Paramedic/RN

[Jwade]

I have read this last part of the thread, and I really don’t know what can come from this discussion. The education of a nurse and a paramedic are different. Maybe in the community college the pre-requisites are the same or similar, but the core classes are different. As far as I know, ADN nurses do not need chemistry courses, but require a biology/microbiology course. I think this is not required for AAS paramedic yet is it, it wasn’t for mine. I think these go a long way to understanding the base of disease and treatments, certainly from an outcome standpoint. Most nursing pharmacology courses are much more in depth than the paramedic curriculum, if you attended the same course as nursing, count yourself lucky and in the majority.

Paramedic training, education if you are lucky, focused on emergent, short term care and taught in a very medical model. Find the problem, focus on the problem, and fix the problem. Nursing is a more holistic assessment and treatment process, and brings into this process a lot of psychosocial and less tangible factors than medicine. I think you can assume, and you would be correct, that the nursing model incorporates many aspects of the medical model; plus the additional factors of home situations, recent lifestyle changes, ability to care for oneself, support systems, etc. None of which would be taught in any paramedic program I have been associated with, although they are all proven to affect the healing process significantly. The additional education in psychiatric nursing is far beyond anything you will see in paramedic school; community health is non-existent in any programs I have seen; geriatric medicine is a specialty barely touched upon in paramedic education, but what percentage are the elderly in your patient logs? Pediatric education is severely lacking in the paramedic education, but is a primary course in nursing; how many pediatric clinical rotations were in paramedic school? There is a depth and breadth of education issue, I believe, at the heart of the question at hand. Nursing education is much deeper in detail and wider in breadth than that of a paramedic. Simply a difference in curriculums and focus; the intent was never to have a paramedic perform long-term care, as far as I know.

As far as skills; monkeys can learn skills and perform repetitive tasks, but thinking through the technology and how it is going to affect the patient is certainly dynamic and an exercise in critical thinking. During all the “clinical” in the ICU, CCU, Stepdowns, med/surg, etc; how much time did you spend actually caring for a patient, talking to the patient and their family, assessing the treatment plans, adjusting the plans accordingly, conversing with the physicians and students and interns…..

I still believe that there is a big difference between the “education” a paramedic attains and that of a nurse. Most paramedic programs are based on training that, like it or not, is based on cookbook type medicine. The average paramedic school graduate doesn’t not have the education that an average nurse has, and I can also pretty much guarantee you than a well educated paramedic would not have anywhere near the education or training that a well educated and trained ICU, CCU, or other intensive care based nurse would have, unless they were also the latter. This, of course, would start the micturation competition you were not looking for.

As both a very educated paramedic and a fairly educated nurse, I can assure you there are differences between nursing and paramedic. Both have their place in the health machine, and are two totally different animals.

Although I don’t think nurses should insult a profession they possibly know little about, if the nurse worked in the ED for any length of time, the insult was likely warranted. You say you are educated to a much higher level than most paramedics (medically I assume); she sees most paramedics. Most medics are the same way towards nurses and they are both way off base.

I still think that comparing a paramedic education to a nursing education is ludicrous, and I also know this discussion will be going on long after this thread is closed, regrettably…

If you don't want to be a nurse, don't. There are already too many disgruntled practitioners out there that are only in it for a paycheck. This can make for very poor patient care and you will be very miserable....I guarantee it.

CCMEDOC,

My paramedic program REQUIRED A&P I,II, Microbiology, Organic Chemistry, Inorganic Chemistry, Pathophysiology, Pharmacology I,II, All these classes were taken in a 300 seat auditorium at a very big University, where all the students of Nursing, EMS, RT, PRE-MED, all sat together for these classes.....Only when we went for our " core" classes did we break up into our respective fields.........

So, after reading this last 2 pages of the thread, both sides present strong and valid points. Unfortunately, politics and ego continue to dominate the efforts needed to make meaningful change. I love EMS and being a paramedic with all my heart, I have NEVER wanted to be a Nurse, but, I went to Graduate School to pursue an education that will hopefully allow me at some point to cut through all the BS on both sides and make some change.....

Respectfully,

JW

[VentMedic]

CCMEDOC,

My paramedic program REQUIRED A&P I,II, Microbiology, Organic Chemistry, Inorganic Chemistry, Pathophysiology, Pharmacology I,II, All these classes were taken in a 300 seat auditorium at a very big University, where all the students of Nursing, EMS, RT, PRE-MED, all sat together for these classes.....Only when we went for our " core" classes did we break up into our respective fields.........

Can you post a link to your Paramedic program so that it can be used as an example?

If this was in MI, why is that state in such of an uproar about just getting accreditation for the Paramedic programs?

