How do you feel Paramedics can improve?

jnette, ASN, EMT-I · Sep 8, 2004

Hey... you know what? I think this is a WONDERFUL question, and really very much appreciated that you should so genuinely ask ! KUDOS to you ! :balloons:

As I don't work in a hospital, I'm not one to ask, but I'm sure you will get some good, thoughtful, and honest responses.

I just think it's really good of you to ask, and your sincerety is evident in your post.

You should get some good feedback.

THANK YOU for asking.

And you paramedics ARE appreciated, even though I'm sure you don't hear it quite often enough. :)

neneRN, BSN, RN · Sep 9, 2004

Our medics are awesome, I have a lot of respect for them. I'm sure that you guys don't hear "good job" as often as you should, especially when you're bringing in someone really sick- because as nurses, we focus on jumping in and doing what we need to do as the next steps for the pt. But we really do appreciate you. Some of our medics do our lab draws out in the field when they're sticking in the line, and we LOVE that!

There are only a very few who cause staff to groan when we hear them calling in. There are a couple who are notorious for NEVER being able to get a line in the patient, and these are usually the same few who rush in lights and sirens no matter what the c/o is, calling it in as a very unstable pt when the pt isn't really that bad off.

Medic_78 · Sep 9, 2004

"I'm sure that you guys don't hear "good job" as often as you should, especially when you're bringing in someone really sick- because as nurses, we focus on jumping in and doing what we need to do as the next steps for the pt."

I want to make it known I'm not all about hearing praise - I know very well in most cases as soon as we walk in the door, we're to give the report and hurry away, as to not get in your way...B/c now you take over.

There are only a very few who cause staff to groan when we hear them calling in. There are a couple who are notorious for NEVER being able to get a line in the patient, and these are usually the same few who rush in lights and sirens no matter what the c/o is, calling it in as a very unstable pt when the pt isn't really that bad off."

I'm getting to know those who have been doing this long enough to know when it/s a genuine L&S call versus the ones who do it for fun. I've read up the statistics how much faster we really get them there, & I know a lot of the time it isnt worth the risk to just get the pt., crew, & other drivers on the road in a safe manner.

There's 2 sides here- the world of nurses, and the world of medics. I'm just here b/c I'm interested in hearing your stories and hope some may be interested in hearing mine.

I as well have a ton of respect for all of you. I know this is a forum for nurses, but I'm hoping I'm welcome here. I'm hoping to learn a lot from all of you

CHATSDALE · Sep 9, 2004

I work in a ltc facility and we frequently have to call ambulance for transport ... degree of emergency can vary from a res who cannot be transport via van to a code in progress...we can get magnificent knowledgeable emts/pm to those who just think they are .. i don't like those who believe that they can assess better than a nurse who sees the res every day...i appreciate those who come in with the best interest of the res and who go to work to stabalize them because we very limited facilities for coding ... basically we start a code and call for amb at first alert and give basic cpr until amb arrives....i just bet that you are going to be a very good competent emt

Hellllllo Nurse, BSN, RN · Sep 10, 2004

All the EMS people who've responded to our calls (dialysis unit) have been awesome.

There have been a few times in my career when I've encountered swaggering, super-macho, know-it-all, rude EMS, and nobody likes them.

The majority of EMS I've been in contact with have been great.

jkaee · Sep 10, 2004

I, too, have worked LTC nursing for a while, and the one thing that burns me up is when PMs or EMTs walk in my facility and treat the nurses like we are a bunch of idiots because we "just work LTC". Just don't talk down to us, or if you find that we should have handled a resident's emergency in a different way, then KINDLY let us know. There are a lot of new nurses in LTC, and even us seasoned ones aren't always on the up and up of emergency care...that's not our forte, and we'd sure appreciate feedback from you guys, too! We are very limited in what we have available to us when an emergency occurs, sometimes that's hard for you guys to understand.

I think it's great that you are looking for advice and feedback from the people that you are going to be working closely with....thanks for caring enough to ask!

