EMS-what's their problem?

sanakruz, ADN · Nov 6, 2003

In a large Ca city where I worked in an acute free standing psych facility, the nursing staff called the EMT's The TESTOSTERONE SQUAD. For some still unclear reason they did not like to respond to this facility and always seemed to have an air of disappointment about them if there wasnt alot of blood apparent... :eek:

I'll leave the city unnamed.

kevro1013 · Dec 10, 2003

Originally posted by Pamela_g_c
From the EMS point of view, I can tell you that EMS personel get frustrated when they are called to an LTC to pick up Grandma because she has a decline in condition, she is 98 years old, and a DNR. Or when EMS is there trying to work a code and the charge nurse comes in and tells them to "get the patient out of here!" Or when EMS picks up a patient and can't find anyone to tell them what is going on with the patient, or why EMS was called, they just get a 15 page stack of paperwork shoved at them. Or how about when EMS gets called out at 3 in the morning for an "unresponsive patient" (again a DNR patient.) Or....need I go on?
Just some examples of why EMS staff sometimes "sports a tude"

Pam:)

DNAR=do not attempt resuscitation; if the pt has a decline in condition do they not deserve medical treatment? DNR means not to "code" them- Withdrawling medical care totally from someone to let them die is hospice care*

I agree if a pt is in LTC and a DNR and they stop breathing don't call EMS let them go for these were their wishes but to imply that they do not deserve an emergent transport for an emergent condition is wrong. I know people who are 25 with advanced directives. It depends on their wishes... Just my 2 measly cents..

sprtbikegrlsv65 · Dec 10, 2003

I have to defend the EMT/Paramedic's here. my best friend is a NYC paramedic, and some nights when he give me a call he has a horrible ATTITUDE with me...NOT because he's just a jerk, but because it was such a horrible day...bad calls...one time he got a call that a 29 yo and 18mo old child were hit by a drunk driver/ they died before making it to the hospital...WOW... i don't think i'd be too kind to take a LTC call either after that...NOT because i didn't care about the patient by i'd be overloaded with my own emotins...they are human just like us! :eek:

As far as checking the EMT for his attitude! GREAT JOB! i do that to my friend as well! sometimes they need that to snap them back into the present...i' wouldn't take it personally though!

and as long as they are caring properly for the patient what does it really hurt if they got an attitude with you?

not trying to be mean jsut giving my own .02 cents!

MrsWampthang, BSN, RN · Dec 10, 2003

DNAR=do not attempt resuscitation; if the pt has a decline in condition do they not deserve medical treatment? DNR means not to "code" them- Withdrawling medical care totally from someone to let them die is hospice care*
I am talking about patients that death is imminent. Their BP is dropping, their HR is dropping, their respirations are slowing down. These are the patients that I get tired of seeing brought into the ER. If death is imminent then why not let them pass away in their own bed and not drag them out in the middle of a cold night?

Pam

anonnotnurse · Dec 30, 2003

I know this post is "old" but I just wanted to say that I, as a cadet on a volunteer squad, often felt overlooked by ER nurses. I'd go to nurses asking for signatures and giving them their copy of the report, and they would shoo me away. And I'm talking about normal, stable patients. Of course, they wouldn't know that I was the one who hauled the equipment to the home and back and made sure the paramedics didn't use the patient as a pin cushion. I was the one who administered oxygen and I was the one who spoke to the families, who ultimately came to the ER much calmer. Of course, after they wouldn't give me the time of day, I'd give the paper to an "adult" member (oftentimes my own father) and they'd smile and chat it up and whatever. I'm sure most of you are much better than this, but I did want to remind you that cadets are important people, too.

Agnus · Jan 11, 2004

What difference does it make if you are transporting a 98 year old DNR or a 20 year old drug overdose. Your response sounds like you have little reguard for the 98 year old DNR.

Actually it sounds down right disrespectful. You prefer responding to calls for young people so you move to the side of town where they are??!!

Discrimination against age and DNR status is toally out of line. It does not matter if you think it is worth your time. It is your job. We don't get to pick and choose who will benefit from our care. If you truly feel this way get out and find something that better suits you.

teeituptom, BSN, RN · Jan 11, 2004

Ive worked this ER for 17 years and I have never heard a medic complain about a patient they transported. I have heard them complain about how unprepared The Nursing home nurses were, and how ill prepared they were to give them a report on the patient. And how rude some nursing home nurses were. Or that they couldnt even understand what the nurse was saying because of broken english and heavy accents.

I hear apologies from the EMS all the time in regards to as little information they were able to obtain from nursing home nurses. No history, no chief complaint, no meds or treatment given prior to their arrival.

Case in point, the EMS brings in a patient with a 106 degree fever when the asked the nursing home nurse if they had given any treatment for the fever the nurse responded that she wanted us to see how high the fever was ourselves and not hide any symptoms from us.

Sorry I can see where they get frustrated with the staff and not the patient themselves.

Just a different view here

I know there are some good nursing home nurses.

ktwlpn, LPN · Feb 12, 2004

DNAR=do not attempt resuscitation; if the pt has a decline in condition do they not deserve medical treatment? DNR means not to "code" them- Withdrawling medical care totally from someone to let them die is hospice care*
I am talking about patients that death is imminent. Their BP is dropping, their HR is dropping, their respirations are slowing down. These are the patients that I get tired of seeing brought into the ER. If death is imminent then why not let them pass away in their own bed and not drag them out in the middle of a cold night?

