I have many friends in the medical field. Most are in the EMS world, whether paramedics or EMTs. Several are physicians. And more than a few are nurses. What I continue to see are people in EMS thinking that they can easily transition to nursing and nurses who think that EMS providers are “ambulance drivers.”
In my opinion, I think a lot of it stems from ignorance. Not stupidity. Ignorance. As the old saying goes, ignorance can be fixed. Stupidity is forever. For me, I first noticed this ignorance during my EMT clinicals and later during my paramedic clinicals. I vividly remember the labor and delivery nursing staff excluding me from any role whatsoever. I was told, “All you need to know is to bring them here.” Sorry, that’s not always an option when my current EMS gig means I’m at least thirty minutes from a hospital. I also remember an ICU nurse asking me what antibioitics we carry on our ambulance, but then acted surprised that paramedics had protocols (AKA standing orders) for airway management. The current educational paradigm for both professions means that nursing students don’t get any exposure to the prehospital care setting and that EMS students get plenty of time in the hospital. And yes, I believe that nurses in the acute care setting (ICU, emergency deparment, etc.) need a couple of shifts on the ambulance as well.
Here’s the thing. Nursing and EMS do overlap to some extent, but they aren’t the same thing. EMS providers have a unique skill set in being able (at least in theory) to rapidly assess patients outside of a hospital (or clinic) setting and provide certain immediate interventions. Nurses have a greater understanding of the disease processes, pharmacology, and the long-term aspects of patient care, but typically act only after receiving orders from a physician. In other words, a paramedic/RN combo could enhance one’s practice in either direction.
In fact, I’d assert that a paramedic with nursing knowledge might be the perfect candidate for community paramedicine roles that involve less urgent or chronic conditions. And similarly, a RN with paramedic knowledge would be perfect for the current trend of in-hospital “rapid response teams” that assess and intervene with patients before they crash.
Let’s quit trying to find shortcuts for paramedics to become nurses and for nurses to become paramedics and start recognizing that the two professions complement each other rather than being a total overlap.
The way I explain it is that nurses and paramedics ate like plumbers and electricians: you need both to build a house, but they do distinctly different jobs.
Hello there!
Having seen both programs of education and working in both, I really see that the two could be combined. Medicine is medicine. A nurse doesn’t practice medicine. We have our nursing diagnoses that are fine, but it’s so off the beaten path. They are ancillary.
A paramedic “doesn’t” either, yet we assess, identify and implement treatments, life saving for the most part, not anything that would “cure” what ails you.
I found it very difficult to figure out “what more” a nurse could do more than a paramedic. All I really saw was that their signature meant more and they had better assessment skills (like you’ve mentioned) from more classical education (among other things).
Seriously- I figure if you just brought the two together you’d have a really good combo everywhere. Why not make a bad ass 4-5 yr degree out of it? Leading to a PA/NP masters? It’s such a conglomeration already.
I’m not saying one is better than the other, just that if you spend some time in one field, you can transition easier to the other. Because the foundation of patient care is the same.
Your argument completely ignores Nursing Theory and Nursing Process. To not address that basic foundation of nursing practice, invalidates any argument you could makes. The lack of understanding of nursing theory illustrates the need for and the uniqueness of the nursing process.
Katie you are wrong, I am a Paramedic and have my RN-MSN . Nursing theory exists only in school. I do agree that there needs to be overlap in education to foster understanding between 2 fields that need to understand each other better.
I wholeheartedly agree. All too often we don’t realize the complementary way we do what we do. I do. Many in nursing certainly don’t. Education will help. Being professional(EMS) will help. Many in EMS become defensive with nurses because ignorance among nursing is often profound. Like your stuff. Keep up the great work.
I have always said that being a nurse does not necessarily make me a better paramedic, but being a paramedic damn sure makes me a better nurse. I agree nurses need EMS rotations. ED nurses at least should have to do annual ride outs with EMS as a condition for licensure.
I’m currently wrapping up my last year of nursing school. I’ve also been in EMS for 3.5 years. I can honestly say that, although a few things overlap, nursing and EMS are almost two completely different fields. My experience in EMS has helped me leaps and bounds in nursing school. And some of my experiences in my nursing clinicals have helped me in EMS. These mutually helpful experiences are pretty much limited to familiarity with medications and certain assessment tools. Somewhat shamefully, I have to admit that the few hours we spent on EKG’s in nursing helped me understand them far more than any other class I’ve ever taken in an EMS setting.
Like you said, they focus on different things. EMS focuses on a quick “sick or not sick” style of looking at things. We’ve been focusing more on long-term management and interventions in nursing school. Trying to combine these two schools of thought has proved to be only frustrating for me. I’d have to agree with you that nurses (at least those in an acute care setting) should do a ride along with EMS. Perhaps a duel degree program will be in order sometime in the future? Like a double-major type of situation? Just thinking out loud. Thanks for the post!
In Australia, the paramedic credential requires a bachelor’s degree, which is typically earned in three years of full-time study. Most programs and students do an additional year, to earn the nursing credential also.
Interestingly, the career strategy is 180 degrees out from the USA. Those with dual degrees first go to EMS (more money, more fun, more respect), then, when they “burn out”, can’t, or don’t want to do EMS any more, they step down to nursing.
As far as community paramedicine, one of the first discussions I had about that topic at Wake County was with a paramedic/nurse named Vince, who had put together a concept of “nurse cars” in the EMS system. Guess what – the CP programs around the country look much like what Vince described to me 8 years ago!