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.