EMT's and how to deal with them

merry nurse · Jun 3, 2005

I know exactly what your talking about! I know some are o.k. but the majority are just like you say. They also think they are more important than us (wee) nurses. I don't know where they get THAT from.I did have one come back once and tell me "That was a good call", as if it mattered.

smelendez · Jun 4, 2005

Currently a Paramedic working on my RN, I wanted to post a reply to this thread. I'm not defending rude behavior by any EMS worker because it is inappropriate and unprofessional. What bothers us EMS workers at times is when we are called out to pick up patients that could be transported by private transfer ambulance services. When we are called out to 911 calls we expect to be responding to life or death emergencies. Some times doctors offices or nursing homes call 911 because they don't want to wait a longer time for a private ambulance service and they know when they call 911 that an ambulance will show up quicker. That is the only time I personally get upset. Not really angry, it just bothers me. Instead of being rude I just mention to the nursing staff to try to call a transfer ambulance next time.

In the case you mentioned, a hypoxic patient with altered mental status seemed like an emergency and I would not have even thought of complaining. I would have just been focused on pt care.

On what you state you have more education than paramedics, I'd have to say you actually do. Does that make you any better than us? Can you intubate? Read and interpret ECGs and 12 leads? Surgical airways? Chest decompressions?

I can also complain about rude ER nurses that act like we are bringing them pts because its fun for us. We know they are busy but we still get called and have to transport pts to the ER. They also get angry when we don't call ahead of time that we are bringing them pts. That is a courtesy. People don't call the ER before they decide to walk into one. We will quit bringing in pts when they turn off the big red 'Emergency Room' sign out front!

So instead of continuing or starting a fight between EMS and nurses, I think we should just work as a team to improve pt care.

Nurse Hatchett · Jun 4, 2005

When I was in nursing school, I had a guy in my class who had been a paramedic for years. I asked him this very same question and his response was that they thought we didn't do anything except pass pills and sit at a desk all day, and thought we sent people out who didn't need to be and it was a waste of their time. Yes there are times I've sent a res to the hospital and thought they didn't need to go, but family wanted them to or they wanted to go, and it made them feel better or the family. In a nursing home we don't have the hi tech equip that a hospital has, or a stat blood draw can take hours to receive. The guy in my class then went to work in a nursing home himself and guess what, he changed his ways of thinking and even griped about the paramedics coming in with their houlier than thou attitudes.

On the other hand you have good nurses and not so good nurses. I overheard a fellow nurse make a stupid comment to a paramedic one day during a code about she knew what he was doing because she had seen it done on ER. So I can understand their frustration if they get a lot of dumb comments and situations. The problem comes when anyone tries to group people in on lump sum... and make generalizations.

I usually just give my report and answer questions, if they don't like why I am sending someone out, to bad, that's their job.... and they don't sign my paycheck!!! I also try to have everything ready for them and have a hx.

One more thing and I will quit rambling. I don't think all paramedics/EMT's have this attitude, but the ones that do are the ones that leave the bad taste in your mouth and who you remember, which I'm sure is how they feel when they have a bad experience with a nurse.

Just my thoughts, sorry so long

MadRedneckRN · Jun 4, 2005

I don't know if this is common (i've been a nurse about a year now) but i work 11-7 LTC and EVERY time I call 911 to send a res to the ER the EMT's act like JERKS... they question me about the why i'm sending them (in a very sarcastic manor) actually state that "there is nothing wrong with them but guess we'll take them anyways" and all around treat me like i'm stupid. Not that it matters, but every time i've sent someone out they've been admitted and although they may be a little better by the time the EMT's get there than when i first found them they still need to go! For instance one day i went into a res room cuz she was makin all kinds of moans and talkin to herself (not like her).. her 02 was in the 70's and wheezes all over.. starting to get cyanotic in her nail beds and not acting right at all.. i called the doc he said to put her on 02.. some of her symptoms subsided due to the O2, i explained all of this to the EMTs they accused me of calling them before i fully assessed the patient and of not checking on her before i called.. which i did.. i was in her room literally like 15 times in a 1/2 hour and had sent aides in there on top of that.. I don't know what the deal is with them.. but i am just wondering if this is common.. i mean correct me if i'm wrong but dont' we get a little more schooling than them? AND i think i know my res a wee little bit more than they do...

