Registered Nurse vs. Paramedic: What's the Difference?

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Published January 17, 2023

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Registered nurses and paramedics both provide life-saving care for patients. Find out which career is right for you.
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Woman paramedic smiling beside an ambulance with open doors Credit: Rawlstock / Moment / Getty Images

Registered nurses and paramedics interact when transferring patients into an emergency department. Both roles are critical parts of acute patient care.

The roles overlap in responsibilities but differ in education, salary, and work setting. Find out which career is the best fit for you.

Registered Nurse and Paramedic Key Similarities and Differences

Registered nurses and paramedics both provide life-saving care to patients in the acute care setting. Both careers require a BLS-CPR certification and a license from your state to practice, but they have some key differences.

Paramedics spend about 23 months in training compared to the 2-4 years that registered nurses spend earning their degrees. However, registered nurses have more options for work settings, higher average annual salaries, and more responsibilities.

What is a Registered Nurse?

A registered nurse is someone who works with doctors and other healthcare professionals to create and carry out care plans for patients in hospitals, outpatient care centers, nursing homes, and home healthcare. They examine and treat patients, give medications, and teach patients how to care for themselves.

What is a Paramedic?

A paramedic is someone who works with a team of EMTs and paramedics to respond to 911 calls and provide emergency medical care. Such care includes stitching wounds, giving first aid and CPR, and providing advanced airway management. They primarily work in ambulances and the field.

Featured Online RN-to-BSN in Nursing Programs

Comparison of Registered Nurses and Paramedics
Registered Nurse Paramedic
Degree Required Associate degree in nursing (ADN) | Bachelor’s degree in nursing (BSN) (preferred) An associate degree or bachelor's degree may be required
Certification Options State- or nurse licensure compact (NLC)- issued RN license | CPR-BLS certification State-issued paramedic license | Paramedic certification from the National Registry of Emergency Medical Technicians (NREMT) | CPR-BLS certificationACLS Certification
Recertification Options Complete the working hours and continuing education your state requires AND Apply for license renewal through their state Pass the exam for recertification for paramedics OR Complete 60 hours of continuing education
Work Settings Hospitals and outpatient care centers Ambulance services, emergency departments, and local government
Duties and Responsibilities
  • Examines and treat patients
  • Teaches patients and their families how to to care for themselves
  • Works with other healthcare professions to create and carry out care plans
  • Observes patients and reports their observations
  • Records patients’ medical histories
  • Decides where to take the patient for the best care
  • Leads the EMS team in the field
  • Gives life support and first-aid
  • Documents and reports treats they give
  • Responds to 911 calls
Average Annual Salary $82,750 $49,500

Duties and Responsibilities

Paramedics and registered nurses share some of the same responsibilities such as giving medication, taking patient histories, examining and treating patients, and reporting their observations.

Registered nurses have more responsibilities, more variety in possible work settings, and more involvement in the care planning process.

What Does a Registered Nurse Do?

Registered nurses work with doctors and other healthcare professionals to provide care, create care plans, and educate patients and family members.

Most registered nurses work in hospitals, physician's offices, outpatient care centers, and nursing homes. Typical registered nursing shifts last 8-12 hours a day. Registered nurses’ duties include:

  • Operating medical equipment
  • Assisting with diagnostic medical testing
  • Observing patients and reporting and recording those observations
  • Collaborating with other healthcare providers to set up or change care plans
  • Taking patients’ medical histories and examining patients
  • Giving medication and treating patients
  • Teaching patients and their family members how to care for themselves and manage their chronic conditions

What Does a Paramedic Do?

Paramedics respond to 911 calls to provide emergency medical care and safely transport and transfer patients to the nearest emergency room, between hospitals, or to another healthcare setting.

They do most of their work in the field, in an ambulance, or in emergency departments. Paramedics who work for a city or fire department often work 24 hours on and 48 hours off. Paramedics’ responsibilities include:

  • Leading the EMS team in the field
  • Deciding where to take patients for the best medical care
  • Replacing, cleaning, and taking inventory of supplies
  • Giving first aid and CPR
  • Providing advanced airway management and advanced cardiac life support
  • Inserting IO and IV lines in the field
  • Documenting and reporting the treatment they provide
  • Transferring patients to the emergency department or other healthcare setting
  • Driving the ambulance and transporting patients safely

Education and Certification

Whether you want to become an RN or a paramedic, you need a high school diploma and CPR-BLS certification. RNs and paramedics both have to take a licensing exam to get a license to practice.

