Rudeness from EMTs and Paramedics - page 8

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

  1. by   jojotoo
    Quote from pumpkin92356
    Boy! O Boy! I dont think there is a nurse out there that hasn't experienced the "Mr. Doctor Paramedic" one night we had to send a resident out who was a brittle diabetic who I had found soaking wet with sweat and registering a 20 blood sugar. Well the RN supervisor who had 40 years under her belt took care of calling the paramedics and doctor and we had worked on this guy till they got there and we had his sugar up to 70 or so and the smart alec paramedic says "Don't you people here know what normal sugar is? What are you calling us for we arent taking this guy to the hospital and with that the nurse said yes you are and I will get the doctor on the phone and the paramedic waited up at the station for the doctor to call back and when he did he proceeded to argue with the doctor!!!!! well after all this fortunately our resident came through okay they took him and while they were leaving to transport this man to the hospital they were making remarks under their breath to the tune of "This place hires idiots!" Boy did I feel like punching that guy right in the mouth ! hahahah! I dont know what gives some of those guys the attitude that they are above everyone else.

    If you have already stabilized your resident's blood sugar, why are you still transporting him to the ER?





    Quote from meanbird
    I never had any trouble from the pay transport EMTs or hospital Paramedics (when a patient is d/c from another facility). But I have noticed an attitude from the 911 EMTs. Not towards the patients, but to staff. It seems if the patient is not in acute distress or visible bleeding, they feel they shouldn't be taking them. It's extremely frustrating to have to go through WHY the patient should go to the hospital when you have already contacted the MD and the family. I always give report, but I shouldn't have to justify sending them out when I have an MD order. I've seen them argue with the MD in person, which is not right.


    When you have a patient that is in "no acute distress" why are you using the 911 system - -which is for emergencies, instead of arranging for a private ambulance to transport your resident?
  2. by   opus13
    Quote from delee99
    i called for a "routine transport... no lights" the emt came in i was on the phone with family. and sent the lpn to help transfer the pt to the gurny. the lpn and the cna all came up and told me that that "guy" was made .... he never gets told any thing.

    i went down and walked into the room and asked what is the problem. he said he is never told anything... i said there is nothing to tell.... this pt is routine transport and you are to bring him to the hospital... where the md will diagnos and treat. then i just stood there. and he just quietly loaded the pt. up i handed him the trasfer papers. and he left...
    not to be picky but the pt obviously has a reason for transport and the ems provider needs to know for a few reasons::

    1. if something happens during transport i need to know susspected, current and past diagnoses
    2. whent the pt arrives at the e.d. the triage nurse is going to want to know why the pt is here, when it started, and what has been done at the ltc facility. now as often as the m.d.s says they will call ahead 99% of the time when i arrive at the e.d. and say "the facility stated the m.d. was going to call" the answer is "well they didn't". so if i don't know it or if it is not on the paperwork the hospital won't know it.
    3. if i don't have all the information i need to generate a run report which reqires a clinical impression/suspected diagnosis the insurance company will probably not pay, saying there is no justification for the ambulance and the pt or family will be responsible for the full bill!!

    now if the transfer paperwork is correctly filled out it will normally have all that information, the emt definately should have lost the tude and just asked nicely why the pt is being transfered. i've never had a nurse not give me the information i needed if they were just asked or told why i needed it in a professional way. also no ems professional should tell a pt the look fine and don't need to go to the hospital, if they know the m.d. wants the pt evaluated at the hospital.

    karl
  3. by   TheCommuter
    Quote from jojotoo
    If you have already stabilized your resident's blood sugar, why are you still transporting him to the ER?
    Because (s)he has a telephone order from the physician to send the pt. to the ED. Always remember that LTC nurses do not decide to send patients out; rather, that decision is made by the MD.
  4. by   danh3190
    Quote from TheCommuter
    Always remember that LTC nurses do not decide to send patients out; rather, that decision is made by the MD.
    I'm not blaming the nurses, because they have to follow their protocols, but many times I wish the nurses were allowed to send the patient to the hospital without family permission and a MD order.

    Many times I've picked up very sick patients who really needed to go to the hospital a couple hours earlier but couldn't because the nurses were waiting on callbacks from somebody.
  5. by   morte
    Quote from danh3190
    I'm not blaming the nurses, because they have to follow their protocols, but many times I wish the nurses were allowed to send the patient to the hospital without family permission and a MD order.

