Rudeness from EMTs and Paramedics

Specialties Geriatric

Published

Are there any LTC nurses out there who have experienced condescending attitudes or blatant rudeness from EMTs and paramedics during the process of sending residents out to the hospital? I simply want to become reassured in the knowledge that I'm not the only LTC nurse out there who has sensed this phenomenon. Thanks in advance.

Specializes in Education, FP, LNC, Forensics, ED, OB.

Posts #106 - 108 merged with existing thread.

the one thing i know that would upset me (and i admit i am impatient) is when i wanted information and the primary nurse was no where to be found to give it to me.

-Allison2008

Ding, ding, ding, we have a winner!! As someone who knows both sides of this fence, this just drives me crazy. If you are an RN in a LTC facility and you call 911, please be prepared to give report to the PROFESSIONAL coming to give care to your patient. The medic has to do an assessment, develop a care plan, etc just like an RN. Knowing the pt's history, baseline mental status, meds, etc are all part of that assessment.

I hate to generalize, but it always seems that whenever we go to a LTC facility the staff just melts away and we are left alone in the room with the pt that is blue, O2 sat of 72 (on 2lpm by NC) and no idea what the history, meds, normal status, etc is. Also, the staff doesn't seem to understand that EMS has protocols for different procedures and we can't "just put the line in and leave".

When I first started LTC (was ER nurse and EMT before RN) I wondered the same thing. Where does the staff go? Until my coworkers confessed that they are so tired of being harassed by emts and medics that they don't want to be found. They don't want to be in the pts room with EMTs because they don't want to be belittled infront of their pt.:o This really struck a cord with me. That this accepted abuse of LTC nurses has gone so far that the nurses are compromising pt care. I'd like to remind EMTs and medics that nurses are your superior.I know they aren't your boss, but they have a higher education and frankly unless they are wearing their resume on their name badge, you don't know what kind of experience they have. So don't assume they "don't know anything" And if we as nurses ever treated the doctors the way you treat us, well, I know some docs that would see to getting the nurse fired! I'm not saying that you have to compromise pt care, but there is a pecking order like it or not, and you need to remember that.:nono: Not to sound mean but point blank, if you know so much, go back to school and become a nurse or doctor.

Also, the pt to nurse ratio is much different in LTC than hospital. Many days I have 30 pts if I'm on a cart or 60 if I'm the desk. EMTs and medics have 1. Its not uncommon to have several urgent issues happening at one time when you are dealing with such a large pt load. Also, when you have so many pts, you are not given a detailed report on the pts. So if a nurse happens to have been at that LTC facility for a long time, she will likely know a lot about her pts, but say she's only been there for a week...how is she going to know details on so many pts? Don't even say "check the chart". Have you ever looked at a LTC chart? :eek:For residents who have been there awhile, its been thinned and those records filed away. What is there is a little longer than a novel, and it would take some time to look through. Of course I can grab the major info out of there, but since the pt is in distress (assuming its an emergency) I'm in with the pt. And I'm counting on another nurse to do the paper hunting. And since there's only 2 nurses, you better hope that the other 60 pts don't need a nurse at all. And when transport comes in, I'm able to tell them very pertnent (sp?) info, but I don't have the chart with me and unles this is a pt whose been here for awhile, I may not know all the answers.

Until you've worked LTC, you can not understand what goes on. :bugeyes:

Specializes in Executive, DON, CM, Utilization.

Dear Casey,

Acute care is not going to survive; LTC is we are picking up sub-acute wings and insurability standards are much higher today. You hang in there we need dedicated floor nurses in LTC with the heart and the soul to do the work. DO NOT take abuse you report this to your charge nurse, or your ADON or DON if need be, and that EMT is there ranting publically you hear me?

I will not allow this to occur to my staff!!

Karen G.

When I first started LTC (was ER nurse and EMT before RN) I wondered the same thing. Where does the staff go? Until my coworkers confessed that they are so tired of being harassed by emts and medics that they don't want to be found. They don't want to be in the pts room with EMTs because they don't want to be belittled infront of their pt.:o This really struck a cord with me. That this accepted abuse of LTC nurses has gone so far that the nurses are compromising pt care. I'd like to remind EMTs and medics that nurses are your superior.I know they aren't your boss, but they have a higher education and frankly unless they are wearing their resume on their name badge, you don't know what kind of experience they have. So don't assume they "don't know anything" And if we as nurses ever treated the doctors the way you treat us, well, I know some docs that would see to getting the nurse fired! I'm not saying that you have to compromise pt care, but there is a pecking order like it or not, and you need to remember that.:nono: Not to sound mean but point blank, if you know so much, go back to school and become a nurse or doctor.

