Fla. Firefighters Hone Nursing Skills as Fallback Career

ST. PETERSBURG -- At 36, Tom Kras, a firefighter with St. Petersburg Fire & Rescue, has already had two knee surgeries. After the second surgery, he was on light duty for several months.

Kras wondered what would happen to him if he could no longer carry people down ladders or cut open a car to pull out an injured passenger.

That's when he decided to make himself more marketable and become a nurse.

"I knew I never wanted to leave the fire department at this age to be a nurse," said Kras. "It was more of a backup plan."

Kras is among a small but growing number of firefighters who are juggling their already unusualschedules to become registered nurses. The shift is happening at fire departments throughout the region.

Like Kras, many aren't going to nursing school to change careers. In fact, many seek the added training to improve their skills as paramedics. It also helps them act with patients' longer-term needs in mind, rather than just patching them up well enough so they're still alive when they reach the hospital.

But nursing also is a good option for firefighters who are no longer physically able to run calls, and it's a better second job than what many firefighters do when they're not at the fire station. Jobs such as construction, landscaping or air-conditioning repair can be almost as physically demanding as responding to fires and vehicle crashes.

"It's an understanding I might not be able to lift these people up stairs in 15 years," said Allen Smay, 31, a firefighter and paramedic with Lealman Fire Rescue who's enrolled in a nursing program at St. Petersburg College.

In Pinellas County, firefighters are increasingly worried about job security because local governments are always looking to cut costs. Recently, for example, county officials decided they no longer want firefighters to respond to low-priority medical calls.

Though the nursing bridge programs have been around awhile, they haven't attracted large numbers of students.

Pasco-Hernando Community College, where Kras received his nursing education, started its program in 1991, but enrollment dwindled to zero after a few years, said Jayme Rothberg, the school's dean of health occupations. In 2007 and 2008, the program was restructured so paramedics and licensed practical nurses were enrolled together. Even so, it's only offered every other year. In the past couple years, 39 paramedics went through the program, with 38 graduating.

St. Petersburg College started a bridge program in 1990, according to Phillip Nicotera, provost at the college's Caruth Health Education Center. Paramedics join other students admitted to the nursing program, with 12 of 192 slots reserved for them each year.

Since the 2007 spring term, 30 of 32 nursing students who also are paramedics graduated with a nearly 94 percent success rate, Nicotera said.

There's little doubt a nursing degree expands a firefighter's options, even as a first-responder.

One of Kras' firefighter colleagues, Kevin Dooley, 43, also works as a flight nurse on Bayflite, Bayfront Medical Center's rescue helicopter, because he is both a registered nurse and a paramedic. Every flight nurse on Bayflite needs paramedic training, Dooley said.

Financially, there isn't much of a difference between a nurse's salary and a firefighter's salary, firefighters say, especially if you consider the benefits and pensions firefighters receive.

"At this point, I can't say leaving the fire department to become a nurse would mean more money," Kras said. "It's close."

Aside from financial and health concerns, there are other reasons firefighters might consider switching careers.

"We both make about the same amount of money, but in the end the paramedics [and] firefighters are spending more time away from their families, and the nurses are working fewer hours," said Smay.

For Steve Bailey, a firefighter with Largo Fire Rescue, becoming a nurse was about having more options. After seven years in Largo where his father was a career firefighter, Bailey has no plans to leave, but nursing brings in extra money and will give him a second career after he retires from the fire department.

"It's just more security," said Bailey, who earned a nursing degree at PHCC last year and started working in the emergency room at Regional Medical Center Bayonet Point in Hudson about a month ago.

"As an RN, you can go many different routes."

Bailey would know: His mother was a registered nurse. So he's following in his parents' footsteps.

Given the choice, most firefighters opt to stay with their agencies even after becoming nurses, as long as their bodies hold up. They like the adrenalin and the heroic aspects of the job.

"When someone is knocking on death's door, the biggest difference can be made in the first 10 minutes," said Dooley, who became a firefighter after first training as a nurse. "Now that I'm on the street, I get that first 10 minutes."

Firefighters trained as nurses also say they appreciate the added perspective nursing gives them.

As a paramedic, 26-year-old Robert Winer, a Clearwater firefighter, said he would routinely give patients suffering from heart failure an intravenous solution. He didn't learn until nursing school that giving a patient too much of the fluid might spur the heart to pump it back into the patient's lungs.

As a paramedic, he was wary of administering paid medication to elderly patients unless he saw "a bone sticking out."

Winer, who also works in a stroke unit at Mease Dunedin Hospital, said nursing has made him more comfortable making such decisions about medication.

"As a nurse, you learn some of the effects of the things you do in the field," Winer said.

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