Who is the highest level of care?

[boneknuckleskin]

Thread was a pissing match long before I posted. I still don't have any clarity on the professional inequality. I read about EMS and low education standards and I hope that NREMT's attempt to phase out non-accredited schools is just the first step in a lot of changes, but with EMS being so young I understand the division. Nursing schools did not start out as BSN programs all those years ago. It took nursing a long time to get where it's at but all this about nursing education being well structured and held to the highest of standards is a myth.

Looking at local options, the busiest nursing school is not college based and awards no college credits beyond the nine prerequisites you take prior to entry, the school is hospital based. The second in line is a 12-month program for those who hold a baccalaureate's degree in any field, including non-science related such communications or composition. These students don't attend formal classes or lecture, but work through online modules and attend a total of 500 hours of clinical time for the program in its entirety in addition to "boot camps" at a cost of $26,000. Students who complete these requirements obtain a BSN and there is no shortage of willing applicants in sight. I suppose these "nursing mills" are the answer for the purported nursing shortage.

The university does offer a traditional BSN program. The EMS program can award either a diploma or a degree, but both last 24 months with one having a lighter course load and both are college based with credit. Students that complete the first degree can progress to Bachelor's in EMS at that point. Regardless, a nurse and paramedic holding similar degrees can graduate and enter the workforce with the nurse making considerably more than paramedic while taking half the responsibility and risk to themselves. The only local health care profession of three that requires a minimum associates degree to practice is the respiratory therapy program.

Also, isn't it right that the Florida RN's must hold an EMT certification before challenging the paramedic exam? If true, I still think of anyone who tried to do so with concern. As Ventmedic said, most paramedics lack the 3 - 5 years experience in the ICU feeding patients ice chips and bathing them post-op but equally so, nurses lack the 3 - 5 years of hands on working experience that paramedics have on the streets without a safety net. Nursing isn't for everyone and it's definitely not for me. Academically, it would be a breeze and I also have a two year old so I already know how to wipe an ass, I just don't want to get paid for it.

[Dustdevil]

...nurses lack the 3 - 5 years of hands on working experience that paramedics have on the streets without a safety net.

So do new grad medics, so what is the difference?

Nursing isn't for everyone and it's definitely not for me.

I can tell. You're obviously not even interested enough to have acquired an intelligent understanding of it.

Academically, it would be a breeze

Every medic who attempts Excelsior says the same thing. Well over ninety percent of them fail. Not sure I have a lot of faith that you are the rare five-percenter.

[VentMedic]

Also, isn't it right that the Florida RN's must hold an EMT certification before challenging the paramedic exam? If true, I still think of anyone who tried to do so with concern. As Ventmedic said, most paramedics lack the 3 - 5 years experience in the ICU feeding patients ice chips and bathing them post-op but equally so, nurses lack the 3 - 5 years of hands on working experience that paramedics have on the streets without a safety net.

I didn't type "feeding ice chips". However, I do believe your post gives us a clue that whatever education you received did nothing for your knowledge about healthcare professionals or the field of medicine.

Paramedics make up the majority of students attempting Excelsior. RRTs usually take the traditional route if they wish to be dually credentialed. They already have a solid educational foundation so only some of the nursing core is required. Many RRTs that do get their RN rarely leave the RT field but use the education to expand their knowledge of the nursing process to compliment their professional goals. RRTs at least have been past the ED and do have an understanding and respect for nursing as a profession before they enter into it.

The reason RT is no longer an attractive option for Paramedics is it requires 76 semester hours at a college without the option of a mail order program. Event the lowest or entry level credential, CRT, requires a minimum of a two year degree.

Late addition: I chose to get another healthcare credential, RRT, in 1986. I was among the many degreed Paramedics graduating in the late 1970s and early 1980s. Nursing had just achieved their professional status with the 2 year degree and it looked like the Paramedic would be next. Then, the medic mills started flooding the market with 3 month wonders who were making the same money with less education, clinical time and knowledge as a degreed Paramedic. It cheapened the profession and many really good Paramedics left for other occupations. In my RT class of 24 students, there were 10 Paramedics. There are several other healthcare professions that may actually pay more than RN which some Paramedics would be better suited for. These are rarely considered because of the time required to obtain the education needed. It seems like Paramedics have also narrowed the options for alternative career considerations because the RN is the only other healthcare professional they "think they know" when in actuality very few know what a nurse is or does.

