Rudeness from EMTs and Paramedics - page 6
Are there any LTC nurses out there who have experienced condescending attitudes or blatant rudeness from EMTs and paramedics during the process of sending residents out to the hospital? I simply... Read More
Jan 8, '08I can shed some light on both sides of this topic. I have been a Paramedic for over 25 years and for 13 of those years I have also been an RN. I will admit that due to a huge difference in pay that I have abandoned EMS for working in a hospital setting. I have also noticed the friction between nurses and medics, most of which I believe is born out of ignorance. Most nurses have no idea what the Paramedic learns during training nor do the Paramedics understand the training of nurses. One seems to think they know more than the other; this is just not true. Paramedic and nursing education while similar are still very different. If I was lying in the street injured from an accident for instance, the LAST person I would want to take care of me (givena choice of course!) would be a nurse or for that matter a doctor (even worse!). Medics have a far superior knowledge of treating and safely transporting critically injured patients in the pre-hospital setting. Conversely, the last person I would want to take care of me in a LTC facility would be a paramedic! Their knowledge LTC issues is severely limited. Do they know and understand lab values? Yes, to a limited extent. Do they understand the challenging issues associated with treating a septic patient? The short answer is no. Do nurses know how to safely transfer a pt from a destroyed automobile to a backboard or even know what a backboard is?? Most likely no.
My point? In my opinion (again...I have worked both sides of the fence for many years) the lack of respect for nurses comes out a lack of respect for the medics and vice versa. Can the medics be rude and out of line? Absolutely. I can tell you that VERY often in my EMS career PLENTY of nurses were very rude to me as well! Want to have a better relationship with EMS staff? Invite them in to learn a bit more about what you do. Better yet, ask them to ride along on a busy night of treating gunshot patients and delivering baby's in hallways of apartments to get a better idea of what it is that they do! Join hands instead of butting heads. I have seen it from both sides and know it can be a challenge. Educate and become educated. Thanks for reading
Lloyd Gillies RN, BSN, CEN, EMPT
Jan 8, '08My required prerequisite was the same as for nursing students (i.e. Micro, A&P, English, Algrabra....blah blah blah, along with 40 credit hours in EMT and Paramedic training. In addition, I had to spend several hundred hours working in the ER and riding EMS units. I received an A.S. degree in Emergency Medical Services. When I went on to complete the Nursing degree I had all of my prerequisite work done!
Jan 8, '08I know this is in the LTC forum and I work med surg, but I have to add something:
It's just not LTC. Our EMT's behave the same way towards us (aides) and nurses. I feel that they treat the pt's not as a human being but more like a chauffer. I'd like to see more compassion but I'm sure they have seen the worse of the worst.
I even had one pt who knew the EMT's well and was crying because she didn't want them near her. I promised to stay by her side and make sure they treated her well and I let them know that I wasn't going to put up with their rudeness. I don't care if they call be every name in the book behind my back, I'm not there to win brownie points. I get the feeling from them that they think they're transferring a LOL who means nothing to them and nothing 'exciting' like a code is going to happen.
But there a couple who are angels and I absolutely love them.
Jan 8, '08RE Bethin:
I am now a nursing supervisor in one of the countries largest and most progressive Cardiac Cath labs and after reading you comments about how the pt's didn't want certain EMS personnel around them made me think back a bit.
Recently, one of our Doctors called me into the office and told me that that he would pull his pt load out of our hospital and take them somewhere else if we EVER let one particular nurse treat ANY of his pt's EVER again! This was a seasoned nurse with a BSN. Know what? I sided with the doctor! She is terrible! She no longer works in the lab...cause she's that bad! Much like your pt saw flaws in the EMS personnel...I see just as many flaws within nursing!
Lloyd Gillies RN, BSN, CEN, EMP-T
Jan 8, '08Hello and no you are not the only one by far. I have been doin LTC for 15 years now and have had several run ins with the emt's and paramedics. Most, not all, act as if we dont need to have people sent to the hospital or even brought back for that matter. I even offer my assistance to help but that is not good enough so to speak. Thank you for bringing this matter up, maybe someone somewhere can do something about it
Jan 8, '08Quote from JohnBearPAIt's too bad that happened. Most of the EMT's and Paramedics I work with are professional and pleasant.I've had one set of emt's be very rude concerning a p/u to go to hosp for eval. The one woman asked why she was going, and when told her lab values prompted her MD to send her out, demanded to look at the labs. Stupidly, I showed her, and she said "hmmmmph, these ain 't that bad, I wouldn't waste the amb time to send her out" at which I couldn't take another moment of this, and replied "well Darlin', when you have the power to decide who goes for eval, no problem, until then, move your butt and get her to the hosp because both her MD and I want her to get checked out, and we both outrank you hon." She was part of a volunteer ambulance org, and wasn't even an EMT, but studying to be one and driving in the meantime.
Second time it happened was when another nursed called for transport to hosp on a DNR pt, who was having trouble breathing. He coded while they were moving him, and they began CPR even when I shoved the yellow DNR form in front of his face. They continued, and the MD chewed MY ass out for the CPR.
Some of these people thing they know everything, and believe me, they don't. Some of them know more than we do, but know how to act and not be obnoxious. Guess I just haven't met many of the latter.