Ok, I have to chime in on this one!!! I've been an EMT for 20 + years and a nurse for 18 years. I think one of the problems (at least in my state) is EMS is a magnet for adrenaline junkies. LTC transfers (commonly called granny tranies) irritate many EMT's because they like the high drama. I've even heard "what I wouldn't do for a good code, car wreck....." Not that I am defending the attitude. As an EMT instructor, it is difficult to teach compassion. There are many people drawn to EMS who are in it to play with the lights and sirens. If this is the case, they usually get bored and leave after a short while. EMS, Nursing.... IMHO is all about patient care and compassion for your fellow human being. It's too bad you have had these experiences with your prehospital people. Rest assured, we are not all rude. Some of us are quite informed and compassionate. I for one appreciate all the LTC, ICU, ER, Floor Nurses..... We need to remember we are all a team and we need one another. I've worked (and continue to do so) on both sides. As much as I love nursing, a part of my heart will always be in prehospital.

Sorry for my terrible spelling!!!!

Lori

Cheetah · Jun 4, 2005

After being on both sides, this can be a complex issue. I have done LTC transfers and 911 calls where the nursing had NO IDEA what was going on with the pt. I have gone to work at a LTC facility and found one of my patients with a six inch lac on her head. When I ask what happened the swing nurse told me "she fell I think" When, "few hours ago." Of course she got transfered to the ER. How does that look to the EMS crew?

On the other hand I have worked on both sides with great nurses in LTC.

Bottom line is both have a job to do and protocals to follow. Communication is the key, give a good report to the EMS crew just like you would do at shift change. Oh and smile, it goes along way.

Of course rude behavior is never expected and should be documented and reported.

Just my thoughts

Chet

dekatn · Jun 4, 2005

We had this one guy (EMT), thought he was God's gift to humanity.After full assessment and contacting the doc, who by the way, gave the direct order to send to ER, this particular EMT, on two separate occasions, was very rude and condescending. The first time, I just let it slide off my back, the second time, I told him, "I call,you haul", if you have any further questions regarding care for my pt. please ask, otherwise, keep your opinions to yourself. Never had anymore problems with him. He still wasn't overly friendly but at least he didn't try to make me look like an idiot.

nurse555 · Jun 4, 2005

Have you talked with your DON or supervisor about this? Sometimes they can help you out with people like that. If not maybe talk with their supervisor. Who knows they may treat others that way not just nursing facility staff and residents in this manner. Good luck. I can sympathize with you there.

AKav8trix · Jun 5, 2005

Currently a Paramedic working on my RN, I wanted to post a reply to this thread. I'm not defending rude behavior by any EMS worker because it is inappropriate and unprofessional. What bothers us EMS workers at times is when we are called out to pick up patients that could be transported by private transfer ambulance services. When we are called out to 911 calls we expect to be responding to life or death emergencies. Some times doctors offices or nursing homes call 911 because they don't want to wait a longer time for a private ambulance service and they know when they call 911 that an ambulance will show up quicker. That is the only time I personally get upset. Not really angry, it just bothers me. Instead of being rude I just mention to the nursing staff to try to call a transfer ambulance next time.
In the case you mentioned, a hypoxic patient with altered mental status seemed like an emergency and I would not have even thought of complaining. I would have just been focused on pt care.
On what you state you have more education than paramedics, I'd have to say you actually do. Does that make you any better than us? Can you intubate? Read and interpret ECGs and 12 leads? Surgical airways? Chest decompressions?
I can also complain about rude ER nurses that act like we are bringing them pts because its fun for us. We know they are busy but we still get called and have to transport pts to the ER. They also get angry when we don't call ahead of time that we are bringing them pts. That is a courtesy. People don't call the ER before they decide to walk into one. We will quit bringing in pts when they turn off the big red 'Emergency Room' sign out front!
So instead of continuing or starting a fight between EMS and nurses, I think we should just work as a team to improve pt care.

As someone who has been in EMS for a while (and also almost done with nursing school), I wholeheartedly agree with what you wrote. I too, want to say that the patient described in the OP certainly sounded like someone who truly needed EMS. I'm sorry the EMT's were rude--nobody has the right to treat someone else that way for any reason, imo. I would have been grateful to get such a thorough patient report. It would have enabled me to be able to continue to provide the best care possible for their patient by having the knowledge of what the patient's presentation had been prior to my arrival.

