Paramedic vs. Nurse: What’s the Difference?


Paramedic and Nurse

A job in the medical field is rewarding in that every day, you’re also preserving something very valuable: human lives. Yet the job responsibilities of a paramedic compared to a nurse are not quite the same, so it helps to know which career path is right for you. What’s the difference between a paramedic and a nurse?

Paramedics will treat patients who need care before said patient gets to a hospital or medical facility while nurses typically will work at the hospital and medical facilities to continue or start a patient’s care. 

In today’s extensive guide, we’ll compare and contrast the job roles of nurses and paramedics in every way. You’ll learn more about the schooling required for these two medical fields as well as salary and career growth expectations. 

If you’re on the fence about whether you should become a paramedic or a nurse, then this is one post you’re not going to want to miss! 

What Is a Paramedic?

Let’s begin by discussing paramedics. Although we’ve done so already once or twice on this blog, we’ll recap everything here for your benefit.

So what is a paramedic, then? 

A paramedic is a medical professional who works in an emergency capacity. They treat a patient at the scene of where the injury or illness occurred, such as the patient’s home, workplace, or even on the street. 

A paramedic must quickly assess the condition of the patient, ascertain what may be wrong, and then administer care to save the patient’s life. 

Paramedics sometimes ride in the ambulance on the way to the hospital or medical facility, but not always. Mostly, it’s emergency medical technicians or EMTs who do that. Paramedics are considered more medically qualified and advanced for administering care compared to an EMT. 

What Is a Nurse?

A registered nurse or RN is someone who has passed a nursing program to obtain a nursing license. The qualifications for earning such a license vary by province, state, and country levels in some instances. 

Nurses don’t always offer general medical care, but may have certain specialties. For instance, there are geriatric nurses, family nurse practitioners or FNPs, ER nurses, critical care nurses, clinical nurse specialists or CNSs, certified registered nurse anesthetists or CRNAs, and cardiac nurses.

Unlike paramedics who come to the patient, with nurses, it’s vice-versa. 

The patient will usually come to them and the nurse will begin offering treatment or care. Registered nurses may also work with new RNs and student nurses to show them the ropes. 

What Are the Job Responsibilities of a Paramedic vs. a Nurse?

Paramedic Job Responsibilities 

Paramedics are often assigned to teams so they don’t work alone. The teams can include new paramedics as well as those with seniority. 

Up to three people might comprise a paramedic crew, although it can sometimes be more and in some instances, even less. 

When a 911 call comes in, the paramedics arrive at the scene. They could be the first one to assess the condition of a patient. 

Since patients are not always conscious after an illness or injury, and even if they are, they’re not always fully coherent, the paramedic will speak to other witnesses to gauge what’s transpired. 

If the paramedic can’t paint a full picture of the scene just by witness testimony, they may speak to the family of the patient as well.

The paramedic will assess the patient to determine their condition. Through this information as well as the testimony, a paramedic can make a quick decision about what kind of care or treatment the patient requires. 

This care is rarely the extent of what a patient will receive, but rather, just enough to keep the patient stabilized and alive so they can get to the hospital or medical facility. 

Paramedics might offer the patient medication like painkillers, infuse them with medication intravenously, and dress wounds.

In the most serious instances when a patient’s condition may be approaching critical, a paramedic can use a ventilator or a defibrillator to save the patient’s life. 

If the patient requires transportation to the hospital, a paramedic may ride in an ambulance or another emergency vehicle, as mentioned. 

Nurse Job Responsibilities

When a patient gets transported to a hospital or medical facility, the job of a nurse begins. He or she will review the patient and do another assessment of the patient’s condition now that they’ve arrived at the facility. 

A registered nurse will also look over patient information, including medical history, to arrive at or confirm a diagnosis. 

If the patient needs further treatment, the nurse will provide this. They’ll also work with healthcare professionals like doctors, collaborating to provide the highest level of care a patient requires. 

The responsibilities of a registered nurse can branch out depending on his or her specialty. Here’s a closer look at the job roles of specialty nurses.

