Rudeness from EMTs and Paramedics - page 9

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   Lannister
    Quote from CapeCodMermaid
    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.
    Of course that's clear now... but your initial post:

    ... [brevity edit]... If it's mild CHF why send them out? Give 'em some IM lasix and supplemental 02 and watch 'em for a bit... [brevity edit]...
    Lead me (us?) to believe that YOU are making the decision... which would be YOU... "practicing medicine without a license"...!!!
  2. by   MrsCaseyRN
    Let me start off by saying I was an EMT for a few years before becoming an RN. I don't know where it all started, but it became known in the EMT world that it was ok the treat LTC nurses like crap. I can say I never did so, because I was a nursing student, but many (not all) did. They just assumed they knew more than the nurses. The paramedics behave the same way.
    Now as a nurse, in LTC, this makes my furous! :angryfire The nurses I work with rarely stand up for themselves, because they were under the impression that EMTs had much more education then they actually do. I have since gone to my DON, but this has been the way (in all LTCF in our area) and eveyone is used it. So nothing got done about it.

    To give a few examples:
    ~Sent pt out. h/h in the 7's/20's. Need PRBCs. Emt Said this is because we don't give pt enough water. (which doesn't make sence anyway?)
    ~Sent pt out for seizures (has hx) BS 150 (pt had DMII) Emt said we obviously don't monitor pts BS, and the pt obviously doesn't get the right coverage, thats why the pt had a seizure.
    ~they frequently make comments to family that nursing staff is poor. and I know this happens at all facilities because like I said I used to be an EMT. I know that a lot of them have the over inflated egos and many of their medical ideas are wrong, yet they continue to do this, and we have to justify everything we do or get treated like garbage right to our faces.
    ~They frequently tell us our assessments are wrong, our nursing judgements are wrong, and often step outside their scope of practice. (They don't think we know they are doing so, but I know because I was an EMT) I had one actually tell me one time a pt didn't have to go to the hospital for an episode of chest pain because their EKG (which we did as per MD while waiting for ambulance) was normal sinus. I was like "I'm sorry, I know you are not trained to read tele" (they are not in our state) only medics and these were EMTs. I told them they should just do their job or they can call the doc and tell him they don't feel this transport is needed b/c pts EKG is RSR!!!:trout:

    But we also get nasty attutides from hospital nurse too. I'm freaking sick of it :angryfire:angryfire:angryfire:angryfire

    I'm tired of getting treated like a moron. Mostly from EMTs who have about 3 months of training and can't even compair to nursing education. Now when I get a nasty attitude from them, I put them in their place by reminding them of how little they know (which is mean, but I'm not going to take it anymore) and I tell them that I used to work the ER at our nearest trama center, and I know my stuff, so BACK OFF!:flmngmd:
    When I'm calling in report to the ER for a pt going over, I have to slip it in each time what I used to do, or I get pooped on.:angthts:
    But,even if a nurse has never worked anywhere but LTC, that doesn't give EMTs or hospital nurses the right to treat them that way.
    I worked in the hospital and was an EMT and never disrespected someone by assuming they were stupid. And I NEVER assume someone was stupid because they work in LTC.

    Does anyone else have this problem? This is very normal in the medical community in my area.
    Last edit by sirI on Mar 2, '08
  3. by   facetiousgoddess
    http://allnurses.com/forums/f22/rude...cs-268561.html

    Hi Casey,

    The Commuter started a thread on this on the LTC forum. Excellent thread and the EMTs/Paramedics participated in a constructive manner, sharing their frustrations.

    Be interesting to see if responses differ in the general discussion forum.

    Tres
    who posted on the other thread...and is in a different county now with awesome EMTs.
  4. by   KarenGeorgeBSRN
    Casey,

    Welcome to nursing and LTC. However, do not bother nor
    waste positive energy. You are welcome to correct said EMT
    in particular in your documentation on the transported patient.
    Keep it simple and honest.

    Thanks,

    Karen G.


