nurses and EMT's

Specialties Emergency

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I'm currently an EMT, but I'm planning to apply to a master's entry program soon. From my own experiences, some of the ER nurses are disrespectful to EMT's. Some nurses don't appreciate the care EMT's give, although limited, in the pre-hospital setting. Sure, nurses are much more skilled and have more knowledge for patient care, but they should at least be polite and professional. I've been ignored and even called "nothing but taxi drivers" and it really upsets me, but I just laugh it off and act as if they were joking, even though they weren't. I find it ironic that some of these nurses treat us like this yet they wonder why some doctors do the same to them. At least I know how it feels so that I know not to do this when I become an NP.

Sorry for the huge paragraphs, for some reason it won't format correctly on this phone.

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Specializes in ER/ICU.
I think that the biggest problem with the turf war between paramedics and nurses is the great degree of variability in education and training. I went through a degree paramedic program and felt like I learned much more in a month then I have learned in the entirety of my nursing school stint. But, there are paramedic program's that are once a week for several months (shake and bake medics) and there are others (like mine) that are structured similarly to an adn or bsn program, with extensive clinical requirements. Additionally, orientation and preceptorships vary greatly. sometimes it is just weeks before you are released on your own, and as anyone who has worked EMS knows, patients rarely fit protocols and those protocols leave lots to be desired anyways. The same holds true at the EMT-B level. Before we can be respected as a profession, some degree of uniformity needs to be present in our training and education. All in all,

It angers me that the professions don't have more mutual respect for each other. There is a great deal of misunderstanding about each professions roles from the opposing profession, even though we work so closely. That being said, you are more then just an ambulance driver! Basic skills do more then drugs and tubes ever have. Make sure you respect the nurses and do your job well, and you will be a part of fostering good, mutually respectful relationships with the nurses in your area.

I agree completely

Sent from my iPhone using allnurses.com

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What most are forgetting here is that respect is earned and not just handed out because you have an EMT patch. Even NPs who have years of experience must earn the respect of their colleagues and not just rely on a title.

But, having more education helps. EMTs are barely trained with only 110 - 140 hours of first aid. Many EMTs believe they know all of about everything because that is how some have taught them and that all nurses are idiots who will disrespect you. This only sets you up for failure with a **** poor attitude formed before you even get your feet wet as an EMT. You probably don't have any respect for other entry level healthcare workers either since it is pretty obvious you don't respect RNs. If you ever advance your education you will see how little you know about medicine by just the EMT cert and some of that chip on your shoulder might go away.

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Specializes in ICU + Infection Prevention.

Right on TraumaSurfer!

It took me less than a day as an EMT to realize I knew virtually nothing (my EMT class was 180 hours + 60 hours of clinical: I knew nothing). That realization was a product of an engineering view of EMT education.

It took me a year as an EMT to realize that other allied health professionals usually knew far more than my nothing. That was a product of youthful arrogance combined with the poor attitudes of some coworkers.

My solution to my attitude problem and knowledge deficit was two-fold:

1. Act like a professional and make no assumptions about the experience and education of others.

2. Seek and seize every opportunity for education and experience.

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EMS are crucial and I for one appreciate their profession. They are truly the front line, especially in trauma care. They often are placed in dangerous situations. In Canada, as I'm sure in the US, there are levels of EMS scope of practice. PCP (primary care paramedics) can do little hands on, not even an IV, but advanced care paramedics can start IVs and some can even intubate and do needle decompression. We are all the same team in the continuity of care. Now firefighters doing CPR, that's a different discussion lol.

For this I would like to point out a couple of differences between the US and Canada.

The PCP in Canada spends more time in school than most Paramedics in the US but yet the PCP is essentially a lower level provider by Canada's standards.

In the US, the Advanced Care Paramedic (2+ years of education) is our regular Paramedic who can actually complete their training in as little as 600 hours in some states like Texas with 1000 total being the average in other states. The US EMT averages about 110 - 140 hours of training in the US. I believe the new Advanced EMT level will be about 150 hours total. EMTs usually work on transfer trucks providing very minimal basic life support skills. Those involved in 911 are usually volunteers in rural communities with education in other professions and are valued providing service on their days off.

Your comment about firefighters sounded like an insult. Here, almost all firefighters are EMTs and are first in units. EMS in the US is also largely fire based so many firefighters are Paramedics. In fact, many departments require all of their firefighters to have a Paramedic patch and will contract with quick study medic mills to get everyone certified especially when taking over a contract previously held by county or private ambulance services. Essentially, in the US even the Paramedic cert is just an add on which does not say much for the EMT cert. There is also little respect in EMS for those who hold just an EMT patch when the Paramedic cert is so easy to get. But then, many don't want to become firefighters either. This leaves many to go on to nursing or some other profession. It can be a ***** to be a stepping stone for a profession other then EMS.

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TraumaSurfer-

I take it from previous posts that you have some personal vendetta against EMS, and I am certainly not here to start a fight, but I feel a little inclined to defend pre-hospital care providers.

