Rudeness from EMTs and Paramedics

dawnb70 · Dec 25, 2007

Too many times to count!!! I thought it was just where I live! Recently we had a78 year old man in respiratory distress. The ambulance arrived to transport him to the ER, received another call and then proceeded to leave to answer that call. It took them a half an hour to return to transport our resident!!! Fortunately we had been able to keep him stable until they returned. Maybe they responded to the other call because it was someone younger...who knows! I wanted to turn them in, but didn't know where to turn!! :angryfire

AnnieOaklyRN, BSN, RN, EMT-P · Dec 26, 2007

My favorite comment ... How long has the pt been like this? As if we just sit around with thumb up butt waiting for the pt to go south and then call 911.
Hi,
I agree with the other poster both as a nurse and a paramedic.... By asking this we are not insultings ones inteligence, but we do need to know and it is a legitament question, because one should NEVER ASSUME in the healthcare feild, not to mention when the ER nurse asked "how long has the patient been like this" we would look awful rediculous if we said " I do not know, I did not ask".
Also never assume on yoru part either that the ambulance crew gets all the info from the dispatcher. Often we have no idea if it came in privatly fronm a nursing home or if the nursing home dialed 911. We only get a very small bit of info when dispatched compared to what we really need, which is why we ask questions on arrival, like "how long has the patient been like this".
Sweetooth

lil' girl, LPN · Dec 28, 2007

Well since we are talking LTC, Mr./Mrs. EMT we don't have an inhouse MD. We see something wrong that we think should be addressed we call the MD and take orders from him as to what to do for the resident. IF he says send to ED then that is what we DO, and since we don't have transport then that is why we call you. So please don't blame us for following doctor's orders. Thank you very much for being so nice when you come to pick up our resident. I will be sure to return the favor.

withasmilelpn · Dec 28, 2007

I am happy and wish I had to deal with RNs like YOU who knew their patients more often. Most are" I don't know" "They are not mine" " I am filling in........."
Also I have seen residents DUMPED into the hospital to give the staff and NH a break or around the holidays, you should see WHO is shipped out. Do all do that No but many do, and are all Medics mean, no some are but I have been treated unkindly when "I" am trying to do MY job too.

Don't you ever transport people you have little to no information about? Please don't dump on the Nurse who is filling in. I always grab the chart when I don't know my patient, but if the info is not there, it is not there. Also many times, I am the nurse running to help out my co-workers, and don't have the answers because I am not that patient's nurse. I am always happy to find out what you need to know, however. Everyone deserves to be treated with respect and assumptions need to be left at the door in my opinion.

MentalRn · Dec 30, 2007

I worked longterm care for 8 years. It was the hardest job I ever had! I have since worked in various other acute care specialties. I think, or rather I know there is a lack of respect toward the LPNs and RNs that work in this field. There is also a lack of respect toward the elderly in this day and age. If your over the age of 65 you might as well tatto DNR on your forhead and forget it. Just to receive help with a broken arm, you name it, the first question is are they a DNR? Funny no one asks that of us when we seek medical care for such basics.

KJB_65 · Dec 30, 2007

I worked LTC for 2 years as an LPN. We all have our place in healthcare. Paramedics and EMT's are valuable members and I acknowledge that they have to get tired of bs calls all the time but one night I had a GTube clog at midnite. The resident was on meds that couldn't wait for a day. I tried all the tricks. The doc wanted her transported to the ER. Which is also a pet peeve as that is always the docs answer....another post. Anyway. I called non-emergency transport. Had this cocky little thing walk in asking me questions which I answered then the "did you try to unclog it"..........."no, I immediately called yall". I didn't say that but wanted to. He grabbed the syringe off the table and said "well you just dont know how to do it then". Guess what neither did he. They ended up taking her anyway.

Bottom line is I have my job and you have yours. I'm sorry this wasn't a code or more exciting for you but I can't take them to the ER myself. Your job is to stabilize and transport not tell me that it's not necessary. I would never dream of telling a paramedic during a code situation that they werent doing something right. Every one has their place. I have a cousin who is a paramedic. I told him I better never hear that he has treated a nurse like that. Don't know what I would really do since he is 6'3 and weighs 250 lbs but I told him anyway.

steven1534 · Dec 30, 2007

As a Paramedic...I want to put my head in this one too. I've been treated horribly working both 911 and Non-Emergency Interfacility Transfer. I want to mention a few circumstances, not because they are true in everyday operations, but rather because they bring up points that I think create the tension.

