The Pay Difference Between Paramedics and Registered Nurses in the USA Essay Sample

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Introduction of TOPIC

            A  paramedic  is  a  qualified  medical  professional   who  usually  works  in  providing    emergency pre-hospital  medical  and  trauma  care besides  medical  services  in  a  certain  given  area (Thomson, 2006). Most  paramedic are  based  in  response  vehicles  and  rescue  teams  which  include  ambulances , fire rescue  and  water  rescue  teams. Usually paramedics  take  hospital  based  roles  such as  drug  dispensation  without  prescriptions  and  also  treatment  of  minor  injuries  in  some cases (Heart, 2006).  A  registered  nurse  on  the  other  side  is  a  qualified  medical  professional   who  is  responsible  for  the  implementation  of  nursing  and  other  health  care  practices  inside  the  hospital  in  collaboration  with  other  qualified  medical  professionals (Thomson, 2006). Registered  nurses   work  as  per  the  will  of  the  patient’s  health  care  and  the  recovery  of  the  sick  through  maintenance  of  their  health. They  are  clinically  trained  and  educated  in  order  to  use  the  nursing   education  to  assess, plan, implement   and  evaluate  the   nursing  care  of  the   sick and the injured (Thomson,1998). Whereas in the United States registered  nurses receive higher pay than  paramedics,  paramedics  should  have  a  higher  pay or equal pay to the  registered  nurses  due  to  a number of reasons  which  include, working  location factors, environmental  factors, work   specialization  and  diversification  factors, and  their  skills  and experience compared to the  registered  nurses.

 Paramedics  work  under  extremely  harsh  condition  and  at  the  end  receive  a  less  pay  than  the  registered  nurses   who  are  settled  in  hospitals  where  they  are not  exposed  to    risks  and  dangers  unlike  for  the  of  the  paramedics(James O,1983). Historically, Para- medicine  first  started  as  a  formal  process  of  managing  injured  people  in  war fields . Those  who  were  no  longer  able  to  fight  were  given   the tasks  of  removing  the  wounded  from  the  battlefields       and  providing  them  with  medical  care. Such  individuals  were  not  trained  but  they  would  complete  amputations ,simple  surgeries  and  saturation  of  wounds(James,1983). The  first  vehicle  specifically  as  an  ambulance  was  horse  drawn   and  was  created  during  the  Napoleonic  war  and  was  intended  to  carry the  wounded  soldiers  to surgeons(Harlan, 2008).

Paramedics thus worked in very harsh conditions. Pre-hospital  medical  care  by  the  paramedics  was  started  in  the  United  States  by  the  early  1960s  when  experiments  meant  for  improving  health  care   already  began  in  some  civilian   centers . These  experiments  involved  cardiac  care  and  first  aids  by  physicians using  a  special  ambulance  called  the  cardiac  one (Harlan, 2008). It  was  staffed  by  a  regular  ambulance  crew  and  a  hospital  intern  who  did  the  advanced  procedures  and  tasks. Currently, paramedics work in  government  agencies  as  a  part  of a  municipal  emergency  medical  service  in  a  public  hospital  system including  public  safety  agencies  such  as  the  fire  rescue, the police ,and  water  rescuers. In  these named  areas, their  role  is  emergency  medical  service  provision  mostly on  contract basis. On  the  other  hand,  registered  nurses  are  employed  mostly  by  government  and  private  hospitals  and  health care units. Having  looked  at  the  different  working  locations  of  the  two,  it  is clear  that  the  paramedics  work in locations that place them at significant dangers to their own health and life compared to the locations served by the nurses and  therefore  they  should  be  paid  higher (Harlan, 2008).

