Academic Preamble

Prior to taking any nursing or general education course, nursing students at the institution I attend are required to take a course titled “Academic Strategies”.

I was not surprised to receive the syllabus on my first day of class that stated that the purpose of every nursing student's 16-hour, 5-day initial course was to facilitate personal and professional success as well as introduce nursing students to the purpose and process of nursing education.  This type of class is usually accomplished by holding a preparatory course, such as this one for longer programs and those offering degrees, or an in-depth orientation for programs that last less than a year and are presented as certificate programs.  The intention of the course was to explore a student's learning styles and present solutions for the potential time management problems and conflicts that are sure to arise in a two year time.  Discussion was also had regarding the mitigation of stressors while in school.  

Beyond this simple exploration however, I found the course to attempt to create a severe warning regarding the difficulty of what was to come in the program.  So much so, that it felt like it was trying to scare away the students who were unsure if this was the path they wanted to take.  On the other hand, there was a great deal of reiteration of the high degree support offered by not only the facilities available, but the faculty’s availability for tutoring.  All-in-all, I think the course intended to be as honest as possible about what we should expect, both in the coursework and support available.

As far as I know, most paramedic courses hold some type of preparatory course which are meant to explore the same topics discovered in the nursing course’s academic preamble course.  The paramedic preparatory course, however, is intended to present a far greater compilation of information than the nurse’s and, weighing in at 48 clock hours vs. the nursing 16 clock hours, I should hope so.  In addition to learning styles, stress level and time management, and a healthy dose of honesty regarding coursework, the paramedic preparatory course delves right into introductory paramedic theory.  For example, topics like medical math and pharmacology, ECG interpretation, and advanced patient assessment approaches are a key component to the curriculum.

This first class is where I began to figure out what is perhaps the major difference between nursing and paramedic school.  Paramedic school jumps right into skills-based lectures and wraps theory around the skills.  Nursing school is designed to present theory in elongated stages – that is to say, before I even touch medsurg nursing theory, I will have had eight months of anatomy and physiology with lab, four months of college algebra, speech, and microbiology, and four months of nursing fundamentals.  In addition to these courses, I had my english, psychology, and sociology courses transferred in, which would have been required prior to, or concurrent with, medsurg courses.

I spoke with the Director of Nursing Education at the school here regarding the nursing perspective of paramedics.  Bear in mind, the Director is an MSN and has worked in a number of different departments in local San Diego hospitals for greater than 10 years, so she has a solid background to draw from.  The Director stated that she agreed with my assessment that paramedics are not looked at as true professionals by nursing staff.  We are respected as hard workers and sometimes heroes, but not true professionals.  The reason?  We do not have the educational background and well-rounded academic experiences that RN's have.

I suppose the greatest revelation I came to during this first week is the potential resolution to the argument between nurses and paramedics and the level of respect given to prehospital providers – nurses receive far more theory than the paramedic while paramedics are focused on skills-based education.  If we, as paramedics, are to ever hope to be seen as equals to the nursing profession (or clinical practitioners as a whole), I believe we need to honestly examine our educational practices. 

Is the patient that we work with any less sick than that of the nurse?  No – and truthfully, they are often times far more ill, presenting with acute, remedy-necessary medical or traumatic illnesses.  Why, then, is our education less than that of the nurse?  Why are we not required to complete courses with the same social, psychological, and general education emphasis as the nursing student?  Why is the paramedic not required to complete courses that will subsequently confer upon them an Associate’s Degree in health care?

The paramedic and their patient alike would only benefit from a greater theory base and stronger understanding of anatomy and physiology, sociology, and psychology, and an improved command of the English language.  It is high time that we recognize that our practice needs to be equal to our education.