October 31, 2024 • 11 mins
Do Medics Need New Grad Internships?
In this episode, I answer this common question - "If I'm a medic, do I really need a new grad internship?" Listen to find out what I suggest and feel free to reach out to me directly with questions, I'm happy to help. I can be reached at paramedic2rninfo@gmail.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Hey guys, I appreciate your questions. I got a response from Kay Fleming and the questions
(00:07):
was, it was two of them I wanted to answer today. One was, as a tenured paramedic, is
a new grad internship required? And also, is there any benefit to pursuing direct positions
that don't require full internships? I'm going to answer those questions in pretty
good detail. So welcome to my podcast. So the situation is, if you've been a paramedic
(00:42):
for 14 to even 20 years and you're really tenured, is a new grad internship required?
I would say yes, and I'm going to tell you why. One of the things you have to remember
is that nursing is not the same as being a paramedic. It's two totally different things.
(01:03):
It's apple and oranges. Now, some areas do kind of overlap like a Venn diagram, but most
of nursing doesn't. Being a paramedic is definitely not the same as being a nurse. And so another
thing you have to look at, what is an internship in nursing? In nursing, we call that a new
(01:26):
grad residency. One of the things you got to kind of look at, what is your residency?
Your residency is nothing more than just an extended orientation. So anytime a nurse gets
a job and you go to that job, typically you have a, depending on what it is, you typically
have an orientation period. And think of your orientation period like clearing, like you
(01:52):
clearing your service. It's the same thing. But as a new grad, it's longer and you're
with the preceptor and you there pretty long. Like for example, most places I've been, orientation
is typically about six weeks. But as a new grad, your orientation is going to be a year.
(02:13):
And why is that? It's because there's certain things you need to know. For example, you
need to learn how to chart. You need to learn how to do an assessment. You need to learn
how to dispense medications from the pixels. You need to learn how to do floor reports
or report to other floors. And you got to know, understand cold statuses. You got to
understand what a cold stroke means and cold STEMI means in your role or cold blue or cold
(02:38):
medic or cold elopes or even baby gets missing, cold pink. And if you don't understand those,
that can put you in a lack of knowledge and that can kind of hurt you in your practice.
So to kind of get back into what I mean, the difference is a nurse, yeah, I mean, a paramedic,
(03:05):
you can function in a place like the ED, but your skills won't, you won't be the practice
in oncology. You have to have an orientation because the medications are different. How
you go about your routine day, how you do your assessment, which, how do you gear up
for medications? How do you give chemo? How do you give radiation? Your medic skills is
(03:26):
not going to help you in these situations. So what's the purpose of the new grad residency?
One is to kind of get you on board. It's to give you a good chance to get acclimated before
us. If you're a new grad and you try to hit a floor like an ICU floor and you don't have
(03:51):
an extended orientation, it's real hard to within a six weeks or even 13 weeks to try
to get all your device training, learn about the impeller, learn about the swan, learn
about CRRT and learn about how to take care of ECMO patients. You're titrating several
drips. So you're charting, you have Q1 tasks, Q2 tasks, Q4 tasks, you have daily tasks,
(04:18):
you have once a day tasks like zeroing your swan. I mean, there's a lot and you have
to ambulate your patients three times a day. So there's a lot that goes into that. And
if you're not really prepared, number one, you're going to get burned out real quick
because you're going to be running around all day. And by you not knowing what to do,
you can put the patient in harm. So that's one of the reasons why as a new grad, you
(04:42):
need orientation. A long, long, long time ago from what I'm hearing from a lot of seasoned
nurses is when you first came into nursing, that was only one place you could go, which
was you had to hit the floor. And when you hit the floor, they mean a med-serve unit
to where you're giving med passes, you're doing a lot of cleaning, you're doing a lot
of the traditional floor nursing. But these days, because especially on the shortage,
(05:06):
I mean, you literally can come right out of schooling and land right into a CT ICU. Where
it's before, you had to have a certain amount of years on the floor before you could go
to a specialty area or area like ED or radiology, oncology, those places, you had to have years
of nursing experience. But now as a new grad, you're coming out. So they just want to
(05:29):
make sure that you're up to par. So for the answer for your first question,
as a tenured paramedic, is a new grad internship required? Yes. Most places, it is going to
be required. Now, to answer the second question, is there any benefit to pursuing direct positions
that don't require full internships, like a direct higher position? In some areas, I
(05:54):
would say yes. There's two places that I feel that as a paramedic, you can come out
and you can work and you can just do your normal nursing six-week orientation period
and be directly ready to go. One place is the ED, I feel like you can, and the other
place is critical care transport if you have experience. Now for the ED, and I think sometimes
(06:20):
this is where medics kind of get, sometimes you can be a victim of your own bubble. Usually,
I hear things coming from paramedics like, oh, I can be a nurse. Nursing is easy. Oh,
I can be a nurse. Yeah. That's only because you're looking at the ED. You hear paramedics
say things like, oh, all you do is sit around and take orders all day. Well, obviously,
(06:46):
everyone takes orders. Doctors have to write orders from everything from an IV to CT scan.
