A few daydreams

[Ken Lawson-Williams <Macgyver@FlightMedicMail.com>]

Some things I have always wondered:

For those of you who are cross trained, did you do the entire program or a bridging process of some sort? 

For those who did the entire program of both professions, If your original training was as a nurse/paramedic, what about paramedic/nurse training was new and useful? Repetitive and least useful?

How long didactically and clinically were the nursing program and the paramedic program you took?

What do you think about the concept of a Bachelors level degree with a 2 year common "Health Sciences" core followed by 2 years of specialisation as a Paramedic, Nurse, Respiratory Tech, Lab Tech, X-Ray Tech (and the appropriate humanities, sciences, phys-ed electives etc throughout)? So once completed any of the "majors" an additional year or so would be all that was required to complete a second "major"?


Lastly - back to the debate a bit, how does the list feel about Nurse Practicioners? In Canada we are just starting to develop them and they can be Masters level or certificate level post diploma individuals (and everything in between). Most are Primary Health Care related serving in isolated outpost nursing stations. A common MD debate here is which is better, NP or PA. They tend to fall on the PA side - as much because they understand them (and their standardised training levels) as anything else. However I have recently had various docs quiz me on Paramedics vs NP's

Before anyone gets shorts twisted - clarification. Many of the np's here are diploma RN's with years of experience who go back to school and get (after a year or so) additional training intubate/io/decompress etc as well as to write scrip, perform x-rays and lab tests, make their own diagnosies determine treatment/medication pathways, refer to MD's or specialists etc. They operate in a collaborative manner, but technically are practicing under the MD's license and stay within treatment guidelines that transfer various medical functions to them etc.

Not unlike how many progressive EMS services operate... off line determination by the medic of a field diagnosis, treatment plan, medications to be administered etc etc. So their question was why not take an experienced Paramedic and train them to become a NP in the same manner as experienced RN's are? Their thinking was that apparently 9in their experience) the hardest thing to teach the RN's was critical thinking and to lose some of the CYA "orders first" mentality/culture of nursing. They felt that associate degree level medics with appropriate training would be better able to make the transition to "independant duty" than the hospital nurse.

Since this jibed with what I have seen over the years with new staff becoming oriented to the flight world, where medics tend to take 25% of the time to reach clinical independance/competance than even ER nurses do, (PLEASE NOTE - I AM SPEAKING OF GENERALISED STEREOTYPES HERE), I thought I'd toss it into the debate. 

Specifically, Why not develop a 3 year clinically based post associate degree program that brings a FP-C Paramedic straight to NP level? (and gives them a Masters degree at the same time)  Say a years worth of general university electives and patho/A&P upgrade etc, a years worth of "assessment of prior learning" credit for a 5 year or so paramedic career, then the same )or very similar) Masters program RN's take to become MN/NP's?

Just a few daydreams to ponder on a slow shift.........

Fly Safe. 
Ken L-W CCEMT-P/RN (both programs from start to finish)


--- message from "Manuel M. Torres, Jr." <m.torresjr@verizon.net> attached:

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