RN on ground ambulance?

[DrParasite]

In NJ, all CCT runs are made by an EMT and an RN, two EMTs and an RN, or a paramedic and an EMT/RN (and sometimes an EMT driver). If the agency that is providing the CCT truck is also an ALS provider, than the Paramedic and RN can answer 911 calls as an ALS unit in the 911 system (depending on availability).

 

[Carlos Danger]

There's lots of opportunity for someone with quality experience in both nursing and EMS, along with dual licensure.

Mostly in CCT and HEMS, but also education, EMS coordinator for hospitals, etc.

 

[NysEms2117]

There's lots of opportunity for someone with quality experience in both nursing and EMS, along with dual licensure.

Mostly in CCT and HEMS, but also education, EMS coordinator for hospitals, etc.

would said EMS experience have to be at the paramedic level? or just knowledge of how pre-hospice care is done?

 

[Carlos Danger]

would said EMS experience have to be at the paramedic level? or just knowledge of how pre-hospice care is done?

Completely depends on the specific position.

 

[VFlutter]

would said EMS experience have to be at the paramedic level? or just knowledge of how pre-hospice care is done?

For my current job they were more than happy with EMT-B since the majority of RNs do not have any prehospital experience.

 

[VentMonkey]

For my current job they were more than happy with EMT-B since the majority of RNs do not have any prehospital experience.

What's the average years of in-hospital experience at your program, though? And is it mainly ICU, ED, or both?

I don't think the level of prehospital certification experience matters much when trying to get a job on an ambulance (air and ground), but still think the mandated years of experience with most services is at minimum sufficient.

Then again, my personally opinion is still about 5-10 years of experience for most single-role (see: none dual-licensed) paramedics. While 3-5 years seems good on paper, it's an arbitrary number in my head.

Now, certainly one can argue that some providers may get that level of experience in the 3-5 year timeframe, but more often than not it seems like a smoother transition when the providers skills need not be honed as much, at least whilst going through the training process.

 

[MackTheKnife]

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.

RN+EMT=PM? Must be a new kind of math!

Sent from my XT1585 using Tapatalk

 

[VentMonkey]

RN+EMT=PM? Must be a new kind of math!

Sounds like some sort of bridge program, Mack. The infamous UCLA Freeman offered this up until as recently as last year.

About the same. 2 weeks of didactic, followed by the full internship hours logged. Then they can sit in on the NRP.

My flight nurse now is waiting for an EMT class to open up. I believe all he would to do is find an EMT class and get permission from the lead instructor (some sort of sign off), then he can take his NREMT-B exam and get his basic back.

The permutations Ep eluded to earlier in regards to California are basically the nurse (and fire) unions have some major clout with things of this nature.

The handful of medic to RN programs 'The Gov-ah-na-tuh' granted about 8-10 years ago have been disbanded, however, he will NOT "be bah-ck" (sorry, too easy).

 

[Jim37F]

At my very first ambulance job, they had CCT units that were staffed 2x EMT and an RN that would take calls that were above a paramedics scope of practice. That same CCT configuration could be (and was) used to take ALS level calls when a medic unit was otherwise unavailable. (I believe this is how companies in Orange County did ALS IFTs before the county began allowing private paramedics, yeah Orange County sometimes manages to make even LA look progressive...)

There were also Respiratory Techs who were on call and would hop on a BLS unit and could take a ventilator dependent pt who otherwise didn't need the Critical Care Nurse.

And also, Kaiser would sometimes have them send an ambulance to pick up an MD to do certain critical care transports (usually a BLS crew was dispatched and the MD hopped on as 3rd man, same as for the CCT-RN or RRT calls.

In my experience, the nurse (or other higher level provider) has always been 3rd person on an otherwise normally staffed dual EMT BLS rig, or simetimes a medic staffed ALS unit.

 

[EpiEMS]

There were also Respiratory Techs who were on call and would hop on a BLS unit and could take a ventilator dependent pt who otherwise didn't need the Critical Care Nurse.