[chbare]

That is one heck of a paramedic program being that a general chemistry course for many universities is typically two semesters long. Then, add courses in organic chemistry, and you are looking at 16 credits of chemistry alone. That is a hefty amount and meets the chemistry requirements for most PA programs in my area.

Take care,

chbare.

[ccmedoc]

@jwade

I, too, love working as a paramedic; and I still do. I do not, however, have any illusions as to the extent of the differences between the educational requisites of either profession; EMS or Nursing.

I find those courses to be a bit excessive, and I would love to see the program, if the anomaly still exists.. You must agree that is no where close to the norm. That is on par with average entry requisites for a BSN program, an AAS most likely does not require all the science, particularly chemistry.

I am not arguing this, simply stating it is borderline inconceivable.

EDIT: Vent, it is because MI is becoming a cesspool..Not much is going well in this fine state..

Edited January 20, 2010 by ccmedoc

[chbare]

Actually, something I did not consider is the fact that many programs require hybrid courses that are not part of the "core" chemistry courses that biology and chemistry majors are required to take. I had to take such a course last semester to obtain additional chemistry credits for health sciences students as required by my RT program and by all the health science courses at my college. (Some credits do not transfer LOL.) The exception being the nursing program; however, this particular chemistry course is required for A&P, so the nursing students have to take it anyway. The grade they receive; however, does not directly effect their application packet into the nursing program, save the fact that it effects total GPA.

The course I attended was one semester and was in essence a 3 credit survey of general, organic, and biochemistry with a 1 credit lab. While not a true course in either "general" or "organic" chemistry by a biology or chemistry major standards, it was actually quite good. Our professor was a neat lady who had her doctoral in organic chemistry. She put on a challenging, informative, and fun course.

Take care,

chbare.

[UMSTUDENT]

Jwade,

You're probably from one of the following:

University of Maryland, Baltimore County-UMBC

UPitt (my second choice)

GW's old program before they cut the clinical portion.

Western Carolina-WCU (excellent program. Buddy of mine graduate from here)

Eastern Kentucky

University of New Mexico

University of Southern Alabama

University of Texas Health Sciences University

Central Washington University

Loma Linda University

Western Carolina and UMBC bicker back-and-forth about who started the first program, but there is some historical evidence to suggest that UMBC's started in 1980. Founded by the late R Adams Cowley. Both WCU and UMBC have fairly elaborate alumni networks.

The above are the only bachelor's programs in the country that aware degrees for clinical purposes. There are other programs that focus on management and healthcare economics. Sort-of disappointed though. The year after I graduated the university made the department lower the entry credit requirements due to too many credits required for graduation. Typically students had to complete almost 150 credits (instead of the typical 120) to finish the program. The university had them remove the chemistry requirement to bring it down to a more manageable course load. Students typically handled a load of at least 15-19 per semester, or took summer and winter classes, to exit within four years prior to the change.

The current prerequisite requirements, prior to applying for application to the major at my school, are:

Introduction to Biology (6 credits w/ lab)

Anatomy and Physiology I & II (8 credits w/ lab)

Finite Mathematics OR Completion of College Algebra and Statistics for the Sciences (4 or 8 credits respectively)

Introduction to Psychology (4 credits)

Introduction to Sociology (3 credits)

Abnormal Psychology (3 credits)

Introduction to EMS (history class) (3 credits)

English Composition (3 credits)

16 Elective Credits. It's my understanding that the department highly encourages competitive applicants to use these to complete at least inorganic or biochemistry prior to application. Prior to my graduation this was a requirement ALONG with 16 elective credits. The school requires a foreign language profiency that eats a lot of those up. Many students choose to add microbiology or other sciences courses. Large subsets of students are premedical or pre-physician assistant so they extend their science education as needed.

[VentMedic]

Jwade,

You're probably from one of the following:

Posted earlier in this thread:

Third, My undergrads are in Physiology and Business Management, My Masters Degrees are an MBA and soon to be completed MHA. Not sure where you are going with that.

Were the chemistry classes required for your Paramedic or were they in preparation for a Physiology degree?

Edited January 20, 2010 by VentMedic

[Jwade]

Posted earlier in this thread:

Were the chemistry classes required for your Paramedic or were they in preparation for a Physiology degree?

Course Requirements for AAS Degree

Paramedic Courses Required

All courses with the PAR prefix must be passed with a "B-" or better in order for a student to progress through the paramedic program sequence.