[Freshmeat]

I dunno & am pretty happy to leave it that way at this point

However, I'm not sure where its possible to compare Medic education with an RN ed. An RN Associates degree is basically equavilent to a 4 year degree with 4 blocks of Nursing school(2years) and about 4 sememsters of Pre req's (2yrs) Mostly Bio & chem + co reqs. Medic school ranges from 9-14 Months in AZ and very few medics I know ever bothered with the associates that goes with it, as it gets you no where; and takes alot of extra time. ("no where" ='s read $$$). My partner has an AA in emergency Medicine and he makes $13.00 an hour just like the rest of the medics with comparable employment time AA or no. PLEASE do not read this as a knock against medics (I spent a better part of my life wanting to be a Medic)..its not a knock, just not seeing how the education is comparable timewise. I wish to god it was comparable, I would be in Block two of nursing school right now!

[spenac]

I dunno & am pretty happy to leave it that way at this point

However, I'm not sure where its possible to compare Medic education with an RN ed. An RN Associates degree is basically equavilent to a 4 year degree with 4 blocks of Nursing school(2years) and about 4 sememsters of Pre req's (2yrs) Mostly Bio & chem + co reqs. Medic school ranges from 9-14 Months in AZ and very few medics I know ever bothered with the associates that goes with it, as it gets you no where; and takes alot of extra time. ("no where" ='s read $$$). My partner has an AA in emergency Medicine and he makes $13.00 an hour just like the rest of the medics with comparable employment time AA or no. PLEASE do not read this as a knock against medics (I spent a better part of my life wanting to be a Medic)..its not a knock, just not seeing how the education is comparable timewise. I wish to god it was comparable, I would be in Block two of nursing school right now!

If all medics were required higher education, pay would be higher. The reason pay is same now, educated or not, is education is not required so the services will pay the lowest rate they can to fill the slot.

Back to OP I am the highest level of care on scene until I turn care over to heli crew.

[VentMedic]

Back to OP I am the highest level of care on scene until I turn care over to heli crew.

You may still have control of the patient but may not necessarily be the highest level of care. If the HEMS crew is flying Paramedics that do not have the ability to perform any additional procedures or protocols or if you actually have more advanced protocols , then yes the level of your care may be equal or greater. There are some services that actually just place ground paramedics on a helicopter without any additional education or training.

EDIT: deleted reference to the new service in Kingman, AZ to give them a chance to prove themselves before forming an opinion.

[spenac]

You may still have control of the patient but may not necessarily be the highest level of care. If the HEMS crew is flying Paramedics that do not have the ability to perform any additional procedures or protocols or if you actually have more advanced protocols , then yes the level of your care may be equal or greater. There are some services that actually just place ground paramedics on a helicopter without any additional education or training.

Your right. I should have said I am in charge until I turn care over. I have kicked doctors out of my ambulance when I felt they were causing more harm by being in the way. Don't take it wrong though, I am happy to get someone with more education or better protocols on board to improve patient care. But I am in charge till patient until I hand them off to the higher level.

[Freshmeat]

You may still have control of the patient but may not necessarily be the highest level of care. If the HEMS crew is flying Paramedics that do not have the ability to perform any additional procedures or protocols or if you actually have more advanced protocols , then yes the level of your care may be equal or greater. There are some services that actually just place ground paramedics on a helicopter without any additional education or training.

EDIT: deleted reference to the new service in Kingman, AZ to give them a chance to prove themselves before forming an opinion.

I'd like to hear what you have to say about River Medical/AMR in Kingman! There is ALOT of talk in my circles about AMR (there is an advertised online hiring ad for Chandler (suburb of Phx. by AMR) and as far as I know they dont have any CON other than River Medicals....talk!! People are listening!!

[Scaramedic]

...but all this about nursing education being well structured and held to the highest of standards is a myth.

Considering the current state of most Paramedic programs I would consider even the worst Nursing program a Gold standard.

Nursing isn't for everyone and it's definitely not for me.

For all nurses and Future Nurses (in my case), thank you.

Academically, it would be a breeze and I also have a two year old so I already know how to wipe an ass, I just don't want to get paid for it.

Saying that Nursing is about wiping asses is about as intelligent as saying being a Paramedic is just about driving an ambulance.

Nor obviously do you want to get paid for having a greater knowledge of anatomy, physiology, psychology, algebra, chemistry, biochemistry, sociology, statistics, microbiology, and nutrition. All of which are just the pre-reqs for entering the Nursing program I am hoping to enter. Not to mention the furtherance of understanding the disease, trauma, care and healing process that is part of the program.