My next door neighbor was an LPN and spent a summer studying for her RN by herself; Maryland apparently has a self-study option so she just had to read/study/learn the textbooks and then take the test. I would go interview the people at the community college and see what various paths and job opportunities there are, etc. in the medical community where you are and what ideas they have. I, personally, would take a quick personal aide course at the community college and get a job in an assisted living facility and go to school part-time for something else as I got a bit of experience and understanding of what there was out there and what I wanted. Does the community college have a job center? I'd investigate that too; sometimes they let people in the community use it, maybe you could start a course there and then use it to continue looking for a job with your EMS skills, etc.?