For those who have worked as EMT's...

[kermitlady]

do you really think badly of nh nurses? i just wondered b/c i was lurking on the student doctor network and found a thread in the emt forum w/an several posts berating nh nurses.

here's a couple of the posts from the thread:

to the nursing home "nurses"

re: several things

1) a person who is very hot to the touch, does not have a normal temperature

2) patients in wheelchairs that disappear eventually turn up at the bottom of the stairs

3) a person who is in cardiac arrest does not require your changing their diapers at that time

4) 4 little nurses, each weighing 100lbs, cannot safely place a 300lb man on the floor from the bed during a cardiac arrest

5) when you see that your patient stopped breathing at 3am, it is not necessary to call the doctor, who will tell you to place them on a 2lpm nrb. then call ems at 6am because they are still not breathing (unless it is my shift)

6) a person with a blood sugar level of 400 is not normal

7) a quick peice of advice, if you do not need a stethascope to determine pulmonary edema, sit the person up. it really helps

8) getting off the boat from the carribean and putting on scrubs does not make you qualified to be a nurse, or a treee surgeon for that matter

and the final peice of advice:

the only use you have to me is to give me the paperwork and tell me how you found them. other than that you are as useless as the mask you put on them. now go an wipe some orifices.

doctor+pulse oximeter+nursing home friday afternoon shift= abuse of the 911 system.

attn nh staff: if pt. has rigor mortis or lividity, please do not attempt cpr. and don't get mad at us when we pronounce the pt. dead.

shift change at nursing homes always occurs about 5 minutes before i arrive. as a result, none of the staff knows anything about the patient.

exception:

apparently sometime before 9pm, all of the nursing staff leaves except 1 nurse. said nurse not only knows anything about the patient, but instead of admitting it, claims that it is all in the paperwork and doesn't have time to give the paramedics report because she "has to take care of the rest of the patients, and thus can not spend time helping out this one patient."

i know there are some bad nh nurse out there but we're not all like this. and as far as the cpr thing goes, in indiana we have to start cpr when we find them until ems arrives. and, believe me, sending someone out to the er requires quite a bit on my part so i'm certainly not going to do it for fun!

[EricJRN, MSN, RN]

Sounds like it was just a vent, much like the ones you would find on this site that describe our experiences with fellow nurses, docs, medics - you name it.

I think you will find many medics with some resentment toward LTC nurses. Much of it is probably due to the fact that our training emphasizes different patient care priorities.

Medics and LTC nurses don't typically spend a lot of time together, so when we do have negative interactions, it can really color our perceptions of an entire profession.

[kermitlady]

Thanks for the reply! I know it was probably more a vent than anything but I figured I'd ask if it was common thinking. Good to know it's not universal!

[rdnkmom01]

The way I see it is this....you know what they say about opinions...lol I've been a LTC nurse and Nurse aide and am also an EMT. Luckily, I haven't run into an EMT who thinks this..that I know of.

[flightnurse2b, LPN]

i am a nurse/paramedic and i have so much respect for LTC nurses. you guys work incredibly hard under not so spectacular conditions/ratios most of the time and are still able to love and care for your residents with a smile on.

to be very frank and honest, yes i have butted heads with nurses in LTC (esp one who took the chart from a patient in cardiac arrest and ran to make copies for 10 minutes while we were trying to transport), and i have responded to 911 calls where the patient has obviously been dead for four hours before someone found them. i had gotten some resentment from LTC nurses as well, because alot of them thought that EMS automatically would have a chip on their shoulder. and yeah, i know why. there are lots of paragods and rude EMTs out there, not discrediting that at all.

although it did make me upset, when i did my rotation in the nursing home in nursing school and shadowed a nurse who had 40 patients to give meds to (who were on 27 meds or so a peice!), treatments, feedings, insulins, family issues, orders, charting, labs, etc, etc, etc in an 8-12 hour shift... i have the utmost respect for you guys. i was absolutely exhausted everyday of that rotation. i could not do your job.

it does make a difference to see things from the outside and to walk a minute in someone else's shoes. eric is absolutely correct--two completely different worlds with two completely different sets of priorities.

god bless you, LTC nurses!!! don't let a silly med student ruin your day.

[kayty2339]

My husband is a firefighter/EMT and he runs a lot of calls to the one of the local nursing homes in our area. He has come home with some pretty wierd stories. Like somebody else said above, he's run a few calls where the nurses or CNA's (not really sure) called 911 and it was obvious that the patient had been dead for hours and there's some other things that have happened as well. I'm sure it depends on the nursing home and these EMT's probably aren't putting two and two together that the nursing home is probably way understaffed and it's really not the nurses fault that the administrators don't want to put the funding in to adequately take care of the residents. I'm sure that has a lot to do with the bad things that go on in some of these places. I sure wouldn't want my family member to be cared for in the one that he frequently visits. It's really sad.

[systoly]

i wouldn't take these threads from the emt forum too seriously, especially since they contradict each other and make statements such as, "... place them on a 2lpm nrb." really? does the bag even stay inflated? - i guess it would since the patient is not breathing. anyhow, it makes no difference whether you're transferring your patient to another nurse or emt or other service, some folks are cool and some have 'tudes.

[getoverit, BSN, RN, EMT-P]

Yeah, I think it's just a vent too. Some of the LTC nurses I've known were great, wonderful people and I've always been impressed by how much work gets done with so little staff and the amazing amount of personal connection they have with some of the residents.

As a responder to nursing homes, I've seen somethings that were hard to explain. Like the "2LPM/NRB", I doubt that was a misprint. I've seen 2L flowing into a non-rebreather. i've also seen it when the patient was apneic.

But the bottom line is EMTs rarely have the experience in LTC to accurately make an appraisal of the nursing home nurses. Same as most nurses don't have the experience to make a blanket statement like that about EMTs.

[kermitlady]

Thanks again for the replies. It is good to know that this was probably more of a vent thread rather than a universal opinion.

[CoffeeRTC, BSN, RN]

yeah, it was a vent, but my BIL (married to sis who is an ICU nurse)actually believes this and stated about the same to me. Yeah, my jaw was on the floor and there was no way in changing his opionon of my non nursing skills, etc. Glad I live in PA and no where near him.

Apparently all the LTCs in his area of TX are horrible. Not single good one at all.

BTW, he is a fire fighter/ paramedic.

As a nurse in LTC....I've see alot of crazy stuff, incompetant, lazy staff, so yes....It is probably out there.

[systoly]

So many missed opportunities. LTC nurses and paramedics can learn a lot from each other - if only we could swallow our pride sometimes. Easy for me to say - I was a medic then EMT before going into nursing.