Pam
Because IT IS NOT UP TO OR I......it is a matter of interpreting the advance directives and that is between the significant others and the physician..I "get tired" of seeing quality of life sacrificed for quantity of life but now that I am mature and had some life experiences involving end-of -life issues myself I can be much less judgemental.I do not make the decision to withdraw treatment from my patients-I am ethically and legally responsible to provide it...I do discuss these issues with the families of my residents in the LTC but sometimes it is wasted breath...
As for making the decision between a routine transfer and emergent-other issues come into play there,too...If the resident is suffering and not getting relief from the limited pain meds I can provide then out they go-fast (we don't give IV meds) The family may be at the bedside and may be demanding immediate transport......I am comfortable with routine transport if the resident appears stable .... As for EMS with attitudes and excuses-that does not fly with me...If you can't maintain you professionalism when scraping a family of 4 off of the highway and turn around and respond to the area LTC and give the same level of care and compassion then you had better apply to Walmart..Nurses have to deal with this all of the time..Look at a med-surg unit and the variety of patients one nurse may have to deal with-for an entire 8 or 12 hour shift.....This just sounds like some people feel that the elderly are not worthy of resources...I wonder how old I will have to be when I am deemed worthless by some of you in the ED and the ambulances? Thankfully I LOOK YOUNGER THEN I AM!

zenman · Feb 12, 2004

Although I'm no longer in EMS, I've been an Army Medic, paramedic, and helicopter flight nurse. It was an exciting life and with more risks than working inhouse. I was reminded of that recently when a medical plane went down here in Hawaii and the pilot and two EMS guys lost their lives on the way to pick up a sick kid.

Nuru99 · Feb 28, 2004

Hi,

I'm kinda new here but I felt that because of what happened to me recently I have to stand up for the EMS guys. I'm a nurse who works in the ICU and as part of the job we do transfers from small hospitals to our ICU. A couple of months ago I went to pick up a real sicky patient you know the type ARDS on pressure control, 80% oxygen, chest tubes, inotropes, yadi, yadi, yadi. Anyways we usually use our private ICU ambulance and a doc, nurse and the driver normally go together.

So anyways here is how it went, got all my equipment ready for the retrieval (vent, drugs, pumps etc), the doc I'm going with is great so no personality crashes took 3 hours to get to the hosp, two hours to prep to get back (you know x-rays, changing drugs, see he's stable on new drugs then we set of to our hosp.

In the ambulance the doc and I did all our checks and we were talking about being hungry or something and then we were talking about how it had taken longer than we thought but at least we know he's stable. Next thing we know we both got thrown up (both of us had our belts on and it hurt), the stretcher got thrown of its railing, the ventilator fell on the lab of the doc (he was at the head and I was sitting on the side) , the monitor fell on me and I can tell you I really thought we were going to die and (i still feel guilty about this) but for just a fraction of a minute I thought to hell (sorry am I allowed to say that here) with the patient what about us (the doc and myself). What can I do to get us out of here.

After what seemed like ages the ambulance stopped and the doc (who I have never heard swear before or since) says "what the f*** happened." I was shaking like there's no tomorrow and next thing i noticed that the ET tube was still in the patient but disconnected from the vent and his arm looked broken. I was about to bring his arm up (it was stuck between the stretcher and the wall) when the doc says forget that lets do the ABC's. We then kinda got into auto mode. I don't know the exact sequance of events but someone outside called another ambulance we got on with stabilizing the patient firemen came, more nurses came, more docs came to help took the pt to a closer hosp. I was baging, doc was drugging, someone else was lifting and somehow we got into another ambulance and to the hosp. We finally got the pt in the ICU and stable.

The reason why I say I have to speak up for the EMS guys is that through out this they were the only ones who said to us (the doc, myself and the driver) "are you all right" they were the only ones who treated us like accident victims and not just there to carry on giving care even in the hosp that we took the patient to there was one point where we were so tired (started work at 7am and it was about 4am when we reached the hosp) I was bagging in auto mode. The hosp we went to I'm sorry to say was horrible and treated us like we intentionally disrupted there place at this hour. They offered no help when we needed things like ABG's done, fluids had run out, drugs about to run out etc.

I remember at one point I had absently said I left my phone in our ambulance and I really wanted to call my hubby did they offer the phone? Oh no. The EMS guys acutually went back and got it together with some more of our things. They made us cups of coffee and tea. One of them fed us. One of the guys got the ER doc to examine us.

I'm sorry but I personally can't fault EMS we all have bad days and say horrid things (I'm sure I've probably done it myself) but give the guys a break. They work hard and I for one can't thank them enough.

Nuru

SickleMoon · Feb 28, 2004

Nuru,

Lovely post. I've just been reading through this thread and wasn't intending to reply at all--I've been (and still am) on both sides of this fence and all the previous posters have pretty much said it all, as far as all of us being human and having our own issues from time to time. But your post reminded me of why we're all in it as a team...

You and your partners seem to have done okay in this accident, and I'm glad for that.

Thanks for the great post!

SharonH, RN · Feb 28, 2004

In the past, I have not had any problems with EMS but since I've been working in employee health we have to send out the occasional emergency and I must say that it is often not a pleasant experience. Quite a few of them are rude and arrogant. The first thing that happens is that they arrive on scene and do not acknowledge me or the other nurses on the scene. On at least two occasions, the EMTs have attempted to talk the client out of going to the ER. One guy told a woman who had a sudden onset of vomiting, blurry vision and BP>200/100 that she probably had a stomach virus and she could just follow up with her PMD. I was furious and I made her go anyway. I just hope they don't go to the local ERs and LIE and claim that they didn't get any type of report when they won't even make eye contact with us, let alone listen to our report. We had a conference call with other health units around the country and some of them have reported similar attitudes so I know that it's not just us. I am sure that the majority of EMS personnel are professional and courteous but it is always the few rotten apples that ruin the bunch.