Ooooooooh, I am SO ticked off right now!!! - page 2

:angryfire OK, here is what happened this morning. One of my residents just came back from the hospital Thursday after a weeklong stay for pneumonia/exacerbation of COPD. Her nurse called me a... Read More

  1. by   txspadequeenRN
    What a #$^&!!!!!! Why does it seems like paramedics and emt's have a god complex.. Not all of them , but most that I have run into have the potential to be real jerks.....
  2. by   TazziRN
    Angie: yes, he jumped to the wrong conclusion with lead boots, but medics have it drummed into their heads that COPD pts should NOT have high flow O2. He went about it the wrong way but I can understand why he thought what he did.
  3. by   MrsMommaRN
    you were doing the right thing. the said emt had an identity crisis going on and needs to be brought down a notch.:angryfire
  4. by   Empress
    Actually it was the opposite for me, we were taught that it more important to give COPD patients high-flow oxygenation instead of worrying about hypoxic drive issues since they took longer to present then usual tranport time.

    He may have assumed since you had a mask on with a lower concentration of o2, it was an issue of "silly nurse doesn't know better," without listening. It's pretty common to go into nursing homes and see a patient on 4 liters with a non-rebreather, and that is suffocating them. I don't know what type of mask you had on them, though.

    He was rude, but he did have right to decide treatment after making contact, i.e. by changing masks. They have to follow their own protocols, not the patients doctor's orders.
  5. by   southern_rn_brat
    Last weekend I had a patient go very bad. I called the ambulance and we started prepping her for transfer and doing what we could at the facility. They are usually there with a couple of minutes for an emergent transfer so when ten minutes had elapsed I called dispatch and was like "hellllllllo?? where are they??"

    they were in the parking lot but hadnt come in yet...so then they come moseying in, I swear they were walking slow and talking as they went down the hall. I got on them and said Get down there she is about to code!!

    the paramedic said something like well if she's so bad why arent you back there with her:angryfire

    my patient died on the way to the hospital
  6. by   LoriAlabamaRN
    Quote from Empress
    . It's pretty common to go into nursing homes and see a patient on 4 liters with a non-rebreather, and that is suffocating them. I don't know what type of mask you had on them, though.

    .
    It wasn't a nonrebreather, just the normal side-vent masks we commonly use with breathing treatments.
  7. by   LoriAlabamaRN
    Well, I emailed my administrator "K" about the entire incident, including the name of the paramedic and the things he said and how he acted. I also told her about my poor patient's O2 sat plummeting as a result of this jerk. She emailed me back today. "K" not only called the company to complain, she actually called the OWNER and told him exactly what was going on. See, this ambulance company makes a fortune off its contract with us. Most transports are to the ER of the hospital that is literally 200 yards away from us, and they get $800 per run. So when "K" called up in arms about this jerk, the owner was GROVELING. He apologized profusely, and stated that if I wasn't comfortable with the idea that the problem guy might be coming back to the facility some other time then he would either change the guy;s shifts or terminate him. He was going to have the guy call me and apologize directly to me. At about 0100, I got a call here at work from "Jerk" telling me over and over how incredibly sorry he was and that he had been completely out of line, that I seemed to be an incredibly competent nurse and there was no excuse for him to treat me as if I weren't. He said he had been having a bad night but that was no excuse for his behavior. He went on to say that he would never treat any of the nurses like that again and he looked forward to the opportunity to apologize to me face to face. I told him that I accepted his apology and that from now on I would like him to realize that we are to work together as a team for the safety and wellbeing of our patients.

    Heeheehee... I love my administrator, and I'm sure this guy will have a complete attitude adjustment next time!!!
  8. by   TazziRN
    Quote from LoriAlabamaRN
    Well, I emailed my administrator "K"
    It's great when you have admin's backup! I'm glad your concerns were dealt with. As I said, I could understand why he said what he did (not how he said, just why) but I am not excusing him by any means. He shouldn't have said it, so now maybe he'll think twice before mouthing off again.
  9. by   banditrn
    Kudos to your administrator for backing you up!!
  10. by   emtb2rn
    You were totally correct in notifying your admin and your admin did the right thing by you.

