Thanks for the reply. Just intrigued about the lack of an EMT-I equivalent in your service. I am surprised that your CEO (the ex CAO of our service here in Auckland as it happens) has not considered attempting to implement this level? You must get extremely frustrated at times not being able to initiate some basic skills that you have already been trained in. What RPL (recognition of prior learning) is possible as an RN migrating into ambulance? Cheers - CraigP