Everybody operates on orders, even nutritionists. But what I'm trying to get at is you only
see nursing through your lens as being a medic. That's because you're not a nurse yet. Once
(07:06):
you're a nurse, you start to understand that there are certain places where your skills
can transfer and the ED is one of them. For example, and I kind of give you my story.
When I first came out of nursing school, I tried to get a new grad residency at a level
one trauma center and I couldn't get it. I tried a level three. I couldn't get an internship
(07:31):
and it baffled me. I'm like, wow. Not only am I a medic, I'm a freaking special operations
medical instructor. I know trauma like that back in my hand. I know what to do. I'm military
trained civilian trained. I know what I'm doing, but yet I didn't get hired. So I wound
(07:56):
up settling for a general medicine step down unit and I was so bored, but I learned so
much. First of all, I learned how to do nursing assessments. I learned how to pass out medications
and just the basic nursing functions I learned. After about six months of that new grad residency,
(08:20):
I kind of got tired of it and I took a direct hard position at the ED trauma center. Matter
of fact, it was one of the trauma centers that initially turned me down. I wound up
going back there and the benefit would be number one to pay because as a new grad, you
(08:40):
would sacrifice and lower pay for experience. But when I got this direct position in the
ED, I did my five weeks internship. I didn't need any other, I'm sorry, my five week orientation.
After that, I hit the floor running. My pay rate was seven more dollars an hour than what
(09:05):
I was receiving as a new grad. So I got seven more dollars an hour and not only that, like
I said, after five weeks orientation, I was good. Now there were some things I kind of
had to learn like the cold strokes and what to do, how to, when I followed them to the
CT scan and what I do after that and things like little stuff like hang, two nurses validation
(09:34):
for things like hanging blood or heparin and all that stuff. That was one of the benefits.
So the ED is one of the places you can go and honestly, you will feel comfortable in
the ED and if you are a medic now working in the ED, I'm pretty sure you probably feel
comfortable. You can transition into a nurse role without any problems. Another one is
(09:56):
critical care transport and this is one of the areas I think that if you're a CCT medic,
you can transition to be a CCT nurse because you're basically doing the same job. It's
only a couple of medication differences, but it's the same thing. I just wish that CAMHPS
accreditation would catch up to what the differences is and stop putting that barrier there for
(10:23):
paramedics to transition over to being a CCT nurse because it's basically the same job.
I've known some places that gave a brief orientation period, but when I first came out of nursing
school, it was real hard if you was a CCT paramedic to transition to a CCT nurse. They
literally wanted you to go to the ICU for a standard period of time, sometimes even
(10:48):
up to three years before you can even come back to get on the truck or fly, which is
ridiculous. Those are the two places that as a medic, that you can literally transition
right into nursing without having to go through a new grad internship. It's the ED and critical
care transport. Hopefully, I've answered both those questions for you. If you still
(11:11):
have any more questions, feel free to reach out.
For anyone, if you guys have any specific questions about some things that you're not
getting from the podcast, you can always feel free to send me an email. It's paramedic2rinfo.gmail.com.
