RN on ground ambulance?

Everybody please be like vent, i can take the brutal-ness of whatever you want to throw at me. I'm not trying to take a short-cut just trying to prepare.
@VentMonkey I wasn't so much looking to go back into EMS right away, just at some point down the road, since im not sure a hospital will be the right spot for me. maybe ICU will be, idk. I'm just better "under pressure" ect. ill save you that speech. My main goal was to try and figure out to see if specific classes down the road are required, so i can take them now under my "elective category"
 
NysEms2117 said:
Everybody please be like vent, i can take the brutal-ness of whatever you want to throw at me. I'm not trying to take a short-cut just trying to prepare.
@VentMonkey I wasn't so much looking to go back into EMS right away, just at some point down the road, since im not sure a hospital will be the right spot for me. maybe ICU will be, idk. I'm just better "under pressure" ect. ill save you that speech. My main goal was to try and figure out to see if specific classes down the road are required, so i can take them now under my "elective category"
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I am biased but in my opinion ICU experience is essential. You can do pretty much anything in nursing after getting quality ICU experience. Have you shadowed a few shifts in an ICU? Under pressure.... trying having a patient on CRRT, vented, Flolan, 8 drips, etc that tries to arrest every time you turn them.
 
@Chase i just entered my first semester of nursing school last week. BSN program, i'm doing 2/5 semesters "full time"(12 credits) approx 1.5 year completion time. All i'm in right now is A&P2, nursing ethics, and IV lab.
 
NysEms2117 said:
im not sure a hospital will be the right spot for me. maybe ICU will be, idk. I'm just better "under pressure" ect.
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Don't think for a second that the ED, and ICU RN's aren't under pressure (I know it's not what you were getting at, BTW).

Just ask an ICU RN about having to wake a grouchy, grumbling intensivist up at 3 a.m. for some ridiculous order they know damn well that the patient will need. Or why their nurse to patient ratio is typically 2:1. Nothing like managing a vented patient on 10 gtts, and invasive lines coming out the wazoo.

And the ED RN's, well, we've all seen what kind of pressure they're constantly under, except unlike us fortunate EMS folks, they're stuck with some of these Darwin award-winning patients, and/ or runner-ups for hours on end. Call-light, anyone?

It is in fact a different pressure from say LE, as you could attest. I think you can tell I have had this drilled into my brain by my loving, endearing wife:).
 
VentMonkey said:
It is in fact a different pressure from say LE, as you could attest. I think you can tell I have had this drilled into my brain by my loving, endearing wife:).
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mhm. I get it, and thankfully you got my point under all of those useless words lol. I'm also aiming for a PDM gig, and i just have no idea what nursing has to offer there, i'd imagine endless shifts, but i have nowhere near enough knowledge in that part to know for sure. Thus why i was leaning toward EMS so heavily because i know for a fact they have PDM.
 
NysEms2117 said:
@Chase i just entered my first semester of nursing school last week. BSN program, i'm doing 2/5 semesters "full time"(12 credits) approx 1.5 year completion time. All i'm in right now is A&P2, nursing ethics, and IV lab.
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You will see different parts of the hospital during your clinicals but you can still sign up to shadow a shift in the ER/ICU or wherever.
 
SpecialK said:
It's interesting you bring this up, as it has been an area historically poorly managed and with much confusion on behalf of the personnel involved.

Now it only happens in two circumstances

1. Either, the ambulance crewmember "happens" to also be a Registered Nurse, as some volunteer officers are. This is now restricted to EMT level only, it is no longer possible to gain ATP at Paramedic or ICP using a "recognition" process. An RN who wishes to practice at, for example, Paramedic level, will need to complete a specific Paramedic tertiary qualification so in essence, they wish to change careers. I have seen a few RN's who've changed but not very many considering the hours of work are much better for RNs than ambulance personnel and a pay is roughly the same.

There is a legal anomaly where an RN is a legally registered professional and can act within their professional boundaries of practice on their own volition (regardless of setting) whereas ambulance personnel have a strictly specified scope listed in the CPGs due to the lack of registration (coming soon hopefully!). What has been inserted in the last couple of editions is a registered practitioner may provide treatment within their professional jurisdiction but outside of any ambulance scope provided it is in the best interest of the patient and broadly consistent with "principles" of the CPGs (i.e. most effective and efficient treatment). A practical example would be an RN who is also an EMT inserting a urinary catheter or manipulating an NG tube, but not automatically gaining IV access as only certain RNs are proficient at this (a Practice Nurse, for example would pragmatically never gain IV access).

