EMTs Ever Look at You Like You're Dumb?

[Avill, BSN, RN]

I'm a new school nurse at a High School, and more than once I've felt that they look at me like I'm dumb. The funny thing is that the nurse who oriented me told that they do that (lol)

Earlier, they came in to take a student to the hospital to get checked out because his pupils were the size of the moon (suspected drug abuse) and he was non responsive, EMT asked me if I knew his history, I said no, he replied "Oh so you're not the nurse",

.... Uh yes I am, excuse me if I don't know the history of my 300+ students

So yeah, I only know if I'm in front of my computer. Ugh. Plus I don't really know what to do when they come in, I just let them take over. Maybe I shouldn't ? Eh I don't know. lol

[Flare, ASN, BSN]

I had a student that was prone to very peculiar 20 + minute long seizures that would not react to diastat. To someone unfamiliar with the student it was unclear whether or not she was seizing since she is verbal - but autistic so can't interact typically. During one such episode, ES was called per protocol and they looked at her teacher and me like we were idiots when we said she was still in a seizure, since she was quietly looking around, but not responding to her name or being her usual animated self. They realized what we meant when she finally came out of it about 5 minutes later.

When the same scene played out a few weeks later, one of the EMTs on the call was the same from the previous time we called them. When their partner started to question me that was this really a seizure - the EMT who had seen the difference in my student last time did come to our defense and said that the student acted much differently last time when the seizure finally ended.

[Farawyn]

Psh, sometimes EMTs can be a bit cocky.

Have a printed out Hx if there is one, and a recent set of vitals. Look them in the eye.

That'll shut 'em up.

[Farawyn]

Also, yes, once they get there, introduce yourself as the nurse, tell them what they need to know, then BACK OFF and let them do what they need to. You called 911 for a reason, yes?

[NutmeggeRN, BSN]

I always try to get a set of vitals and their hx and allergies, if I'm in my office and have access. I just give them my assessment and let them do their gig. Small town, small dept, they are used to me now LOL!. Have worked with them for many years. Maybe if you can schedule a meeting with them to get a feel for how they view your role. They may be in for a surprise! Remember to address YOUR scope of practice and the liability the school system carries for the students while in their care. You are probably much smarter than many of the folks initiating a 911 call and they need to remember that!

[ohiobobcat]

For a while I knew most of the EMTs who responded to calls in my school because I worked with them when I worked in the ER. I enjoyed that because there was a certain level of respect between us. They trusted my judgement and knew I wouldn't be calling them if I didn't have a good reason.

Now when I call EMS, 3 years out from my ER position, I don't know as many of them. I had to call yesterday because I has a kid pass out after a head injury. I knew 1 of the crew. And the ones I didn't know questioned me about whether I really noticed 3 seconds of tonic-clonic seizure-like activity as I was holding the passed out student in my arms. (That sounds creepy- let me explain- he passed out as I was standing behind him so I pulled him against me and gently lowered him to the floor). I was like- Derrrr...I dunno? What's a seizure? Is that, like, a salad?

But I trust my assessment skills, and I am confident in my nursing decisions. So I try not to let it bother me when I get attitude. I like it better when it's people I used to work with, though.

[Keepstanding, ASN, RN]

I often feel that the EMS folks come in and don't want to hear me out when I want to give them a report. Like they are Supreme and I am a worm or something. Often they bark questions at me like they are an MD with a pissy attitude. Conversely there have been EMS people who have been courteous and thoughtful. These I like. Work with me here !

[Avill, BSN, RN]

That's the thing, I would have a grand stack of papers with me if I printed all of these students history, and for example, this student in particular had no medical history listed, but the counselor knew his behavioral history (which was relevant in this case). I'm going to make a little carry-out baggie to be able to write down vitals like you all said, and give it to them.

I'm still trying to figure out how to have students medical history ready even though sometimes I don't even know their names until I get there, and I don't want to leave their side until EMS arrives.

Any suggestion? I'm in a pretty big school and would take me a bit to go to office, print info out, and come back.

[MrNurse(x2), ADN]

EMS is used to dealing with the general public. A lot of them feel intimidated when they encounter other medical professionals. My neighbor's kid was tachy with periods of apnea which I had to do rescue breathing for (never want to be in that position again, scary). I gave full report, only the Paramedic never gave that to the ER, as our mutual pediatrician was in the ER on his arrival. I discussed it a few weeks later and he said he never knew he was respiratory arrest. Probably didn't believe me, but that grey is something that doesn't lie.

[Flare, ASN, BSN]

i don't have a problem with sending others to my office to fetch a file for me. It makes my admins feel useful in a crisis situation. They understand that there is no way that i can keep the complete medical history of the entire student body off the top of my head. Additionally, we keep the abbreviated medical history on their student emergency cards and keep copies alphabetized in my office and also locked in the main office. Of course this info is what the parents supply us year to year and if they choose to leave something off or if something happens during the course of the school year, it may not be accurate, but it's better than nothing.

[MrNurse(x2), ADN]

Of course this info is what the parents supply us year to year and if they choose to leave something off or if something happens during the course of the school year, it may not be accurate, but it's better than nothing.

This! I plead with parents to disclose everything with the disclaimer that in the event of emergency. I'll have kids tell me all the time about meds or conditions I knew nothing about. Most of them are the same parents that would complain if anything happened.

[OldDude]

If the kid needs help, the kid needs help regardless of whether you know, or can get, the medical history or not. Beat the clock for the "Golden Hour" and you've done your job.

Don't worry about what EMS thinks about you. As indicated above they are a varied group of people. Most of them know what they are doing. Some of them are dumber than a sack of hammers. All of them are underpaid, or volunteers, and all expected to perform miracles under trying circumstances; kinda like school nurses sometimes!!

A medical history would be nice, and I'm sure if we if we thought long enough we could come up with some exception, but treatment from the scene to the ER is gonna be the same regardless of the medical history ABCDE...