Paramedic vs ER Nursing?

[BushyFromOz]

I think you have to ask yourself which you enjoy more and what your personality predisposes you too. I thought about doing the Nursing/Paramedic double degree, but eventually thought - Why? In what world do I want to be a nurse? What in, essence, floats your boat when it comes to EM?

Dead set, i had this exact opinion, and so did a LOT of guys who di pre-hospital care. The concensus among most people i know is that having the BN would have been a very handy addition, not necessarily because you want to be a nurse, but when your mid 40's and sick of ambulance, it provides a fall back that pays well, in an industry where you can more or less select your own hours and is far more transportable than ambualance is, and generally you get more credits for a BN than a degree in ambulance if you chose to do further study as it has more in common with other allied health degrees than ours does. You listed a lot of good stuff there about career progression, unfortunately ambulance is THE commonality again, not that its a bad thing, it just doesn't leave you with many options if its ambulance your sick of.

At the very least, the extra A&P would have been handy (but seeing your a monash student, that's probably not a problem for you )

Personally, ifeel RN's that think like an ambo's are machine's!

[Timmy]

You could always work for RFDS doing retrievals and play paramedic, nurse and doctor in the back of a plane... That would be an awesome job!

[Kiwiology]

You know the more I look at it, I don't see it as being all that different really.

I mean we all want to help people, and we like our drugs and toys and physiology and IV fluids right? I know I do!

So if that's the case then look at this way ... so what if you have to clean up somebody else's poo as a nurse, you're still helping that person. So what if you need to scurry off and ask "Doctor may I?" it's really not that big a deal, you're still getting to stick people and give them drugs and use your knowledge.

You also get far-in-advance the opportunities to travel and participate in research and challenge your clinical brain as a nurse than in the ambulance service; last time I checked they weren't doing any clinical trials.

I have been told by our DHB nurse educators that the autonomous ability to give med's, intubate or decompress chests is really non-existent in a hospital setting because you have so many other clinical specialties to help you.

Am I saying all of this to make my time on the BN (if I ever get in) barely palatable because in reality I really do like working in the street, you bet your arse I am, but, on the other hand, is it probably true and I do actually believe it, you bet your arse I do!

[melclin]

Dead set, i had this exact opinion, and so did a LOT of guys who di pre-hospital care. The concensus among most people i know is that having the BN would have been a very handy addition, not necessarily because you want to be a nurse, but when your mid 40's and sick of ambulance, it provides a fall back that pays well, in an industry where you can more or less select your own hours and is far more transportable than ambualance is, and generally you get more credits for a BN than a degree in ambulance if you chose to do further study as it has more in common with other allied health degrees than ours does. You listed a lot of good stuff there about career progression, unfortunately ambulance is THE commonality again, not that its a bad thing, it just doesn't leave you with many options if its ambulance your sick of.

At the very least, the extra A&P would have been handy (but seeing your a monash student, that's probably not a problem for you )

Ahh, I'm actually sitting here with my A&P book, reviewing some basics, prior to placement next week, and I'm thinking I don't remember half of this stuff from last year.

Personally, ifeel RN's that think like an ambo's are machine's!

Well to a certain extent that doesn't matter too much (if i get sick of the ambo thing, I'm fairly certain I'm not going to chuck it in for OT or midwifery etc) but the transferability of skills is the biggest downer for me. Specifically because of...

You could always work for RFDS doing retrievals and play paramedic, nurse and doctor in the back of a plane... That would be an awesome job!

I've been to the Broken Hill RFDS base (good museum), it's, foshiz, an awesome gig, I'd love to give it a shot. And I'd like to spend a year with Médecins Sans Frontières. Neither of which are impossible, but it's crazy complicated to work it given the B. Emerg Hlth is officially recognized, but not really accepted in the sense that most people just haven't heard of it. I spoke to a guy at MSF and they do take degreed medics, its just a more difficult process. So there's that to think about.

At the end of the day OP you'll get credit for which ever degree you decide on if you wanna up and do the other one down the track. I've heard here its only 1-2 years depending on the time you have here, but there might not be a lot of reciprocity over the ditch given that the degree is newer (I think). Still, you'll get something, and if you can't you can just come over here like all the rest of your countrymen

[BushyFromOz]

and if you can't you can just come over here like all the rest of your countrymen

now that was funny...

[Kiwiology]

now that was funny...

The NZ Govt in its infinite wisdom has come up with a goal that by 2020 it will have closed the income gap with Australia, yes, there's a good idea, try to compete with a country 20x the size of us with an economy to boot .... stupid bastards

[Timmy]

I work in a rural hospital, we have no hospital medical officer. During business hours the medical clinic (which is branched onto the hospital) has a roster of general practitioners who will be on call to come into or be a referral source for phone orders, down side is if there called over to the hospital this puts the medical clinic patients behind. The same for after hours, there will be a doctor on call (most of the time) or available by phone (most of the time).

So when someone comes into our 4 bed Urgent Care Centre (we see about 15 patients in a 24 hour period but can reach 60 patients during summer when the campers flock in) it's really 50/50 to whether the doctor will come in, most of the time there happy to come in (can take up to 30mins by the time they fix up there tie) but they'll give you a phone order while your waiting.

There is a standing order in place for the RNs who have completed the front line emergency care course to initiate certain emergency medications e.g. Adrenaline, glucagon, salbutamol, certain analgesia, certain antiarrhythmics, start fluids and so on. They can also put down LMAs, initiate a cannulation etc. But it's less paperwork to get a phone order from the on call doctor which only takes 2 seconds. If something challenging comes in we call the ambos then the doctor, it generally takes 10 mins for the the ALS crew to arrive but can take an hour for the MICA crew to come over and if your really unlucky and our ALS crew is already out it can take a fair while. Your assessment initiates what level of response comes in.

So there is some room in a rural setting for RNs to have an extended scope of practise and work without a doctor or with only a phone order. I do admit it's not the world's busiest ED but when things start going down hill there is only a very small team of people who play a vital part in keeping the patient alive until the next level of care arrives.

[PolynesianMedic]

My thought on this is simple. Go for the Paramedic degree if you don't want to deal with the nonsense of the hospital, BUT go with the RN degree if you can deal with that and want the money. I worked for 2 1/2 years in an ER, and a year with an interventional cardiologist office, to see if I wanted to go back to school for my RN, or MD/DO. The final result is that I am and ALWAYS will be a Paramedic. Being inside of these two situations made me appreciate my job so much more. I hope this helps.