    Many times I've picked up very sick patients who really needed to go to the hospital a couple hours earlier but couldn't because the nurses were waiting on callbacks from somebody.
    just sent someone out a few days ago without a MD order....hung on the line for 3-4 minutes (at 4AM) no answer from the service....said the "heck" with this....did the paper work, called 911 and out they went....called the service again, finally answered, doc called back, not one of the easiest to get along with, told him what happened, he acknowledge the "quality" of the service, and said "sometimes YOU just have to make the decision......
  6. by   CapeCodMermaid
    When in doubt- ship 'em out. I have no trouble sending someone without a doctor's order. I usually call 911, get all the paperwork ready-a 3 page referral and a verbal report to the EMT's and once the patient is on his way to the hospital, I call the doctor and inform him that I've sent the patient out for xyz reasons.
    That said, I try to treat as much as I can in the facility. If it's mild CHF why send them out? Give 'em some IM lasix and supplemental 02 and watch 'em for a bit. If after that they don't improve then send them.
  7. by   Lannister
    Background: 20 years working in healthcare as a CNA (LTC & Hospital), EMT-B/I/P (yes I took all three of them individually in the military and worked "the bus" and the ED/CCU as a Tech in civilian healthcare), LPN (LTC), RN (Med-Surg/CCRN/EDRN), NPP (FNP/PA-C in ED/IM/Cards/Remote Med). I teach ACLS to the local EMT students and work in Cardiology and Internal Medicine and the ED Per Diem.

    I has gotten so bad that I started keeping a copy of my licenses in the nursing station.

    The last time this happened (about a year ago)... I called local department to speak to the director personally (He is a drinking buddy of mine) to ENSURE that the medic was disciplined or fired!!!

    Personal EGOS have NO PLACE in patient care...!!!!
    Last edit by sirI on Jan 15, '08
  8. by   Lannister
    Quote from CapeCodMermaid
    When in doubt- ship 'em out. I have no trouble sending someone without a doctor's order. I usually call 911, get all the paperwork ready-a 3 page referral and a verbal report to the EMT's and once the patient is on his way to the hospital, I call the doctor and inform him that I've sent the patient out for xyz reasons.
    That said, I try to treat as much as I can in the facility. If it's mild CHF why send them out? Give 'em some IM lasix and supplemental 02 and watch 'em for a bit. If after that they don't improve then send them.
    That's cool... but

    Without a "order"... YOU are "practicing medicine" WITHOUT a license to do so!!!

    There ARE a few nurses (that I know well) that I WILL cover for such a act... but you should be careful...!!!
  9. by   morte
    Quote from lannister
    That's cool... but

    Without a "order"... YOU are "practicing medicine" WITHOUT a license to do so!!!

    There ARE a few nurses (that I know well) that I WILL cover for such a act... but you should be careful...!!!
    paramedics and EMTs have a saying "i would rather defend my actions with a live patient than a dead one"......
  10. by   PsychNurseWannaBe
    I am surprised that there appears to be a "turf war" between two practicing individuals. The nurse should expect the EMT to play 20 questions because the EMT must in turn answer questions once they arrive at the ER.

    The EMT should realize that the nurse has a medical order to send and at this point and time there is no reason for the EMT to assess if the patient is "worthy" enough to go to the ER.

    I give a verbal report to the EMT along with the copy of my progress note to the EMT and then I call the hospital to give a verbal report to the ER RN.

    The two practicing individuals should be working together because this is about the patient and not each others egos. However, as long as the patient is in the building they are under the care of the RN and the EMT can not get in between the nurse-patient relationship. Similarly the RN can not terminate the nurse-patient relationship because the EMT is there.

    I see nothing wrong with a RN reminding the EMT that they are still the one in charge of the patient per the Nurse Practice Act. I just don't think it should have to come down to that.
  11. by   TheCommuter
    Quote from PsychNurseWannaBe
    However, as long as the patient is in the building they are under the care of the RN and the EMT can not get in between the nurse-patient relationship. Similarly the RN can not terminate the nurse-patient relationship because the EMT is there.
    In nursing homes, an RN is legally required to be in the facility for only 8 hours per day. At most nursing homes, the DON fulfills this requirement, even though none of the patients are technically being cared for by him/her. So, I ask you: "If there's no RN in the nursing home 16hours per day, does his/her legal responsibility continue even though (s)he is at home?"

    My point is that many people who are unfamiliar with LTC do not realize that the LPN/LVN is the only licensed nurse in the building for much of the day.
  12. by   CapeCodMermaid
    Quote from lannister
    That's cool... but

    Without a "order"... YOU are "practicing medicine" WITHOUT a license to do so!!!

    There ARE a few nurses (that I know well) that I WILL cover for such a act... but you should be careful...!!!
    Sending someone to the hospital via rescue is NOT practicing medicine without a license. It is a prudent thing to do given the fact that the docs sometimes take too long to call back. Of course I don't give meds without an order.
  13. by   PsychNurseWannaBe
    Quote from TheCommuter
    In nursing homes, an RN is legally required to be in the facility for only 8 hours per day. At most nursing homes, the DON fulfills this requirement, even though none of the patients are technically being cared for by him/her. So, I ask you: "If there's no RN in the nursing home 16hours per day, does his/her legal responsibility continue even though (s)he is at home?"

    My point is that many people who are unfamiliar with LTC do not realize that the LPN/LVN is the only licensed nurse in the building for much of the day.
    Regarldess if the person is an RN or an LPN, the EMT should not be getting in spouting matches with them.

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