  • Clinical nurse specialists: A CNS is considered an advanced practice registered nurse. Since they have more education and experience, they are skilled enough to specialize in several areas of nursing. CNSs may be lead nurses that offer advice and assign tasks to other nurses with lesser roles. They can even create policy change in the hospital or medical facility.
  • Rehabilitation nurses: For those patients with chronic illnesses or disabilities, rehabilitation nurses can treat them.
  • Public health nurses: The duties of a public health nurse are to diagnose chronic conditions through health screenings. They might also work in areas such as community outreach, blood drives, and immunizations.
  • Nephrology nurses: Patients with kidney conditions will see a nephrology nurse. These nurses can diagnose and treat high blood pressure, diabetes, and even kidney conditions caused by alcoholism.
  • Genetics nurse: Genetic conditions like cystic fibrosis require specific care. A genetics nurse can diagnose, treat, and counsel these patients.
  • Critical care nurses: Often employed at hospitals, critical care nurses can provide quick care for illnesses and injuries that are serious in nature. 
  • Cardiovascular nurses:  When emergencies strike from heart conditions like heart disease, cardiovascular nurses are on the scene.  
  • Addiction nurses: An addiction nurse will aide those with substance and/or alcohol abuse problems, helping them overcome their addiction. 

What Kind of Schooling Do You Need to be a Paramedic vs. a Nurse?

Paramedic Education

Nurses may have a more encompassing role than paramedics, but you still must be committed to putting in hours upon hours of schooling to obtain a role as a paramedic. 

You’ll spend between 1,200 and 1,800 hours in a paramedic training program (click the link to find a program in your area), which is about two years. A university or community college near you should offer such a training program.

If you have a background in subject matter such as biology, math, and English, you’ll be at an advantage. 

These areas of schooling are required as part of your paramedic training degree program, so you might be looking at a course load that’s closer to 1,800 hours than 1,200 hours without having studied those topics.

After completing your paramedic training, you can take a test to earn your National Paramedic Certification or NRP. The National Registry of Emergency Medical Technicians or NREMT is one such entity that administers the necessary testing.

You’ll have to take a psychomotor exam and a cognitive exam to get the NRP. The psychomotor exam includes the following areas or skills: 

  • Integrated Out-Of-Hospital Scenario: During the Integrated Out-Of-Hospital Scenario or IOOH, you work with a professional paramedic partner to assess a patient, inspire a team, and stay professional through the extent of the patient’s care.
  • Oral Stations Cases A and Case B: In both Oral Stations, you’ll be tested on your interpersonal relations, patient assessments, and scene management skills. 
  • Static Cardiology: Static Cardiology as part of your cardiac management abilities requires you to review four ECGs and then determine the voice and rhythm of each so you can correctly treat the patient. 
  • Dynamic Cardiology: The Dynamic Cardiology part of the exam is scenario-based with a cardiac arrest having occurred. You have to use electrical therapy on the scenario patient to save their life. 
  • Trauma: Your assessment and treatment of a simulated patient is necessary for this part of the exam. 

If you pass the psychomotor exam, you move on to the cognitive exam next. This is a computerized adaptive test or CAT that includes 130 to 150 questions, including some live ones. 

As many as 20 questions are considered pilot questions that have no bearing on whether you pass or fail. 

The exam time is short, only two and a half hours. 

You’ll need to have studied areas like pediatric patient care, geriatric and adult care, EMS, gynecology and obstetrics, trauma, resuscitation, cardiology, and ventilation and respiration to pass. 

If your job duties as a paramedic do necessitate you riding an ambulance, you may also have to pursue your Emergency Vehicle Operator Course or EVOC license. These states require you to have the license:

  • Alabama
  • Connecticut
  • New Mexico
  • Florida
  • Hawaii
  • Pennsylvania
  • Kentucky
  • Minnesota
  • Missouri
  • Nebraska
  • Delaware
  • District of Columbia
  • Oklahoma
  • Oregon
  • Iowa
  • Virginia
  • West Virginia
  • Wyoming

Nurse Education

If you’re interested in becoming a registered nurse, you must be in it for the long haul. To earn one’s Associate Degree in Nursing or ADN, you’ll undergo two years of schooling. For a Bachelor of Science in Nursing or BSN, you must study for four years. 

Such areas of schooling you might focus on during your time in class include professional nursing, nursing research, psychology, nutrition, microbiology, healthcare policy, chemistry, statistics, biochemistry, physiology, and/or anatomy.

You don’t necessarily need to commit to four years of schooling, as you can become a registered nurse with only your ADN. Well, once you pass the National Council Licensure Examination-Registered Nurse or NCLEX-RN, that is.

The National Council of State Boards of Nursing, Inc. or NCSBN creates the NCLEX course. The test is a CAT that you must take at a Pearson Professional Center. The questions are completely randomized and selected depending on the answer you chose prior. 