The problem described in your second scenario is this.....if an ambulance crew is called to a nsg home for a resp./cardiac arrest or distress, they are doing what they are supposed to do by performing CPR. Why call an ambulance if nothing was to be done for the distress? It is inherently against a paramedics nature and his/her job description to kick back and watch while someone codes in front of them. If you called them, then they more than likely are thinking that someone along the whole messed-up advanced directive BS line decided something SHOULD be done. Here's something else....if they get to the ER with a resp./cardiac arrest and haven't done ACLS protocol, they're butts are going to get chewed up by their medical command physician and the nsg staff at the ED. Plus, if the ER isn't supposed to perform ACLS, exactly what ARE they supposed to do? 9 times out of 10, the family will come in to the ED and completely turn over an advanced directive out of panic. So in the end, I think the overall view of EMS is to do CPR until directed by the POA or medical command to stop.
Jan 8, '08I have had rude behavioral problems, yet have EMT friends and it is on both sides of the coin. I am a former Army Medic, so needless to say I just state "the Doctor said to send the Pt out" , or I assessed a need and didn't have time for the Doctor to approve, and If I get any rudeness, I have sternly said on numerous occasions...
"we are not triaging the Pt here, the ER will, I just want to know if you have a license to drive the vehicle and transport without jitting every bump in the road!"
My last time I got rudeness, I actually pondered a good 30 seconds, then opened the doors as they loaded the Pt and said "Hey boys, I don't wake you up for nothing, next time you see me, know there is a critical reason!!!....:sfxpld:
I have had no problems since with our small city Medics...:redlight:
Jan 8, '08I used to work at LTC facility for years as Sup. RN. I truly agree that EMS are valued, and truly needed for their expertise and training BUT whenever I called for transport and the majority of them (after I had done complete assessment and had everything written for them and all papers ready for transport) would re-do my assessments, question everything I had done, and on occasion, argued that they did not need to be sent out. I would argue that I had Dr. order to send out and that is final. I really had so many cocky, arrogant, nasty people that I decided to get out of that field. I now work in Mental Health and like it so much better. On the few times I have to send someone out, I can handle a few rude ones.
Jan 8, '08Quote from aloeveraThankfully, this allows me to point out another example of how both sides, unfortunatly, do not understand each side. EMS providers of all levels are taught to assess and reassess every patient. Vitals eveny 15 minutes, at the most...and don't even take your best friend's word on what their assessment found. So, please, don't be offended if we re-do assessments...but I do apologize for those who who are arrogant. It may come from, as I mentioned earlier, the need and desire to operate independently (not 100%, because we need to go to the hospital eventually, but when we are out on the road...we are it)I used to work at LTC facility for years as Sup. RN. I truly agree that EMS are valued, and truly needed for their expertise and training BUT whenever I called for transport and the majority of them (after I had done complete assessment and had everything written for them and all papers ready for transport) would re-do my assessments, question everything I had done, and on occasion, argued that they did not need to be sent out. I would argue that I had Dr. order to send out and that is final. I really had so many cocky, arrogant, nasty people that I decided to get out of that field. I now work in Mental Health and like it so much better. On the few times I have to send someone out, I can handle a few rude ones.
Jan 8, '08I work at a hospital on a med surg floor, and don't get the pleasure of dealing with this, but has anyone ever heard of better safe than sorry anyway. We have alot of frequent flyers from ECF's and what some ignorant people may view as just a little dehydration can lead to hyperkalemia, leading to dysrhythmias and so on. I can't believe they would act that way. so sorry to hear this.
Jan 8, '08Quote from pink dolphinSome people operate on the principal of "better safe than sorry" and do the assessment and treat altered mental status as it is and as it should be...others treat it as just another effin drunk. Washington D.C. Fire and EMS along with Howard University Hospital made the wrong decision...I work at a hospital on a med surg floor, and don't get the pleasure of dealing with this, but has anyone ever heard of better safe than sorry anyway. We have alot of frequent flyers from ECF's and what some ignorant people may view as just a little dehydration can lead to hyperkalemia, leading to dysrhythmias and so on. I can't believe they would act that way. so sorry to hear this.
I think at 8 pages, most of us can agree that some EMTs and Paramedics are rude and ignorant, while others are highly educated. We can also agree that some nurses are excellent, and some just plan suck. Oh, and I am definitely sure that we can take a look at some physicians who really are amazing...but there are some out there who are a few flowers short of a bouquet too. The same applies to teachers, drivers, salesmen, actors, chefs, fast food clerks........
So anyways, my name is Steven, and if we ever meet I hope that you judge me based on my individual merits and not as "just another one of those paramedics..."Last edit by steven1534 on Jan 8, '08 : Reason: Fix hyperlink
Jan 9, '08I think one of the problems concerns company policies. For instance the company I work for has been sued multiple times by greedy family members who seize a loophole and get millions of dollars. Because of this, the company has set in place certain policies that dictate that nursing staff send folks out to the acute hospital for minor things like an unwitnessed fall - even if there is no apparent injuries. Granted, we all make mistakes, but come on!! When there is no obvious trauma, it is frustrating that I have to do the paperwork to send them out, then some EMT comes in and gives me a hard time about it. I can only explain the policy, admit that it may seem foolish, but if the resident is not transferred, I will have to call their supervisor, and have our administrator get in touch with their supervisor. So, I guess we could point a finger at the general public as well. Just a thought.....
Jan 9, '08I'm a nurse at a nursing home, I've never have had a real problem with paramedics. I do know we are both very busy professions, I understand you have other pick ups and I have many other residents to attends to as the above student has noticed so neither of us has time for the other not to be unorganized for not ready for the other. I believe that's where most of the misunderstanding comes in at. I hear a lot of other nurses where I work c/o paramedics and I believe it's because when they arrive the nurse is not ready for them yet. She has sometimes 40-50 pts and the paramedic has that one to worry about at that moment. Parmedics get the worst of all calls I have nothing but respect for them!