Incessant beeping, scrambling movement, and urgent shouts: our hero is bent over a patient, breaths short and fingers interlaced as he forcefully pumps sternum to heart. In the background, sirens wail as the ambulance streaks its way to the nearest hospital, where another team of medical professionals await.
Sound familiar? We’ve all watched medical dramas, and we’ve all come across a scene where the paramedic races against time trying to save a life in the confines of an ambulance. But where does his role end and the hospital-based nurse’s begin?
Paramedic vs. Nurse: A brief introduction
Both paramedics and nurses fulfil the same goal, which revolves around helping patients with medical needs. The main difference is that the former practices emergency care in the environment outside of the hospital, which often involves managing care on the way to the hospital, while the latter is typically based in a hospital, other healthcare facilities, or the patient’s home.
As such, ‘better’ is subjective. Your suitability to each role depends largely on you – your preference for working environments, teams, working pace. To help decide if you should pursue a career as a paramedic or a nurse, let’s delve deeper into both roles.
Paramedics provide advanced emergency care to patients – they assess the patient’s immediate medical needs and try to stabilise their condition until they can receive more extensive and specialised care in the hospital.
Where necessary, paramedics also administer drugs to the patient at the scene of an emergency, or conduct invasive procedures like airway management, cardiac monitoring and wound cleaning.
As first responders who are getting patients to the hospital, paramedics also keep in contact with an emergency room physician through phone, radio, or pre-written orders. Although they work outside the hospital setting, paramedics are also trained healthcare professionals who have gone through intensive training, which will include ambulance driving techniques, emergency resuscitation, trauma management, and extrication techniques. This ensures that they are able to stabilise the condition of patients who are suffering from a cardiac arrest or brain injury.
Paramedic vs. EMT
You might have heard the term “Emergency Medical Technician” as well – while used interchangeably, there are differences between the two. In short, a paramedic is a type of EMT, but not all EMTs are paramedics. Either way, both EMTs and paramedics are considered first responders.
Paramedics continue their education past the required courses of EMTs, hence they have more advanced medical skills and knowledge that allow them to provide further medical services in higher risk situations. In fact, paramedics are the highest level of the EMT certification.
There are three levels of EMTs: EMT-Basic (EMT-B), EMT-Intermediate (EMT-I) and EMT-Paramedic (EMT-P). The EMT-B is the entry-level certification, whereas the EMT-P is the most highly-trained of the three types.
In general, the biggest difference between an EMT and a paramedic is the education and training that each receives. While an EMT’s training programme may be as short as six months, the paramedic training program is at least two years.
Both types of first responders often work together, but the paramedic’s longer training hours will translate to greater autonomy and responsibilities than an EMT. Other than basic medical care, which the EMT will also provide, paramedics are also able to administer medication, insert IV lines, and perform intubation, among other procedures.
Nurses typically work with patients in medical facilities; if they are homecare nurses, they will work at the patient’s home instead. In an emergency case, they will be part of the team receiving the patient from the ambulance.
In general, nurses are focused on patient care – they work closely with other medical professionals like doctors and other nurses to ensure that the patient receives holistic care.
A nurse’s job scope is broad. Among others, it involves assessing a patient’s physical condition, performing health-related procedures, coordinating with the healthcare team, and educating or informing the patient and their families about medication, health status, and further check-ups.
In Singapore, there are generally two types of nurses: Enrolled nurses and registered nurses. Just like with EMTs and paramedics, the roles of enrolled and registered nurses can be similar (e.g., both are registered with the Singapore Nursing Board), but have some key differences, the biggest being the amount of training and educational qualifications required for each.
To become a Registered Nurse, you will need to have completed more than two years of education and training, and possess either a Diploma in Nursing or a Bachelor of Science (Nursing).
Registered Nurses also have greater opportunities for specialisation than Enrolled Nurses. In Singapore, they can further their career along three tracks: Clinical Track, Education Track, and Management Track.
The Clinical Track is best suited for those who wish to provide direct care to patients and their families – in other words, be in the clinic. In this track, you will be able to develop your knowledge in specialised disciplines like critical care, gerontology, neuroscience, and oncology.
The Education Track is best suited for those who prefer passing on knowledge and nurturing the next generation of nurses; this will enable them to either work in a hospital to develop and implement education and training programmes, or be a nursing lecturer in an education institution.
The Management Track is best suited for those who love planning to better a team – on this track, you will be responsible for the professional and personal development of your team, and to create a conducive working environment for them.
To become an Enrolled Nurse, you will need to study for two years to obtain the NITEC in Nursing, which will skill you in assisting in medical administration, performing selected nursing procedures and treatment orders, and effective communication between patients and the team. Enrolled Nurses assist Registered Nurses in providing holistic nursing care for patients.
As an Enrolled Nurse, you also have opportunities for career advancement to become a Senior Enrolled Nurse.
Key differences between the two
As explained above, nurses typically work in hospitals, medical facilities or in the patient’s home, whereas paramedics treat patients pre-hospital – at the site of an emergency, or in the ambulance on the way to the hospital.
The paramedic is responsible for delivering emergency care to the patient in the field, from the site of the emergency to the hospital. As such, their role will centre around stabilising the patient’s condition until they can receive more comprehensive care in the hospital or medical facility.
The nurse, on the other hand, takes over the care of the patient once they have reached the hospital. Here, the nurse will work with other medical professionals to develop a treatment plan. As such, nurses have a broader range of responsibilities that include emergency, convalescent, and outpatient care.
When it comes to the nitty gritties however, both paramedics and registered nurses are qualified to perform emergency intubation, start intravenous lines, and administer oral, injectable and intravenous medications. Both are also trained in emergency procedures like cardiopulmonary resuscitation.
Time with Patient
Unsurprisingly, the paramedic’s time with the patient is fleeting, as they aim to bring the patient to the hospital as fast as possible to receive comprehensive and stable care. This also means that they have very little time to assess the patient’s condition and treat their needs.
In contrast, the nurse, while also having to respond quickly to emergency situations in the hospital, will have more time to assess the patient’s needs once their condition has stabilised.
When it comes to deciding which career path is best for you, keep in mind the characteristics of each job. If you are someone who thrives under constant change or movement, becoming a paramedic might be more suitable for you. Likewise, if you find that seeing through a patient’s holistic care programme gives you greater fulfilment, you might want to consider a career as a nurse. Remember – no one career is better than the other; instead, find one that is best suited for you, to ensure that it remains meaningful for you in the long run.
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