You might also take the National Council Licensure Examination-Practical Nurse or NCLEX-PN. On your NCLEX-PN or NCLEX-RN test, you’re quizzed on the following materials:

  • Physiological integrity, including physiological adaptations, risk potential reduction, parenteral and pharmacological therapies, and basic comfort and care
  • Psychosocial integrity
  • Health maintenance and promotion
  • Safe care environments, including infection control and care coordination 

There are 119 questions on the NCLEX in all, and you get six hours to complete the test. If you pass, then you can get your state nursing license. Those who fail can retest in 45 days. The average rate of aspiring nurses who pass the NCLEX on their first go-around is 70 to 75 percent. 

How Much Money Can You Make as a Paramedic vs. a Nurse?

Paramedic Salary

According to the U.S. Bureau of Labor Statistics or BLS, in 2019, paramedics brought home $17.02 an hour, which is $35,400 a year. 

However, the BLS also considers EMTs and paramedics as one in the same. If you read our article contrasting the duties of a paramedic versus that of an EMT, you’ll remember these two jobs are not interchangeable. (click the link to see that article)

EMTs often undergo less schooling to be eligible to work in this role. While both EMTs and paramedics have to pass psychomotor and cognitive exams, EMTs cannot administer care to patients to the extent that a paramedic can. 

Thus, it seems somewhat unfair to lump the two jobs together. This data includes hourly and yearly pay. 

Wyoming $14.17 an hour, $29,467 a year
Wisconsin $13.40 an hour, $27,862 a year
West Virginia $13.72 an hour, $26,534 a year
Washington $15.52 an hour, $32,286 a year 
Virginia $14.08 an hour, $29,288 a year
Vermont $14.29 an hour, $29,715 a year
Utah $13.30 an hour, $27,672 a year
Texas $12.75 an hour, $26,514 a year
Tennessee $13.52 an hour, $28,131 a year
South Dakota $13.76 an hour, $28,631 a year 
South Carolina $13.58 an hour, $28,249 a year
Rhode Island $14.36 an hour, $29,877 a year
Pennsylvania $13.65 an hour, $28,396 a year 
Oregon $13.54 an hour, $28,155 a year 
Oklahoma $13.26 an hour, $27,582 a year
Ohio $13.43 an hour, $27,929 a year
North Dakota $14.18 an hour, $29,492 a year 
North Carolina $11.57 an hour, $24,072 a year
New York $15.78 an hour, $32,823 a year
New Mexico $12.72 an hour, $26,457 a year
New Jersey $13.74 an hour, $28,569 a year 
New Hampshire $15.21 an hour, $31,643 a year
Nevada $14.23 an hour, $29,604 a year
Nebraska $14.27 an hour, $29,677 a year 
Montana $13.51 an hour, $28,093 a year
Missouri $12.44 an hour, $25,869 a year
Mississippi $12.47 an hour, $25,930 a year
Minnesota $13.57 an hour, $28,223 a year
Michigan $12.69 an hour, $26,390 a year
Massachusetts $15.63 an hour, $32,513 a year 
Maryland $14.49 an hour, $30,131 a year
Maine $13.21 an hour, $27,483 a year
Louisiana $13.16 an hour, $27,372 a year
Kentucky $13.80 an hour, $28,699 a year 
Kansas $13.31 an hour, $27,684 a year 
Iowa $13.02 an hour, $27,090 a year
Indiana $13.28 an hour, $27,626 a year
Illinois $12.61 an hour, $26,227 a year
Idaho $13.22 an hour, $27,504 a year
Hawaii $15.01 an hour, $31,226 a year
Georgia $12.90 an hour, $26,822 a year
Florida $12.15 an hour, $25,281 a year
Delaware $13.53 an hour, $28,151 a year
Connecticut $14.48 an hour, $30,122 a year
Colorado $13.52 an hour, $28,114 a year
California $14.14 an hour, $29,419 a year
Arkansas $12.68 an hour, $26,370 a year
Arizona $13.37 an hour, $27,804 a year
Alaska $14.35 an hour, $29,838 a year
Alabama $12.59 an hour, $26,195 a year

Nurse Salary

The BLS has salary information for registered nurses as well. According to 2019 median pay data, a registered nurse earns $35.24 an hour on average, which is $73,300 a year. 

