December 29, 2024 • 9 mins
Paramedic to RN
Avoid the Mistake I Made, Assumed I Knew It All (Dec. '24)
The exposure I had to nursing as a paramedic was limited, but I didn't realize it at first.
Tune in to hear how I had to push past my assumptions and perceptions of nursing to get to where I am today. Keeping your options open is one key takeaway from this episode.
Season 2 has wrapped! This bonus episode is a part of a six-part mini-series that will be shared throughout December 2024 as an intermission between seasons.
The 1st episode of Season 3 drops at noon on Jan., 3, 2025! Be sure to tune in!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
But as far as your practice goes, you have a title of nurses called Advanced Practice
(00:08):
RNs.
These are equivalent to your PAs.
We call them APRNs for short, but the Advanced Practice RNs because in most states they have
prescribing rights, they have an advanced scope of practice, they work off the medical
model, which means that they can diagnose and treat.
(00:29):
So the first Advanced Practice RN I want to talk about is nurse practitioners.
Obviously most people know, but there are different types of nurse practitioners.
For example, you have acute care nurse practitioners, you have family nurse practitioners, you have
psychiatric nurse practitioners, neonatal nurse practitioners, and you have emergency
(00:49):
nurse practitioners.
The emergency nurse practitioners are nothing more than a family nurse practitioner, but
they have a year of emergency medical fellowship.
On your nurse practitioner side, your patients are usually broken down by population and
that kind of what decides your expertise.
For example, if you're acute care, you do pediatrics or you do adults.
(01:15):
So the next Advanced Practice RN is your CRNA, which is your nurse anesthesist.
A lot of paramedics are familiar with CRNAs.
Most people say, oh yeah, CRNAs because they make a ton of money.
Well one thing about a CRNA is that you have to at least have some critical care experience
as being a nurse before you can apply to the school.
(01:37):
So most require you to work maybe about a year or two in an ICU because believe it or
not, if that patient's in the OR, it ain't the circulator nurse who keeps an eye on that
patient vitals, it's the CRNA that does.
So that's the reason why if you want to look at that track when you become a nurse, you
(01:58):
need to go directly to the ICU.
So then that way you can be prepared to apply for CRNA school.
The next Advanced Practice RN is your clinical nurse specialist.
These guys are not as known, but they do a lot of impact.
For example, your CRNA usually have five subtitles.
(02:19):
They're listed as their expert clinicians because they have a patient population as
well.
They're researchers, they're consultants, they're educators and leadership.
Those are those five sub areas.
And I got a little interesting story about working with a clinical nurse specialist.
(02:40):
We had a situation in the hospital where we found out that patients with sleep apnea,
and diagnosed tend to have longer hospital stays.
It's because they're not getting oxygen to their tissues usually at night.
So the nurse, the clinical nurse specialist consulted with the anesthesia team and the
(03:03):
clinical nurse specialist came up with a program in EPIC in conjunction with the nurse informaticist,
which I'll talk about later.
But they came up with this thing called a stop bang score.
And what the stop bang score did was you asked a set of questions.
For example, do you snore?
Have anyone ever observed you stop breathing in your sleep?
(03:26):
It takes in a consideration your BMI.
And it puts together a score that means you more than likely have sleep apnea.
Those patients that have that higher score, they will look at closely by the care nurse
at night and that decreased the hospital stay.
(03:48):
And that's the reason why clinical nurse specialists are needed in the hospital system.
A lot of hospital systems use them.
For example, WakeMed uses them.
I know Duke uses them.
East Carolina uses them.
Across the country, Emory uses them.
And I've noticed I'm not going to say one hospital system in particular that doesn't
use them.
And they don't use them.
(04:09):
And it's obvious that they don't use them.
And if they use them, then their whole entire system of operation would change.
The last advanced practice RN I want to talk about is the nurse midwife.
I don't know too much about midwifery, but I do know that they play a huge part in laboring
(04:33):
delivery.
And they get a lot of women that really gravitate toward that area.
But again, advanced practice RNs, they have prescribing rights.
Usually it's through the Board of Nursing.
It depends on the state.
But they all have an advanced scope of practice.
They work on a medical model and they can diagnose and treat.
(04:55):
Now on the leadership track, on the graduate side, you have your MSN and administration.
Most of these nurses tend to go your nurse manager route or like your nurse director
route.
I know from a lot of the jobs that I've had, most of my nurse managers have all had their
(05:16):
masters.
And even the directors of those departments had either their masters or they had a doctorate.
There's an education track, which is you can get your masters, your master's science in
nursing and nurse education.
These nurses tend to work on the hospital unit as being nurse educators.
(05:36):
They can work in a hospital system in the nurse education department.
