer, or even Public Health which you can not just obtain an associate's degree or below in and begin working. When you look at it like this and your comparing "the national mainstream" minimum standards it feels a bit more like comparing apples to oranges to me at the CC level.

I think what Vene is saying is very accurate, as someone who has worked as a medic(FF?) and then gone on to the university level and medical school.

Everyone is out here measuring their ****'s. I don't agree with the RN here or some of the medics. I bet if I met either of you I would think highly of your abilities and you would probably be above the minimums of your fields, hence your egos and why you are fiercely defending yourselves.

The fact is generally university level studies are more rigorous than CC, furthermore a top level university can be even more demanding simply by the fact that they want to make it extremely difficult. As someone who attended a science focused university then went to paramedic school I can attest to this.

In my role as a paramedic I am categorized with the run of the mill vocational paramedic until my colleagues (of all levels) learn otherwise. No need to argue here. A CC trained paramedic or nurse is not going to have the knowledge of say a John Hopkins trained nurse, simply based on the quality of study from the get go. A rogue CC trained nurse paramedic may be smarter than that BSN but the university holds more weight, prior to gaining field experience.

Take med school prerequisites at cc then take them at a top 50 university and you'll see what I'm saying. Unit counts have an asterisk on them.

That said, as a majority paramedics are much better trained to deal with delegation and on scene management, than a nurse, without either having field experience, (We do MICN evaluations with experienced ED/trauma RNs) and it's just different.

 

[Handsome Robb]

I really did not want to get into it, especially not with you Rob, but come on...

Firs off I have never liked the idea of just challenging the paramedic exam. The PHRN involves classroom education as well as clinicals with a set number of supervised ALS runs. They are also required to take all the paramedic exams (At least in IL). It is more of a bridge process.

I agree there is a double standard which is unfortunate for medics. But what is EMS doing about it? Do you think current paramedic education is adequate? Is there any plans to improve educational standards? There are plenty of countries where EMS and Nursing education is equal. How is EMS's lobbying power? Kind of hard to talk tough when you have teenagers doing the job and a large percentage of medics who are only in it for that fire department job.

I can see no reason to sit through a 600 hour class taught at a high school level when I have already spent 4 years in college. I know that sounds condescending and arrogant but it is what it is. Do I think I could go out on the streets today with no extra education and function as a medic? Absolutely not. But do I think I need to go through an entire medic program to get what I need? Nope.

You are kidding, right? I can guarantee you nursing programs go over the topic of delegation way more than any paramedic program. Pick up an NCLEX review book and there will be multiple chapters dedicated solely to the topic of delegation.

Oh I forgot that I just take orders from a MD and do nothing except get delegated to. Well, at least they pay me good for it.

As far as scene management they are required to take an EMT-Basic course. How much of scene management did you learn in class as opposed to actual doing it in the field?

Alright. You know I have respect for nurses, especially you even if you're a snot nosed rookie , but you know what I'm saying is true. BSN is more education than the majority of medics receive, obviously, I'm not going to argue that but it's different education.

They do classroom training yes, and clinicals yes, and internships yes, but every PHRN program I've heard of requires the bare minimum. You're talking 40 ALS contacts. They hit #40 and get signed off. Sure there are medic programs out there that pull this crap too but they're the minority. I did~500 hours on an ALS ambulance with >120 ALS contacts and even more BLS/ILS contacts than that. That doesn't include all the patient contacts I had working as an Intermediate during school with medics that let me "run the show" because I was driven to do so and asked if I could. Yes I learned more about scene control during my internship than I did during classroom time but it's still a topic that's covered. It's arguably the most difficult thing a medic has to learn, some may argue it's easier to teach it to a medic with no EMT experience. I'm still learning to better manage my scenes on every single call I go to. Is this all medic students? No. But despite popular belief there are plenty of very intelligent, very motivated EMS Students, EMTs and Paramedics out there.

I'm not going to get into it with you about current EMS education standards more than I already have. You know exactly how I feel about it.

I know nurses have standing orders just like paramedics do and can operate autonomously to a point but at the same time you're not making the decision to pull the trigger on an invasive procedure or giving medications that potentially could be fatal to that patient. Not saying nurses can't make those decisions but when I have to walk a BSN ED nurse through the dosage and administration of adenosine to only have the MD ask the nurse to give me the meds rather than ****ing around trying to explain it to him raises some questions in my mind. Is this all nurses? Absolutely not, but I've met plenty of incompetent nurses just like I've met plenty of incompetent medics.