    Quote from CaseyGirl827
    Let me start off by saying I was an EMT for a few years before becoming an RN. I don't know where it all started, but it became known in the EMT world that it was ok the treat LTC nurses like crap. I can say I never did so, because I was a nursing student, but many (not all) did. They just assumed they knew more than the nurses. The paramedics behave the same way.
    Now as a nurse, in LTC, this makes my furous! :angryfire The nurses I work with rarely stand up for themselves, because they were under the impression that EMTs had much more education then they actually do. I have since gone to my DON, but this has been the way (in all LTCF in our area) and eveyone is used it. So nothing got done about it.
    To give a few examples:
    ~Sent pt out. h/h in the 7's/20's. Need PRBCs. Emt Said this is because we don't give pt enough water. (which doesn't make sence anyway?)
    ~Sent pt out for seizures (has hx) BS 150 (pt had DMII) Emt said we obviously don't monitor pts BS, and the pt obviously doesn't get the right coverage, thats why the pt had a seizure.
    ~they frequently make comments to family that nursing staff is poor. and I know this happens at all facilities because like I said I used to be an EMT. I know that a lot of them have the over inflated egos and many of their medical ideas are wrong, yet they continue to do this, and we have to justify everything we do or get treated like garbage right to our faces.
    ~They frequently tell us our assessments are wrong, our nursing judgements are wrong, and often step outside their scope of practice. (They don't think we know they are doing so, but I know because I was an EMT) I had one actually tell me one time a pt didn't have to go to the hospital for an episode of chest pain because their EKG (which we did as per MD while waiting for ambulance) was normal sinus. I was like "I'm sorry, I know you are not trained to read tele" (they are not in our state) only medics and these were EMTs. I told them they should just do their job or they can call the doc and tell him they don't feel this transport is needed b/c pts EKG is RSR!!!:trout:

    But we also get nasty attutides from hospital nurse too. I'm freaking sick of it :angryfire:angryfire:angryfire:angryfire

    I'm tired of getting treated like a moron. Mostly from EMTs who have about 3 months of training and can't even compair to nursing education. Now when I get a nasty attitude from them, I put them in their place by reminding them of how little they know (which is mean, but I'm not going to take it anymore) and I tell them that I used to work the ER at our nearest trama center, and I know my stuff, so BACK OFF!:flmngmd:
    When I'm calling in report to the ER for a pt going over, I have to slip it in each time what I used to do, or I get pooped on.:angthts:
    But,even if a nurse has never worked anywhere but LTC, that doesn't give EMTs or hospital nurses the right to treat them that way.
    I worked in the hospital and was an EMT and never disrespected someone by assuming they were stupid. And I NEVER assume someone was stupid because they work in LTC.

    Does anyone else have this problem? This is very normal in the medical community in my area.
    Last edit by sirI on Mar 2, '08 : Reason: quoted edited post
  5. by   sirI
    Posts #106 - 108 merged with existing thread.
  6. by   MrsCaseyRN
    Quote from rigmedic
    the one thing i know that would upset me (and i admit i am impatient) is when i wanted information and the primary nurse was no where to be found to give it to me.
    -Allison2008

    Ding, ding, ding, we have a winner!! As someone who knows both sides of this fence, this just drives me crazy. If you are an RN in a LTC facility and you call 911, please be prepared to give report to the PROFESSIONAL coming to give care to your patient. The medic has to do an assessment, develop a care plan, etc just like an RN. Knowing the pt's history, baseline mental status, meds, etc are all part of that assessment.

    I hate to generalize, but it always seems that whenever we go to a LTC facility the staff just melts away and we are left alone in the room with the pt that is blue, O2 sat of 72 (on 2lpm by NC) and no idea what the history, meds, normal status, etc is. Also, the staff doesn't seem to understand that EMS has protocols for different procedures and we can't "just put the line in and leave".
    When I first started LTC (was ER nurse and EMT before RN) I wondered the same thing. Where does the staff go? Until my coworkers confessed that they are so tired of being harassed by emts and medics that they don't want to be found. They don't want to be in the pts room with EMTs because they don't want to be belittled infront of their pt. This really struck a cord with me. That this accepted abuse of LTC nurses has gone so far that the nurses are compromising pt care. I'd like to remind EMTs and medics that nurses are your superior.I know they aren't your boss, but they have a higher education and frankly unless they are wearing their resume on their name badge, you don't know what kind of experience they have. So don't assume they "don't know anything" And if we as nurses ever treated the doctors the way you treat us, well, I know some docs that would see to getting the nurse fired! I'm not saying that you have to compromise pt care, but there is a pecking order like it or not, and you need to remember that. Not to sound mean but point blank, if you know so much, go back to school and become a nurse or doctor.