2. Or, when a transit nurse accompanies a patient to provide clinical care. This applies to some jobs undertaken by the Patient Transfer Service. Sometimes the transit crew also includes a Doctor but not very often; I've only seen it a couple of times and it's been air ambulance transfers.
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Practice Nurses as in LPN? They start IVs all the time.

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MackTheKnife said:
Practice Nurses as in LPN? They start IVs all the time.

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SpecialK is on the other side of The Pond. Paramedic and RN training is much different there.
 
Chase said:
SpecialK is on the other side of The Pond. Paramedic and RN training is much different there.
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Ah!

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CALEMT said:
Only place that I've heard of that's using a nurse for 911 calls is LAFD.
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It's actually a Nurse Practioner. They are staffed as a NP/Paramedic and usually only dispatched to calls that could benefit from a NP and that usually do not require transport(stitching, referral to a Dr, antibiotics, etc). The goal of LAFD starting it was to provide a way for patients to get treated in the field without tying up an ambulance crew/engine, the hospital and so the patient doesn't have to go to the hospital as well. Last I heard, it was working pretty well and it is primarily in the South LA region.

To NYSEMS2217: In los angeles county, private ambulances are allowed to run paramedics as well as RN's. The RN's in private ambulances usually only accompany a patient when the medicine/drips they have fall out of the scope of a paramedic. For instance: My friend's father had liver cancer and had to be transferred from a smaller hospital to UCLA Medical Center. Unfortunately, he was on multiple pressors which fell out of the scope of a paramedic, so a RN had to accompany him during the transport(Bower's Ambulance, great crew). Sometimes, it is necessary for a hospital to call 911 for inter-facility transfers(Stemi, trauma, neuro, etc). Same thing applies, if anything falls out of the scope of the paramedic, an RN or DR from the facility will usually accompany the patient with the ambulance crew to the hospital.
 
Billy D said:
To NYSEMS2217: In los angeles county, private ambulances are allowed to run paramedics as well as RN's. The RN's in private ambulances usually only accompany a patient when the medicine/drips they have fall out of the scope of a paramedic. For instance: My friend's father had liver cancer and had to be transferred from a smaller hospital to UCLA Medical Center. Unfortunately, he was on multiple pressors which fell out of the scope of a paramedic, so a RN had to accompany him during the transport(Bower's Ambulance, great crew). Sometimes, it is necessary for a hospital to call 911 for inter-facility transfers(Stemi, trauma, neuro, etc). Same thing applies, if anything falls out of the scope of the paramedic, an RN or DR from the facility will usually accompany the patient with the ambulance crew to the hospital.
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This would differ because California has decided to be a special snowflake, no?
 
VentMonkey said:
There, fixed it. While my state has its issues, they're the gawd awful worst.
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sorry sir i ajolopise. I have looked into it a bit in my swift break between work and class, and have become seriously interested in becoming a VA RN to get my feet wet/started.
 
Chase said:
I hope that CAMTS removes CEN as an accepted "Critical Care" certification as it does not compare to CCRN or CFRN.
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This. I just passed my CEN, now I'm studying for my CCRN, and the two aren't even close.
 
NysEms2117 said:
@Chase i just entered my first semester of nursing school last week. BSN program, i'm doing 2/5 semesters "full time"(12 credits) approx 1.5 year completion time. All i'm in right now is A&P2, nursing ethics, and IV lab.
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When you're doing clinicals, if they give you the chance to choose where to "float" for the day, choose ICU. You'll learn more in one day shadowing in ICU then you will the rest of the semester on a med-surg floor.
 
medichopeful said:
When you're doing clinicals, if they give you the chance to choose where to "float" for the day, choose ICU. You'll learn more in one day shadowing in ICU then you will the rest of the semester on a med-surg floor.
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will do, thanks for he advice.
 
There are nurses in Colorado with EMT licenses acting as paramedics on 911 ambulances. I am not sure how this works, but a friend is one. I keep forgetting to get the explanation.

Massachusetts had a transition program for RN to medic which was a small class and internship. Most of the CCT programs had dual certified RN/medics as a result.
 
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