But mainly they are the instructors at the community college and universities.
I know some board of nurses requires a MSN education degree to teach in school.
It's a requirement.
So that may be a track for you as well.
(05:57):
Master's science in nursing, we call this your nurse informaticist.
These guys can kind of combine IT and nursing together.
You have a PhD nurse scientist or researcher for those of you who want to get your PhD.
And I think for me, looking at all this information, I kind of thought to myself, well, there's
(06:22):
several tracks I like to go on.
I may not just want to go down one track.
Well, I found out that a lot of programs have combined programs, a lot of schools do.
For example, I've seen MSN MBA programs.
I think ECU just came out with one, if I'm not mistaken.
(06:43):
East Carolina University, they have a master's science in nursing MBA program.
It's a dual track program to where you are literally a dual enrolled student in both
programs, but when you complete, you complete both programs at the same time.
You have a lot of combined nurse practitioner programs to where you can become dual certified.
(07:05):
Some of these combined programs I've seen was acute care and family nurse practitioner.
I've seen FNP and psych nurse practitioner programs combined.
I've seen emergency nurse practitioners and family nurse practitioners combined.
And the interesting thing about these programs is it doesn't take a long time.
(07:27):
Usually your master's of science is two years and your doctorate by itself is usually two
years.
But now I've seen what's called BSN to DNP tracks to where you literally could do it
within three years.
And what I mean by the BSN to DNP in the state of North Carolina, most of your CRNA tracks
(07:50):
offer you to go to CRNA school.
If CRNA school is three years long and you come out with a doctorate, I know some nurse
practitioner programs here also to where you go into nurse practitioner program, you come
out, but you come out three years with your doctorate.
So for those of you who are kind of education buffs like me, you can kind of do two things
(08:13):
at one time.
You can get your education, you can get your advanced practice, and you can get your doctorate.
So hopefully guys, I gave you a little bit more information that you can kind of do the
same research I did.
And to me, this was the hidden gem of nursing and it was a no brainer for me.
(08:34):
So if you're a paramedic and you want to get into advanced practice, this is the route
to go.
And I stand by it.
So see you guys next podcast.
Go ahead, do your research just like I did and make an informed decision.
And I see you guys all the time.
Bye bye.
I wanted to take a moment and let you really know how much I appreciate your support.
(08:56):
If you've been listening to me for a while, I'd like to hear from you.
So just leave a comment from time to time.
Hit the like button.
Just let me know that you really enjoyed the episode.
Make sure you share my content with others.
And of course, subscribe and follow me.
My goal is to help as many people as possible to make the transition from paramedic to RN.
So thanks as always and happy nursing.
But as far as your practice goes, you have a title of nurses called Advanced Practice
(00:08):
RNs.
These are equivalent to your PAs.
We call them APRNs for short, but the Advanced Practice RNs because in most states they have
prescribing rights, they have an advanced scope of practice, they work off the medical
model, which means that they can diagnose and treat.
(00:29):
So the first Advanced Practice RN I want to talk about is nurse practitioners.
Obviously most people know, but there are different types of nurse practitioners.
For example, you have acute care nurse practitioners, you have family nurse practitioners, you have
psychiatric nurse practitioners, neonatal nurse practitioners, and you have emergency
(00:49):
nurse practitioners.
The emergency nurse practitioners are nothing more than a family nurse practitioner, but
they have a year of emergency medical fellowship.
On your nurse practitioner side, your patients are usually broken down by population and
that kind of what decides your expertise.
For example, if you're acute care, you do pediatrics or you do adults.
(01:15):
So the next Advanced Practice RN is your CRNA, which is your nurse anesthesist.
A lot of paramedics are familiar with CRNAs.
Most people say, oh yeah, CRNAs because they make a ton of money.
Well one thing about a CRNA is that you have to at least have some critical care experience
as being a nurse before you can apply to the school.
(01:37):
So most require you to work maybe about a year or two in an ICU because believe it or
not, if that patient's in the OR, it ain't the circulator nurse who keeps an eye on that
patient vitals, it's the CRNA that does.
So that's the reason why if you want to look at that track when you become a nurse, you
(01:58):
need to go directly to the ICU.
So then that way you can be prepared to apply for CRNA school.
The next Advanced Practice RN is your clinical nurse specialist.
These guys are not as known, but they do a lot of impact.
For example, your CRNA usually have five subtitles.
(02:19):
They're listed as their expert clinicians because they have a patient population as
well.
They're researchers, they're consultants, they're educators and leadership.
Those are those five sub areas.
And I got a little interesting story about working with a clinical nurse specialist.
(02:40):
We had a situation in the hospital where we found out that patients with sleep apnea,
and diagnosed tend to have longer hospital stays.