    Also, the pt to nurse ratio is much different in LTC than hospital. Many days I have 30 pts if I'm on a cart or 60 if I'm the desk. EMTs and medics have 1. Its not uncommon to have several urgent issues happening at one time when you are dealing with such a large pt load. Also, when you have so many pts, you are not given a detailed report on the pts. So if a nurse happens to have been at that LTC facility for a long time, she will likely know a lot about her pts, but say she's only been there for a week...how is she going to know details on so many pts? Don't even say "check the chart". Have you ever looked at a LTC chart? For residents who have been there awhile, its been thinned and those records filed away. What is there is a little longer than a novel, and it would take some time to look through. Of course I can grab the major info out of there, but since the pt is in distress (assuming its an emergency) I'm in with the pt. And I'm counting on another nurse to do the paper hunting. And since there's only 2 nurses, you better hope that the other 60 pts don't need a nurse at all. And when transport comes in, I'm able to tell them very pertnent (sp?) info, but I don't have the chart with me and unles this is a pt whose been here for awhile, I may not know all the answers.
    Until you've worked LTC, you can not understand what goes on.
  7. by   KarenGeorgeBSRN
    Dear Casey,

    Acute care is not going to survive; LTC is we are picking up sub-acute wings and insurability standards are much higher today. You hang in there we need dedicated floor nurses in LTC with the heart and the soul to do the work. DO NOT take abuse you report this to your charge nurse, or your ADON or DON if need be, and that EMT is there ranting publically you hear me?

    I will not allow this to occur to my staff!!

    Karen G.

    Quote from CaseyGirl827
    When I first started LTC (was ER nurse and EMT before RN) I wondered the same thing. Where does the staff go? Until my coworkers confessed that they are so tired of being harassed by emts and medics that they don't want to be found. They don't want to be in the pts room with EMTs because they don't want to be belittled infront of their pt. This really struck a cord with me. That this accepted abuse of LTC nurses has gone so far that the nurses are compromising pt care. I'd like to remind EMTs and medics that nurses are your superior.I know they aren't your boss, but they have a higher education and frankly unless they are wearing their resume on their name badge, you don't know what kind of experience they have. So don't assume they "don't know anything" And if we as nurses ever treated the doctors the way you treat us, well, I know some docs that would see to getting the nurse fired! I'm not saying that you have to compromise pt care, but there is a pecking order like it or not, and you need to remember that. Not to sound mean but point blank, if you know so much, go back to school and become a nurse or doctor.

    Also, the pt to nurse ratio is much different in LTC than hospital. Many days I have 30 pts if I'm on a cart or 60 if I'm the desk. EMTs and medics have 1. Its not uncommon to have several urgent issues happening at one time when you are dealing with such a large pt load. Also, when you have so many pts, you are not given a detailed report on the pts. So if a nurse happens to have been at that LTC facility for a long time, she will likely know a lot about her pts, but say she's only been there for a week...how is she going to know details on so many pts? Don't even say "check the chart". Have you ever looked at a LTC chart? For residents who have been there awhile, its been thinned and those records filed away. What is there is a little longer than a novel, and it would take some time to look through. Of course I can grab the major info out of there, but since the pt is in distress (assuming its an emergency) I'm in with the pt. And I'm counting on another nurse to do the paper hunting. And since there's only 2 nurses, you better hope that the other 60 pts don't need a nurse at all. And when transport comes in, I'm able to tell them very pertnent (sp?) info, but I don't have the chart with me and unles this is a pt whose been here for awhile, I may not know all the answers.
    Until you've worked LTC, you can not understand what goes on.
  8. by   flightnurse2b
    Quote from CaseyGirl827
    When I first started LTC (was ER nurse and EMT before RN) I wondered the same thing. Where does the staff go? Until my coworkers confessed that they are so tired of being harassed by emts and medics that they don't want to be found. They don't want to be in the pts room with EMTs because they don't want to be belittled infront of their pt. This really struck a cord with me. That this accepted abuse of LTC nurses has gone so far that the nurses are compromising pt care. I'd like to remind EMTs and medics that nurses are your superior.I know they aren't your boss, but they have a higher education and frankly unless they are wearing their resume on their name badge, you don't know what kind of experience they have. So don't assume they "don't know anything" And if we as nurses ever treated the doctors the way you treat us, well, I know some docs that would see to getting the nurse fired! I'm not saying that you have to compromise pt care, but there is a pecking order like it or not, and you need to remember that. Not to sound mean but point blank, if you know so much, go back to school and become a nurse or doctor.
    i cannot believe that someone who used to be an EMT would make an ignorant statement like that. most nurses are associate degree and bachelor degree trained. paramedics are also associate or bachelor degree trained. with an EMT, yes, maybe higher education, but with a paramedic, no, it is typically equal. you wouldnt walk up to someone with a degree in accounting and say you were better educated because you had a degree in nursing would you? no. because the peice of paper still is an associates or bachelors of science, just in a different field of study. and from working as an EMT, you know that if you work EMS as an LPN or RN, you may not function in your capacity as a "higher educated person" and you may be following direction from the lowly paramedic on duty.