That's paramedic2info.gmail.com. Guys, thank you for joining me and you guys have a nice
(11:37):
day.
Hey guys, I appreciate your questions. I got a response from Kay Fleming and the questions
(00:07):
was, it was two of them I wanted to answer today. One was, as a tenured paramedic, is
a new grad internship required? And also, is there any benefit to pursuing direct positions
that don't require full internships? I'm going to answer those questions in pretty
good detail. So welcome to my podcast. So the situation is, if you've been a paramedic
(00:42):
for 14 to even 20 years and you're really tenured, is a new grad internship required?
I would say yes, and I'm going to tell you why. One of the things you have to remember
is that nursing is not the same as being a paramedic. It's two totally different things.
(01:03):
It's apple and oranges. Now, some areas do kind of overlap like a Venn diagram, but most
of nursing doesn't. Being a paramedic is definitely not the same as being a nurse. And so another
thing you have to look at, what is an internship in nursing? In nursing, we call that a new
(01:26):
grad residency. One of the things you got to kind of look at, what is your residency?
Your residency is nothing more than just an extended orientation. So anytime a nurse gets
a job and you go to that job, typically you have a, depending on what it is, you typically
have an orientation period. And think of your orientation period like clearing, like you
(01:52):
clearing your service. It's the same thing. But as a new grad, it's longer and you're
with the preceptor and you there pretty long. Like for example, most places I've been, orientation
is typically about six weeks. But as a new grad, your orientation is going to be a year.
(02:13):
And why is that? It's because there's certain things you need to know. For example, you
need to learn how to chart. You need to learn how to do an assessment. You need to learn
how to dispense medications from the pixels. You need to learn how to do floor reports
or report to other floors. And you got to know, understand cold statuses. You got to
understand what a cold stroke means and cold STEMI means in your role or cold blue or cold
(02:38):
medic or cold elopes or even baby gets missing, cold pink. And if you don't understand those,
that can put you in a lack of knowledge and that can kind of hurt you in your practice.
So to kind of get back into what I mean, the difference is a nurse, yeah, I mean, a paramedic,
(03:05):
you can function in a place like the ED, but your skills won't, you won't be the practice
in oncology. You have to have an orientation because the medications are different. How
you go about your routine day, how you do your assessment, which, how do you gear up
for medications? How do you give chemo? How do you give radiation? Your medic skills is
(03:26):
not going to help you in these situations. So what's the purpose of the new grad residency?
One is to kind of get you on board. It's to give you a good chance to get acclimated before
us. If you're a new grad and you try to hit a floor like an ICU floor and you don't have
(03:51):
an extended orientation, it's real hard to within a six weeks or even 13 weeks to try
to get all your device training, learn about the impeller, learn about the swan, learn
about CRRT and learn about how to take care of ECMO patients. You're titrating several
drips. So you're charting, you have Q1 tasks, Q2 tasks, Q4 tasks, you have daily tasks,
(04:18):
you have once a day tasks like zeroing your swan. I mean, there's a lot and you have
to ambulate your patients three times a day. So there's a lot that goes into that. And
if you're not really prepared, number one, you're going to get burned out real quick
because you're going to be running around all day. And by you not knowing what to do,
you can put the patient in harm. So that's one of the reasons why as a new grad, you
(04:42):
need orientation. A long, long, long time ago from what I'm hearing from a lot of seasoned
nurses is when you first came into nursing, that was only one place you could go, which
was you had to hit the floor. And when you hit the floor, they mean a med-serve unit
to where you're giving med passes, you're doing a lot of cleaning, you're doing a lot
of the traditional floor nursing. But these days, because especially on the shortage,
(05:06):
I mean, you literally can come right out of schooling and land right into a CT ICU. Where
it's before, you had to have a certain amount of years on the floor before you could go
to a specialty area or area like ED or radiology, oncology, those places, you had to have years
of nursing experience. But now as a new grad, you're coming out. So they just want to
(05:29):
make sure that you're up to par. So for the answer for your first question,
as a tenured paramedic, is a new grad internship required? Yes. Most places, it is going to
be required. Now, to answer the second question, is there any benefit to pursuing direct positions
that don't require full internships, like a direct higher position? In some areas, I
(05:54):
would say yes. There's two places that I feel that as a paramedic, you can come out
and you can work and you can just do your normal nursing six-week orientation period
and be directly ready to go. One place is the ED, I feel like you can, and the other
place is critical care transport if you have experience. Now for the ED, and I think sometimes
(06:20):
this is where medics kind of get, sometimes you can be a victim of your own bubble. Usually,
I hear things coming from paramedics like, oh, I can be a nurse. Nursing is easy. Oh,
I can be a nurse. Yeah. That's only because you're looking at the ED. You hear paramedics
say things like, oh, all you do is sit around and take orders all day. Well, obviously,
(06:46):
everyone takes orders. Doctors have to write orders from everything from an IV to CT scan.
