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| No. 42 | 
Dec 30, 2007, 12:49 PM
 Re: Rudeness from EMTs and Paramedics
As a Paramedic...I want to put my head in this one too. I've been treated horribly working both 911 and Non-Emergency Interfacility Transfer. I want to mention a few circumstances, not because they are true in everyday operations, but rather because they bring up points that I think create the tension.
In nursing, you are educated in pharmacology, patient management, and many many other things. In EMS we are educated in the same, except we don't have a doctor on call or in the building and the ones that we have available don't have a relationship with that patient...yet.
So first - I had a nurse tell me she hates EMTs because once she was at a bar and saw a guy fall over in the street. She went to help. When EMS arrived they cursed at her and told her to leave. She told them she worked on a neuro floor and they didn't know anything about that and she did and he could have a head injury. Well, the first problem with this situation is 1) they are in the street; 2) airway, breathing circulation first, then check the pupils; 3) outside of a bar. As EMS providers we spend a lot of time learning about the dynamics of scene control. Controlling a situation out in the field is a lot different than in the hospital. There are many, many things you have to concern yourself with. Like - traffic in the street that could cause further injury ], hundreds of people outside the bar who are intoxicated and could pose a threat, drunk healthcare providers who think they can help but may cause further injury because they are intoxicated. In a situation like that, quick and strong decisions must be made to ensure the safety of the providers, patient and bystanders. Sometimes some verbal force may be used.
Second - "I just got this patient" isn't an excuse. When I get to the ED, I just got the patient too, but I've performed an assessment, gotten paperwork and history and made it available for continuity of care. It takes a few minutes for us to get there, so that should be enough time to get someone to obtain necessary information. Yes, I have taken people without information, but when it very well should be readily available and on file, it shouldn't happen because that could be of detriment to the patient.
But anyways, my basic point is that neither side truly knows what the other half does unless they experience it for themselves. I don't know about nursing because I have only experienced a little bit of nursing during my clinicals...and not enough to know. Neither do I know what a physician has to do in his realm. I will fully admit that once I get to the hospital and I've run through the meds I know I really do not know how to proceed and return to rehabilitation. I guess I basically want to say: I respect you because you have a different set of goals. Understand mine: get the patient to the hospital in a condition similar to or better than what I found them...or at least keep some blood flowing somewhere. And I must do this with the drugs and equipment I can shove into a Ford Truck...and use myself without much assistance.
I may be different because I don't second guess everyone on things that I admit I don't know about...btu not everyone in the world is perfect. So anyways, have fun and be safe. And maybe one day we will meet up. Sorry too if I am rude, but I am a Type A personality and can sometimes say things in a less than "nice" way.
 | | No. 43 |
Dec 30, 2007, 04:27 PM
 Re: Rudeness from EMTs and Paramedics Originally Posted by steven1534  As a Paramedic...I want to put my head in this one too. I've been treated horribly working both 911 and Non-Emergency Interfacility Transfer. I want to mention a few circumstances, not because they are true in everyday operations, but rather because they bring up points that I think create the tension.
In nursing, you are educated in pharmacology, patient management, and many many other things. In EMS we are educated in the same, except we don't have a doctor on call or in the building and the ones that we have available don't have a relationship with that patient...yet.
So first - I had a nurse tell me she hates EMTs because once she was at a bar and saw a guy fall over in the street. She went to help. When EMS arrived they cursed at her and told her to leave. She told them she worked on a neuro floor and they didn't know anything about that and she did and he could have a head injury. Well, the first problem with this situation is 1) they are in the street; 2) airway, breathing circulation first, then check the pupils; 3) outside of a bar. As EMS providers we spend a lot of time learning about the dynamics of scene control. Controlling a situation out in the field is a lot different than in the hospital. There are many, many things you have to concern yourself with. Like - traffic in the street that could cause further injury ], hundreds of people outside the bar who are intoxicated and could pose a threat, drunk healthcare providers who think they can help but may cause further injury because they are intoxicated. In a situation like that, quick and strong decisions must be made to ensure the safety of the providers, patient and bystanders. Sometimes some verbal force may be used.
Second - "I just got this patient" isn't an excuse. When I get to the ED, I just got the patient too, but I've performed an assessment, gotten paperwork and history and made it available for continuity of care. It takes a few minutes for us to get there, so that should be enough time to get someone to obtain necessary information. Yes, I have taken people without information, but when it very well should be readily available and on file, it shouldn't happen because that could be of detriment to the patient.
But anyways, my basic point is that neither side truly knows what the other half does unless they experience it for themselves. I don't know about nursing because I have only experienced a little bit of nursing during my clinicals...and not enough to know. Neither do I know what a physician has to do in his realm. I will fully admit that once I get to the hospital and I've run through the meds I know I really do not know how to proceed and return to rehabilitation. I guess I basically want to say: I respect you because you have a different set of goals. Understand mine: get the patient to the hospital in a condition similar to or better than what I found them...or at least keep some blood flowing somewhere. And I must do this with the drugs and equipment I can shove into a Ford Truck...and use myself without much assistance.
I may be different because I don't second guess everyone on things that I admit I don't know about...btu not everyone in the world is perfect. So anyways, have fun and be safe. And maybe one day we will meet up. Sorry too if I am rude, but I am a Type A personality and can sometimes say things in a less than "nice" way.
