The Infamous Cab-ulance

Specialties Emergency

Published

I'm curious to know some of the things your patients call the ambulance for. Just recently we've had patients who present to the ED via EMS and c/o ripped cuticle, or a med refill, along with many more complaints that, in my opinion, absolutely do not justify the need for emergency medical services. The worst one lately, though, was a patient who presented to the ED and when getting off the stretcher, stated that they just needed a ride to this side of town to get to their friend's house and simply walked out the EMS bay doors. I was flabbergasted.

What inane EMS runs have you experienced?

Specializes in Current: ER Past: Cardiac Tele.
22 y old male. "I havent urinated in 3 years."

Did you offer the life-saving foley?

Up Vote Up Vote ×

May I add a few that never saw the ED, but still got a full response, sometimes including a fire truck and PD?

-toenail too long to put on shoes, too obese to cut own toenail

-I'm cold

-I'm hungry

-My roommate took my stuff

-a little ol lady with an overflowing toilet (she was actually very sweet)

-we don't have a bed for this psych patient, please have the ED hold on to him until we do

-the urgent care is closing and this person didn't get well enough in time

Oh, the list goes on...and Medicare patients aren't the only abusers...sigh.

Up Vote Up Vote ×
Specializes in RN.

Seen a lot of these types as well.

It should be illegal, and maybe we should include it in out Patient Education.

Up Vote Up Vote ×

It should be illegal. Most of them are illegal and or doing illegal **** anyways. Sick of them sucking up valuable time from decent citizens who need an ambulance with Paramedics who are there to help those who really need it. Paramedics should be able to decide who gets help and who doesn't. Most of these people should be left on the street.

Up Vote Up Vote ×
Paramedics should be able to decide who gets help and who doesn't.

They can already intubate like physicians while nurses can't, so why not? :)

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
They can already intubate like physicians while nurses can't, so why not? :)
This is not necessarily true. I have worked at facilities that allow nurses in certain circumstances intubate.

I think that it would be difficult and a huge liability for the medics/EMTs to determine medical necessity on the street...have one bad outcome and there will be hell to pay.

Up Vote Up Vote ×
They can already intubate like physicians while nurses can't, so why not? :)

You obviously missed the point. Why should EMS transport every little booboo? Or the drunk who can go to a drunk tank by cop car? Paramedics are on the streets on the frontline.

Up Vote Up Vote ×
This is not necessarily true. I have worked at facilities that allow nurses in certain circumstances intubate.

I think that it would be difficult and a huge liability for the medics/EMTs to determine medical necessity on the street...have one bad outcome and there will be hell to pay.

I bet those nurses didn't have their licenses very long. ACLS and PALS does not entitle you to do intubation as a nurse. Many states do not allow nurses to intubate under any circumstances and that includes those working flight which is why Paramedics are almost always on flight teams.

Paramedics already have treat and release or just release programs many areas. EMS does not have to transport every Tom with a Harry Dick to the ER just because they want a ride. This is not new. For someone who says they were once an EMT you have not kept up with EMS but yet want to preach it like you are the only authority on the subject. Maybe since you don't know what Paramedics can or can not do, you probably shouldn't be telling others what they can do to Paramedics.

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I bet those nurses didn't have their licenses very long. ACLS and PALS does not entitle you to do intubation as a nurse. Many states do not allow nurses to intubate under any circumstances and that includes those working flight which is why Paramedics are almost always on flight teams.

Paramedics already have treat and release or just release programs many areas. EMS does not have to transport every Tom with a Harry Dick to the ER just because they want a ride. This is not new. For someone who says they were once an EMT you have not kept up with EMS but yet want to preach it like you are the only authority on the subject. Maybe since you don't know what Paramedics can or can not do, you probably shouldn't be telling others what they can do to Paramedics.

First I never said ACLS nor PALS entitles a nurse to intubate. You are not a nurse and I have been one for 35 years and I have intubated and my license if just fine. I NEVER said I was an EMT I said I was a medic (acquired for flight nursing in 3 states) and yes...there are select services that allow the release of patients. However, it is NOT the general rule of thumb. I never indicated it was a good practice to transport individuals who clearly have the only intention of getting a ride....and yes it takes up valuable resources.

The reasons that there is or is not a nurse or medic on board, or one cannot fly without the other, has nothing what so ever to do with intubation.

I disagree that the states do not "allow" nurses to intubate...could you please resource your information please? The are facility/program policies that restrict the task of intubation to one professional or the other to keep the skill set specialized...but there are NO "state laws" that prohibit the skill task of intubation to be solely a paramedic function. Many nurses on RRT teams intubate and perfom this task very well. In the hospital setting there is little need for nurses to intubate as there are others available to relegate that task to...it is impossible to guarantee competency for most nurse would never be able to do it often enough to ensure competency.

I have not kept up my paramedic....it isn't necessary any longer. However...while I have been a medic you have not been a nurse.

But...I will not try to change your mind. You are free to believe to believe what you wish.

Up Vote Up Vote ×
First I never said ACLS nor PALS entitles a nurse to intubate. You are not a nurse and I have been one for 35 years and I have intubated and my license if just fine. I NEVER said I was an EMT I said I was a medic (acquired for flight nursing in 3 states) and yes...there are select services that allow the release of patients. However, it is NOT the general rule of thumb. I never indicated it was a good practice to transport individuals who clearly have the only intention of getting a ride....and yes it takes up valuable resources.

The reasons that there is or is not a nurse or medic on board, or one cannot fly without the other, has nothing what so ever to do with intubation.