RN92 · Sep 10, 2004

Oh My God, when I worked in the ER - it was the highlight of my day to see the Memphis Fire Dept Paramedics coming down the hall. I respect them as much as the Doctors. Could you imagine going into someones home, assessing them with out of control family. Then trying to stabilize that pt until you get to the hospital. I admire anybody who can start an IV while in the back of an ambulance going as fast as it can. And, did I mention how that they are also members of the fire dept - meaning they are very well built. I hate for them to have to wait in the hall for a bed - but I really enjoy talking with them. They see a side of the pt that we dont see. (home environment, family attitude and compliance, etc, etc) They are a very IMPORTANT part of the medical system. As long as there is mutual respect, we can learn from each other.

Hint: please keep up with what the pts bring with them or dont bring. We always get accused of "stealing" their greasy tacky clothes.

Medic946RN · Sep 22, 2004

As a nurse that was (is) a practicing paramedic for the last 25 years. (I know, I'm old) I can tell you one of the best things to do is seek out the nursing staff or even the MD when you have one of those borderline calls that your not so sure about. Ask them, hey I felt this guy was a (add your feild diagnosis here) was I right, was my treatment appropriate. This goes miles. As long you're not doing it on every call. In the nursing profession it's collaborating. The RN's and Doc's will take you for Paramedic that concerned about his patients and improving his practice. You automatically set yourself up as part of health care team, which you are. (It's much nicer nowadays, I remember back in the Dark Ages of Paramedicine when nurses and medics were mortal enemies and the patient usally got the short end) Don't be afraid to ask questions and don't be afraid to check on your previous patients when you bring a new one in. Good luck and stay safe!

walnuttree91 · Sep 22, 2004

I wish our paramedics would call before bringing in a patient, so that we can prepare.

PHTLS · Sep 24, 2004

This one time, one of my DNR residents became unresponsive and had Kussmaul breathing, so I called his doctor anyway (hospital policy regardless of code status) and I was ordered to tx him to the nearest ER. Meanwhile, another licensed nurse was monitoring him closely (DNR) while I called the paramedics. 15 minutes later, he stopped breathing and when the paramedics arrived, one of them started acting like a jackass stating that I shouldn't have brought out the crash cart and so on because of his DNR status. I'm thinking, screw you! A responsible family member can change the code status of the pt anytime with the doctor and I wanted to make sure I had my equipment with me....well, because I'm hardcore! There was a dozen staff and visitors outside the resident's door at the time (curtains drawn) who witnessed us not initiating resuscitation actions with that resident. It's like screw these morons, I used to participate with code blues all the time when I worked acute care and being a part time EMT with the army reserves, I know my $hit! The problem with me is that I look really young and people/patients automatically assume I'm a naive newbie!

Anyhoo, this dork insisted on us putting up DNR signs and I'm like...helllo! does HIPAA ring a bell? What pisses me off was the next day, when my DON starts chewing my head about the crash cart BECAUSE she's afraid of lawsuits by the family or citations from whomever. Gee, thank you for the benefit of a doubt....witch! I already knew the resident was DNR, hell, we all knew his condition got worser and worser every week and his code status was always something we went over during report and from reading his orders.

Some of these paramedics can't even tell the difference between an Atrial Fib vs. V-Tach. Something I witnessed watching them transport a resident I had before who developed a stomach infection and was extremely hyperglycemic (no sliding scale). This one paramedic couldn't even interpret what she was seeing off her portable monitor. I just stood there stoic and I was thinking 15 liters of o2 for starters would be nice and rapid transport before the "golden hour" expires cretins!

Another time when I was a CNA in a convy, my RN at the time called for a transfer, and this freaking gorilla paramedic jut bit her head off about something. He was a total jerk with delusions of grandeur. It was like, sorry, did we disturb your coffee break or something.

Furthermore, I hate ED techs/ Paramedics who look down on nurses. They always brag about how they save people on the spot. Well, so what! they may know how to put on a PASG, but paramedics spend most of their time putting on o2 instead. Besides, who get's paid more and who has more training/education? Nurses!

mattsmom81 · Sep 24, 2004

I have a lot of respect for paramedics because I can only imagine the difficulties of emergency care in the field...I would not want their job. It is hard enough in facilities!

Yes, I run into a few paramedics who look down on nurses, but since I work ICU and used to work ER, they seem to be a tad more respectful...I guess they can relate more to the emergency settings.

Tunnel vision abounds and its easy for people to miss the big picture in favor of their own narrow view.