Nurses vs EMTs?

Nurses General Nursing

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I have a question for you all. Who is higher ranked a nurse or an emt. I was an emt in h.s. and always thought that nurses, doctors, ect were higher than us. Now I am a nurse and yesterday a little boy had a seizure in the grocery store. His mother was screaming and people were just freaking out. I went over and made sure the area was clear so he would not injure himself anymore (he had a pretty big fall out of the cart onto his head on his way down). I was starting to check ABC'S and he stoped seizing. He was having a lot of trouble breathing because he had thrown up and it was in his mouth. I told two people who were now saying they had first aid experience that we needed to log rol him so I could clear his airway. The this kid who said he was an emt started yelling that we can't move him because of his head injury and wanted to start rescue breathing. I told him that the child was breathing, but at risk for aspiration and that rescue breathing would cause more damage. So we log rolled him and got the vomit out, he was then able to breathe better and started to come to. When the ambulance got there the emt kid told them "that woman is anurse but she wouldn't listen to me he needed mouth to mouth" The other emt agreed with me on what I did, but then said "but next time be a bit more respectful to an emt because e are higher up than you outside of the hospital" I am sorry but I think that is bull. Yes emt's can provide BLS but we have a lot more training and knowledge than them. What do you all think?

Around here, an EMT cert is 11 credit hours at our community college. That's MUCH different than a adn/bsn regardless of the rigorousness of the courses. No matter what the training is...there are bad nurses and great EMT, clearly this kid was not one of them.

Allison

Specializes in Education, Acute, Med/Surg, Tele, etc.

My hubby is a paramedic, and while I was in RN school I learned most of my emergency and stabilization through them because I had that resource.

The fields are different but we are all on the same team with the same goal! Respect, no matter what a rank is should be done, and you were NOT respected!

What you did was A+100% right on! AIRWAY first, breathing second...reason behind that huh? Especially in a child!

Heck, my hubby has run into Doctors that are totally daft about emergencies and still gives them the respect even if they are not doing what they really should be! (I hear the stories often!). But my hubby has over 18 years of experience in this and very good at communication so he can really quell a situation like this quit quickly by knowing that each memeber is trying to help, just some people know a little more in a given situation...and it switches between disiplines!

Also my hubby is one of the best at thinking of the underlying probelm, knowing quite a bit about what the hospital is going to do once the pt is there, much about post ER care...and really does his darndest to help out this process for the sake of the patient! I wish I worked with him much more!

I don't play that RN vs other healthcare provider game...we are all on the same team, and it all should boil down to ONLY one thing...the PATIENT! Working together does that.

ALSO...my hubby was watching quite a few shows on Nurses and the recent trend of trying to get the public to understand nursing! He loves it...but would LOVE to see this done with EMT/Paramedics too! I totally agree! Not only does the public need this information, but healthcare providers...of all ranks/disiplines need to understand all our team members roles so we can transition and provide continuity of care :).

To the OP, heard anything on the kid?

I am RN and EMT as well.OP was really good one and the others poster were superb.I agree that EMT kid was wrong on his approach but you could have teached him then and there that basic is ABC.

Whatever you did was great one but establizing the c-spine was also neccessary.

But I would say that we work together as our main aim is the patient's well being. There is no questions of who is ranked higher.

Now am a ER/ICU nurse

uhh you have EMTs who are still in high school!!!! I cant really decide if thats ssssooo cool or ssssooo not good. I'm in st john ambulance which is like a volunteer first aid thing (im 15) the most advanced stuff we do is SAED, 02, Asprin, salbutamol via aerosol puffer, oral airways(oropharangeal(speling, i know))

and paracetamol. If I understand correctly EMT-B's (which i assume these high school kids are) can give epinephrine, activated charcoal (I assume this includes NG insertion) all off their own backs? I think that most teenagers I know are as or more capable that most adults In St John. But still 15 year olds giving adrenaline? My word.

By the way I'm in Australia.

Oh and whats with all of this competitive stuff, arent they just DIFFERENT jobs with DIFFERENT responsibilities?

And I was shocked to read a nurse saying that she thought a doctor was ABOVE her! Is it still the ninteenth century!!!??

Specializes in Combat Support Hospital; Geriatrics.
I was an EMT for over 9 years, and now a student nurse graduating in May, who works in the ER. So let me just say this: first off, your actions were right 100%, second of all, even the "right of school" nurse has more education and training than an experienced EMT. EMT, training is extensive, but is geared to BLS, trauma etc. no disease process, treatment, pathophys....etc...

Why he even would bring up "who's higher up the chain," shows me, he is being a head case. There is no "higher or lesser" It's just a fact of who has rights to patient care.The EMT who responded, is only "higher than you" outside the hospital, because he in fact, is being paid to respond, in turn that becomes his patient. He doesn't have to listen to you, or even discuss patient care with you. ( I mean after all, you're saying your nurse, but he has no proof of that, also HIPPA) Basically, you just have no rights at the scene. Once in side the hospital and pt care is transferred to a nurse, she is the "higher" one, because it's now her patient. I had a sutitaion similliar years ago, a SNF RN and I an EMT were arguing wether a patient needed to be transferred to the ER. To make a long story short, our medical control, told me, the patient is in her facility, under her care, then she calls the shots. If the patient was d/c'd and stumbled outside, then it would be my patient, and I would call the shots.