I noticed this when I was looking through LA County's (comprehensive list of) policies -- it seemed like a reasonable approach (based on the inventory required, for example - things that an already intubated IFT patient might need). Seems like a nice (affordable?) idea.

 

[VentMonkey]

I noticed this when I was looking through LA County's (comprehensive list of) policies.

You sir, are too kind with your words.

 

[Akulahawk]

My understanding is that in order for a vehicle to be legally counted as an "ambulance" it must be staffed with someone that meets "ambulance driver" qualification and a second person that's an EMT or higher (and is authorized to do prehospital care). Therefore an ambulance must be staffed with two people that are authorized to do prehospital care (because the ambulance driver is allowed to do first aid at emergency scenes). Thus RN level CCT ambulances are supposed to be staffed EMT/EMT/RN or EMT/Paramedic/RN in order to be considered ambulances. Now if the RN is also dual certified/licensed as an EMT or higher, that second license counts... Using that logic, since I'm dual licensed, I would be able to be counted as both a prehospital provider and an RN, allowing the ambulance to be considered an ambulance while only being staffed by two people.

 

[VentMonkey]

Using that logic, since I'm dual licensed, I would be able to be counted as both a prehospital provider and an RN, allowing the ambulance to be considered an ambulance while only being staffed by two people.

This would be correct. You could also in theory take the ADL exam, pass it, and be an ambulance operator as well; a very well paid, and over educated ambulance operator.

 

[VFlutter]

Certain state such as Arkansas require RNs in any prehospital role to have at least EMT-B. So all their flights nurses must go through an EMT course prior to flying. I was told there are lots of opportunities for over time in those parts

 

[NysEms2117]

Certain state such as Arkansas require RNs in any prehospital role to have at least EMT-B. So all their flights nurses must go through an EMT course prior to flying. I was told there are lots of opportunities for over time in those parts

A bit out of my geographical range

 

[DrParasite]

Certain state such as Arkansas require RNs in any prehospital role to have at least EMT-B. So all their flights nurses must go through an EMT course prior to flying. I was told there are lots of opportunities for over time in those parts

I think we can all agree that an RN's clinical education is far superior to an EMTs; however, there are still several parts of the EMT course that most nurses know absolutely 0 about. Off the top of my head, that includes ambulances operations, communications, ambulance equipment, lifting and moving (doing stuff hospitality is MUCH different than in a hospital with all the extra hands, space and light that you need), and scene safety and sizeup, would need to be covered. And that's not even covered working in a moving ambulance going down the road vs being at the patient's bedside.

When I worked a a member of a pediatric CCT unit, we required the nurses to go though an EMT refresher class. The truth is, unless the RN had any EMT experience, while they were able to treat the patient, they had now idea where anything was, how to use any equipment on the ambulance that wasn't also on their floor, and they had little to no desire to try to learn where it was or how to use it. Heck, our nurses didn't even check them ambulance to make sure all their equipment was there and working. I know we were required to have a lifepack on the ambulance, because an ambulance needs a defibrillator..... none of the nurses knew how to use it, anytime we needed a monitor, they had to take one off the floor and bring it with them in the ambulance.

 

[EpiEMS]

, they had now idea where anything was, how to use any equipment on the ambulance that wasn't also on their floor, and they had little to no desire to try to learn where it was or how to use it.

These could be handled by an in-service, they don't necessitate a full EMT course (or even a refresher, I'd say), but there is certainly some CYA benefit to having a refresher.

 

[DrParasite]

the refreshers were basically 24 hour classroom time divided over 3 days. there was no hands on, no actual familiarization, and no demonstrating competency. At least with the full EMT class, those three things should be taught, reviewed, demonstrated and documented.

 

[EpiEMS]

there was no hands on, no actual familiarization, and no demonstrating competency.

Ooh. That's even worse than the worst in-service I have been to.

 

[scotty vidrine]

I guess I'm just being territorial but i don't like the thought of nurses on the units or any kind of transport. Nurses have so many job opportunities and we have a limited amount. After 28 years in the business I thought it would have expanded more but it still just centers around ambulance services. I wish it was different. Not many opportunities out there. Many reasons why I'm sure but that is for another post I think