In nursing, you are educated in pharmacology, patient management, and many many other things. In EMS we are educated in the same, except we don't have a doctor on call or in the building and the ones that we have available don't have a relationship with that patient...yet.

So first - I had a nurse tell me she hates EMTs because once she was at a bar and saw a guy fall over in the street. She went to help. When EMS arrived they cursed at her and told her to leave. She told them she worked on a neuro floor and they didn't know anything about that and she did and he could have a head injury. Well, the first problem with this situation is 1) they are in the street; 2) airway, breathing circulation first, then check the pupils; 3) outside of a bar. As EMS providers we spend a lot of time learning about the dynamics of scene control. Controlling a situation out in the field is a lot different than in the hospital. There are many, many things you have to concern yourself with. Like - traffic in the street that could cause further injury ], hundreds of people outside the bar who are intoxicated and could pose a threat, drunk healthcare providers who think they can help but may cause further injury because they are intoxicated. In a situation like that, quick and strong decisions must be made to ensure the safety of the providers, patient and bystanders. Sometimes some verbal force may be used.

Second - "I just got this patient" isn't an excuse. When I get to the ED, I just got the patient too, but I've performed an assessment, gotten paperwork and history and made it available for continuity of care. It takes a few minutes for us to get there, so that should be enough time to get someone to obtain necessary information. Yes, I have taken people without information, but when it very well should be readily available and on file, it shouldn't happen because that could be of detriment to the patient.

But anyways, my basic point is that neither side truly knows what the other half does unless they experience it for themselves. I don't know about nursing because I have only experienced a little bit of nursing during my clinicals...and not enough to know. Neither do I know what a physician has to do in his realm. I will fully admit that once I get to the hospital and I've run through the meds I know I really do not know how to proceed and return to rehabilitation. I guess I basically want to say: I respect you because you have a different set of goals. Understand mine: get the patient to the hospital in a condition similar to or better than what I found them...or at least keep some blood flowing somewhere. And I must do this with the drugs and equipment I can shove into a Ford Truck...and use myself without much assistance.

I may be different because I don't second guess everyone on things that I admit I don't know about...btu not everyone in the world is perfect. So anyways, have fun and be safe. And maybe one day we will meet up. Sorry too if I am rude, but I am a Type A personality and can sometimes say things in a less than "nice" way.

Medic04 · Dec 30, 2007

As a Paramedic...I want to put my head in this one too. I've been treated horribly working both 911 and Non-Emergency Interfacility Transfer. I want to mention a few circumstances, not because they are true in everyday operations, but rather because they bring up points that I think create the tension.
In nursing, you are educated in pharmacology, patient management, and many many other things. In EMS we are educated in the same, except we don't have a doctor on call or in the building and the ones that we have available don't have a relationship with that patient...yet.
So first - I had a nurse tell me she hates EMTs because once she was at a bar and saw a guy fall over in the street. She went to help. When EMS arrived they cursed at her and told her to leave. She told them she worked on a neuro floor and they didn't know anything about that and she did and he could have a head injury. Well, the first problem with this situation is 1) they are in the street; 2) airway, breathing circulation first, then check the pupils; 3) outside of a bar. As EMS providers we spend a lot of time learning about the dynamics of scene control. Controlling a situation out in the field is a lot different than in the hospital. There are many, many things you have to concern yourself with. Like - traffic in the street that could cause further injury ], hundreds of people outside the bar who are intoxicated and could pose a threat, drunk healthcare providers who think they can help but may cause further injury because they are intoxicated. In a situation like that, quick and strong decisions must be made to ensure the safety of the providers, patient and bystanders. Sometimes some verbal force may be used.
Second - "I just got this patient" isn't an excuse. When I get to the ED, I just got the patient too, but I've performed an assessment, gotten paperwork and history and made it available for continuity of care. It takes a few minutes for us to get there, so that should be enough time to get someone to obtain necessary information. Yes, I have taken people without information, but when it very well should be readily available and on file, it shouldn't happen because that could be of detriment to the patient.
But anyways, my basic point is that neither side truly knows what the other half does unless they experience it for themselves. I don't know about nursing because I have only experienced a little bit of nursing during my clinicals...and not enough to know. Neither do I know what a physician has to do in his realm. I will fully admit that once I get to the hospital and I've run through the meds I know I really do not know how to proceed and return to rehabilitation. I guess I basically want to say: I respect you because you have a different set of goals. Understand mine: get the patient to the hospital in a condition similar to or better than what I found them...or at least keep some blood flowing somewhere. And I must do this with the drugs and equipment I can shove into a Ford Truck...and use myself without much assistance.
I may be different because I don't second guess everyone on things that I admit I don't know about...btu not everyone in the world is perfect. So anyways, have fun and be safe. And maybe one day we will meet up. Sorry too if I am rude, but I am a Type A personality and can sometimes say things in a less than "nice" way.