    i am sorry you have had a bad experience with EMT's and paramedics. but judging from your posts, you may come off to them that you think you are better, because thats the vibe i am getting. there is no pecking order.
  9. by   TheCommuter
    Quote from flightnurse2b
    there is no pecking order.
    Yes, a pecking order definitely exists.

    The patient is at the top of the pecking order.

    Without our patients, none of us would have our jobs. In order for healthcare to exist, we need a supply of patients to care for. We'd have nothing to do without sick people, so our patients should come first.

    Unfortunately, that's not the case with each and every situation.
  10. by   proud2b1
    Oh,I cant count the times.One time the lady was a full code,and I had done the appropriate cpr.When they came and took over they simply barely pushed two fingers,effortlessly ...Needless to say this was my first situation,and many have followed.I will say I have ran into some very professional ones too!:icon_roll
  11. by   flightnurse2b
    Quote from TheCommuter
    Yes, a pecking order definitely exists.

    The patient is at the top of the pecking order.

    Without our patients, none of us would have our jobs. In order for healthcare to exist, we need a supply of patients to care for. We'd have nothing to do without sick people, so our patients should come first.

    Unfortunately, that's not the case with each and every situation.
    i very much so agree with you, commuter. my response to the pecking order was between EMS/nurse. i guess what i meant is if we spent a little less time worrying about who has a better education and who should be in charge, maybe the patient outcome would be better.
  12. by   MrsCaseyRN
    Quote from flightnurse2b
    i cannot believe that someone who used to be an EMT would make an ignorant statement like that. most nurses are associate degree and bachelor degree trained. paramedics are also associate or bachelor degree trained. with an EMT, yes, maybe higher education, but with a paramedic, no, it is typically equal. you wouldnt walk up to someone with a degree in accounting and say you were better educated because you had a degree in nursing would you? no. because the peice of paper still is an associates or bachelors of science, just in a different field of study. and from working as an EMT, you know that if you work EMS as an LPN or RN, you may not function in your capacity as a "higher educated person" and you may be following direction from the lowly paramedic on duty.

    i am sorry you have had a bad experience with EMT's and paramedics. but judging from your posts, you may come off to them that you think you are better, because thats the vibe i am getting. there is no pecking order.
    I don't know what its like in the state you live in, but medics in this state ARE NOT COLLEGE EDUCATED. So I believe you have made the ignorant statement. They are highly trained techs in our state. They are NOT taught to critically think. They are educationally below RNs without a doubt. And YES there is a pecking order. That's just life. In any profession. Deal with it.
    To put in bluntly, some EMS transport have some nasty attitudes. They think they know more than they do. I saw it from both sides of the fence, and yes, there are some awesome emt and medics who are professional and knowledgable, but some need to get off their high horse.
    As for your vibe, I am typing a post online. You have no idea what vibe I give off. I assure you (although what you think doesn't really make a difference in the end) that I am very polite and I give full reports, and respect to EMS because I know whats its like to be in their shoes, but some is them are so rude that they are just nasty from the start. The worlds greatest nurse would not be good enough for them. I doubt you have ever worked in LTC and dealt with such. I'd be surprised to find out otherwise.
  13. by   TheCommuter
    Good day, ladies and gentlemen!

    This is a demand that we refrain from hurling personal attacks while posting on this thread. I can conjecture that we are all responsible adults who know how to convey our thoughts and opinions in a respectful manner without stepping on each other's toes.

    To be rather blunt with you all, we are not going to achieve any progress by playing the 'one-upmanship' game regarding who's more knowledgeable and better-educated. We all have something valuable to bring forth. This thread was originally started to get a personal question answered.

    Thank you for your understanding!

close