EMS-RN

While I wouldn't ever hand a medic a patient on 12 drips, CRRT, & ballon on pump, neither would I expect an RN to take Medical IC of an MCI. The "I'm better 'cause I'm a ____" attitude is tiresome. Different disciplines, different focus. I've seen brilliance & boneheads, kindness & jerks come from every corner, license, and degree. The start of this whole thing mentioned an interaction between different disciplines, but it really wasn't about who had what license...it was about attitudes & respect. I'd like to take a moment to remind my RN colleagues that condescending attitudes can go both ways. Medics & EMTs find themselves on the receiving end from RNs also. We *all* should be mindful of the attitudes & image we project.

LEV... As an ICU & CCT RN (and former ER RN) I will firmly disagree, but you are entitled to your opinion. Not excusing the behavior Avill experienced, nor will I excuse the medics failure to attempt a BLS airway in your examples, but if we're changing the question to the ability to assess, manage, and treat an out-of-hospital emergency scene without the vast resources of the well lit and staffed facility (and the luxury of time to mull over details...a commodity the medics in the field rarely if ever enjoy), aside from flight nurses, I can count on one hand the nurses I'd trust my life to as much as a medic. Just my opinion.

I work 12hr nights... Gratefully my observations are different from yours. Whenever I walk out on the med/surg/tele floors it seems like everyone is trying to be quiet - unless something is going on it sounds a bit like a hushed ghost town. In the ICU where I'm at my observation is if we have an alert patient we'll try to limit disturbances, though if they're sick enough to be in ICU a bunch of disturbances is typically inevitable - we'll try to be minimally intrusive with our disturbances (though that's not always possible). Their complaints tend to be far more about the constant stream of alarms from the monitors, the arrays of IV pumps and ventilators rather than the staff (sorry...the alarms are staying on...sleep is important but breathing and a blood pressure is even more so).

Avill... Getting nailed with a million-and-three questions all at once is ok, but receiving snide remarks to an "I don't know" isn't - Sorry for that. Would've been better had they just respectfully asked if you had access to (or could send someone to retrieve) the requested info. Again, sorry for the unnecessary rudeness. I >>**Really** As far as what to do when they arrive: **Concise** focused report about what happened, what's been done, and basic info about the patient (Age/Hx/Meds/Allergies - allow me to reiterate my love of Jen-Elizabeth's solution). Even if they may not appear to be paying attention, any decent crew will be listening. Do remain present and available to assist but also try to stay out of their way. Once summoned and on scene it becomes theirs. Laws may change from place to place but where I'm at it's an automatic misdemeanor to interfere with EMS, upgraded to felony if the interference results in suspected pt harm (happy to say that's such a rarity it's not even an issue - in 30 years I've only seen that occur once).

Kidzcare... No, and I make an effort to thank staff regardless of the quality of the report or what they managed to do. Being nice costs $0.

SnowyJ, RN.... What happened, What's been done, Main/pertinent Hx, Main/pertinent meds, Allergies, latest V/S. Thank you...I *sincerely* mean that...Thank you. I wish all reports were like that.

Having worked on both sides of the fence I'll simply (sadly) say, they're not trained to look at nurses like they're dumb...they've just repeatedly responded to SO many calls where the RNs gave them reasons to develop those attitudes. Not saying their general attitudes toward us is right, but we're the ones responsible for developing their attitudes of us. I spent well over a decade on the bus (and still do) before I became an RN. I can't begin to tell you how many calls I've responded to where the nurse was clueless about the patient's situation, or had put a NRB mask on the patient (flowing at 2 LPM), or had a patient in full blown approaching a need for intubation respiratory failure and was having a fit because we wanted to give more than 2 LPM O2 to them 'cause they had COPD. I've seen many (literally hundreds) of miserable failures of employing basic BLS by staff. I have also encountered nurses who have done everything right and gave quick concise reports nailing all the pertinent info. We notice and appreciate those. I regretfully have to say those experiences for us seem to be rare exceptions. If you don't like the stereotype, don't be the stereotype. That's the only way to change opinions. We are responsible for developing their attitudes toward us. We are responsible to reverse it.

I work as an RN both on a medical floor and in an emergency department. I've also worked on an ambulance since...um...not going to admit my age. :-) Though you've probably long since had your questions answered, I thought I'd throw my two cents in anyway... In California, as an RN, you can challenge the Paramedic license. Though the exact requirements can vary from school to school, as I understand it at a minimum the candidate must A) Be affiliated with a paramedic program (i.e. have an endorsing school), B) Must pass the skills test(s) and written examination(s), C) Must successfully complete a field internship, and D) Must successfully pass the national registry exam. At this point you will be indistinguishable from the paramedics who went through the full paramedic program, but you aren't done yet... The county in which you intend to work will have a few more hoops for you to jump through as well...usually written test, fees, letter of intent from a prospective employer, etc. (unlike many states, in CA the paramedic protocols and certification is a county-by-county thing rather than a full state thing). Having said all this I must caution you (and any other RN intending to become a paramedic) that working as a paramedic is NOT the same as working as a nurse. I would VERY STRONGLY enourage anyone considering this jump to at least have their EMT and a good year of experience of working on an ambulance or they may find the internship on the ambulance to be something of a disaster.