North Carolina $24.50 an hour, $50,955 a year
Missouri $26.31 an hour, $54,735 a year
Illinois $26.74 an hour, $55,624 a year
Mississippi $26.82 an hour, $55,791 a year
Michigan $26.88 an hour, $55,903 a year
Arkansas $26.89 an hour, $55,928 a year
Florida $27.39 an hour, $56,969 a year
New Mexico $28.06 an hour, $58,358 a year
Iowa $28.35 an hour, $58,965 a year
Alabama $28.38 an hour, $59,030 a year
Kansas $28.63 an hour, $59,554 a year
Colorado $28.64 an hour, $59,568 a year
South Carolina $28.75 an hour, $59,796 a year
Louisiana $28.79 an hour, $59,886 a year
Georgia $29.06 an hour, $60,444 a year
Utah $29.06 an hour, $60,455 a year
Oregon $29.07 an hour, $60,461 a year
Kentucky $29.30 an hour, $60,952 a year
Ohio $29.44 an hour, $61,244 a year
South Dakota $29.52 an hour, $61,411 a year
Wisconsin $29.53 an hour, $61,423 a year
Tennessee $29.66 an hour, $61,692 a year
Minnesota $29.69 an hour, $61,751 a year
Indiana $29.93 an hour, $62,256 a year
Arizona $30.12 an hour, $62,658 a year
North Dakota $30.41 an hour, $63,259 a year
Nevada $30.42 an hour, $63,278 a year
Montana $30.44 an hour, $63,309 a year
New Jersey $30.47 an hour, $63,384 a year
Alaska $30.66 an hour, $63,779 a year
Texas $30.68 an hour, $63,824 a year
Rhode Island $30.85 an hour, $64,159 a year
Pennsylvania $31.02 an hour, $64,529 a year
West Virginia $31.17 an hour, $64,842 a year
Maine $31.26 an hour, $65,014 a year
Connecticut $31.29 an hour, $65,090 a year
Idaho $31.67 an hour, $65,882 a year
Wyoming $32.09 an hour, $66,749 a year
Hawaii $32.18 an hour, $66,936 a year
Vermont $32.72 an hour, $68,066 a year
Massachusetts $33.24 an hour, $69,143 a year
California $33.70 an hour, $70,090 a year
Oklahoma $33.82 an hour, $70,349 a year
New Hampshire $34.70 an hour, $72,180 a year
Delaware $34.79 an hour, $72,367 a year
New York $35.87 an hour, $74,611 a year
Virginia $35.91 an hour, $74,698 a year
Nebraska $36.39 an hour, $75,961 a year
Maryland $37.17 an hour, $77,304 a year
Washington $37.64 an hour, $78,300 a year

Is There Room for Advancement as a Paramedic vs. a Nurse?

If you started as an EMT and became a paramedic, what could be next for your career? You want to keep advancing in the ranks as a paramedic? 

As you may remember from earlier in this guide, we discussed that there are senior-level paramedics. They must train beginner paramedics and teach them what they need to know to someday advance.

Once you become a top-tier paramedic, you might decide that you want to become a registered nurse. 

As an RN, your job settings would change and your income potential would grow. The skills you learned as a paramedic could make transitioning to working as a RN somewhat easier, but you will still need to pass the NCLEX, even if you have a paramedic’s license.

If you’re already an RN, you can become a nurse specializing in areas like addiction, rehabilitation, heart care, kidney care, and the like. 

You can also strive to become a clinical nurse specialist or CNS, nurse practitioner or nurse anesthetist (CRNA) which are some of the more advanced roles in the field of nursing. You might lead a team of new nurses as a nurse manager or instruct them as a nurse educator. 

Should you decide you want to take one giant leap forward for your career, since you already have at least a bachelor’s degree, you might go back to school to obtain a doctorate or even a Ph.D. through an advanced degree program. 

You will spend at least 8.2 years in school chasing a Ph.D., so decide carefully if this is the right career path for you before you begin venturing down it. 

What’s the Career Outlook as a Paramedic vs. a Nurse?

One of the benefits of working in a medical career is that your job is always in-demand. Between 2019 and 2029, BLS estimates that the jobs of paramedics and EMTs will grow 6 percent, which is considered faster than the norm. 

It’s expected that 17,000 new paramedics and EMTs will begin working within that decade.

Registered nurses are on track to grow even faster, up to 7 percent between 2019 and 2029. That again is considered more growth than the average job field sees. 

In the next decade, 221,900 new nursing jobs should open up. 

Conclusion

If you’re passionate about helping people through dedicated medical treatment, a job as a paramedic or nurse might be right for you. These two roles are both about administering the best possible care, albeit in different settings and capacities. 

Now that you know what it takes to become a paramedic and a nurse, you should find it easier to determine which of these two jobs is the best fit for you. Best of luck!  

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