Both roles have to apply for license renewal and complete continuing education to renew their license every few years.

Deciding which career path you want depends on how much time you want to spend in school.

How to Become a Registered Nurse

If you choose to become an RN, you need to earn at least an associate degree in nursing (ADN), which takes two years to complete.

Many employers now require or prefer nurses to get their bachelor’s degree in nursing (BSN), which takes four years to complete. If you want to pursue management positions, further your education, or earn higher salaries you'll need a BSN.

After you earn your degree, you'll need to pass the National Council Licensure Examination (NCLEX) to get an RN license in your state.

Before the exam, you’ll need to submit an application for licensure to be eligible to register for the NCLEX through the NCSBN and study for the exam.

Once you're a licensed registered nurse, you’ll need to complete continuing education, work a certain number of hours, and apply to renew your license every few years according to your state’s guidelines.

How to Become a Paramedic

If you choose to become a paramedic, you need to complete an accredited paramedic program, which takes 16-18 months. To apply for these programs, you’ll need a high school diploma, an active EMT license, and a CPR-BLS certification.

After you complete your paramedic program, you’ll need to pass the licensing exam in your state.

You’ll need to show proof of your EMT license and CPR-BLS certification to apply for the exam. You will also need to complete a skills test on tasks like taking patient histories. In some states, you may have to pass a background check.

After completing those steps, you can apply to take the National Registry of Emergency Medical Technicians (NREMT) paramedic certification exam and become a nationally certified paramedic.

To renew your certification every two years, you can take the recertification exam or complete 60 hours of continuing education to renew your certification.

Salary and Career Outlook

Registered nurses make about $33,000 more annually than paramedics. Salaries for both careers can vary based on experiences, skills, and location.

The Bureau of Labor Statistics (BLS) projects job growth that is slightly higher than average for both registered nurses (6% growth) and paramedics (7% growth).

Registered Nurse Salary and Career Outlook

$82,750
Average Annual Registered Nurse Salary

Source: BLS

Registered nurses make an average annual salary of $82,750, according to 2021 BLS data. They make an average of $39.78 an hour. Nurses' salaries may vary based on experience, skills, and specialty.

Nurses with more than five years of experience may earn more than average, according to November 2022 Payscale data.

Nurses with skills in critical care, emergency response, insurance, and medical records can expect to earn more than average. Nurses in specialties such as oncology, geriatrics, and pediatrics may earn higher salaries.

Paramedic Salary and Career Outlook

$49,500
Average Annual Paramedic Salary

Source: BLS

Paramedics make an average annual salary of $49,500 and an average of $23.80/ hour, according to the BLS. Paramedic salaries may vary based on experience, skills, and location.

Paramedics who have more than 10 years of experience may earn higher salaries, according to November 2022 Payscale data.

Paramedics with skills in leadership, critical care, and advanced cardiac life support can earn higher-than-average salaries, especially in states like Washington, New Jersey, Washington D.C., Connecticut, and Maryland.

Registered Nurse vs. Paramedic: Which Career is Right For Me?

Registered nurses and paramedics both provide essential care to patients in the acute care setting. They even perform many of the same duties.

Whether you want to become a registered nurse or a paramedic comes down to what you want for your annual salary, your responsibilities, your work setting, and your education timeline.

Registered nurses have more responsibilities and more options for work settings outside acute care. They also make a higher average annual salary than paramedics.

However, paramedics spend less time in school, especially when you consider that registered nurses need a four-year BSN degree to pursue management positions and earn more money.

  • Salary: Registered nurses make about $33,000 more annually than paramedics. This comes out to about almost $16 /hour more for nurses than paramedics.
  • Education Timeline: Paramedics spend just under two years in school between their EMT and paramedic training. Registered nurses spend 2-4 years earning their degrees.
  • Work Setting: Registered nurses often work in hospitals and outpatient settings while paramedics most often work in the field or in an ambulance.

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Page last reviewed January 12, 2023

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