Thoughts on RNs being allowed to challenge Medic exam?

ruralEMSgirl

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In my state of residence, RNs (and PAs) are allowed to challenge any level of the NREMT exam, up to and including the Paramedic exam.
As far as I could tell, no pre-hospital experience required. Meaning, a RN who's only prior training was nursing school and their current RN position, is allowed to test for their medic, and potentially become a licensed medic as a result.

I was honestly really surprised when I found this out- as an EMT who is currently in Nursing school, I've seen again and again just how different the nursing approach is from the pre-hospital approach. Not only that but this raises so many questions to me, as there is no required pre-training or EMS experience, they are allowed to just straight up test for and then become a Medic: how does an RN know how to perform various Medic-level skills and interventions that are not normally covered in nursing school? Moreso than the interventions/skills: how would an RN even learn to think like a medic?

What are y'alls thoughts on this? Is this a safety issue secondary to insufficient training requirements? Or is this no big deal as RNs (and certainly PAs) go through their own robust training? Is an RN/PA with no pre-hospital experience "safe" to operate in the field as a Medic?

(New to the forum so please delete if not allowed/ a repeat question.)
 

Summit

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Nobody would hire with zero relevant experience... but then medic pays way less so why would a PA or a RN bother?

If the RN is a flight RN, then the dual cert makes sense but there's your experience...

Outside of general EMS operations, there isn't much in the medic scope that an experienced crit care/emergency PA or RN isn't familiar with.

All that said, there is a good argument for relevant experience requirements and some ride alongs.

Now which state?
 
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ruralEMSgirl

ruralEMSgirl

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Nobody would hire with zero relevant experience... but then medic pays way less so why would a PA or a RN bother?

If the RN is a flight RN, then the dual cert makes sense but there's your experience...

Outside of general EMS operations, there isn't much in the medic scope that an experienced crit care/emergency PA or RN isn't familiar with.

All that said, there is a good argument for relevant experience requirements and some ride alongs.

Now which state?
https://www.healthvermont.gov/sites...EPRIP_RNPALicenseandExamApplication140514.pdf

It's a little wordy & visually cluttered, but here's what I read that led me to make this post, straight from the source! (above)

I agree with the points you made...I guess my big mental hang-up was just the wide array of different skillsets in different nurses, and
Based on what I read above, it seems like some 1 year old Med-Surg nurse could just go ahead and take the exams -> become a Medic -> suddenly be awarded a relatively high-stakes scope of practice in the field. It's that aspect that gives me pause.

Maybe the current system makes sense, maybe it's no biggie, but I would love to see the state tack on some additional requirements like ride alongs.
And also mandatory pre-testing psychomotor training- I'm envisioning something like the in-service a nearby agency made all medic providers attend. They practiced the higher-risk interventions.

I remember hearing they had a good working relationship with a nearby butcher, and their medics were practicing cricothyrotomies on recently deceased pigs.

I just feel like...medics go to school to become medics. They aren't going to nursing school, they go to MEDIC school. Surely they spend that year(+/-) of training learning necessary skills. I don't buy that clinical experience (even a great deal of it) is going to address any deficits in skills/clinical judgement for a provider.
 

DrParasite

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It's a fine question... why should an RN have to go through an EMTs education? or a paramedics? If they can pass the exams, that means they have the knowledge needed to be a medic right?

I know some RNs who worked as EMT-RNs, and they are awesome providers on 911 calls, as well as Paramedics who went to nursing school and now work as MICN; they are good at what they do.

I also know some who are downright scary; when you take the experienced RN out of the hospital, and put them on a moving vehicle, and expect them to do patient care where things aren't nearly as controlled as they are used to, they melt down.

Most EMS agencies that hire an RN as a newbie medic are still going to put them through the credentialing process, just like they would any other newbie medics, as well as pair them with an FTO until they are fully cleared.

Personally, unless you were an ER RN, or an ICU RN, or had some type of EMS experience, I would much rather you stay in the hospital. While I have no doubt there are some great providers, working in the field with much fewer resources in a much more dynamic atmosphere is much different than working in a hospital.
 

MMiz

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This is going to be an unpopular opinion, but I think that if you can pass the licensing exam and have the required hours internship hours, you should be able to be licensed in EMS.

Michigan didn't allow nurses or other providers to challenge EMS exams when I was going to school. I had a Nurse Anesthetist in EMT-Basic class with me. She was a rockstar in class and during clinicals.
 

mgr22

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This is going to be an unpopular opinion, but I think that if you can pass the licensing exam and have the required hours internship hours, you should be able to be licensed in EMS.

Michigan didn't allow nurses or other providers to challenge EMS exams when I was going to school. I had a Nurse Anesthetist in EMT-Basic class with me. She was a rockstar in class and during clinicals.
I agree. Getting licensed isn't the same as getting hired, or at least it shouldn't be. Let employers consider the pluses and minuses associated with each licensed candidate and decide who gets offers.
 

Akulahawk

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This is going to be an unpopular opinion, but I think that if you can pass the licensing exam and have the required hours internship hours, you should be able to be licensed in EMS.
I have no problems with this. However, I must say that doing internship hours should be a requirement of attaining a Paramedic cert. The reason I say this is actually pretty simple. An internship allows for an easily supervised learning experience for the person that's never done EMS before. For the PA and RN, it effectively becomes a transition course so that they can safely begin to do the job in the field. Once that's done, then any company would be able to hire and use the "new" Paramedics just like any "new hire." The internship process for the PA/RN would ideally also include modules for familiarizing the applicant with the various skills and policies/procedures typically used in the prehospital environment.

For the ED/ICU nurse, or a similarly experienced PA, the skills verification process itself should be very rapid as they're already familiar with most of the skills used by Paramedics.

One of the more interesting conversations I've had over the years was with the Chief Flight RN at Stanford Health (at the time) and it pretty much involved this topic. His personal opinion, which was shaped by his experience, was that it takes about 6 times longer to train a non-EMS nurse to the flight environment than it does for a nurse that has a couple years of EMS experience (Paramedic specifically). The "medicine" isn't the issue... the nurses know that VERY well and is about the same for EMS/Non-EMS nurses. It's the rest of it all that takes the extra time.
 

DrParasite

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A bit like making a firefighter an EMT or paramedic (can of worms now open)
actually, it's not. In your example, the hose dragger is completing a full EMT or paramedic class, taking tests along the way, and having documented their completion of any skills accomplished successfully. There is no "challenge", they are simply completing the class. It's not like someone is saying "well, since you spend a lot of time on an engine, you must know EMS. here, take this exam, and if you pass, we will give you a formal EMS certification." Two completely different scenarios.
 

akflightmedic

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Agree on the personality. These RNs are high speed ICU, ER, CVICU. They typically know their shyte, and are more than welcome to challenge and add the letters. I do like the requirement that FL has however, all Flight RNs must, and any RNs who wish to challenge, shall also complete an EMT course. That is a great class for them to get the fundamentals of radio ops, scene activity, body mechanics, stretcher ops, etc.

And no, I do not think the other way around is advisable. I used to; however, my personal experience has changed my opinion. Medics should not be allowed to challenge the NCLEX.
 
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