In  the  United  States  the  use  of  the  word  paramedic  is  restricted  by  the  law  unless  the  claimant  of  the  title  has  passed  the  specific  set  of  examinations  and  clinical placements ,holds  a  valid  registration , and  certification  or  license  from  a governing  body ( Heart,1986). In  the  United  State  skills  performed  by  paramedics in various working  locations  vary  from  what  a  paramedic  is  trained  and  permitted  to  do  from  place  to  place. They   are  employed  by a  variety  of  different  organizations , their  services  usually  occur  differently   depending  on  organizational  structures  depending on  the  part  of  the  world(James,1983). Many  paramedics  centers  in  the  United  States  have  began  to  specialize  and  train  for  other   roles  at  their  work. An  example  was  in  the  aviation  medicine  where  there  involved  the  use  of  helicopters, most  of  them  had  to  train  to  be  pilots(Heart,1986).

The United  states  still  use  physicians, nurses  and  technicians   for  the  role of  the  critical  care. This  role  is for  specially   trained, senior  and  experienced  paramedics   who  primarily  perform  this  jobs. Roles  such  as

tactical  paramedic  working  in police  tactical  units  , marine  paramedics, hazardous 

materials  teams  and  urban  search and  rescue  teams  too  require  a lot  of  training  in  the  security  field (Thomson, 1998). Provision  of simple  health   care  and  assessment   services   is  a  new  and  evolving role  of  paramedics  in  the  expansion  of  their  practices. Paramedics’  at  some  points  are  forced  to  train  on  activities  which  don’t  involve  medical  practice. For  instance, in  the  war  field  a  paramedic  has  to  be  physically  fit  in order  for  him  to  help  the  injured. These  extra  specializations  do  not  fall  to  registered  nurses  since  they  are  in  a  hospital  setting.  Therefore, this suggests  paramedics   require  high  skills  and  training  therefore  their  pay  should  be  higher or equal to  that  of  the  registered nurses.

On  the  other  side  registered  nurses  in  the  United  states  are  the  largest  medical  health  care  occupants. Their  nature  of  work  include   treating  of  patients, providing  advice   and  emotional  support  to  patients’  family  members. Registered Nurses record  the   medical  symptoms  of  their   patients  and  help  in   performing   diagnostic  tests   through  analysis  of  results  and  finally  administer  treatment  and  medications , they  then  teach  the  patients  self-medication  of  treatment  and  physical  therapy . Registered  nurses  operate  machines  meant  for  medical  purposes   and  also  help  patients  with  their  rehabilitation  processes. They   also educate  patients  and families  on how  to  live  with  and  how  to  manage  an  illness   or  injuries  by  educating  them  with  the  post-treatment   care  needs  at  home, diets, nutrition, and  exercises  programs (Thomson, 1998).

Work  responsibilities  and  roles   vary  from  one  registered  nurse  to  another. Registered Nurses  specialize  in  one  or  more  areas  of  patient  care  but  in  a  hospital  setting. While some  registered nurses assists  surgeons, others  specialize  in  one  or  more  organs  of  the  body   and  body  systems  like  the  eye  disorders. The    fourth  group  of registered nurses  deal    with  a  well  defined  population,  such  as  the  women(Thomson 1998). These  factors  show  the  registered  nurses  do  not  work in a conditions that expose them to environmental  dangers  and  risks  such  as  fires, water, domestic  violence and  entry  into  high  crime  violent  areas. These  are  conditions  that  are  experienced  by  paramedics  and  therefore  the  need  to  match or surpass the  registered  nurses  pay (Thomson 1998).

The  common  skills  to  all  paramedics   levels  include  airway  management  through  manual  removal  of  obstructions   and  manual  repositioning. In  breathing  the  practice  include   active  oxygen  administration  by  Bag-Valve-Mask  device, oxygen  administration   by  nasal  canula, re-breathing  and  non-breathing  mask. In  circulation  they  assess  the pulse  rates, rhythm, volume  and  blood  pressure. They  also  practice  patient  positioning  to  enhance  circulation, recognition  and  control  of  hemorrhage  of  all  types  using  direct  and  indirect  pressure  and  obtaining  intravenous  access. In  a case   of  cardiac  arrest  they  practice  cardiopulmonary  resuscitation, airway  management, manual  ventilation  with  BVM  and  use  of  automatic  external  defibrillator. Wound  management  is done  through   controlled  bleeding  and  application  of  pressure  dressings  and  other types  of  dressings  and  treatment. Spinal  injuries  are  managed  through  immobilization  and  safe  transport. Use  of  traction  splints  is  applied  in  fracture  management, assistance  and  assessment  with complicated  childbirths   through  recognition  of  and  procedures for  obstetrical  emergencies  such  as  breech  presentation, cord  presentation  and  placental  abruption(Harlan, 2008).