    Our EMS protocols are the same as what Empress noted, if the pt is in resp distress, they're getting high flow O2, regardless of COPD hx.
  11. by   vamedic4
    Quote from LoriAlabamaRN
    Well, I emailed my administrator "K" about the entire incident, including the name of the paramedic and the things he said and how he acted. I also told her about my poor patient's O2 sat plummeting as a result of this jerk. She emailed me back today. "K" not only called the company to complain, she actually called the OWNER and told him exactly what was going on. See, this ambulance company makes a fortune off its contract with us. Most transports are to the ER of the hospital that is literally 200 yards away from us, and they get $800 per run. So when "K" called up in arms about this jerk, the owner was GROVELING. He apologized profusely, and stated that if I wasn't comfortable with the idea that the problem guy might be coming back to the facility some other time then he would either change the guy;s shifts or terminate him. He was going to have the guy call me and apologize directly to me. At about 0100, I got a call here at work from "Jerk" telling me over and over how incredibly sorry he was and that he had been completely out of line, that I seemed to be an incredibly competent nurse and there was no excuse for him to treat me as if I weren't. He said he had been having a bad night but that was no excuse for his behavior. He went on to say that he would never treat any of the nurses like that again and he looked forward to the opportunity to apologize to me face to face. I told him that I accepted his apology and that from now on I would like him to realize that we are to work together as a team for the safety and wellbeing of our patients.

    Heeheehee... I love my administrator, and I'm sure this guy will have a complete attitude adjustment next time!!!


    NOW THAT'S WHAT I CALL DOING SOMETHING ABOUT IT!!! GOOD FOR YOU.
  12. by   nursemike
    Why is it those who know the least are so often the quickest to second-guess?

    I've had to get rather firm, lately, with a couple of aides who appear to think treating them decently is an invitation to question my judgement or write their own orders--well, they aren't quite enough to write them. Even had a phlebotomist try to tell me a nonverbal, GCS 7-8 depressed skull fracture was refusing to be stuck. Hallelujah--it's a miracle!

    We do have one new aide who's trained as a Paramedic, who is kind of amusing and not at all inappropriate. He'll go out of his way to report things like a patient who was deeply asleep with a BP a little below normal at midnight is now awake with a BP on the high end of normal at o400. Say a jump from 105/60 to 135/70. Yes, he's right, that's a 30 point jump in systolic in four hours. So I thank him and say I'll keep an eye on it. It may just be me, but sometimes I think he looks a bit disappointed. Still, he never gets out of line, and I do want him to keep reporting anything he thinks is worth reporting. I'm just not quite ready to page for a hydralazine order for 135/70...
  13. by   betweenprofessions
    Okay...some perspective of this incident. There are a lot of EMT's and Paramedics that are ignorant about the system in a LTC facility. You all are limited in most instances, as to what you can treat in an emergency. But you have vast and valuable knowledge in other areas.

    Having been a paramedic for a few years now, it has been my experience that most "arrogant" EMT's and Paramedic's are usually very new and inexperienced.

    I don't know the individual that was disrespectful to you, nor do I know his years of service. But if I had to guess about what his issue was, I would surmise, exhaustion. We work some very VERY long hours. It is very difficult to switch gears from a drive-by shooting, or a horrific DOA, to a person with a slightly elevated temperature and diarrhea that needs to be transferred for ER evaluation (not that this isn't important). Your patient was obviously more acute, and the paramedic's behavior was unacceptable. But what I am hoping for is more understanding between healthcare professionals.

    When we have been working for 20 hours straight, without a break, sometimes we aren't always chipper when we walk through the door. There are shortages of paramedics in many areas of the country right now, and we are just plain overworked (just like nurses).

    I think that if I were to write a complaint about every physician and nurse that had been disrespectful to me since I first entered the profession, the paper stacks would be higher than the roof of my house.

    I hope that you are never in this situation again, and if you are....put them in their place. Many times they will realize that they are being jerks and will be apologetic.

    But anywho, I respect your position in LTC, as I know that you have a lot of patients to attend to, and depending on where you work, sometimes the funds are low. Thank God there are people like yourself that have the compassion and patience to deal with challenging patients on a regular basis.

    We are all professionals and under stress. Hopefully someday we will all be on the same page. I'm optimistic.

    EMT-P 10 years and current RN student.

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