Paramedics and Nurses

Paramedics and nurses generally seem to get along fairly well in the ER. But there is always some underlying tension between the two professions about which is the better profession. Eleven years ago, I was taking my first EMT course (known then as EMT-Ambulance instead of EMT-Basic). We learned the very first basics of EMS, and we had some fun doing it. Most of the people in my class went on to the EMT-I class the next semester. The instructor was pretty proud of his students, and told us that some day, when and if we became experienced paramedics, we "would be smarter than any nurse or resident". (Before anyone takes offense, I didn't say this, and the instructor passed away two years ago.) I have no idea where he got this idea, as he had no experience as a nurse or a physician. This man did train about 30% of the EMT's in that county, as well as some EMT's that went on to become instructors. The attitude is still pretty common in that area, and I've seen it in others. The fact is, if you're a smart and experienced paramedic, you do know more about your field than other professions will. A physician can identify a fractured femur, but can't tell you to cut at the A-pillar or the B-pillar during extrication. A nurse can help you with an arrest, but she's not going to be the one hauling your 400 pound patient out of their attic apartment. But that knowledge relates to your chosen profession of paramedicine, and not to nursing or medicine. I had plenty of medics who decided to "help" me while I was studying my butt off for the NCLEX. Most of them gave up after two or three practice questions- apparently it hadn't occurred to them that I had to study a lot of things EMT's don't.
Nurses also seem to have the attitude that they know more than paramedics do. Just as I had a EMS instructor degrade nurses during class, so it was with my first nursing professor during her class. Apparently, an extremely arrogant paramedic had started classes and not done well. Every medic that followed this guy had to hear about how arrogant and useless all medics are. Great.
So, here's my statement as a medic-turned-RN. The two professions are different. Very, very different. EMS is alternately dull and stressful, with some skills that are hardly used but can be needed in the blink of an eye (think IO's on a infant arrest). Paramedics don't have a staff to back them up, and have to do their thing in an unpleasant array of environments (imagine opening a closet door and having 200 roaches fall on your head). Paramedics do learn a number of assessments and techniques. And they mainly work off protocol (but there are always calls that defy every protocol known to man). They have certain drugs available, and they need to know the indications and contraindications for those drugs.
Nursing is also alternately dull and stressful. Nurses, especially those in teaching hospitals, have to know the indications and contraindications for any drug they're going to administer. They take orders from physicians, but they have to be aware of what they are giving. Many medication orders result from requests from the RN's. ("Doctor so-and-so, patient x is complaining of these symptoms, would you like to order medication y for him?"). Nursing also has to take into account both the long and short term effects of treatment and education for the patient. Once a patient survives the "golden hour" of EMS, there is still a large amount of treatment to be done.
The fact is, there are some very, very experienced RN's that can do the work of a medic. There are some very, very experienced medics who could fill the shoes of an ER nurse. But the vast majority of nurses and EMT's could not switch jobs for an hour without a f***up. RN's with medic experience don't go around trashing either profession, because they recognize the differences.
If you are a paramedic who is smarter than any nurse, or a nurse who's smarter than any medic, then this blog is not for you. You may, however, be suffering from rectocranial inversion, so please seek treatment.