I can only write from my perspective, so this opinion is what it is. I know I am smart and capable. I am the guy who never studied for anything, sailed through high school honor classes, blasted some college courses in pursuit of one day being a doctor, before being seduced into EMS. Became an EMT after penciling the NR Exam in about 45 minutes, and then promptly enrolled in Paramedic school. A program that was less than 6 months in length, which often had the instructor saying, "if you see this, you give gray box, you see this, give purple box". I learned what I could from the program but knew there had to be better and it would be up to me to find it. I was 19 when I sewed on my NR Paramedic patch.
I left good old SC and moved to Florida. Wow, huge learning curve for me. Went to work for an all-ALS service, double medic truck, no fire, county service that had National recognition a few years prior. They were progressive, aggressive, and huge supporters of education. I quickly realized my cookbook recipe education was not going to fly for very long. I had to dig deep to self-learn, became an instructor and started teaching to assist reinforcing my knowledge base. Then I decided I wanted to become a flight medic. I took the courses required, but could not break in the field in FL. So, to realize my dream, I made a move to Alaska. Holy Cow!! Another huge knowledge gap...remote, rural, frontier...those are the only descriptors. I did my first chest tubes there, administered blood, delivered high risk babies, RSI my butt off. It was freaking amazing, however again, required tons more of education along with experience.
As some of you know, I jumped from flight service to flight service, went to work for DOS in Philippines, then onwards to the world of DOD contracts in Afghanistan, Iraq, parts of Africa. I then turned all that into a rather long successful business venture. Again, knowledge and experiences I never had before. Diagnosing and treating, no medical top cover, prescribing meds, ABX, suturing, prev med, occ med, crisis counseling, Nutrional counseling, on and on. Then I sold the business, cashed out, and entered personal life turmoil which flipped all I had known upside down.
So, with my world spinning, I made future plans for myself several of which would necessitate having RN behind my name. It was the "easiest" path for me to follow, as I knew I did not have the time or mentality to pursue any higher-level provider degree. With my three year no-compete in effect, I returned to college and began nursing school. I chose to do the full brick and mortar program as I wanted to not short change myself in any way. Could I have taken the medic to RN route, yep I would have skipped the first semester only, and by doing so, missed out on building rapport with my classmates, but also receiving exposure to many elements of that first semester which I have never been exposed to. By completing that first semester, the state also automatically granted a CNA license. I then took a job in a local ICU as a CNA so I could have real time exposure to ICU level Nursing to further assist me down the road. That first semester gave me exposure to feeding tubes, Gtubes, wound care, much of the basic crap which I have no desire to ever deal with, however knowledge that is sometimes needed, even in the ER.
Nursing school sucked. I truly was bored majority of the time, I did skip lectures often, and yes, I absolutely had enough knowledge to just challenge the exams. I spent more time hosting study groups, teaching my cohorts, and drilling them for practicals and exams. Nursing school barely scratches the surface of actual nursing, and it mostly prepares one to be a MedSurg nurse at best. I was almost kicked out on two different occasions, because I am that guy who will push the envelope, challenge instructors, and always demand to know why or more. For the record, most do not like that. I was even banned from class exam review my senior year due to my frequent challenges backed by facts, so I had to schedule 1:1 reviews.
Despite all these hurdles, I do not regret doing the program the way I chose to do it. Once graduated, I sat for NCLEX and it shut off on #75. Not bragging, just facts.
I apologize for the lengthy surface background; however, I think it is needed to potentially understand my perspective. Once I had RN, I went straight to an ER, have never worked a day in any other unit. I did ok in the ER, I thought I was doing great, but I did have some awesome preceptors. I thought I did not need this orientation period or preceptor. I was slightly cocky on some things for sure. The only reason I improved is because of who I am. I looked around and saw other Medic to RN staff, and they were mediocre at best. They struggled or they simply were indifferent. RN was just a pathway to better money. Sadly, those clowns in my area helped foster a mindset that the Medic to RNs sucked. They were not wrong on most. LOL
After 5 months or so in the ER, I started travel nursing. Talk about jumping in the shark waters!!! During my travels, I have met many Medic RNs, some good, some bad. Not every Medic education is the same, so that does directly correlate to nursing competency initially. I would absolutely be concerned with any RN in a critical care capacity overseeing my care, knowing they only had challenged the exam. I did yield benefit from nursing school that has been relied on by me in various ER situations. No school, then I would not have had this prior exposure and then I would either burden my already burdened coworkers, or I would provide substandard or neglect care.
As I said, for many, many years I was shoulder shrug to the difficulty level of nursing, and I did sign up a few times early in my paramedic career for Excelsior. I wanted to fast track because how simple it was to be. I absolutely have the intelligence, the experience, and personal drive to accomplish becoming a RN simply by "testing out", however what I did not know was all the smaller nuances, skills not taught in medic or nursing school which impact the level of care and flow of care I provide. There are so many to list, I simply do not have the time. But I think even you yourself have stated in the past, or implied, "you don't know what you don't know". Again, I have no factual peer reviewed studies to back any of this up, just a well-informed guy sharing how he went about it all, and what he thinks of it all. I would be a way less nurse had I not endured the trials and tribulations of nursing school, with all of its clinicals, and then subsequent new hire orientation period.
I feel as if no matter what is stated, you will not be convinced otherwise, and the only way you might even come close is if you yourself choose to attempt it and then report back. The unfortunate part of the study is you can only choose one path personally, so then the results themselves are still technically flawed, right? To each their own I guess, however this old man took the long route and does not regret it.
