So, I am currently working in a small ED. Prior to this ED, I have worked in a Level 1 Trauma and a SICU prior to that. I love being an ED nurse. I like the slower pace this facility has to offer. However, there are a few issues that I am having a hard time with. We have a tech that is PRN that works about 24hr/wk. She has her EMT-B, which is great for her cuz she does this full time. She really enjoys it. However. Her work ethic as a tech is horrible in the ED. Here are a few examples. She will document a patients heart rhythm or chart a critical lab value, or put in verbal MD orders, take out IV's, flush IV's- all of which are not with in her scope of practice at this facility. After being told multiple times, she still continues to do so. That is not just it. The techs in this ED work hard helping the patients and helping the nurses keep the patients safe. They can do EKG's, vitals, assist pt to the rest room and transport to the floor. She is the exception to this. She really thinks she is above the RN's level of knowledge. Multiple RN's have to ask her multiple times for help. Like, "Hey, HER NAME, can you get an EKG,Vitals or run pt in room 3 up for me while I give report to the accepting hospital." Her response is, "Why can't you do it?" As she is on her phone. Recently I asked her to get an orthostatic on a pt. She started w the pt sitting instead of laying. I seen it and corrected her and said no, they have to be laying flat, then sitting and then standing. She told me in front of the pt, "You do it then." All the nurses have encountered this with her. She won't even acknowledge you if you ask her for your help, it is like it's an inconvenience she is there. And she is rude to the patients.
She also thinks and says RN's know nothing and could never make it in an ambulance because we rely on doctors. She says, she doesn't need any doctors order to do anything as a Basic. Also, Flight RN's only do paperwork and it is the medics who run the codes. (Flight Nurses are very,very knowledgeable and so are Flight medics. Hello, they take ECMO and IABP pt's)
Little does she know, most of the ED RN's are ECRN because we are medical control for the surrounding hospitals and in order to have your ECRN, one must take the protocol test for BLS, ILS, and ALS. The Protocol books for the surrounding regions are by the call radio for EMS. So, really, her scope in the pre-hospital world is very limited. It is all protocol. But she doesn't see the point. That is out in the field, and her ED tech job is in the hospital.
Now, you are probably thinking, tell your boss. In fact we have, many times. No corrective action has ever been taken. IF she spoke to her, nothing has changed from it. It is hard to work with someone like her. It is not safe or effective care the patients are getting. They are having to wait longer for the nurses who are busy doing her job and then trying to do everything else. She refuses to keep up on protocol vitals. The other techs and nurses show up to work to care for patients.
Our boss knows about it and since she is a new boss, she has not done anything to change it. Should I go to the next chain of command?
What are your thoughts? How would you feel? What would you do in your ED?