Also, the pt to nurse ratio is much different in LTC than hospital. Many days I have 30 pts if I'm on a cart or 60 if I'm the desk. EMTs and medics have 1. Its not uncommon to have several urgent issues happening at one time when you are dealing with such a large pt load. Also, when you have so many pts, you are not given a detailed report on the pts. So if a nurse happens to have been at that LTC facility for a long time, she will likely know a lot about her pts, but say she's only been there for a week...how is she going to know details on so many pts? Don't even say "check the chart". Have you ever looked at a LTC chart? :eek:For residents who have been there awhile, its been thinned and those records filed away. What is there is a little longer than a novel, and it would take some time to look through. Of course I can grab the major info out of there, but since the pt is in distress (assuming its an emergency) I'm in with the pt. And I'm counting on another nurse to do the paper hunting. And since there's only 2 nurses, you better hope that the other 60 pts don't need a nurse at all. And when transport comes in, I'm able to tell them very pertnent (sp?) info, but I don't have the chart with me and unles this is a pt whose been here for awhile, I may not know all the answers.

Until you've worked LTC, you can not understand what goes on. :bugeyes:

Specializes in EMS, ER, GI, PCU/Telemetry.
When I first started LTC (was ER nurse and EMT before RN) I wondered the same thing. Where does the staff go? Until my coworkers confessed that they are so tired of being harassed by emts and medics that they don't want to be found. They don't want to be in the pts room with EMTs because they don't want to be belittled infront of their pt.:o This really struck a cord with me. That this accepted abuse of LTC nurses has gone so far that the nurses are compromising pt care. I'd like to remind EMTs and medics that nurses are your superior.I know they aren't your boss, but they have a higher education and frankly unless they are wearing their resume on their name badge, you don't know what kind of experience they have. So don't assume they "don't know anything" And if we as nurses ever treated the doctors the way you treat us, well, I know some docs that would see to getting the nurse fired! I'm not saying that you have to compromise pt care, but there is a pecking order like it or not, and you need to remember that.:nono: Not to sound mean but point blank, if you know so much, go back to school and become a nurse or doctor.

i cannot believe that someone who used to be an EMT would make an ignorant statement like that. most nurses are associate degree and bachelor degree trained. paramedics are also associate or bachelor degree trained. with an EMT, yes, maybe higher education, but with a paramedic, no, it is typically equal. you wouldnt walk up to someone with a degree in accounting and say you were better educated because you had a degree in nursing would you? no. because the peice of paper still is an associates or bachelors of science, just in a different field of study. and from working as an EMT, you know that if you work EMS as an LPN or RN, you may not function in your capacity as a "higher educated person" and you may be following direction from the lowly paramedic on duty.

i am sorry you have had a bad experience with EMT's and paramedics. but judging from your posts, you may come off to them that you think you are better, because thats the vibe i am getting. there is no pecking order.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
there is no pecking order.

Yes, a pecking order definitely exists.

The patient is at the top of the pecking order. :)

Without our patients, none of us would have our jobs. In order for healthcare to exist, we need a supply of patients to care for. We'd have nothing to do without sick people, so our patients should come first.

Unfortunately, that's not the case with each and every situation.

Oh,I cant count the times.One time the lady was a full code,and I had done the appropriate cpr.When they came and took over they simply barely pushed two fingers,effortlessly ...Needless to say this was my first situation,and many have followed.I will say I have ran into some very professional ones too!:icon_roll

Specializes in EMS, ER, GI, PCU/Telemetry.
Yes, a pecking order definitely exists.

The patient is at the top of the pecking order. :)

Without our patients, none of us would have our jobs. In order for healthcare to exist, we need a supply of patients to care for. We'd have nothing to do without sick people, so our patients should come first.

