The Comparison And Contrasts Between Adult Nurses And Paramedics

Both professions require a high level of education. Similarly, both professions require a 3-year undergraduate degree, there are various routes to get to this goal. Higher National Certificate courses are available at selected colleges, however, as told by NHS careers (2020) applicants can apply to health or science-based subject to become a paramedic but states that nursing applicants may apply only to a healthcare practice course. The Scottish Widening Access Programme is for adult learners who have virtually no qualifications, a vital stepping stone enabling their path to university. Apprenticeships are offered, these vary slightly. A nursing applicant can apply to a modern apprenticeship in a healthcare support role, whereas a paramedic has the opportunity to apply for a foundation apprenticeship, which will enable skills and work experience to be expanded as told by NHS careers (2020).

Nursing and Paramedic graduates both have to register with their regulatory bodies. An adult nurse must register with the Nursing and Midwifery Council (NMC) and paramedics must register with the Health and Care Professional Council (HCPC) both regulatory bodies are very similar with slight differences. Registering with the NMC a registration fee of £120 and a declaration must be signed and paid. The registration of a paramedic is very similar, but the HCPC (2018) confirms a new graduate registration is £90, so differing from the NMC. Both professions have to meet standards to register, paramedics with 'standards of proficiency' (HCPC, 2014) nurses with 'The code' (NMC, 2018).

Revalidation defined by the royal college of nursing (2020) is the process required every 3 years to continue to practice as a registered nurse. Revalidation encourages an environment for self-reflection, sharing, and personal growth. There are certain requirements to be met, for example, NMC (2019) requires 450 practice hours, 35 hours of CPD including 20 hours of participatory learning, etc. Continuing Professional Development (CPD) is defined by The CPD Certification Service (2020) as the term used to describe the learning activities professionals engage in to develop and strengthen their abilities. Nurses have to revalidate every 3 years whereas a paramedic renews every 2 years. While a nurse has to complete additional requirements such as a reflective discussion, a paramedic keeps a continuous CPD profile, which involves learning activities that are most relevant to a paramedics practice, The College of Paramedics (2019) aims to support and further professional development. As per HCPC (2018), a CPD audit is a part of the renewal process for a paramedic, only 2.5% of registrants will be asked to submit their profile, this differs from the renewal process for a nurse.

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A code of conduct is very important for both professions as it ensures each professional adheres to the values and principles set out. The HCPC (2018) explains that the professional is solely liable for their actions. A nurse must adhere to The Code and paramedics must adhere to the Standards of Proficiency. Both are very similar, per the NMC (2018) there are four categories that a nurse must adhere to when practicing - Prioritise people, Practice effectively, Promote professionalism and trust, and to Preserve safety. Although one difference is that the HCPC (2014) lays out 15 categories as opposed to the 4 categories within 'The Code'. The similarities for both professions are to practice effectively and promote professionalism and trust. What differs is a paramedic must practice as an autonomous professional, autonomous being defined by the Cambridge Dictionary (2020) as being independent and having sole power when making decisions. So, with the HCPC (2014) an individual must be able to make informed, reasoned decisions about their practice and rationalise any decision if asked to. The standards are not set to catch any individual out, it is the opposite they are there to relate elements of their practice to. Professional boundaries are necessary when practicing as a nurse or indeed a paramedic. With regards to the Standards of conduct, performance, and ethics from the HCPC (2016) they state that paramedics must maintain appropriate boundaries, and to use social media responsibly. The Code, NMC (2018) is very similar as they state that a nurse should uphold professional boundaries with current and past patients. NCSBN (2018) defines professional boundaries as the space between a nurse's power and the patient's vulnerability, also relatable to a paramedic. Similarly, both codes reference the use of social media, this is a big factor in maintaining professional boundaries. It would be deemed unprofessional to befriend any patient past or present, or to discuss patients online as this could potentially jeopardise a patient's safety. Business Dictionary (2020) defines ethical behaviour as showing honesty, fairness, equality, dignity, diversity, and individual rights. There are few differences and a lot of similarities with regards to ethical behaviour, as previously stated both, the standards of conduct, performance and ethics, and The Code stress the importance of upholding honesty and dignity with regards to the wellbeing and treatment of a patient. Ellis (2020) states that the failure to understand ethical decision making may lead to putting not only themselves but the patient in danger. This is very important as it makes both professionals stop and think about the potential repercussions of any decision they make. Ethics can be argued back and forth as a patient does have the right to refuse any kind of care or treatment and Law Teacher (2019) argues that no paramedic nor nurse can take that away from a patient. However, the patient's wish can be overturned if they are deemed incapable to make such a decision. A paramedic could justify overturning a patient's decision by referring to HCPC (2016) identifying and minimising risk, assessing the situation properly, and having taken all reasonable steps, therefore reducing the possibility of harm towards both the paramedic and the patient. A nurse treating a patient in this situation can refer to The NMC (2018) in particular protecting the best interest of people at all times by keeping to the relevant law about the mental capacity to ensure the rights and best interest of a patient are still at the centre of the decision making process.