Nurses have a lot of education but nursing education to EMS education is apples to oranges. We're talking long term care vs. emergency medicine, generally

I'm absolutely open to a bridge class, with proper requirements, but nurses trying to challenge the EMT-P because they had RN and EMT-B after their name is downright insulting. That's a two way street, there are medic-to-RN bridges out there but good luck getting a good nursing job with that kind of education behind your RN license even with thousands of ALS patient contacts as the Paramedic In Charge. Unless you've spent any amount of time working in EMS you truly don't know how it works, EMT-B class does not adequately prepare you or give you a good picture of what EMS truly is.

I truly doubt that a ADN or BSN goes over delegation vastly more than a good paramedic program. EMT-B courses barely even touch on delegation, that's not even a point you can use in this argument...

It's not unusual for me to run an entire ALS call, take a cardiac arrest for example, without doing a whole lot, if any, skills. Can I do all of them? You bet but I have bigger fish to fry than to get tied up drilling an IO or starting a line or dropping a KING airway or pushing an epi prefill. Some medications are all me and even if I could delegate them I wouldn't, that's just my preference. I'm sure some people will say I'm wrong for saying this but it's a fact, I'm confident in my medicine and QA/QI/Clinical Direction has absolutely no problems with the way I operate. I'm still new and have a ton to learn, I don't want this to sound like I think I'm the :censored::censored::censored::censored:, because I'm not, but I'm good at my job and always seek critiques to better myself.

The comparison I've always hear is "A paramedic is like the conductor of an orchestra, you don't play the instruments, but you direct the musicians and bring them all together in harmony". That's not what a nurse does, sorry, you can't argue with that. I have no doubt that nurses delegate but in a sick patient, they are the conductees, not the conductor.

Sorry, not trying to be an :censored::censored::censored::censored::censored::censored::censored: but this is something that has always irked me. I know plenty of very experienced flight nurses here that don't even try to mess around being in charge on scene calls because they know the ground and flight medic are in their element and, for lack of a better term, are better at it.

 

[Veneficus]

Unlike say a Physician, Engineer, Lawyer, or even Public Health which you can not just obtain an associate's degree or below in and begin working. When you look at it like this and your comparing "the national mainstream" minimum standards it feels a bit more like comparing apples to oranges to me at the CC level.

I would agree with you that the CC programs are usually (there is always a bad apple and I do know one or two of them) better than the vocational programes.

However, this difference I think is becomming less and less as vocational programes in order to meet NR requirements are becoming "remote campuses" of CCs. Instead of making bad programs better though, it is dragging down the good ones.

The good programs are also understress from the bad ones in order to maintain both price and student interest. MOst students simply will not pay a CC more and attend 4 semesters of school, when they can do the same in 6 months at a voed and come out with the same cert and same job prospects. (sometimes better prospects if they are applying to an FD because they are not seen as a promotional threat or a "thinking man on a working man's job.")

When I was applying to jobs, (ok, I admit, a very long time ago) when I proclaimed I got my medc at a CC, people looked at me like "so what?" I am sure it hasn't changed that much.

The academy I taught for is a remote campus of a CC not even in the state. Those students get the same job offers at the same pay. Some are better than the CC graduates, some are not.

What you say about entry level requirements for doctors, engineers, lawyers, etc is true. But it is not true for all of CC education. You can get an entry level accounts payable/receivable job with a CC associates in economics or accounting degree. You can get a job mixing chemicals in a vat with an associates of chemistry or science. You won't be deciding which chemicals to mix, but you can still stir.

EMS, which is still considered vocational, has a strange place in the CC system. You really don't need to go to a CC to learn it. Paramedic is still the highest level of prehospital provider in the US. Which by default puts CC educated medics at the top of the EMS education food chain. Not the traditional entry level of the CC degree.

But I also think that creates a false impression on the level of "education" involved. It artificially elevates the value of a CC in many eyes. That is why people transferrring science to university get a major wake up call when they get there. Then as I did, you must choose between paying to "retake" classes or attempt to take higher classes and make up for your knowledge deficit while studying new material. From experience, I really, really, do not suggest the later.

