[cotjockey]

One of our ER nurses has been just UGLY to all of our EMS people over the past couple weeks. No matter what EMS brings in and no matter what EMS does she finds fault with it. She is refusing to answer questions when calling the service for an interfacility transport, "I want a paramedic to transport a patient and that is all you need to know!," she'll say. She's also told paramedics who have offered to assist with getting IVs started, inserting foleys, EKGs, that those procedures require a REGISTERED NURSE, not an ambulance driver who got their license out of a mail order catalog, has ripped out IVs started by EMS, removes C-spine precautions, refuses to take report, and the list goes on and on. There is already tension between the EMS people and the ER staff as it is...don't know why, just one of those long standing things.

So what's is your opinion? As a member of the ambulance service and the ER staff, I am caught in the middle a lot. When I am on duty in the ER, this nurse is my supervisor and if she tells me to pluck out the IV, I am expected to do it. When I am on duty with the ambulance service, I am MAD when I am told I am too stupid to do a procedure that I do on a regular basis and is makes me really mad to have my judgement questioned by someone who thinks we shouldn't have c-spined a patient who had MOI.

The ER supervisor and the ambulance service supervisor (who just happen to be best friends) are aware of the situation and they just keep telling everyone, "Well, that's just how she is...don't let her get to you." Fine, great answer, but it sure makes for a lot of tension and makes people not want to show up in the ER when this nurse is on...

[ITSJUSTMEZOE]

Thats the sure signs of BURNOUT, BURNTUP and BURNTUGLY.
Is she that way with all the staff or just the EMT's, or to the Paramedics as well? Its been awhile since I worked in the ER and I was so thankful when anyone helped during a time of need I didnt care if the janitor helped. How long has she been in the job, how long has she been understaffed and how long has she held such a grudge? Sounds like a cold hard case of the Burnts.
Even worse management knows about it and yet they sit back and allow it to happen. My advise is to do your job, which Im sure you do, When your working with her, then do as it is to be done even if her way is more harmful to the patient, no patient enjoys multiple sticks, but she wants another IV then just do it and explain to the patient that The RN and state her name instructed you to do so. She can not deny that it is her rationel for the IV change, if that is her policy. Maybe she will see how stupid it is and how potentially infectious it is to the patient and not cost effective at all. Some Nurses do have an authority issue, apparently she is one of them. Its her way or the highway. Possibly she feels threatend when a EMT or Paramedic enters her rhelm and could possibly take away from her glory (who knows) of being Nurse on the spot, the Senior, the High Honcho. I do hate your going through this , its sad but do understand Not every Nurse you will come across is like this. Most of us enjoy extra help and hands with knowledge to boot.
Just my thoughts
Zoe

[rebelwaclause]

Sounds like a paramedic dumped her sometime in her life, and she's never quite gotten over it

Are you scared to write her attitude up?

[ITSJUSTMEZOE]

LOL Rebel thats what I thought and she is still burnt from that lol
wonder if the guy works on one of them that often come in for a visit and drop off?
Zoe

[Gator,SN]

has ripped out IVs started by EMS, removes C-spine precautions, refuses to take report, and the list goes on and on.

Sadly, this will someday be a costly mistake and no amount of anger in the world is going to save her butt!

Talk to your director. She is the one with the problem, so don't let her make you feel like you are less capable just because she has an attitude problem.

[Stargazer]

The paramedics and nurses who are being directly impacted by her vicious remarks and make-work orders need to start writing up these incidents and submitting them to, yes, their supervisors, but with copies to the supervisor's bosses and to Risk Management. Special care should be taken to put unprofessional or derogatory comments in direct quotes and note witnesses, including patients and family members; to note the patency of IV's one is asked to remove; and to note the busyness of the department at the time you are being asked to re-do work that has been done.

Above all, be sure to point out that this woman is compromising pt care by prematurely ripping off C-collars and subjecting pts unnecessarily to invasive procedures like repeated IVs. And in doing so, she is making herself and the hospital the target of increased liability.

Agree with Zoe that RNs should be documenting on the patient record why they are replacing perfectly good IVs. Include copies of some of these records with the written incident report. Risk Management folks and hospital Legal Depts. break out in hives over this stuff.

[l.rae]

ll think you should write her up and send copies to several above the nurse managers head....just keep going up the chain of command......this is inexcusable!

[massEDgirl]

Is it just EMS...or is she like this with everyone???

She can't be there 24/7.....Let here make herself look like a jerk with these guys.......it will come back to haunt her sooner or later.

If your EMS guys are like our EMS guys...I am sure they can handle themselves......and her to.

I'd like to sic an few of our EMS people on her...she'd change her tune real quick!!

[canoehead]

EMS people here do seem to know how to handle themselves, and generally they figure that once they've given report then any mistakes a nurse makes are on her. If she refuses to take report document it. If she refuses to tell you more about the pt let her know you will be unable to decide who is qualified until she gives you the information you ask for. As far as IV's go I have been to some courses that say IV's placed in the field should be replaced within 24h because of an increased risk of contamination. We usually wait for our EMS people to tell us if one should be redone but she may just do them all.... I question her judgement in removing one before she gets the new one, and in doing it before the pt is completely assessed and seen etc, but she may just get off on being rude.

[tattooednursie]

Well . . as an EMS worker myself, (I'm also on the medical team for my volunteer fire departmet, averaging about 3 calls a month) I am VERY PEEVED with the words "ambulance driver" EMT's and Paramedics do much more than that! That nurse needs to quit! now! Yeah, EMT's and paramedics don't have nearly as much schooling as RN's, but the courses are still hard (I've taken the EMT B class). That nurse needs not to treat anyone like that! I would be so p'd off if I asked a nurse what our situation was and the answer I get is " I need a paramedic and thats all you need to know"

Rude people shoudnt even be allowed to work in a hospital.