THANK YOU THANK YOU THANK YOU!
| | No. 44 |
Dec 31, 2007, 07:02 AM
Re: Rudeness from EMTs and Paramedics
Again, as I said, I am typically the nurse that has run from 1st floor to second to help in the code. Typically we need people who are free to run and get supplies if we need them (and we usually do). Some nurses work well together and will help you make copies of the chart while you are dealing with the situation. The transfer sheet also needs to be filled out. Sometimes in the rush paperwork from the chart is still being copied when 911 arrives. If you are one of the first responders and are in the midst of doing compressions and someone else has the chart copying it, you really can only answer what you know. In any one of these situations whether you are a nurse running to help, or the chart hasn't gotten back to you yet, there are good,solid reasons why and it usually beyond the nurses control. Sometimes the nurses don't work well together and the primary nurse ends up at the desk with the paperwork end of it by herself. (So therefore they are not at the bedside with the patient to answer your questions) Sometimes they run like clockwork, sometimes they don't. Hospitals and EMTs don't have to make sure the paperwork is completed when they are coding someone to my knowledge.
So at any rate my advice if you are an EMT or paramedic, don't judge.
LTC is just a step up from patients being at home sometimes. We have to scrounge for basic equipment all the time. We have absolutely had patients dropped of by their family members with no med list or history and then be almost impossible to get a hold of. Families won't bring in the patient's advance directive and be shocked when we end up sending patients out that were not supposed to. We have hospice patients that multiple times the family insisted we send to the hospital which frankly drives us as crazy as it drives you. And yes, I might totally agree with you about why Mr. so and so should not go to the hospital, but it is not my call to make. I have had endless hopeless conversations with families regarding end of life care that get no where too many times to count. So please don't take it out on me, don't treat me with disdain, like you would do things differently if you were in my place or like I don't know anything.
| | No. 45 |
Dec 31, 2007, 07:04 AM
Re: Rudeness from EMTs and Paramedics
I am a paramedic who also works LTC, so I can see it from both sides. I work over 30 miles from home in a town that is not part of our mutual aid region, so the EMTs there don't know me. I've called 911 twice when I have been charge and was treated like a complete idiot once. The EMT was angry that I had called in the first place because it was 0200 and was even more upset that once I called the resident decided she was fine and wasn't going to the hospital. It was one of those situations where everyone but the resident felt she needed to be transported. It put everyone in an awkward situation because they couldn't force her to go, but they also couldn't leave her when she was having chest pain and was diaphoretic. I can definitely see how a lot of 911 calls to an LTC seem like nonsense calls. She ended up having an MI, so she really did need to go, but at the time it didn't really seem like it.
But...as a paramedic, I have been told how to splint, how to start an IV (by a CNA), how to place defibrillator patches, and how to auscultate lung sounds. I have had transfer papers ripped out of my hand and told that they were for the hospital, not for me and that if I read them they would report me for breach of confidentiality (this was pre-HIPAA). I have been told that the staff was not going to let me and my crew in the room until the resident had been shaved. I have walked into a facility and asked where the patient was and been told, "In their room, duh!" I have been told not to park my ambulance in front of the building because it looks bad for the facility...at the same facility, we were told to come in through the kitchen entrance...as soon as the administrator got there with a key to open the kitchen for us. I have been told that there were too many people in the resident's room already and that I could wait in the hall...when I asked if there were any paramedics in the room, I was told that everyone on the fire department is a paramedic (nope...just me and two others). I have had nurses tell me that the resident has only been there for a week, so they don't know them well (don't tell me that...you have a chart and you have other staff to consult with), that they don't know what their meds or diagnosis are (again, grab the chart...I don't expect that you have every resident memorized, but I can expect you to look things up), and that they haven't called the family because they don't want to wake them up.
So...I can see why EMTs sometimes are frustrated by the calls that are seemingly nonsense (it is awkward for everyone), but I can also see why EMTs have attitude about going to an LTC before they even walk in the door. As professionals they need to learn to keep the attitude in check, but so do the LTC nurses.
| | No. 46 |
Dec 31, 2007, 08:00 AM
Updated
Jan 01, 2008 at 11:55 PM by donsterRN
Re: Rudeness from EMTs and Paramedics
CotJockey,
I do agree that both sides need to keep the attitudes in check, because both sides have EMTs or Nurses who are there to save the world...
Its too bad that the ******** are the ones who stand out...and not the cooperative healthcare professionals who make things work but go unnoticed.
| | No. 47 |
Dec 31, 2007, 08:06 AM
Re: Rudeness from EMTs and Paramedics
quick ethical question
Anyone Help
| | No. 48 |
Dec 31, 2007, 08:08 AM
Re: Rudeness from EMTs and Paramedics
Pt is DNR but A/O on Tube Feed. Usually absent family in for holiday, wants to DC Feed. Pt on Hospice, but expresses desire to live. Family has POA. What now
| | No. 49 |
Dec 31, 2007, 08:14 AM
Re: Rudeness from EMTs and Paramedics Originally Posted by longhornfan1 Pt is DNR but A/O on Tube Feed. Usually absent family in for holiday, wants to DC Feed. Pt on Hospice, but expresses desire to live. Family has POA. What now
POA only comes into play when patient UNABLE to make decisions (sp)
perhaps a social worker is needed? and a new POA?:angryfire
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