Ooooooooh, I am SO ticked off right now!!!

[LoriAlabamaRN]

: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

[UM Review RN, ASN, RN]

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.

Could you explain what you mean by that?

From what I'm getting, the medic jumped to a conclusion without listening to Report. That's about twenty shades of wrong. JMO.

[txspadequeenRN, BSN, RN]

What a #$^&!!!!!! Why does it seems like paramedics and emt's have a god complex.. Not all of them , but most that I have run into have the potential to be real jerks.....

[TazziRN, RN]

Angie: yes, he jumped to the wrong conclusion with lead boots, but medics have it drummed into their heads that COPD pts should NOT have high flow O2. He went about it the wrong way but I can understand why he thought what he did.

[MrsMommaRN]

you were doing the right thing. the said emt had an identity crisis going on and needs to be brought down a notch.:angryfire

[Empress]

Actually it was the opposite for me, we were taught that it more important to give COPD patients high-flow oxygenation instead of worrying about hypoxic drive issues since they took longer to present then usual tranport time.

He may have assumed since you had a mask on with a lower concentration of o2, it was an issue of "silly nurse doesn't know better," without listening. It's pretty common to go into nursing homes and see a patient on 4 liters with a non-rebreather, and that is suffocating them. I don't know what type of mask you had on them, though.

He was rude, but he did have right to decide treatment after making contact, i.e. by changing masks. They have to follow their own protocols, not the patients doctor's orders.

[southern_rn_brat]

Last weekend I had a patient go very bad. I called the ambulance and we started prepping her for transfer and doing what we could at the facility. They are usually there with a couple of minutes for an emergent transfer so when ten minutes had elapsed I called dispatch and was like "hellllllllo?? where are they??"

they were in the parking lot but hadnt come in yet...so then they come moseying in, I swear they were walking slow and talking as they went down the hall. I got on them and said Get down there she is about to code!!

the paramedic said something like well if she's so bad why arent you back there with her:angryfire

my patient died on the way to the hospital:o

[LoriAlabamaRN]

. It's pretty common to go into nursing homes and see a patient on 4 liters with a non-rebreather, and that is suffocating them. I don't know what type of mask you had on them, though.

.

It wasn't a nonrebreather, just the normal side-vent masks we commonly use with breathing treatments.

[LoriAlabamaRN]

Well, I emailed my administrator "K" about the entire incident, including the name of the paramedic and the things he said and how he acted. I also told her about my poor patient's O2 sat plummeting as a result of this jerk. She emailed me back today. "K" not only called the company to complain, she actually called the OWNER and told him exactly what was going on. See, this ambulance company makes a fortune off its contract with us. Most transports are to the ER of the hospital that is literally 200 yards away from us, and they get $800 per run. So when "K" called up in arms about this jerk, the owner was GROVELING. He apologized profusely, and stated that if I wasn't comfortable with the idea that the problem guy might be coming back to the facility some other time then he would either change the guy;s shifts or terminate him. He was going to have the guy call me and apologize directly to me. At about 0100, I got a call here at work from "Jerk" telling me over and over how incredibly sorry he was and that he had been completely out of line, that I seemed to be an incredibly competent nurse and there was no excuse for him to treat me as if I weren't. He said he had been having a bad night but that was no excuse for his behavior. He went on to say that he would never treat any of the nurses like that again and he looked forward to the opportunity to apologize to me face to face. I told him that I accepted his apology and that from now on I would like him to realize that we are to work together as a team for the safety and wellbeing of our patients.

Heeheehee... I love my administrator, and I'm sure this guy will have a complete attitude adjustment next time!!!

[TazziRN, RN]

Well, I emailed my administrator "K"

It's great when you have admin's backup! I'm glad your concerns were dealt with. As I said, I could understand why he said what he did (not how he said, just why) but I am not excusing him by any means. He shouldn't have said it, so now maybe he'll think twice before mouthing off again.

[banditrn]

Kudos to your administrator for backing you up!!:yelclap: :yelclap:

[emtb2rn, BSN, RN, EMT-B]

You were totally correct in notifying your admin and your admin did the right thing by you.

Our EMS protocols are the same as what Empress noted, if the pt is in resp distress, they're getting high flow O2, regardless of COPD hx.

[vamedic4, EMT-P]

Well, I emailed my administrator "K" about the entire incident, including the name of the paramedic and the things he said and how he acted. I also told her about my poor patient's O2 sat plummeting as a result of this jerk. She emailed me back today. "K" not only called the company to complain, she actually called the OWNER and told him exactly what was going on. See, this ambulance company makes a fortune off its contract with us. Most transports are to the ER of the hospital that is literally 200 yards away from us, and they get $800 per run. So when "K" called up in arms about this jerk, the owner was GROVELING. He apologized profusely, and stated that if I wasn't comfortable with the idea that the problem guy might be coming back to the facility some other time then he would either change the guy;s shifts or terminate him. He was going to have the guy call me and apologize directly to me. At about 0100, I got a call here at work from "Jerk" telling me over and over how incredibly sorry he was and that he had been completely out of line, that I seemed to be an incredibly competent nurse and there was no excuse for him to treat me as if I weren't. He said he had been having a bad night but that was no excuse for his behavior. He went on to say that he would never treat any of the nurses like that again and he looked forward to the opportunity to apologize to me face to face. I told him that I accepted his apology and that from now on I would like him to realize that we are to work together as a team for the safety and wellbeing of our patients.

Heeheehee... I love my administrator, and I'm sure this guy will have a complete attitude adjustment next time!!!

NOW THAT'S WHAT I CALL DOING SOMETHING ABOUT IT!!! GOOD FOR YOU.