Possibility of EMT after nursing??

Hello all. I have been mulling over an idea recently and wanted to get any feedback someone may be able to offer. I have been a nurse since 1991 and worked on various specialties. There is one thing I have always wanted to do and need some opinions. I have always had the desire to work as an EMT. When I was in nursing school during the day, I enrolled in EMT class at night. I was about halfway done and had to have GB surgery and got behind trying to catch up on nsg school and EMT at the same time so I dropped EMT class.

After nsg school, I started on a med surg unit and telemetry. I have always loved my profession, but started wishing that I had finished EMT school. Once I transferred to the ER, I knew this was the type of nursing for me. I have worked in both big city and also small rural ERs and have seen different traumas and injuries in both.

I like to think that I am able to remain calm in a crisis or code situation. I get along well with my patient's family members and enjoyed the runs I was able to go on when doing clinicals in the ambulance in school.

I know this is totally different from ER nursing, but I just wanted to throw it out there to get some opinions. I at one time thought about the possibility of flight nursing but I saw our air ambulance crash next to the interstate in a storm and that kind of ruined that idea for me. I thought at least being on the ground might be better suited to me.

Please feel free to share your opinions and/or stories that may help me. Thanks!

Anne, RNC
Wow. You're the first person I've encountered who wants to go from (ER) nursing to EMS. Usually it's the other way around.I volunteered as an EMT for seven years. I really enjoyed it. There can be an awful lot of heavy lifting involved though, which is one of the reasons I eventually decided it was time to hang it up. People often talk about the lifting part of nursing - imagine having to carry a 180 lb. person on a cot up or down long flights of stairs on a regular basis just to get them out of their house onto an ambulance, and only your partner is with you.You sound very much like you have the temperament that would really enjoy EMS. Are there opportunities in your area to volunteer with a local rescue squad? That would give you a chance to try it out before making any big career moves.Also, with your background, I would think you would want to go for paramedic certification. Paramedics have training and authority to do much more than EMTs.

I have volunteered as an EMT & it is rewarding. However most RN's do go for paramedic licensure. The big frustration with being an RN and a Basic EMT is scope of practice. Althought the EMT can do really is basic stabilization and administer O2 while transporting. This becomes a real issue when as an RN you know the patient is having, for example, an MI and you can't even give him an aspirin. Your RN scope of practice no longer applies in EMS. Paramedic is an Associate Degree program with required "clinical" time and preceptorship after graduation to acquire medical control. Many trauma centers offer accelerated RN to Paramedic courses. In the college programs the pre-req's are essentially the same as you have already taken.

My little sister has just started a double degree in Paramedical Science and Batchelor of Nursing. Flinders University runs the programme which has students working on the cars after their first year as a "basic" Ambo, earning a living while continuing with the education. I know it is no help as we are a bit far from the US but it shows that someone smarter than me thinks that it is a good combination of skills.

Now this is just hearsay, but around here I have heard that you can take the paramedic test if you are an RN. I do know several RNs that do volunteer EMT, and they actually don't have to do anything but say, hey I'll do 1-2 shifts a month, etc. They are glad to have the experienced help on the squads. Maybe someone here with more experience can speak up.

Nurses can never just "take" the paramedic test as there is a great deal of difference in training and knowledge base. In most states the RN can challenge the EMT Basic exam, usually after having taken a class in care of patients during vehicle extrication. The National Registry of EMT's and the Department of Transportation set the standards for EMT and EMT-P education. The paramedic is trained in skills such as interpreting the EKG, intubation, surgical crichoidectomy, starting intra-osseous IV's, starting external jugular IV's and other skills that RN's don't normally have. Volunteering/working as an EMT is not a bad thing, it can just be frustrating.

There are also dual paramedic/RN programs at the AD level. The main focus of such programs, AD or BS, is to prepare flight nurses. Most air ambulance services require both licenses for flight nurses. This is because of the difference in scope and knowledge base. Major medical cenetrs and trauma centers also prefer nurses with both licenses in the ER.

I kind of did a similar thing - I had my RN lisence for a few years before becoming an EMT basic. In my state (NJ) RN's only need to take a 3 day class and the exam to get their emt - b certification. I did this with thoughts of attaining the certification of MIC-RN (a nurse riding a paramedic unit). I haven't started the paramedic courses as of yet -but i do maintain the emt-b and ride on calls with my local ambulance squad (when i'm not fighting fires!). I will add this as well -my primary job is that of a school nurse - where i am alone in my office and the sole medical opinion in the building and I was interested in the new skills and things i learned in the brief emt class and their application into my day to day job.

X-EMT-I (EMT without the AD) Was a medic in VA for several years, Now getting ready to start LPN school. Its true as a medic, your scope is much larger then that of an RN.. You diagnose, treat, and transport. Push all sorts of meds.. (adenison is always fun in the back of a bus) But Its not always a picnic.. Its a rule that 400+ pound pts have to live on the 3rd floor!! I can't stress enough that you and your partner/driver need to be on the same page, have great communication, and have the ability to almost read each others minds at times, because the back of an ambulance can be alot more dangerous then the chopper you saw crash. You are not buckled in and you are doing procedures hauling ass down the highway or thru town, just because you have lights and sirens doen't mean that the world is gonna stop for you and give you the right of way. The driver brakes without warning and you may very well eat the wall, or even your pt. You will be using needles, scissors, AEDs, 02, suction, or doing CPR, etc. You will get to the point that you can only "get the stick" if you are moving, as doing proceedures setting still will no longer be the norm. I could go on and on, however, I wouldn't change my experience for the world, its a great job and very rewarding, and the good outcomes far outweigh the bad ones! So I say go for it, you will be surprised and the skills you will aquire and be able to use. Good luck with your decision.

I'd say if you're interested, go for it!I talked to a guy recently who is doing this. He said that the EMS training has really boosted his assessment skills.

There are bridge programs available in most areas for the RN to go for paramedic training, but it is not as simple as just challenging their exam.Same way that a paramedic cannot just challenge the RN exam.There are still many skills that need to be learned that are not part of the normal RN training.

Have you thought about becoming a flight nurse? I feel like you would be incorporating a lot of the things you really like without sacrificing your scope of practice. There is a lot of autonomy from what I hear and it can be very exciting. Good luck!

Quote from JDNJQX-EMT-I (EMT without the AD) Was a medic in VA for several years, Now getting ready to start LPN school. Its true as a medic, your scope is much larger then that of an RN.. You diagnose, treat, and transport. Push all sorts of meds.. (adenison is always fun in the back of a bus) But Its not always a picnic.. Its a rule that 400+ pound pts have to live on the 3rd floor!! I can't stress enough that you and your partner/driver need to be on the same page, have great communication, and have the ability to almost read each others minds at times, because the back of an ambulance can be alot more dangerous then the chopper you saw crash. You are not buckled in and you are doing procedures hauling ass down the highway or thru town, just because you have lights and sirens doen't mean that the world is gonna stop for you and give you the right of way. The driver brakes without warning and you may very well eat the wall, or even your pt. You will be using needles, scissors, AEDs, 02, suction, or doing CPR, etc. You will get to the point that you can only "get the stick" if you are moving, as doing proceedures setting still will no longer be the norm. I could go on and on, however, I wouldn't change my experience for the world, its a great job and very rewarding, and the good outcomes far outweigh the bad ones! So I say go for it, you will be surprised and the skills you will aquire and be able to use. Good luck with your decision.