I disagree that the states do not "allow" nurses to intubate...could you please resource your information please? The are facility/program policies that restrict the task of intubation to one professional or the other to keep the skill set specialized...but there are NO "state laws" that prohibit the skill task of intubation to be solely a paramedic function. Many nurses on RRT teams intubate and perfom this task very well. In the hospital setting there is little need for nurses to intubate as there are others available to relegate that task to...it is impossible to guarantee competency for most nurse would never be able to do it often enough to ensure competency.

I have not kept up my paramedic....it isn't necessary any longer. However...while I have been a medic you have not been a nurse.

But...I will not try to change your mind. You are free to believe to believe what you wish.

You need to check your state laws for nurses and intubation again. You are wrong. Just look at the nurse practice acts in other states. Google is your friend to find BONs in other states and their opinion on intubation.

Your cohort in medic bashing on the other discussion was the one who said ACLS and PALS gave nurses independence to which you agreed or did not dispute.

Are you intubating in the hospital assuming your medic license will still cover you? I think you might be in for a big surprise. If you are a Paramedic, why did you not know Paramedics did more than just spinal immobilization. It appeared you are only familiar with an EMT scope of practice. BTW you must be an EMT before becoming a Paramedic in 49 states.

I also never said intubation is limited just to Paramedics. I just stated that most states limit RNs who can do intubation. Physician Assistants, doctors, nurse practitioners and respiratory techs can intubate. It is in their scope of practice but not necessarily in the scope for nurses in every state like you claim it to be.

Say what you want since this is your nurse forum. We all know the double standard and most nurses are clueless about the difference between EMTs and Paramedics or anything outside of the hospital.

If you have not been a Paramedic for over 35 years, I fail to see where you could be an authority on what Paramedics can or can not do. EMS has changed quite a bit over the past 3 decades. I also don't believe you should be speaking about who can boss Paramedics around either.

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
You need to check your state laws for nurses and intubation again. You are wrong. Just look at the nurse practice acts in other states. Google is your friend to find BONs in other states and their opinion on intubation.

Your cohort in medic bashing on the other discussion was the one who said ACLS and PALS gave nurses independence to which you agreed or did not dispute.

Are you intubating in the hospital assuming your medic license will still cover you? I think you might be in for a big surprise. If you are a Paramedic, why did you not know Paramedics did more than just spinal immobilization. It appeared you are only familiar with an EMT scope of practice. BTW you must be an EMT before becoming a Paramedic in 49 states.

I also never said intubation is limited just to Paramedics. I just stated that most states limit RNs who can do intubation. Physician Assistants, doctors, nurse practitioners and respiratory techs can intubate. It is in their scope of practice but not necessarily in the scope for nurses in every state like you claim it to be.

Say what you want since this is your nurse forum. We all know the double standard and most nurses are clueless about the difference between EMTs and Paramedics or anything outside of the hospital.

If you have not been a Paramedic for over 35 years, I fail to see where you could be an authority on what Paramedics can or can not do. EMS has changed quite a bit over the past 3 decades. I also don't believe you should be speaking about who can boss Paramedics around either.

I do not bash. It is not my style. I also NEVER said I can boss around anyone. I look at all the team members as a valuable part of the whole. A GOOD department is a collaborative effort. The best environment I have ever worked was where the medics for the community were hospital based. I LOVED having them help with codes, IV's, triage...they did IV starts in the house and answered house codes.....we worked well together it was a well oiled machine. I have seen many of the medics intubate when the ED MD couldn't. By far the BEST place I ever worked.

Google is my friend....I know the state nurse practice acts does not restrict nurses from intubation it states they must be trained and prove competency. I asked YOU to find me a state statue that specifically prohibits nurses from intubation. I am no longer a medic. I was a medic/flight nurse for about 20 years. I haven't been a medic or in flight for about 5 years. Up until then....I did flight nursing. I don't recall ever saying that ACLS and PALS gave nurses free license to intubate...you must have me confused with someone else.

Sigh...this is not my forum. I don't own it.

Nurses are not restricted by state statue. They are restricted by facility policy. I don't bash medics I never have. Al I ask is that you respect critical care and emergency nurses for they are as highly trained, in most cases, as yourself.

It is clear you are not interested in learning about the role of many nurses in critical care areas. That is your choice I have said my piece.

Up Vote Up Vote ×
I do not bash. It is not my style. I also NEVER said I can boss around anyone. I look at all the team members as a valuable part of the whole. A GOOD department is a collaborative effort. The best environment I have ever worked was where the medics for the community were hospital based. I LOVED having them help with codes, IV's, triage...they did IV starts in the house and answered house codes.....we worked well together it was a well oiled machine. I have seen many of the medics intubate when the ED MD couldn't. By far the BEST place I ever worked.

Paramedics should be intubating. Not nurses.

Google is my friend....I know the state nurse practice acts does not restrict nurses from intubation it states they must be trained and prove competency. I asked YOU to find me a state statue that specifically prohibits nurses from intubation. I am no longer a medic. I was a medic/flight nurse for about 20 years. I haven't been a medic or in flight for about 5 years. Up until then....I did flight nursing. I don't recall ever saying that ACLS and PALS gave nurses free license to intubate...you must have me confused with someone else.

Sigh...this is not my forum. I don't own it.

Nurses are not restricted by state statue. They are restricted by facility policy. I don't bash medics I never have. Al I ask is that you respect critical care and emergency nurses for they are as highly trained, in most cases, as yourself.

It is clear you are not interested in learning about the role of many nurses in critical care areas. That is your choice I have said my piece.

Nurses have a state nurse practice act. You are not without scope of practice.

Nurse practice acts in each state are laws that define responsibilities of the nurse and "scope of practice" – the range of activities and services as well as the qualifications for practice.

Up Vote Up Vote ×
+ Add a Comment