Management , recognition and  classification  of  burns  and  treatment  is  a  practice  of  the  paramedics. It’s  also  their   practice   to  assess  and  evaluate  general  incident  scene  safety through  routine  radio  operating  and  medical  equipments  maintenance  procedures  and   responsibility  to  handle  and  take  care  of  emergency  vehicles(James,1983).  Paramedics  also  practice  cardiac  monitoring  and  interpretation  of  ECGs. Drug   administration  is  through  intramuscular  injection  and  oral  administration. The  drugs  that  are  permitted   must  have  low  risk  and  immediate  requirements which  include  Aspirin, nitroglycerin, oral  glucose, glucagon, epinephrine  and  albuterol. Patient  assessment  is  mostly  based  on  physical  signs   and  history  of  general  and  current   condition (Thomson,1998).

The  above  widely  discussed  role  of  the  paramedics  show  that they are  practically  experienced  and  therefore having  looked  at  the skills  of  paramedics  and  the  registered  nurses  its  vividly  clear  that  they  are  both  medical  professions  with paramedics required to have wider practical skills and thus the need to compensate them adequately.  Paramedics deals with effective emergency services which primarily provides advanced per hospital  care   for  the  injured  and  therefore  deals  with  the  field  hospitality  whereas  registered  nurses  profession  entails  health  care  responsibility  for  the  implementation  of  nursing  practices  with  in-hospital  practices. Therefore, looking  at  paramedics   skills  in practical medical   field  experience and  working  conditions  over  the registered  nurses  they  should  have  a  higher  pay  than  the  registered  nurses(Thomson Peterson’s ,1998).

            Unfortunately, paramedics  who  have  practical experience  and are  exposed  to  more  environmental  dangers  earn  less  than  registered  nurses .The  average  salary  of  a  paramedic  is  approximately  37,000  dollars  per  annum  whereas  that  of  a  registered   nurse  is  approximately  60,000  dollars  per  annum. The  main  difference in  the  pay  scale  is  that  paramedics  are  only  considered  as  emergency providers negating their active medical background (Heart, 2006). However, the  pay  of  both  the    paramedics  and  the  registered  nurses  depend  on  the   level  of  educational  experience.(Heart, 2006). This  pay  scale  and  the  working  conditions   of  the  paramedics   forces  them  to  bridge  to  the  registered  nurses  faculty  leaving  the  emergency  services field  so  that  they  can  access  the  luxury  of  working  on  only  one  job as a  registered  nurse  in   a  hospital   setting  free  from  all  dangers  and  work  overload  in  the  fields. This  paramedics  to registered nurses  bridging  leaves  the  emergency  field  unit  completely  lacking  experienced  paramedics ( Heart, 2006).

It is thus clearly evident that paramedic should receive equal or higher pay to the registered nurses since  they not only work in harsh environments that place significant risks to their life and health but due to work   specialization  and  diversification  factors, and  their  skills  and experience compared to the  registered  nurses. This will attract paramedic to remain in the job and not to bridge to the nursing profession creating a shortage of employees in the field.


Heart  J(2006).Medical  professionals  salary. Paramedic’s vs.  Registered nurses pay scale.       Washington: Oxford University Press.

Heart  J(1986). The  role  of  the  Paramedics  in  the  emergency  medical  unit. New York:

 Oxford University Press.

Harlan,  M (2008). Reducing   door  to  balloon  times. Journal watch, 27(3) 35-45.

James O. (1983). Paramedic   science.  New York: Oxford University Press.

Thomson, P ( 2006).Emergency  medical  services. Paramedics  in  the  United  States. New

  York:  New York Press.

Thomson, P (1998).The  Nurse  Ph.D. A  Vital  profession  needs  leaders. New York: Crescent             Books.

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