Unfortunately, that's not the case with each and every situation.

i very much so agree with you, commuter. my response to the pecking order was between EMS/nurse. i guess what i meant is if we spent a little less time worrying about who has a better education and who should be in charge, maybe the patient outcome would be better.

i cannot believe that someone who used to be an EMT would make an ignorant statement like that. most nurses are associate degree and bachelor degree trained. paramedics are also associate or bachelor degree trained. with an EMT, yes, maybe higher education, but with a paramedic, no, it is typically equal. you wouldnt walk up to someone with a degree in accounting and say you were better educated because you had a degree in nursing would you? no. because the peice of paper still is an associates or bachelors of science, just in a different field of study. and from working as an EMT, you know that if you work EMS as an LPN or RN, you may not function in your capacity as a "higher educated person" and you may be following direction from the lowly paramedic on duty.

i am sorry you have had a bad experience with EMT's and paramedics. but judging from your posts, you may come off to them that you think you are better, because thats the vibe i am getting. there is no pecking order.

I don't know what its like in the state you live in, but medics in this state ARE NOT COLLEGE EDUCATED. So I believe you have made the ignorant statement. They are highly trained techs in our state. They are NOT taught to critically think. They are educationally below RNs without a doubt. And YES there is a pecking order. That's just life. In any profession. Deal with it.

To put in bluntly, some EMS transport have some nasty attitudes. They think they know more than they do. I saw it from both sides of the fence, and yes, there are some awesome emt and medics who are professional and knowledgable, but some need to get off their high horse.

As for your vibe, I am typing a post online. You have no idea what vibe I give off. I assure you (although what you think doesn't really make a difference in the end) that I am very polite and I give full reports, and respect to EMS because I know whats its like to be in their shoes, but some is them are so rude that they are just nasty from the start. The worlds greatest nurse would not be good enough for them. I doubt you have ever worked in LTC and dealt with such. I'd be surprised to find out otherwise.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Good day, ladies and gentlemen! ;)

This is a demand that we refrain from hurling personal attacks while posting on this thread. I can conjecture that we are all responsible adults who know how to convey our thoughts and opinions in a respectful manner without stepping on each other's toes.

To be rather blunt with you all, we are not going to achieve any progress by playing the 'one-upmanship' game regarding who's more knowledgeable and better-educated. We all have something valuable to bring forth. This thread was originally started to get a personal question answered.

Thank you for your understanding!

Specializes in ER paramedic.

I have been a paramedic for 7 years, an EMT for 19 years before that. During Paramedic training we had to do rotations in a locked down psych ward, OB, a LTC, cath lab, ER, accompany a respitatory therapist for a day, watch an autopsy, and finally precept with a senior medic on a truck. Between clinicals and class we put in over 1400 hours. Sure we didn't have algebra or english compisition, so we don't get to put A.S. or B.S. behind out names. Do not belittle someone because you have a piece of paper that says you were able to BS your way through 2-4 years of college. That paper "says" you know something and the NCLEX is supposed to prove compentence at a certain level. Does experience count for anything? We have protocols to guide our treatment decisions, which are made and implemented in the back of a moving ambulance. We treat based upon the findings of our assessment. We do not ask for permission to start an IV or give Benadryl and Epi for a severe allergic reaction. Can you do anything without a Doctor's order? Our Medical Director is a Doctor of Osteopathy (D.O.), we operate under his medical license and are not allowed to work unless he has the confidence in our abilities to make sound treatment decisions and then carry out the care plan. It's all about our patients lets jsut take good care of them and sort the rest out here. By the way I am 47 y/o, working full time, in my third semester of an ASN program, and carrying a 4.0 GPA. How smart am I and where do I fit in the "pecking order"?:twocents:

Specializes in OB, M/S, HH, Medical Imaging RN.

In HH and private duty I have been treated as though I was totally invisible by the EMT's. I gave them some patient history and they didn't even respond.

At the outpatient center they sometimes bring LTC patients over for scans and they act pretty much the same way. Once an IV was leaking badly and I said we'll have to DC this and start a new line. The EMT basically moved me out of the way and said "I do this thank you". When he/she needed their receipt signed he/she said do you have an RN here who can sign this? I said "yes, that would be me, I am a Registered Nurse" , he/she got quiet and respectful after that.

Gees!...I'm not saying all EMT's are like this but the one's I've dealt with thought they were superior.