It's because they're not getting oxygen to their tissues usually at night.
So the nurse, the clinical nurse specialist consulted with the anesthesia team and the
(03:03):
clinical nurse specialist came up with a program in EPIC in conjunction with the nurse informaticist,
which I'll talk about later.
But they came up with this thing called a stop bang score.
And what the stop bang score did was you asked a set of questions.
For example, do you snore?
Have anyone ever observed you stop breathing in your sleep?
(03:26):
It takes in a consideration your BMI.
And it puts together a score that means you more than likely have sleep apnea.
Those patients that have that higher score, they will look at closely by the care nurse
at night and that decreased the hospital stay.
(03:48):
And that's the reason why clinical nurse specialists are needed in the hospital system.
A lot of hospital systems use them.
For example, WakeMed uses them.
I know Duke uses them.
East Carolina uses them.
Across the country, Emory uses them.
And I've noticed I'm not going to say one hospital system in particular that doesn't
use them.
And they don't use them.
(04:09):
And it's obvious that they don't use them.
And if they use them, then their whole entire system of operation would change.
The last advanced practice RN I want to talk about is the nurse midwife.
I don't know too much about midwifery, but I do know that they play a huge part in laboring
(04:33):
delivery.
And they get a lot of women that really gravitate toward that area.
But again, advanced practice RNs, they have prescribing rights.
Usually it's through the Board of Nursing.
It depends on the state.
But they all have an advanced scope of practice.
They work on a medical model and they can diagnose and treat.
(04:55):
Now on the leadership track, on the graduate side, you have your MSN and administration.
Most of these nurses tend to go your nurse manager route or like your nurse director
route.
I know from a lot of the jobs that I've had, most of my nurse managers have all had their
(05:16):
masters.
And even the directors of those departments had either their masters or they had a doctorate.
There's an education track, which is you can get your masters, your master's science in
nursing and nurse education.
These nurses tend to work on the hospital unit as being nurse educators.
(05:36):
They can work in a hospital system in the nurse education department.
But mainly they are the instructors at the community college and universities.
I know some board of nurses requires a MSN education degree to teach in school.
It's a requirement.
So that may be a track for you as well.
(05:57):
Master's science in nursing, we call this your nurse informaticist.
These guys can kind of combine IT and nursing together.
You have a PhD nurse scientist or researcher for those of you who want to get your PhD.
And I think for me, looking at all this information, I kind of thought to myself, well, there's
(06:22):
several tracks I like to go on.
I may not just want to go down one track.
Well, I found out that a lot of programs have combined programs, a lot of schools do.
For example, I've seen MSN MBA programs.
I think ECU just came out with one, if I'm not mistaken.
(06:43):
East Carolina University, they have a master's science in nursing MBA program.
It's a dual track program to where you are literally a dual enrolled student in both
programs, but when you complete, you complete both programs at the same time.
You have a lot of combined nurse practitioner programs to where you can become dual certified.
(07:05):
Some of these combined programs I've seen was acute care and family nurse practitioner.
I've seen FNP and psych nurse practitioner programs combined.
I've seen emergency nurse practitioners and family nurse practitioners combined.
And the interesting thing about these programs is it doesn't take a long time.
(07:27):
Usually your master's of science is two years and your doctorate by itself is usually two
years.
But now I've seen what's called BSN to DNP tracks to where you literally could do it
within three years.
And what I mean by the BSN to DNP in the state of North Carolina, most of your CRNA tracks
(07:50):
offer you to go to CRNA school.
If CRNA school is three years long and you come out with a doctorate, I know some nurse
practitioner programs here also to where you go into nurse practitioner program, you come
out, but you come out three years with your doctorate.
So for those of you who are kind of education buffs like me, you can kind of do two things
(08:13):
at one time.
You can get your education, you can get your advanced practice, and you can get your doctorate.
So hopefully guys, I gave you a little bit more information that you can kind of do the
same research I did.
And to me, this was the hidden gem of nursing and it was a no brainer for me.
(08:34):
So if you're a paramedic and you want to get into advanced practice, this is the route
to go.
And I stand by it.
So see you guys next podcast.
Go ahead, do your research just like I did and make an informed decision.
And I see you guys all the time.
Bye bye.
I wanted to take a moment and let you really know how much I appreciate your support.
(08:56):
If you've been listening to me for a while, I'd like to hear from you.
So just leave a comment from time to time.
Hit the like button.
Just let me know that you really enjoyed the episode.
Make sure you share my content with others.
And of course, subscribe and follow me.
My goal is to help as many people as possible to make the transition from paramedic to RN.
So thanks as always and happy nursing.
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