Hello again, been awhile since i posted here! I just wanted to take a minute to aplologize for past posts that may have offended Nurses, becuase of my hot headedness toward nursing. While working as a CNA I really gained a new prospective of how hard the Floor Nurses job is in a LTC Facility and how hard the CNAs job is too for that matter is in LTC Facility with the MANY problems and shortages that the LTC Industry faces. In my five months working as a CNA I realized that I just couldnt handle those unhumane LTC Resident to Caregiver ratios. I have developed a profound respect for all LTC LPNs and CNAs for being able to do those seemingly impossible routine tasks over and over day in day out and make it look so easy (I say LPNs because in my area only LPNs are floor Nurses, RNs are supervisors ONLY in LTC). Anyhow I also discovered that the Nursing field was not for me and enrolled in EMT training with private ambulance. And now love my job.
It just saddens me because i read alot of posts where long term care nurses and EMTs just cant seem to cooperate for continuty of care for the patient, and cant respect each others medical education. Because I worked in long term care I often have to settle my rowled up Paramedic or EMT partner when we arrive at an LTC Facilty when he is raising hell because all the paperwork wasnt completed on time, and I having worked in Long Term Care know that if one incident happens such as a fall or EMS call, or death, your scheduled routine is shot and it becomes a nightmare, almost worth bawing in tears over. I can understand how a Paramedic or EMT with no knowledge of Long Term Care mangement would get upset and misunderstand why things are not always on time. But last week our unit was dispatched to a proximal nursing home for emergency fall (pretty severe one too). We arrive and we have this LPN charge nurse with nothing but attitidude, beacause she was tied up with a family member raising cane, the CNA showed us wich room the patient was in, we begin assessing the patient and begin our treatment within our protocol and she barges in, and says "stop what you are doing now, you can not just come into the facility and begin care without informing me i could have you arrested, then she proceeds to say that I am a nurse, and you will follow my orders" I politely say mam I know your upset but we legally cannot stop emergency medical care once we begin it.
And as an EMT we cannot accept orders from a LTC Nurse. While my Paramedic partner is starting an a saline IV she then says that you cant do that, i do not want you to start an IV on this resident, i am giving an order an I will be contacting your supervisor if you fail to follow it. Im all for understanding an compasson but i could see that my partner was having trouble concentrating and she was basically to the point where she was obstructing emergency care, and it got so bad to where we were considering calling police for back up. But we just did our best halled her in and notified the ed we ere en route.
I think that its very neccessary for EMS and Nursing to act as professionals and get along. As an EMT i was instructed that EMS is higher emergency medical care when it comes to long term care. Wich means that when we get there the Nurses must cease care on our command, any rescuatative care they have began and turn over care to us. (and please dont get offended its not really our command its our Medical Directors). Accepting an order regarding emergency care from an RN, or LPN at the scene is highly agaist our protocol, the only way we could accept an order from a nurse is if the Nurse is a trauma certified RN, or of course an RN, EMT-P that is a feild supervisor other than that its a no no. And i havent been in EMS long enough to know but the seasoned veterans say often times there problems are with the Licensed Practical Nurses in long term care facilities. That the LPN doesnt understand (only some of them not all) that EMS has protocols for patient care that are different than the nursing protocols. Nurses are not superior to EMTs and Paramedics. Just like EMTs and Paramedics are not superior to Nurses. EMTs and Paramedics are prehospital emergency care experts. Our training is narrow and focused on Emergency Medicine. Nurses are condition managent and care planning exerts. So Nurses that think you have a higher education than an EMT or Pramedic you do have a higher university education, and a broader medical knowledge of all specialties of nursing, but that doesnt mean you know more than the EMT or Paramedic about pre-hospital emergency medicine, therefore it doesnt matter that you have more education, an Accountant has more education than a LPN too, but that doesnt mean that he can take over nursing care and supervise nurses, same thing with EMTs and Nurses.
God Bless Nurses and CNAs for all they do. That is truley a very very very tough job, very stressful. I have the utmost respect for Nurses and there education. As an EMT I listen when a Nurse gives report an I say yes mam/yes sir. I also like it when i see a new young nurse say yes sir to a 30 plus year paramedic, it just shows respect. As Nurses and EMTs we are colleagues, and should treat each other as such. We should treat our medical knowledge as not equal, not one side higher than the other, but seperate. Seperate entities of the broad medical field. And let nurses handle nursing and let EMTs handle pre hospital emergency care. And when it comes to DNR, I assure you a good EMT are Paramedic will no what there doing because in school we spend a great deal of chapters dealing with DNR ethics and protocols. And I can tell you now, EMS does not like or endorse DNR, wich meanse there not taking anybodies word for it, if you dont have the signed original and place it in the EMTs hand there is NONE!! The residents family can be threatining on every legal threat they can find, and the nurse can talk till she turns blue in the face if we dont have the original there getting full rescusitative care. So for one second think that DNR means slower arrival time or anything of the sort, until we get there and receive the DNR order its a full care case!! HAPPY HOLIDAYS EVERYONE!!