I have been a paramedic for 7 years, an EMT for 19 years before that. During Paramedic training we had to do rotations in a locked down psych ward, OB, a LTC, cath lab, ER, accompany a respitatory therapist for a day, watch an autopsy, and finally precept with a senior medic on a truck. Between clinicals and class we put in over 1400 hours. Sure we didn't have algebra or english compisition, so we don't get to put A.S. or B.S. behind out names. Do not belittle someone because you have a piece of paper that says you were able to BS your way through 2-4 years of college. That paper "says" you know something and the NCLEX is supposed to prove compentence at a certain level. Does experience count for anything? We have protocols to guide our treatment decisions, which are made and implemented in the back of a moving ambulance. We treat based upon the findings of our assessment. We do not ask for permission to start an IV or give Benadryl and Epi for a severe allergic reaction. Can you do anything without a Doctor's order? Our Medical Director is a Doctor of Osteopathy (D.O.), we operate under his medical license and are not allowed to work unless he has the confidence in our abilities to make sound treatment decisions and then carry out the care plan. It's all about our patients lets jsut take good care of them and sort the rest out here. By the way I am 47 y/o, working full time, in my third semester of an ASN program, and carrying a 4.0 GPA. How smart am I and where do I fit in the "pecking order"?:twocents:

I'm going to go through this once, and then I'm done:

#1 Although it is very rude to suggest anyone BS their way through college, personally, after growing up in a very poor home, actually homeless at times with an abusive mentally ill parent, I worked to support myself and paid and earned my own way through nursing school (AAS degree) Oh yeah, and I graduated a member of Phi Theta Kappa the national honors society. I graduated at 25 years old , on an EMT salary, not a medics, so don't even go there.

#2 RNs learn more in general in the medical field than medics. End of story. Otherwise the hospitals would just phase out all nurses and hire medics and a better cost to the hospital. I went to nursing school with a medic (that I happened to know from being out on the road) and in our state, medics can test out of 1st semester only, and must attend 2nd, 3rd, and 4th. LPNs can test out of the 1st & 2nd semester, but must attend the 3rd & 4th. If the only thing that seperated medics and nurses was a piece of paper, this would not be the case.

#3 When I was an EMT, (and even now as a nurse, if we have both EMTs and medics on a call) the medics frequently talk down to the EMTs. This hasn't even been talked about in this thread, but medics abusing EMTs is a common thing also. Medics (in my area) have no problem putting down the EMTs training (which they shouldn't) but let a nurse remind a medic of theirs...well they just won't have it.

#4 The pecking order does not mean the right to be rude to others. It means, unless your judgement tells you that what the nurse is doing may actually harm the pt, it is not your place to refuse or argue transports. That was my point. The doctor is at the top of the food chain. While we are pt advocates, we are not in the position to argue with the doctor's decision. That is because he has a silly piece of paper saying he has a greater education. I don't suppose you would think that a brand new MD, DO, NP or PA doesn't know as much as a medic that's been doing his job for 20 years? Trust me, there are times (I used to work at a teaching hospital with residents) when a seasoned nurse knows more, and there are POLITE ways to make suggestions to these residents, but there are also times when they remind you of their title and that silly piece of paper.

#5 Basically, if you arrive on a call, you have your strengths and the nurse has hers or his. If you disagree with care, it should be handled professionally. But I had a pt a few months ago c/o chest pain. MD wanted pt sent out, b/c even though she had a nitro order (which was given and gave relief) these episodes were too frequent as per the doc. When the medics arrived they did their assessment and of course chest pain was gone b/c we admin nitro, and the medic told me, her tele looks fine and she doesn't need to go! I explain that the doc wants her to go reguqrdless, b/c of frequent episodes. And the medic continued to argue with me in front of the pt!!

That's what I mean by pecking order. I mean, Hello!?!? Doesn't anyone see the problem with this? If you as a medic are being told by the RN that the MD wants this pt to go to the hospital reguardless, you need to not argue with the nurse and take the pt. ITS NOT THE MEDICS DECISION IF THE PT GOES. Its really the pts. And if the pt is confused and the nurse is saying the pt needs to go (which is really coming from the doctor) the medics/EMTs job is not to argue!! I don't care if the pt is sitting their happy as can be, with a smile on her face, and textbook perfect vitals. That doesn't mean that something isn't going on that can't be seen at this time. And those college classes you eluded to as being BS through, and you named classes like english and math, well RNs sit through a full year of anatomy and physiology, in addition to their nursing courses. Maybe its different in other states, but in mine, medics don't have that back ground. Just because things look peachy on the out side doesn't mean that there isn't something going on that needs to be handled at a hospital!

Does anyone understand what I am saying??? :scrm:

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