Both a nurse and paramedic have huge levels of responsibility, they need to be accountable for their decisions. There isn't much that differs, they both provide a high level of care and respond to a patient's physical and emotional needs. However, NHS Scotland Careers (2020) tells us that a paramedic will provide an immediate response to accidents and medical emergencies. The main difference is that a paramedic will be the first to assess and care for the patient, a nurse will then continue to monitor, assess as told by NHS Scotland Careers (2020). Both would be held accountable if any of the decisions they made regarding the patient caused any kind of trauma. Per the NMC (2018) if a task is delegated to another member of staff the nurse must ensure this is within their scope of practice and the instruction is fully understood. A nurse could be deemed incompetent and negligent if passing on tasks and not ensuring that patient safety and well-being are secured. There is no difference in this aspect as the HCPC (2016) states that a paramedic must always delegate responsibilities appropriately and could face possible discipline if this is not adhered to. Griffith (2015) states that accountability underpins the professionalism, integrity, and probity of practice. Clinical supervision allows for a better working environment for the nurse/paramedic which ultimately will reflect on the care of the patient. College of Nursing (2020) describes clinical supervision as a way to promote critical reflection, development needs, and supporting revalidation. Unlike with nursing, where a student nurse on placement will have a mentor or a qualified nurse will have the nurse in charge to, turn to offload any emotional difficulties. A paramedic does not have as great access to professional supervision as a nurse, as argued by Ellis (2013) this was slower to develop within the paramedic community. The need for supervision for a paramedic will change as they develop throughout their career. Ultimately professional supervision is important for both careers as it allows for a channel of communication and ultimately a way to constantly improve practice. As both a nurse and paramedic have to meet the standards of their own code, a key factor to this is having to refer a colleague to a professional who outranks them or their regulatory body. Referring a colleague for a misdemeanour could be due to them exploiting the vulnerability of a patient, which could cause anyone to cause harm as they now know confidential information, and this is an immense breach of all codes of conduct. Both the NMC and the HCPC recommend that an issue be taken up with the colleague in question directly or with management as the HCPC (2018) confirms that this is usually the most effective method of resolving a complaint. Maintaining patient safety is a huge similarity for a nurse and paramedic, and to keep within their scope of practice. A difference is a paramedic practicing as an autonomous professional HCPC (2014) upon assessing and determining the initial treatment plan for a patient, identify when they do not possess such knowledge and refer to a more superior experienced colleague for help to ensure patient safety is not jeopardised. A nurse is not classed as an autonomous professional which differs however, there are similarities as like a paramedic and following the NMC (2018) help must always be offered if they see an emergency arising, taking account of their own ability and seeking the availability of other options for providing care to avoid putting anyone's life at risk.

Ultimately there are far more similarities than differences upon comparing and contrasting adult nursing and paramedics.