PAR 1000 EMT Basic (2)

PAR 1001 EMT Basic Lab (4)

PAR 2000 Intro to Paramedic Practice (4)

PAR 2010 Medical Emergencies (6)

PAR 2020 Traumatic Emergencies (3)

PAR 2030 Special Considerations in Paramedic Practice (3)

PAR 2040 Paramedic Clinical I (4)

PAR 2100 Advanced Paramedic Practice (4)

PAR 2110 Paramedic Clinical II (3)

PAR 2120 Paramedic Internship (9)

Students participating in the distance education “Skills Camps” will also complete the following:

PAR 1011 EMT Intermediate Intro Lab (2)

PAR 1021 EMT Intermediate Lab (2)

PAR 1031 Advanced Cardiac Life Support (ACLS) (1)

Biomedical core courses required (or acceptable equivalent)

HTHS 1101 Medical Terminology (2)

Must be taken in sequence

HTHS LS1110 Health Sciences (Biomedical Core) (4)

HTHS 1111 Health Sciences (lab) (4)

Acceptable Equivalent to completing the anatomy and physiology requirement

ZOOL 2100 Human Anatomy (4)

ZOOL 2200 Human Physiology (4)

or HTHS 1115 Biomedical Principles for Certificate of Completion for Paramedics (4)

Support Courses Required (15 credit hours)

COMM HU2110 Interpersonal & Small Group Communication (3)

HLTH 3400 Substance Abuse Prevention (3)

HTHS 2230 Pathophysiology (3)

PSY SS1010 Psychology (3)

SOC SS/DV1020 Social Problems (3)

This is how the program stands now, as compared to when I started 20 years ago. Most of the same requirements still in place. The differences from my day are I don't see any specific Pharm I,II classes, and the Chemistry, Micro have been combined into the year long Bio-Medical core classes, which give you A&P, Micro, Organic/Inorganic Chem over the course of a year, minus summer semester. Obviously, on top of the above are all the general requirements as well, English, Psych, College Algebra, etc.......

The chemistry was required for the AAS when I started, again, the chem is still in the program if the student takes the BioMed Core classes. This was NOT in michigan.

Respectfully,

@jwade

I, too, love working as a paramedic; and I still do. I do not, however, have any illusions as to the extent of the differences between the educational requisites of either profession; EMS or Nursing.

I find those courses to be a bit excessive, and I would love to see the program, if the anomaly still exists.. You must agree that is no where close to the norm. That is on par with average entry requisites for a BSN program, an AAS most likely does not require all the science, particularly chemistry.

I am not arguing this, simply stating it is borderline inconceivable.

EDIT: Vent, it is because MI is becoming a cesspool..Not much is going well in this fine state..

I guess it depends on how you "qualify" normal? This was my world when i started, so for me, that was my normal. Now, what has happened over the last 20 years is up for debate obviously. In looking at UMSTUDENT list of schools, seems there are still some doing it correctly.....

Mine has clearly changed somewhat from when I was going to school there. However, for the most part, this program is still clearly a few standard deviations above the mean! :-)

Respectfully,

JW

Edited January 20, 2010 by Jwade

[bryan20w]

I think that this entire post is trying to compare compantency of the strongest nurses and the weakest paramedics. I have seen paramedics that I would rather have taking care of my emergant need over any doctor, and then I have seen RNs that i would not trust with a pt that actually had a complaint. I think that to compare RNs to Paramedics are like comparing apples and oranges. Paramedics specialize in the ABC's and a few have extended education in critical care to handle the dynamic nature of an ICU patient for a shorter period of time, there job in this setting is not to fix, or improve the outcome of this pt, their job is simply to maintain the patients stability.

[VentMedic]

Paramedics specialize in the ABC's and a few have extended education in critical care to handle the dynamic nature of an ICU patient for a shorter period of time, there job in this setting is not to fix, or improve the outcome of this pt, their job is simply to maintain the patients stability.

Is this in the United States?

How many hours of actual education for the care of the ICU patient did you get in your Paramedic program and how many hours of hands on care in the ICU did your clinicals provide. There is a considerable difference between a patient that is stabilized for transport from the field and one that is in an ICU. There's a different focus, different protocols, many different meds that are rarely mentioned in most Paramedic classes and technology that one would not use in the field.

Even RNs who work in the ED don't consider themselves to be ICU capable unless they have had the training/education due to the dynamic nature of the ICU patient. The same goes for many ED physicians. I don't believe there are too many Paramedic programs that produce ICU capable Paramedics. Yes they may be able to handle some ICU patients for a very short time but that would be only if the medications are familar to them as is the technology. However, it would be wise to have additional training and education beyond the normal Paramedic program.

The focus of the Paramedic is emergent care in the prehospital setting which includes stabilization. The patient is not yet "ICU" and all the things that make the patient "ICU" may not always be initiated until they reach the ICU. Not every ED is capable of performing at the level of an ICU. Have you never heard "gotta get them upstairs to ICU as soon as possible"?

Edited January 20, 2010 by VentMedic