Everybody operates on orders, even nutritionists. But what I'm trying to get at is you only
see nursing through your lens as being a medic. That's because you're not a nurse yet. Once
(07:06):
you're a nurse, you start to understand that there are certain places where your skills
can transfer and the ED is one of them. For example, and I kind of give you my story.
When I first came out of nursing school, I tried to get a new grad residency at a level
one trauma center and I couldn't get it. I tried a level three. I couldn't get an internship
(07:31):
and it baffled me. I'm like, wow. Not only am I a medic, I'm a freaking special operations
medical instructor. I know trauma like that back in my hand. I know what to do. I'm military
trained civilian trained. I know what I'm doing, but yet I didn't get hired. So I wound
(07:56):
up settling for a general medicine step down unit and I was so bored, but I learned so
much. First of all, I learned how to do nursing assessments. I learned how to pass out medications
and just the basic nursing functions I learned. After about six months of that new grad residency,
(08:20):
I kind of got tired of it and I took a direct hard position at the ED trauma center. Matter
of fact, it was one of the trauma centers that initially turned me down. I wound up
going back there and the benefit would be number one to pay because as a new grad, you
(08:40):
would sacrifice and lower pay for experience. But when I got this direct position in the
ED, I did my five weeks internship. I didn't need any other, I'm sorry, my five week orientation.
After that, I hit the floor running. My pay rate was seven more dollars an hour than what
(09:05):
I was receiving as a new grad. So I got seven more dollars an hour and not only that, like
I said, after five weeks orientation, I was good. Now there were some things I kind of
had to learn like the cold strokes and what to do, how to, when I followed them to the
CT scan and what I do after that and things like little stuff like hang, two nurses validation
(09:34):
for things like hanging blood or heparin and all that stuff. That was one of the benefits.
So the ED is one of the places you can go and honestly, you will feel comfortable in
the ED and if you are a medic now working in the ED, I'm pretty sure you probably feel
comfortable. You can transition into a nurse role without any problems. Another one is
(09:56):
critical care transport and this is one of the areas I think that if you're a CCT medic,
you can transition to be a CCT nurse because you're basically doing the same job. It's
only a couple of medication differences, but it's the same thing. I just wish that CAMHPS
accreditation would catch up to what the differences is and stop putting that barrier there for
(10:23):
paramedics to transition over to being a CCT nurse because it's basically the same job.
I've known some places that gave a brief orientation period, but when I first came out of nursing
school, it was real hard if you was a CCT paramedic to transition to a CCT nurse. They
literally wanted you to go to the ICU for a standard period of time, sometimes even
(10:48):
up to three years before you can even come back to get on the truck or fly, which is
ridiculous. Those are the two places that as a medic, that you can literally transition
right into nursing without having to go through a new grad internship. It's the ED and critical
care transport. Hopefully, I've answered both those questions for you. If you still
(11:11):
have any more questions, feel free to reach out.
For anyone, if you guys have any specific questions about some things that you're not
getting from the podcast, you can always feel free to send me an email. It's paramedic2rinfo.gmail.com.
That's paramedic2info.gmail.com. Guys, thank you for joining me and you guys have a nice
(11:37):
day.
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