Rudeness from EMTs and Paramedics - page 2

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... Read More

  1. by   Medic04
    Quote from allison2008
    it definately can go both ways. i am not defending either or, im just playing both sides of the fence.

    i am a paramedic, and also a nursing student who happens to be doing clinicals in a nursing home at this moment. the thing ive noticed, is when a patient needs to be sent out, before the EMTs even get there, the nurses are talking about how much they "hate EMTS because they dont know what they are doing and are cocky", and when the EMTs get there, they have a chip on their shoulder kinda like "oh god not this place again. these nurses are dumb."

    i truly do respect nurses who work in LTC, god bless you all, because i dont know how you do it. it is incredibly difficult work.

    honestly, my experience while working in the field with nursing home pts has not all been good. i dont relate it to the nursing staff, but the lack of nursing staff. the nurses and aides are so overwhelmed with so many patients and so many things going on that when we would arrive it was difficult to find anyone to explain what was going on because nurses always had to run and scoop someone off the floor, fumble through medical records to find labs, get nana off the potty, etc etc, and EMS wants to go, go, go. 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.

    i have learned alot from being in clinical at the nursing home, and i now see how incredibly stressful and busy the job of an LTC nurse is.i have responded to many calls at LTC that were organized and the nurses were very helpful and the patient was transported quickly. i have responded to calls where we have saved lives together.

    but, i have also responded to many calls where as soon as we arrived, eyes were rolled at us and orders barked. i have picked up patients who have been dead on the floor for hours, and no one knows what happened. i have picked up patients that have DNR/DNI/DNH orders, and if we refuse to take them, we are the bad guys for not wanting to get charged with assault and battery.

    i think something ive learned from being on the other side, and spending clinical time in a nursing home is that we as EMS dont know the facilities protocols, and vice versa. recently, a patient at my nursing home coded, and CPR was not initiated because the patient was a DNR per their facility. when EMS arrived, they did not have a copy of the state DNR, only the facility DNR, and EMS is obligated to perform CPR until a copy is produced. ugly words were exchanged and heads were butted. i pulled the ADON to the side, and once i explained this to her, she calmed down and the patient was transported and pronounced at the hospital ER. she also told me that she doesnt hates paramedics... she just doesnt understand why we do the things we do.

    i know there are definately impatient and nasty paramedics. but there are also not so friendly nurses. im not trying to upset anyone, just seen it from both sides, and it definately goes both ways.... just two totally different worlds colliding.
    AMEN two sides of ever street.
    You said what many of us feel and know
  2. by   marymack57
    I don't get near as much trouble from EMS staff as I do the nurses/doctors at our local emergency room. They talk about our facility as it were the armpits of hell, and then expect us to be amenable to their calls and such.
    The last fiasco was when we sent a gentleman to the ER for changed mental status, and they removed a dressing on his leg and the doctor wrote the wound was "molded" in the ER report. If you think about it a minute, you'll know what I'm talking about. The wound had a silver based medication on it...and guess what? As soon as its applied it changes colors. I actually did make a formal protest about that one, and asked that the doctor's report be re-written to delete the mold statement.
    I hope I used this story in the right way, as a humorous though exasperating event. I don't want to be an ER nurse, and I certainly don't want to be an EMT...I applaud those people for being able to do their jobs. BUT...I would like that same consideration, thank you very kindly
  3. by   Medic04
    Quote from leeae85
    That's the way I feel, I work the same hall every time I work, half of my patients have been there the whole time i have (15 months) so if i see a total change in their behavior, wether or not vitals are off, and the on call md says send them, I send them. Then a couple of cocky jerks show up and look at me like i have 2 heads! i sent one little lady out because she was calm and quiet, and her baseline was kicking and screaming. she wasn't complaining of anything, but just seemed off. EMT shows up, GRILLS me up and down. turns out, she was almost uroseptic! i dont know everything, but i know my residents!
    I am happy and wish I had to deal with RNs like YOU who knew their patients more often. Most are" I don't know" "They are not mine" " I am filling in........."

    Also I have seen residents DUMPED into the hospital to give the staff and NH a break or around the holidays, you should see WHO is shipped out. Do all do that No but many do, and are all Medics mean, no some are but I have been treated unkindly when "I" am trying to do MY job too.
  4. by   pumpkin92356
    Boy! O Boy! I dont think there is a nurse out there that hasn't experienced the "Mr. Doctor Paramedic" one night we had to send a resident out who was a brittle diabetic who I had found soaking wet with sweat and registering a 20 blood sugar. Well the RN supervisor who had 40 years under her belt took care of calling the paramedics and doctor and we had worked on this guy till they got there and we had his sugar up to 70 or so and the smart alec paramedic says "Don't you people here know what normal sugar is? What are you calling us for we arent taking this guy to the hospital and with that the nurse said yes you are and I will get the doctor on the phone and the paramedic waited up at the station for the doctor to call back and when he did he proceeded to argue with the doctor!!!!! well after all this fortunately our resident came through okay they took him and while they were leaving to transport this man to the hospital they were making remarks under their breath to the tune of "This place hires idiots!" Boy did I feel like punching that guy right in the mouth ! hahahah! I dont know what gives some of those guys the attitude that they are above everyone else.
  5. by   vamedic4
    This thread reminds me of those days of long ago when I did critical care transports. From my experience personally, I can say that I've never questioned a need to transport a patient from one facility to another, at any time. It's not my call to make - that's far above my pay scale. I get a call, I go pick someone up and take them somewhere else. I must apologize to those who have been treated rudely by EMTs or paramedics.