That being said though; unfortunately, I have been on several calls where the patient simply needed to be brought to the ER for a few stitches, or to have a foley replaced, and other things that are not emergencies, nor required the staff or equipment on an ALS ambulence. When my service runs a call like that, it means our rural district is without a 911 ambulence for > 1.5 hours only because someone wouldn't wait for a non-emergent transfer ambulance or car to come, or didn't consider other non-911 options, first.

The problem isn't even that we get called for something non-emergent (we can always evaluate the person and give a second opinion on whether they should be seen in the ED right away or not). It never hurts, when in doubt, to call 911. The problem is when we've evaluated the patient and determined they really don't need a 911 ambulence ride and recommend an alternate, but the caregiver still insists we take them in regardless. We do not have the option to refuse. It can be frustrating, but does not make it okay for anyone to be rude.

I have been on a few pretty serious calls at LTC's, and assisted living places, where it was because of the close, careful, attention of the nurse or CNA who noticed a serious problem developing with a client, that the client was quickly transported and treated at the nearest hospital before the problem became fatal. My hat is off to all of you who work so hard to care for your many clients/patients to ensure they have the best life possible.

I have seen less than desirable patient care performed because of the egos of both medics and nurses. Sometimes, I've wondered if it wouldn't be a bad idea to have each side spend a few days in the other's shoes, if that were possible. I think it might foster a little more understanding regarding why the other person is reacting the way they are to a situation.

Nurse Hatchett · Jun 5, 2005

I also agree about calling 911 for non emergency care, we have a transporter ambulance as well, but when they are on call and out of town sometimes it will take 2-3 hours for them to get back in town. It isn't always the nurses who are unwilling to wait if it isn't an emergency, it is the family. There has also been times that I have called the transporter ambulance and they have said that they don't feel comfortable transferring that person d/t what is going on with them. Then we don't have any other choice.

Also while we are on this subject. I was always taught if someone falls and we suspect a hip fx to leave them and not move them, yet when the ambulance gets there they usually make some comment about it. All the nurses in my facilty were taught this as well, is this standard practice????

Thanks

hollyster · Jun 5, 2005

I also agree about calling 911 for non emergency care, we have a transporter ambulance as well, but when they are on call and out of town sometimes it will take 2-3 hours for them to get back in town. It isn't always the nurses who are unwilling to wait if it isn't an emergency, it is the family. There has also been times that I have called the transporter ambulance and they have said that they don't feel comfortable transferring that person d/t what is going on with them. Then we don't have any other choice.
Also while we are on this subject. I was always taught if someone falls and we suspect a hip fx to leave them and not move them, yet when the ambulance gets there they usually make some comment about it. All the nurses in my facilty were taught this as well, is this standard practice????
Thanks

You are right Nurse Rachett. If a pt falls and there is any question of a break the pt should not be moved. Call 911 and cover the pt and make them as comfortable as possible. Obtain vitals and brief assessment for report. Another poster wrote about a pt who dropped their sat. It is always considered an emergency whenever respiration and mentation changes occur.

Lori wrote about the young gun EMTs who want car wrecks and trauma. After a few years of cutting children out of cars or trying to save gunshot victims with half their faces gone or have to go into a burning building but are too late to rescue anyone a LTC call will be a welcome relief.

Nurses and Fire/Rescue have different skills but they are both trying to provide the best care then can. I love being a unit RN and I teach at Fire/Rescue on the weekends and unfortunately the Us vs Them attitude still exsist.

CapeCodMermaid, RN · Jun 5, 2005

At my facility, if someone falls, we call Code Star. The DNS, ADNS, and supervisor all respond to the scene. The thought is...better to have many people decide if the person is stable to move...we must hang together or surely we shall hang seperately. (Thank you Ben Franklin) If there is the least question of a fracture, we leave the person on the floor and call 911. We have developed a good raport with the local rescue guys....they know we only call in a "true" emergency. I wish I could say the same for the local chair car service...yikes... I think they all wanted to work in the ER and ended up driving a wheel chair van to take Aunt Minnie to the eye doc!! No wonder they have major attitudes.