How can I combine my nursing practice with my interest in prehospital emergency care?

By | 2022-02-14T18:09:18-05:00 October 24th, 2011|0 Comments


Dear Donna,

I’m a critical care nurse with less than two years of experience and an EMT for a local ambulance service, and I feel like I’m coming up on a crossroads in my career. The deadline for special student registration to take individual graduate courses next semester is approaching, and I must soon make a decision about whether to either start down the path toward graduate school or pursue education as a paramedic in the near future.

My ultimate career goal is to combine my interest in prehospital care (EMS) with my nursing practice. I know flight nursing would be the most obvious choice; however, I’d also like to consider other avenues. I read “The Road Less Traveled” on, an article about nurse-paramedics in New Jersey. I would love to practice in a similar role either in clinical practice, quality assurance/education or both. I’ve talked to a few different people who hold both RN licensure and paramedic certification about how to attain such a position, but their answers don’t really show a clear path I could follow. The people I spoke to who practice both nursing and prehospital care (other than flight nurses) have acquired an eclectic combination of experience, training and education. Although there are nurses who officially are recognized and authorized to practice both nursing and paramedicine in California, New Jersey, Pennsylvania, Illinois and the United Kingdom, there don’t seem to be any in my state.

Although a streamlined EMS education process for nurses exists, my state of residence doesn’t have an official EMS certification for nurses practicing in the prehospital environment. Instead, nurses must obtain at least EMT-Basic or EMT-Paramedic certification to practice in an EMS system (their RN licensure/education is not recognized at all).

How do I reach my goal of practicing both nursing and prehospital care without moving miles away or completely changing job classifications? I don’t want to leave my position prematurely because I have a good job with excellent benefits and continuing education. It seems there aren’t many people in either professional community who understand what I want to do.


Dear Donna replies:

Dear Lost,

If your current state of residence does not offer a nurse paramedic option, then flight nursing might be the way to go. Have you done any informational interviewing ( or general inquiry calls with flight and surface transport nurses in your home state? Have you visited the Air and Surface Transport Nurses Association, formerly known as the Flight Nurses Association, ( Your state chapter of ASTNA (or members in your state) would be your best resource for exploring the type of options you mention.

Many flight or surface transport nurses are employed by trauma centers where they work regularly in an ICU or ED and are on call for emergency prehospital care.

Beyond that, if you don’t plan to relocate, you could try to initiate in your home state the RN/EMS model that exists in other states. Speak to those involved in this in other states, including those mentioned in the article you reference, and get their suggestions on how to get this started where you live. Many a nurse has created his or her own position or started a nursing program or movement. You have an opportunity to pioneer this in your area.

By all means plan to move toward graduate school as soon as possible. Higher education can be the wave that propels you into the future, even if you’re not yet sure exactly where you’ll wind up. Graduate schoolwork also stimulates ideas, information, contacts, resources and research projects that can help you to create your own future. I say go for it and see where the path takes you.

My best wishes,


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