EMS talking down to Nurse

[heynurse1996]

School Nurse Vent!!!

So, I see my nurse assist per IEP diabetic three times a day, he sticks himself but I carb count for him and help him draw up the insulin, supervise and make sure hes rotating sites,ect. Today he came in very panicked. Stating he was in DKA.

Now this kid is happy go lucky and never has a complaint...ever. So immediately I am worried. He has Large ketones in his urine, Blood glucose 390 (he usually runs low,never seen him above 180) And generally knows whats going on with his own body, He's vomiting, kussmaul respirations, fruity breathe, weakness, blurred vision, sleepiness the whole nine yards.

So I call 911, the EMS team thought I was an idiot, the paramedic informed me "390 is not even that high" I replied that he is a type one with dx hypoglycemia issues per MD and even printed out his CBG record and MD note stating this. Still the whole time they rolled my eyes made a big production and were dragging there feet on taking him. At one point when I handed them his dx list they stated that this was probably a "panic attack" because of his mental health dx. None being anxiety mind you.

I finally tell them they need to go with him to the hospital now. With some shuffling they go on. My RN supervisor (I'm an LPN) Seems to think its because I'm young and stated the same thing happened to her....I was wondering if anyone else has had the same experience.

It just frustrates me that people with mental health dx are being overlooked when its a WAY bigger issu because "Its just part of it" Anyways...very upset about the whole thing and kind of still seeing red...

Update: He's being transported to the "big city" Diabetic Peds unit...it was DKA

[not2bblue]

Several years ago I worked in an LTC ( I was the only RN at the time). Resident slumped over in wheelchair, slurred speech. Called EMS (we used a service, so it wasn't 911) and told them I thought he was having a stroke and needed to go to the hospital. One of them told me it didn't look like a stroke. They still HAVE to take him because it is LTC not assisted living and they don't have family to take them, the nurses in the LTC can't take them, ect. So anyway long story short. The resident never came back. Because he died that night. In the ER. From a stroke.

[K9lover, ASN, RN]

EMS has a lovefest with talking down to RNs who are not in acute care I discovered upon becoming a correctional health nurse. We do not call over blood sugar generally but we have MDs/NPs available. We do call over seizures/traumatic injuries and such. When EMS arrives they get a tad pissy if we don't step out of the way stat.

It really does not faze me, they can get a large gauge IV into anyone in a split second no matter how combative the patient is and my ER experience is years ago, in all honesty they get 'er done more rapidly than I would as that is what they do all day. While I can handle anything that comes up I am still quite relieved when EMS arrives and takes over. I have had to call on totally non-responsive patients who had perfect vital signs, I did not see true catatonia until I worked in jail but the EMS team who responds to the facility had.

I say just let them think you are over-reacting if that is what floats their boat. You were right to call, the thing is EMS respondents only see the emergency, they don't do follow-up so they do not know the child was admitted with DKA. They do not need the follow-up, they are spot-on at what they do which is get the patient to the hospital alive. In all honesty I am happy not to be 'the last house on the block' when it comes to emergency practice.

[Have Nurse, ADN, RN]

Education and experience aside: There is no excuse for discourtesy to a fellow colleague whether in the office, hospital, clinic or the field.

We are suppose to support not only our patients, and clients, but one another.

EMTs aren't doctors, but they are very important to all of us. He could have treated you with better manners at any rate.

[ana010]

I am late to this conversation, but am catching up on posts. I have had to call EMS many times in the years I have been a school nurse. I have had lovely people I do not know take report from me while taking vitals and smoothly transition to their routine. I have had rude folks talk down to me and the patient because he was having a panic attack, but is undiagnosed with anxiety because his mother does not want him to have the stigma. (But full blown panic attacks at school she's ok with, I don't get it!) The EMS worker that was initially rude did end up helping the young man having the panic attack. So while he felt we were wasting his time, he had some compassion.

My neighbor is an EMS worker and is one of the loveliest gentlemen I know. He has forgotten more than I will ever know and I have a bachelor's degree and worked peds ICU. He has put forth the effort to further educate himself in his field though. There is no one size fits all. I just give report and if I am rebuffed chalk it up as his/her problem, advocate for my patient and carry on.

[MrsNurse08]

You are not alone in this. I get the same reaction from them (I called them MEDICAL DOCTORS ON WHEELS) too but I just speak to them in my man from the clear eyes commercial voice and tell them to get to transporting. And kudos to you for doing a wonderful job!!

[MrNurse(x2), ADN]

My wife, who works subacute rehab, once told a repeat offender paramedic that she can call the doctor to let him know that the paramedic was refusing transport. Shut him up QUICK!

[AdobeRN]

Our EMS/firefighters are friendly for the most part - the only issue I have with them is that they really don't care about my "report" to them when they arrive - or at least that is the feeling I get. Last time I had an encounter with them I just told them real quick what happened, gave the name and age and stepped back to let them do their thing - didn't go into details like I would do if I were giving report to another nurse or doctor, they didn't want to hear it and they went into doing their own assessment.