Published Aug 14, 2006
LoriAlabamaRN
955 Posts
:angryfire OK, here is what happened this morning.
One of my residents just came back from the hospital Thursday after a weeklong stay for pneumonia/exacerbation of COPD. Her nurse called me a little after midnight because her O2 sats had dropped to 83% on 3L O2PNC. She was also very hard to arouse. I called the ambulance for transfer, called report to the ER. Her MD was there and advised me to go ahead and bump her O2 to 5L (even though she is COPD) and put her on a mask. OK, done. By the time the ambulance arrives, her O2 sat was 90-91% and holding, but she was still close to unresponsive. When the EMT walks in, he stops, gives a "oh you idiot" sigh and said "Well, there's your problem right there. I'm not trying to hurt your feelings, but you are killing this lady. Do you even have a clue about nursing?" I stood there with my mouth open and then said "What are you talking about?" He proceeds to tell me that since I put her on a mask instead of leaving her on a nasal cannula, that I am suffocating her. I told him firmly that I had spoken with her doctor, done exactly what HE told me, and that her sats had come up to 91% as a result. He laughs at me- LAUGHS at me, and says "Oh, right. I'm so sure."
:angryfire
To make things worse, he reaches down and unplugs her O2 and takes off her mask, telling his partner to get the tank ready. That's right, he didn't leave her on O2 until the tank was ready for him to switch to, he just took it off. Well, his partner can't find the right mask, then the right tubing, and I am watching this poor woman gasp like a fish as her sats plummet. I try to get around the stretcher to put her mask back on myself, and he blocks me and says "Look, I am TAKING CARE OF IT." That poor woman was off oxygen for SIX MINUTES and her O2 sat was 72% when they finally got it hooked back up. Oh, and what did he use? A MASK. :trout:
Needless to say, as soon as they left I called the ambulance dispatcher, got his name and told them how incredibly rude and unprofessional this man was and that I will be filing a complaint. :angryfire
goats'r'us, ASN, RN
307 Posts
good on you!
that is terrible practice from someone who's meant to be on the same team, working for the same goal as you.
you have every right to be pi**ed, and every right to make a complain, and i applaud the fact that you are, given that i reckon if the same happened to me, i probably would have simmered over it for ages, complained about it to co-workers and loved ones, but never actually acted on it.
hooray for you!
jmgrn65, RN
1,344 Posts
Wow what an @@@, I can't believe how rude some people can be, I guess he felt he had something to prove:devil: I hope you charted all of it, and I think I would put it all in writing and give your supervisor and the ambulance a copy.
UM Review RN, ASN, RN
1 Article; 5,163 Posts
Whatta jerk! Worse than that!
I think you should file a complaint. People like this need to know that they were wrong, because otherwise, he'll forever brag about the "nurse who knows nothing". :angryfire
I have done the exact same thing under the same circumstances for a COPDer in respiratory distress. You did the right thing; that guy was WRONG.
Hellllllo Nurse, BSN, RN
2 Articles; 3,563 Posts
Do EMTs have some kind of licensing board this person can be reported to?
rn2md2b
13 Posts
Good Job!!!!! But don't let this one get away, report him. No matter what level of care or field we are one team and the patient is our goal.
SouthernLPN2RN, MSN, RN, APRN, NP
489 Posts
That's horrible! It's kinda strange to me that emt's and paramedics in the county I live in will put anybody on 100% O2. The response I got was that it wouldn't kill them by the time they got to the ER.
PACPhD
10 Posts
If you don't mind a response from a (emergency medicine) PA on the subject. I was also in the EMS world for 10 years.
There is an old joke: What is the difference between god and a paramedic? God doesn't think he is a paramedic.
When I take a report in the ED from EMS (of course not all, just a few of the idiots) I occasionally get the look when I question them of "Oh look, the doctor thinks he has a clue about anything we do out in the field". Of course I then throw at them that I was in EMS for 10 years, sat on MAC committees, ran QC/QI for years for ambulance coprs, was a chief, etc. That usually shuts them up.
If it ever happens to you again, I would do exactly what you did, and get your medical director to call and specifically state that the particular EMT/Medic is never to enter your establishment again. That usually makes your point better than anything.
Sorry you had to encounter that idiot. And for the record, oxygen is basically never withheld when needed. That is why there are Ambu bags : )
traumaRUs, MSN, APRN
88 Articles; 21,268 Posts
Even folks with COPD (CO retention) need oxygen. They aren't going into oxygen narcosis immediately! As to the mask, if they are gasping or mouth breathers a non-rebreather at at least 10 liters is what is indicated. However, if you used a simple mask or some other kind, then 5 liters was okay.
I say take the complaint further.
Jo Dirt
3,270 Posts
Around here there is a natural animosity between nurses and EMT's. Rarely does a transfer go smoothly without the EMT second guessing everything or arguing with the nurse.
TazziRN, RN
6,487 Posts
Yes, the medic was wrong to treat you the way he did, and yes, I would most certainly write him up formally, but I can also understand why he did it.
Tweety, BSN, RN
35,413 Posts
Exactly what you should do. Sheesh.