If you look a most CC adverts, "the knowledge you need for today's jobs," or something of the like. (some even use the word career) These places are designed to put people to work, and as you yourself said, not at the professional level. The current shift towards the BSN in healthcare istaking nursing out of the CC level. Many programes remain, but I wouldn't wager on it being much longer unless they are going to try to complete the RN reqs of a BSN program and then suggest you could "transfer" to a university.

Don't forget CC are businesses, they want to make money. for a CC EMS is like a cash cow. They can and do even get federal money specifically for having a "public safety" program. In addition to all their other revenue streams.

It is a large draw for students too. If you are deciding what to do out of highschool, making widgets at the local factory (I am a yankee, it is what the option is) or hacking down sugarcane from sunup to sunset down South, (one of my good friends is a medic who was a former cane farmer) that picture of a firefighter, police officer, and paramedic looks really enticing. Especially for those that didn't really do well or get in line with the academic system in school.

As I have come to know you, you are probably one of the best medics in or out of the US, but your level does not even come close to being average. Take credit for your success and ability.

http://en.wikipedia.org/wiki/Dunning–Kruger_effect

"The Dunning–Kruger effect is a cognitive bias in which unskilled individuals suffer from illusory superiority, mistakenly rating their ability much higher than average. This bias is attributed to a metacognitive inability of the unskilled to recognize their mistakes.[1]

Actual competence may weaken self-confidence, as competent individuals may falsely assume that others have an equivalent understanding. David Dunning and Justin Kruger conclude, "the miscalibration of the incompetent stems from an error about the self, whereas the miscalibration of the highly competent stems from an error about others".[2]"

(and for the mods, that is only a short excerpt, not a copy of the whole or even majority of the link)

 

[HMartinho]

No.

They don't teach RNs to manage scenes or delegate, they are taught to be delegated to

Are you serious?

A nurse does only what is delegated by the MD?

If the doctor prescribes a drug that the patient does not need, the nurse will give it without even questioning the MD about it? Or in a inappropriate dosage?

If the doctor prescribes a drug contraindicated in a patient, the nurse will give it without questioning the MD about this? Like nitroglycerin for right ventricular AMI?

I know I'm from a different country. In the U.S. there are paramedics and I have the utmost respect for them. They do what they are trained for, But here all ALS units are staffed by a physician and a nurse, and all ILS units are staffed by an EMT and a nurse.

I had the opportunity to work with nurses who are a "disaster" to work on PH. Nevertheless, I have had the opportunity to work with ICU Nurses / Nurse Anesthetists, with additional training in ALS, TNCC, difficult airway management, etc, which are really good to work on PH.

There are good and bad professionals everywhere, Nurses, Doctors, EMT's, whatever.

And quite honestly, I do not want to be treated by a nurse who merely do what is delegated by the MD.

 

[SanDiegoEmt7]

Are you serious?

A nurse does only what is delegated by the MD?

If the doctor prescribes a drug that the patient does not need, the nurse will give it without even questioning the MD about it? Or in a inappropriate dosage?

If the doctor prescribes a drug contraindicated in a patient, the nurse will give it without questioning the MD about this? Like nitroglycerin for right ventricular AMI?

I know I'm from a different country. In the U.S. there are paramedics and I have the utmost respect for them. They do what they are trained for, But here all ALS units are staffed by a physician and a nurse, and all ILS units are staffed by an EMT and a nurse.

I had the opportunity to work with nurses who are a "disaster" to work on PH. Nevertheless, I have had the opportunity to work with ICU Nurses / Nurse Anesthetists, with additional training in ALS, TNCC, difficult airway management, etc, which are really good to work on PH.

There are good and bad professionals everywhere, Nurses, Doctors, EMT's, whatever.

And quite honestly, I do not want to be treated by a nurse who merely do what is delegated by the MD.

I think delegate is in regard prehospital on scene management. In the US, prehospital providers are trained rigorously to handle emergency scenes, something that could be taught to RNs, most definitely, but it is not the focus in nursing education. Paramedics are trained to turn chaos into something to work with and then bring those patients to definitive care as stable as possible.

RNs have a better breadth of general knowledge (generally) and when specialized and experience are not drone worker bees, well at least the majority (there are just as many cookbook medics too).

The word delegate was brought up in the sense that an RN challenging the paramedic qualifications should complete a large part or all of paramedic training to be as qualified as paramedics in regard to prehospital scene/patient management which requires a certain thought process to accomplish efficiently and effectively.