I'm curious why this one had a nurse
and a paramedic on board. Can't the nurse do paramedic stuff?
Without special training and dispensation and oversight, no. With special dispensation and training beyond that of a nurse, yes, but their experience leading to the flight role is different. Not better nor worse, just different.
Nurses are trained in school to be generalists, and much of school really is weeding you out. You learn real world on your first job in an apprenticeship role.. indoors.. in good lighting.. with lots of support staff.. and lots of specialists around. School is about big picture, whole body, long term implications, and encompasses so much more than just the short term acute care setting.
Paramedics are trained primarily in trauma and cardiology. Actual skills practice - airway management, immobilization, rapid assessment and treatment decisionmaking, without the benefit of extensive labs, xrays or back up. Its drilled in your head, its practiced regularly. Nurses may spend a few days in a skills lab where medics will spend an entire semester. Consequently, a green rookie paramedic is still minimally proficient to actually go and manage a life threatening emergency on day one (provided they actually recognize it
in front of them). They work in the dark, the rain, the cold, with patients trapped upside down. Its not an exaggeration when I tell you peers have started IV's on inverted, pinned in patients with gasoline leaking on them. Or intubated and started resuscitating someone who was strapped in upside down. I've had to go under water to enter a vehicle for an entrapped patient rescue... in the winter. . Not typical nursing fare..
There are things I can do as a paramedic, that I would lose my job and my license for if I performed them as a nurse.
In an aeromedical setting, many of the flight nurses are (or are expected to become) cross trained and cross credentialed as paramedics. It IS an ambulance.. and many EMS boards require credentialing as an EMS person if your regular role is working on an ambulance of any sort..
So really then.. its about complimenting skills: your flight nurses tend to have years of ICU/ER/Trauma management in house with all sorts of gadgets and special therapies. Your medics tend to have down and dirty street skills, for lack of a better term..
Then another reason? Money... In my region, in my experience over the past 20 years, paramedics have tended to earn 2-3x the prevailing minimum wage.. so nowadays thats maxing out in the low 20's/hr.. STARTING nursing wages in my region average 4X min, and tend to top out at 5X.. So you can have a medical crew labor cost of $55/hr with a nurse/medic or a labor cost of closer to $70/hr with two nurses.. and that adds up over time..
Dave, a nurse AND paramedic.