Re: RN to paramedic

July 23, 2010

Rob,

Thank you. You are absolutely right. Paramedics going through Excelsior are, by

the same process, exempted from clinical hours. I knew if I wrote long enough

I'd make an incorrect statement somewhere. Also, I agree, very civil discussion

for such a touchy subject.

>

> Although I received a backchannel spanking for spurring this discussion on in

the first place, I am beyond pleased at the way it has turned out. Steve,

Austin, , Lou, and Doc Krin all contributed some excellent observations

and thoughts on the matter, as well as addressing all the issues brought up, and

nobody got nasty about it. I call that a success. There is, however, one last

thing that should be clarified:

>

> On Friday, July 23, 2010 14:24, " nrcollinsemtp " said:

>

> > I suspect that most people who take issue with this do so because the same

or

> > similar process is not afforded to Paramedics wishing to become an RN.

>

> Not actually true. The Excelsior College route is precisely the same process

that you describe for RNs transitioning to Paramedic. In fact, medics going

that route get a much better deal than RNs going to medic. Wheras RNs are, as

says, not skipping out on any lecture or clinical time necessary to

become a paramedic, paramedics are allowed to skip out on a HUGE portion of both

lecture and clinical time necessary to complete nursing school. Hell, even

EMT-Bs are allowed to do it. And trust me, it shows when those new medic-to-RNs

get to their first job. This, however, does not make the transition approach

easier, by any stretch of the imagination. If it were easier, we'd see a lot

more RNs on this group. Instead, the vastly overwhelming majority of all medics

who start that program never even complete their prerequisite courses, much less

the challenge process, after spending several years and thousands of dollars

trying.

>

> I would like to clarify for those who do not know me personally. I was a

medic first, many years before becoming a nurse. EMS is my first love. I am

not on any nursing discussion lists. I went to nursing school only after I was

physically disabled from working in EMS by an ambulance wreck. There seems to

be some misconception here that I am just a nurse here to antagonise medics with

some sense of nursing superiority, and that could not be farther from the truth.

When I criticise the state of education and competency in EMS, it is because I

love this profession, and would like to see it elevated to the status of a true

profession someday, not because I think nursing is superior.

>

> Rob

> RN/EMT-P (Retired), BS, BSc, AAS

>

July 23, 2010

To comment on Excelsior, as I have a -lot- of first-hand (and recent) knowledge

about that program.

Excelsior College offers a distance learning nursing program for people of

significant medical background to become RNs. While their admission standards

were much more lax in the past, they have been tightened up considerably.

EMT-Basics or -Intermediates are no longer accepted into the program. The vast

majority of enrollees are LPNs/LVNs and foreign medical grads, from my

experience at one prep course and during the clinical testing. They also accept

a number of other fields such as respiratory and " certain classifications of

military corpsman. " See their admission policy for more info.

The majority of people who enroll into Excelsior don't finish the program,

regardless of their background. Excelsior is a college that is designed for you

to fail, but they drag you along the path until they can maximize the amount of

money you've put it. That's not to say that you can't pass, it's just a response

to " the majority of medics don't finish, " which is slightly disingenuous because

it implies that " others " finish while " medics " cannot.

Medics aren't skipping " a huge portion of both lecture and clinical time. "

They're getting credit for time served, in a much more formal process then

nurses who undergo the challenge process for becoming a 'medic. The didactic

testing process is rather thorough, and requires a significant amount of

preparation. Excelsior uses several of the tests as revenue enhancers, as many

people fail at least one of the tests, and some tests are -extremely- hard.

While in three hours, they can't test everything, the topics are very broad,

meaning that in order to ensure you pass you have to be well prepared.

Regarding clinical time, trying to find " real data " on this is difficult. Most

people I have asked and most information I can find online has RN programs

(either ADN or BSN) completing approximately 400-700 hours of clinical practice.

The paramedic school I taught for had 800 hours programmed as a minimum, and

with absence, etc, I still don't know of a single person who graduated with

less then 750. I do know that there are schools that graduate people with less,

the least I know of is 600 hours and I wouldn't be surprised if there were

schools with fewer. Which is sad, but there are at least many bad nursing

schools as there are paramedics schools

Two other points to consider: (a) Much clinical time for student nurses is

" gopher " work, or sitting and waiting. When I've had nursing students with me,

they are usually surprised at what I want them to do and how much I'm willing to

let them do. So I wonder how worthwhile those hours are (though I will stipulate

that the same could and does exist for paramedic students in the hospital.) (

Both when I was a student and an educator, many of my classmates and student

WELL exceeded the minimum clinical hours, as did I. While that opportunity does

exist in nursing school (particularly the final semester) it is utilized much

less by nursing students then by paramedic students.

( With all that said, I would NEVER recommend Excelsior to anyone. There are so

many more disadvantages to that program then advantages, I wish I had gone to

ANY OTHER program that could have gotten me to the same place. I can probably

never practice in California, Washington or land, because the state boards

there will not recognize Excelsior College, regardless of how much time or

experience I gain as a nurse. )

Neither being a paramedic or being a nurse is rocket science. While not

equivalent, they certainly have a lot of overlap in practice and knowledge. As

to why there aren't more Paramedic-to-RNs in the world, I have my opinions, but

I don't think it's due to any lack of ability or special education. ly,

many ERs are now staffing paramedics in place of a portion of the nurses because

they are cheaper and more (or if you disagree, just as) suitable. The reason

that there is a difference is because the two practices were created in

differing paths and from divergent ideas. If crossing over from Paramedic to RN

is going to be " hard " (which it is) then RNs shouldn't expect to get their

" ticket punch " in an area that they aren't prepared for, either in clinically or

didactically.

Austin

> Although I received a backchannel spanking for spurring this discussion on in

the first place, I am beyond pleased at the way it has turned out. Steve,

Austin, , Lou, and Doc Krin all contributed some excellent observations

and thoughts on the matter, as well as addressing all the issues brought up, and

nobody got nasty about it. I call that a success. There is, however, one last

thing that should be clarified:

>

> On Friday, July 23, 2010 14:24, " nrcollinsemtp " nrcollins74@...> said:

>

>> I suspect that most people who take issue with this do so because the same or

>> similar process is not afforded to Paramedics wishing to become an RN.