    I don't much care if you're a LTC worker or an ICU long as you treat me with respect, you will get the same. I understand all about how busy you can be with your patient load and acuity.

    I won't make excuses for rudeness, there's always someone who can justify it somehow-on both sides of the coin. One thing I've learned in more than 20 years in this business - you think you have it bad? I guarantee you someone else has it worse.

  6. by   rigmedic
    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.

    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".
  7. by   Elektra6
    I never had any trouble from the pay transport EMTs or hospital Paramedics (when a patient is d/c from another facility). But I have noticed an attitude from the 911 EMTs. Not towards the patients, but to staff. It seems if the patient is not in acute distress or visible bleeding, they feel they shouldn't be taking them. It's extremely frustrating to have to go through WHY the patient should go to the hospital when you have already contacted the MD and the family. I always give report, but I shouldn't have to justify sending them out when I have an MD order. I've seen them argue with the MD in person, which is not right.

    Have you ever had them ask a confused resident if they wanted to go and when they said no, refused to take them? It's a lot of fun, you have to call the power of attorney to get permission (and you already called to tell them about taking their family to the ER).
  8. by   TheCommuter
    Quote from Medic04
    I am happy and wish I had to deal with RNs like YOU who knew their patients more often. Most are" I don't know" "They are not mine" " I am filling in........."
    Not that it matters or anything, but the poster you are referring to is an LPN. Therefore, give the good LPN credit where it is due.
  9. by   flightnurse2b
    Quote from meanbird

    Have you ever had them ask a confused resident if they wanted to go and when they said no, refused to take them? It's a lot of fun, you have to call the power of attorney to get permission (and you already called to tell them about taking their family to the ER).
    one of the cardinal laws of EMS is you cannot take a patient anywhere, really cant even touch them, without their consent unless they are demented, unconcious or dead.... kinda like the rule of with the heimlich manuever... falls into that whole mess of assault and battery. ive noticed thats were alot of head butting gets done. i definately know nurses have alot of CYA-ing to do, but EMTs do also.

    there are alot of ambulance watchers out there. just like nurses, EMTs are monitored closely and put in legal jeopardy if the protocols are not followed. if i responded to a patient who called 911 and said they were dying of a heart attack, and i arrived at their house and they say dont touch me, and i took them anyways, i am very, very liable to be sued.
  10. by   LesMonsterRN
    I've had my share of "cowboy" EMTs/Paramedics over the years but for the most part I've had good interactions with EMS staff. The teams we have had in our facility lately have been around for a while, know our building and a goodly amount of our staff and we've had few, if any, problems with them.

    Someone earlier in the thread mentioned seeing the situation from both viewpoints and how most of us don't - we're either seeing things with nursing eyes or with EMS eyes and sometimes those yield different impressions. I wonder how feasible it would be for nursing schools to include an EMS rotation - maybe just a few days' ride-alongs to give us a better sense for what EMS deals with? Or for an EMT/Paramedic a day or two in a LTC facility to see what we do? Just a thought to chew on.
  11. by   CoffeeRTC
    Well, If we wouldn't be so stupid, lazy and fat......they wouldn't have a problem with us

    That is what my sister's fiance said. Yep....he went on an all out tirade against LTCs. Sister is an ICU nurse. Ummmm. I'm kinda glad he lives a few thousand miles away.
  12. by   txspadequeenRN
    uhhhh i was not responding to you post but to the op the commuter...i haven't even read your post....

    Quote from allison2008
    please dont take my post that way. just explaining it from a paramedics point of view who has now seen it from the ltc side. im not trying to justify any emt treating a nurse poorly, i think the problem is two very different fields of expertise with very, very different protocols in a hectic situation. im not trying to sword fight with you
  13. by   CapeCodMermaid
    [FONT="Comic Sans MS"]If you read even a few of these posts, you'll see that there are bad nurses and good nurses in LTC--rude EMT's and wonderful EMT's. It seems to me we are losing sight of what is important---our patients. If I have to put up with 'attitude' to get my patient to the hospital I will. We have established protocols when we send someone out rescue. One nurse runs and gets chart information;someone runs to the copy machine to make copies of the med sheets, the other person stays with the patient. We call the front desk to let the receptionist know that rescue is coming and which floor they should go to. We have the elevator on hold. Someone always either escorts or meets the EMTs in the room and gives a verbal report. Has all this made it better? Of course. Does it work every time? Of course not. As with everything else we do we just do our best (which is pretty damn good) and take care of our patients.
    That said, I am the first one to defend my nurses from stupid/rude/idiotic/did I say stupid? comments made by EMTs, or ER nurses or docs.
    We sent a woman to the ER with a fractured hip. The ER nurse called and threatened one of my nurses with the DPH because we must have either dropped or hit the resident. I called her up and said WHAT? She proceeded to tell me that 'anyone knows little old lady's hips don't just break' Rather than holler at her, I asked her if she could see an orthopedic surgeon standing in the ER and if she could she should put me on hold and go ask him if 94 year old women with significant osteoporosis could suffer spontaneous hip fracture.....needless to say she was not a happy camper to have been proved wrong. But I made my point and my staff knew I wouldn't let anyone bad mouth them.
    Sorry--looks like this turned into a rant....must be the 4 cups of early morning coffee.