Now, as for you and another EMT, who are off duty and stumble on a pt....your both working under good sam. laws, so I would think no one is higher than the other, and your only using first reponder skills anyway. It's not like you have an 02 tank and c-spine board in your pocket. So that guy, is just being a jerk. The objective was to help the patient, which is what you did. He should be greatful. I think the problem is there has always been a small fued with EMT's and RN's. EMT's complain RN's show them no respect, which I admit has happened to me, but not all the time. RN's argue, EMT's think they now more or are better. And sometimes thats true, I've had many co-workers complain, they are better EMS providers. I think we should all try to work together to achieve pt. care, but guess the fued is still going on.

Ha! I'm not doing mouth-to-mouth if I don't have a mouth barrier handy.

Personal and scene safety first.

And speaking of "head injury" did both of these responders even consider stablizing the victim's head? Oh wait, the EMT responder was aware of the injury....my bad.

Well personal safety is great but if I am in a situation where a pt is not breathing and has a pulse, I am going to start rescue breathing because no breathing= no pulse. Suppose that it happens at the local Save A Lot in my home town with our lights and sirens it would take in the neighborhood of 15 minutes from the time we got the call from dispatch. If that kid stopped breathing in the first two-three minutes after the incident occured by the time we got on scene the patient may have already suffered irreversible brain damage. I have a CPR mask in my car but if its not convenient I will not hesitate to do mouth to mouth.

Well personal safety is great but if I am in a situation where a pt is not breathing and has a pulse, I am going to start rescue breathing because no breathing= no pulse. Suppose that it happens at the local Save A Lot in my home town with our lights and sirens it would take in the neighborhood of 15 minutes from the time we got the call from dispatch. If that kid stopped breathing in the first two-three minutes after the incident occured by the time we got on scene the patient may have already suffered irreversible brain damage. I have a CPR mask in my car but if its not convenient I will not hesitate to do mouth to mouth.

Please dont take this as an attack, just something to think about. One of my old instructors from years ago happened to be one of the original paramedics in southern California. He taught me something that has stuck with me to this day, and has served me well in keeping focused on the task at hand and providing the best possible help I can for my patients. He taught me to always remember "it's their emergency, it's not your emergency." As soon as you make it your emergency, you begin to lose focus and perspective. Keeping it as "their emergency" will stop you from doing the rain dance on some poor victim in a burning building, it will keep you off of the X in some sniper's man-trap, and it will keep you from contracting Bubonic Gonoherposyphalaids - c. The National Registry of EMT's curriculum for EMT at all levels (basic, intermediate, and paramedic) all teach that BSI and scene safety for the rescuer comes before anything else with a capital A.

I teach American Red Cross BLS classes as a part time gig, CPR for the Pro, First Responder, Lifeguard, pretty much all of it. When the video says "place a breathing barrier over the victims mouth and nose and give 2 rescue breaths. If a breathing barrier is not readily available, you may choose to give breaths without one." I also caveat, " you may choose to juggle chainsaws, wrestle sharks or participate in any other hazardous activity, I do not recommend it."

Again just something to think about.

aloha

Jim

I understand scene safety and BSI however if it comes down to a kid dying because I am afraid of what he may have, I am going to do my best to save the child. I know what can happen on a scene, I was watching the local NBC affiliate one afternoon when they broke into whatever show I was watching, their news crew was diverted from a story for a call of a woman down in her front yard, a possible domestic violence incident. They had arrived with the engine and ambulance and filmed the crews getting out of the units. There was a man hiding in the house, he opened fire on the crew, killing an EMT and wounding her partner so severly that he had to retire from emergency medical services and the fire department. It was all broadcast live that day. The tape was later used as evidence in his murder trial. The wife also passed away.

I understand scene safety and BSI however if it comes down to a kid dying because I am afraid of what he may have, I am going to do my best to save the child. I know what can happen on a scene, I was watching the local NBC affiliate one afternoon when they broke into whatever show I was watching, their news crew was diverted from a story for a call of a woman down in her front yard, a possible domestic violence incident. They had arrived with the engine and ambulance and filmed the crews getting out of the units. There was a man hiding in the house, he opened fire on the crew, killing an EMT and wounding her partner so severly that he had to retire from emergency medical services and the fire department. It was all broadcast live that day. The tape was later used as evidence in his murder trial. The wife also passed away.

I'm glad that you understand the inherent dangers here. Google search job openings for both "hero" and "martyr" pretty slim pickens these days. Be careful, these lessons are written in blood.

aloha

Jim

Being a hero or martyr is not exactly the same as providing rescue breathing to a dying patient when no type of barrier device is available. If a stranger found you in respiratory arrest would you want them to not perform rescue breathing because they were unsure if you have any illnesses? I WANT TO LIVE!!!! OK even I am willing to admit that last bit was pretty cheesie, despite being cheesie, its true.

Specializes in Pediatric Pulmonology and Allergy.

I think you need to weigh the risks to yourself vs. the benefit to the patient. In a case where the risk to myself was slight, while the benefit to the patient was great, I'd put myself at slight risk to save someone else's life.

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