EMT-P to RN Bridge Question

Having had discussions with the nurses at my service, there is a fundamental difference in how we as medics approach a situation and how nurses approach a situation. We are trained, very well, to deal with the immediacy of emergency medicine, and for those of use that have pursued further instruction, in the continuation of care in the transport environment. Nurses on the other hand are trained to think about the longer term, i.e., how what is done now will impact the patient an hour, a couple days, a month from now. It is this difference in training and approaches that in my opinion makes a medic/nurse team on a flight service the best crew configuration for whatever situation you're presented with.

From strictly a skills perspective, most any paramedic should be able to do a nurse's job; however, I think before we can truly do a nurses job, we need to learn to think like nurses. That thought process is what makes nursing what it is, and it's that thought process that makes nursing valuable. A bridge course needs to focus on the part of nursing. We don't need training in how to do hands-on skills; we need to learn to think like nurses.

Similarly, from strictly a skills perspective, most nurses should be able to a paramedic's job; however, most medics still cringe at that thought. Why? I think it's because nurses, though they have gained excellent training and experience, don't understand that in field EMS, we generally don't have time to think about the long-term effects of what we're doing. We have to, as mentioned earlier, deal with the immediacy of emergency medicine. For that reason, nurses should be trained to "think" like paramedics before being put into that environment.

To this end, I think there is definitely a place for bridge programs going both directions. Now the question that would remain is "How long does the program need to be?" That's going to be dictated by how we and our nursing counterparts look at the program. If it's strictly to thought processes, the program could possibly be as short as 6-months, but if we want to make our counterparts "put in their time" and "pay their dues," then the programs get longer. I think we need to be logical when we approach the latter. Nursing students get their hands-on experience with patient care during their clinical rotations; paramedic students get their hands-on experience with patient care during their hospital clinicals and their field training time. We've both put in our time with patients, and I don't think we need to do it again.

To everyone out there working on a transition or thinking about doing it, the only thing I would say is this... We've all seen medics that are medics because they have to be, and generally, this is a job that requires a certain amount of passion for what you do. Those that are doing it because they have to generally don't give it as much effort as those who are empassioned about it. Similarly, nursing is a job that requires heart, probably even more so than being a paramedic, because you're dealing with the whole patient for a longer period of time, not just the broken part for thirty minutes. Check your motiviation. If you're transitioning to better yourself and because you want to be a nurse or a medic, then I think you'll be the better for it; but if you're doing it just to make more money, then I think you're doing a disservice to both professions. With that said, I wish anyone pursuing this the best of luck in their endeavors.

[A quick side note to Craig Button's message--Though I would agree that the Excelsior Program has a good track record, not every state, Illinois being one of them, will recognize the program as legitimate for purposes of obtaining a license.]