THANK YOU THANK YOU THANK YOU!

withasmilelpn · Dec 31, 2007

Again, as I said, I am typically the nurse that has run from 1st floor to second to help in the code. Typically we need people who are free to run and get supplies if we need them (and we usually do). Some nurses work well together and will help you make copies of the chart while you are dealing with the situation. The transfer sheet also needs to be filled out. Sometimes in the rush paperwork from the chart is still being copied when 911 arrives. If you are one of the first responders and are in the midst of doing compressions and someone else has the chart copying it, you really can only answer what you know. In any one of these situations whether you are a nurse running to help, or the chart hasn't gotten back to you yet, there are good,solid reasons why and it usually beyond the nurses control. Sometimes the nurses don't work well together and the primary nurse ends up at the desk with the paperwork end of it by herself. (So therefore they are not at the bedside with the patient to answer your questions) Sometimes they run like clockwork, sometimes they don't. Hospitals and EMTs don't have to make sure the paperwork is completed when they are coding someone to my knowledge.

So at any rate my advice if you are an EMT or paramedic, don't judge.

LTC is just a step up from patients being at home sometimes. We have to scrounge for basic equipment all the time. We have absolutely had patients dropped of by their family members with no med list or history and then be almost impossible to get a hold of. Families won't bring in the patient's advance directive and be shocked when we end up sending patients out that were not supposed to. We have hospice patients that multiple times the family insisted we send to the hospital which frankly drives us as crazy as it drives you. And yes, I might totally agree with you about why Mr. so and so should not go to the hospital, but it is not my call to make. I have had endless hopeless conversations with families regarding end of life care that get no where too many times to count. So please don't take it out on me, don't treat me with disdain, like you would do things differently if you were in my place or like I don't know anything.

flashpoint · Dec 31, 2007

I am a paramedic who also works LTC, so I can see it from both sides. I work over 30 miles from home in a town that is not part of our mutual aid region, so the EMTs there don't know me. I've called 911 twice when I have been charge and was treated like a complete idiot once. The EMT was angry that I had called in the first place because it was 0200 and was even more upset that once I called the resident decided she was fine and wasn't going to the hospital. It was one of those situations where everyone but the resident felt she needed to be transported. It put everyone in an awkward situation because they couldn't force her to go, but they also couldn't leave her when she was having chest pain and was diaphoretic. I can definitely see how a lot of 911 calls to an LTC seem like nonsense calls. She ended up having an MI, so she really did need to go, but at the time it didn't really seem like it.

But...as a paramedic, I have been told how to splint, how to start an IV (by a CNA), how to place defibrillator patches, and how to auscultate lung sounds. I have had transfer papers ripped out of my hand and told that they were for the hospital, not for me and that if I read them they would report me for breach of confidentiality (this was pre-HIPAA). I have been told that the staff was not going to let me and my crew in the room until the resident had been shaved. I have walked into a facility and asked where the patient was and been told, "In their room, duh!" I have been told not to park my ambulance in front of the building because it looks bad for the facility...at the same facility, we were told to come in through the kitchen entrance...as soon as the administrator got there with a key to open the kitchen for us. I have been told that there were too many people in the resident's room already and that I could wait in the hall...when I asked if there were any paramedics in the room, I was told that everyone on the fire department is a paramedic (nope...just me and two others). I have had nurses tell me that the resident has only been there for a week, so they don't know them well (don't tell me that...you have a chart and you have other staff to consult with), that they don't know what their meds or diagnosis are (again, grab the chart...I don't expect that you have every resident memorized, but I can expect you to look things up), and that they haven't called the family because they don't want to wake them up.

So...I can see why EMTs sometimes are frustrated by the calls that are seemingly nonsense (it is awkward for everyone), but I can also see why EMTs have attitude about going to an LTC before they even walk in the door. As professionals they need to learn to keep the attitude in check, but so do the LTC nurses.

steven1534 · Dec 31, 2007

CotJockey,

I do agree that both sides need to keep the attitudes in check, because both sides have EMTs or Nurses who are there to save the world...

Its too bad that the ******** are the ones who stand out...and not the cooperative healthcare professionals who make things work but go unnoticed.

longhornfan1 · Dec 31, 2007

quick ethical question

Anyone Help