I feel about as comfortable letting a Paramedic take 6 patients on a med surge floor as I do letting that med surge nurse work a bad call in a snowstorm 45 minutes away from the closest hospital. These roles are equally as important, but different. I respect an entry level paramedic exactly the same amount as I respect an entry level RN.

I, like you good folks, believe that trust and clinical judgement come with time, and that you must earn these through experience and excellent performance. However, nobody seems to realise that some EMS program's require as much as some BSN programs. We need standardisation so that we can grow as a profession and not just as technicians.

Also on respect- you see, I have this radical idea that everyone deserves respect (I know, crazy!) You seem to disagree. While I respect your opinion, I feel like of you looked internally, you may find that much of your negativity towards pre-hospital providers stems from you and not from them and their giant egos and actions. If you go into a communication with a bad attitude like yours- you're sure to fail!!

Basically, what I am trying to say is that I feel like you should learn to respect others before you participate in discussions on respect.

You are ruining it for the rest of us who are all trying to be friends. Big egos are not strictly an EMT, Paramedic, FR disease...

I probably should have said that more therapeutically (since that's all I've learned in nursing school) but anyways...... (Sorry nurses, bad attempt at a joke and doesn't reflect my beliefs :)

I will now proceed to put on my flame resistant clothing.

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Specializes in ICU + Infection Prevention.
TraumaSurfer-

I take it from previous posts that you have some personal vendetta against EMS ... However, nobody seems to realise that some EMS program's require as much as some BSN programs. We need standardisation so that we can grow as a profession and not just as technicians.

Such programs are quite rare. I don't know TraumaSurfer or his/her posting history, but I know that outlook. It comes straight from a subset of medics and EMTs on the various EMS forums. I agree with your last statement and I bet TraumaSurfer does too.

I'd peg TraumaSurfer as an EMS provider frustrated with the lack of educational rigor and professional nature usually found in EMS. I feel that frustration. I went the nursing route because of the state of EMS. If we the US had an EMS field like Canada or New Zealand, I'd have stayed in EMS. In those systems, there are standards and they are high. The working conditions, pay, and professional duties match the standards.

Nurses argue about whether you should have bachelors degree to enter the field. The employers seem to be preferring BSNs.

EMS argues about whether a GED is sufficient. Employers largely don't give a hoot about degrees (except Orgeon).

There are a bunch of EMS providers who bring great care to patients and aim to lift the profession and progress it. There are plenty that get frustrated along the way and jump ship.

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Understand that nursing in general (and even emergency nursing) are two different worlds. As an EMS provider you are concerned with the immediate assessment/treatment of the sick and injured to keep them alive and get them to the hospital. As a nurse your role is patient managment. Both are extremely important in their own right.

.

Be professional, earn the trust of the nurses you encounter in the ED, ask questions and do your own patient follow-ups if you can. Make it clear you want to learn more, are willing to admit mistakes or lapses in judgement.

Enhance your own assesment skills, expand your own knowledge base. Do not let the curriculum of your EMT program limit what you know, read everything you can. Your curriculum, knowledge, and experience may not have the breadth and depth of a nurse, but your role as an EMS provider important in the urgent care of the extremely sick/injured. Do not be in awe or intimidated by nurses or doctors, we all have our own place in the care of the patient.

.If you can find an NP program with a concentration in emergency nursing go for it..or consider getting your CEN after a few years of experience.

Above all, be a patient advocate with whatever you do. Its sad that nurses and EMS providers are two teams playing the same sport but seem divided rather than united by the same goal: patient care.

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Specializes in Emergency Dept. Trauma. Pediatrics.

Crazy, I love our EMT's and Paramedics, all our ER techs are EMT certified. They have to be. Myself, I am going to do the Paramedic program and work as a medic PRN outside of working as a ER RN. I notice some of the people in my ER tend to be cliquish. But I would say majority of the people are nice and friendly to the ancillary staff and we are like a big extended family.

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TraumaSurfer-

I take it from previous posts that you have some personal vendetta against EMS, and I am certainly not here to start a fight, but I feel a little inclined to defend pre-hospital care providers.

I feel about as comfortable letting a Paramedic take 6 patients on a med surge floor as I do letting that med surge nurse work a bad call in a snowstorm 45 minutes away from the closest hospital. These roles are equally as important, but different. I respect an entry level paramedic exactly the same amount as I respect an entry level RN.

I, like you good folks, believe that trust and clinical judgement come with time, and that you must earn these through experience and excellent performance. However, nobody seems to realise that some EMS program's require as much as some BSN programs. We need standardisation so that we can grow as a profession and not just as technicians.

Also on respect- you see, I have this radical idea that everyone deserves respect (I know, crazy!) You seem to disagree. While I respect your opinion, I feel like of you looked internally, you may find that much of your negativity towards pre-hospital providers stems from you and not from them and their giant egos and actions. If you go into a communication with a bad attitude like yours- you're sure to fail!!

Basically, what I am trying to say is that I feel like you should learn to respect others before you participate in discussions on respect.

You are ruining it for the rest of us who are all trying to be friends. Big egos are not strictly an EMT, Paramedic, FR disease...

I probably should have said that more therapeutically (since that's all I've learned in nursing school) but anyways...... (Sorry nurses, bad attempt at a joke and doesn't reflect my beliefs :)

I will now proceed to put on my flame resistant clothing.

My only vendetta or agenda is to raise the level of professionals standards in EMS. However, that is a difficult path since the thought of more education than a 6 month cert scares the hell out of some.

You are very wrong about EMS requiring a Bachelors in some places in the US. That is true for other countries but definitely not in the US.

Only Kansas requires an Associates degree. Oregon does in a way but also has a 5 year deferral or a wavier in some situations.

Most states require only a few hundred hours to become a Paramedic after the 110 hour EMT course. No college is needed and the testing is geared for the lowest common denominator.

I would also be hard pressed to allow a Paramedic who does only routine transfers and has not intubated or started an IV in 5 years handle an emergency. It is frightening enough to see brand new Paramedics paired with only EMTs on a truck after just a couple of shifts of orientation. Many do not even have intubation skills since schools and states aren't requiring it during training. Have you not heard about all the intubation controversy in the US? College level A&P is also not something required in many programs.

There are only about 10 BS programs for Paramedics in the US and most are geared towards management. The CCEMTP is a Bachelors plus the equivalent of a Masters in other countries. Here in the US it is an additional 2 week cert on top of a 6 month Paramedic course which can be done as a new grad. Experience is recommended but not required. The new CCP exam can also be taken without any experience and there is info available to help you pass the test fairly effortlessly. Any ICU RN who has taken the CCEMTP course has gotten nothing but a good laugh and their bubble busted about "Critical Care Paramedics". At least an RN who wants to take the CCRN must show proof of actually being inside of an ICU for a certain amount of time even if it is not the greatest one.

So, if you are going to be just another Paramedic who wants to stick their head in the sand of denial who believes Paramedics are the perfect profession with no flaws, then you will fit right in with the majority who continue to fight against higher education and tougher oversight to allow accountability for expanded scope of practice.

While it is good to have a good working relationship, being a nurse or Paramedic is alot more than just a social event. The education and skills should also be there to provide good patient care.

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Specializes in NRP, FP-C, CCP-C, CCEMT-P.

Thank you for letting us know how all Paramedics are useless & ignorant TraumaSurfer and I am glad that YOU are here to save everyone from us. Yes, we do have problems in EMS, and YES we do have some people that we would probably be better without, HOWEVER that does not mean all of us are like that. While I get along with most Nurses I meet, I'd like to inform you that there are some Nurses that are as bad, if NOT worse. That happens in any profession.

And as to the CCEMTP program, I know Nurses that enjoyed the program and learned things, but certainly it is "geared" as an introduction to Critical Care Transport, for those who have no or little Critical Care experience.

I remained silent until this time BUT, I think KatieLuckey is correct, YOU have a "personal vendetta against EMS".

RWT NREMT-P, CCEMT-P, FP-C

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Thank you for letting us know how all Paramedics are useless & ignorant TraumaSurfer and I am glad that YOU are here to save everyone from us. Yes, we do have problems in EMS, and YES we do have some people that we would probably be better without, HOWEVER that does not mean all of us are like that. While I get along with most Nurses I meet, I'd like to inform you that there are some Nurses that are as bad, if NOT worse. That happens in any profession.

And as to the CCEMTP program, I know Nurses that enjoyed the program and learned things, but certainly it is "geared" as an introduction to Critical Care Transport, for those who have no or little Critical Care experience.

I remained silent until this time BUT, I think KatieLuckey is correct, YOU have a "personal vendetta against EMS".

RWT NREMT-P, CCEMT-P, FP-C

But yet you are the one who uses the phrase "ALL Paramedics are useless and ignorant". At no time did I use those words. However, under educated would easily describe several in EMS. But that does not necessarily make them useless and ignorant as you have implied with your comment. You need to understand the difference in my statements about the **** poor education involved in the US programs leading to under educated Paramedics trying to function efficiently in a system that has run amok with special agendas.

I am however glad you realize that the CCEMTP is an introduction to critical care. Yet, some in EMS believe it is all that is needed to function at a Critical Care level which is very, very dangerous.

It is only through education that those in EMS will be on a more level playing field with all the other healthcare professions. Everyone of the others have known the struggles of their profession to gain recognition and respect as a profession. It is only EMS that still believes just a uniform and another cool title is all it takes to be given respect and fee meals as part of their entitlement.

Overall, EMS seriously needs to take many lessons from nursing and respect the struggles their profession has gone through. It might also do well to look at Radiology Technologists, Radiation Therapists, Occupational Therapists, Physical Therapists, Medical Lab Technologist, Respiratory Therapists, Speech Language Therapists, Athletic Trainers, Exercise Physiologists and several others who also deserve respect for their achievements as professions in the world of medicine.

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