Rudeness from EMTs and Paramedics

TheCommuter, BSN, RN · Jan 11, 2008

I just had to post after I read the first post and apologize if I missed something.. The OP is in Fort Worth.. well, my husband works for the EMT service for FW and I am sorry that some/most of them are rude. I just thought it was interesting that you brought this up and that there might be a chance that he has been to your LTC!

Well, I work at one of the larger LTCFs in the Southwest part of the city. It is a 200-bed skilled nursing facility, so there's a decent chance that your spouse has been to my workplace at one time or another. :)

TheCommuter, BSN, RN · Jan 11, 2008

ADDENDUM: I recently sent a patient out to the hospital. This patient had been lethargic all day with an irregular apical pulse of 140, and a recent xray report that was indicative of pneumonia.

The paramedics and EMTs arrive, mildly annoyed that they had to drive to our facility with a full lights and sirens response for an 80-year-old man. I had the paperwork ready, and I had complete answers to all of their questions. The female paramedic says to the man, "You look fine to me." She also call the patient's daughter on the cell phone, and seemed shocked that I had notified the family of the impending transport. She proceeds to tell the family, "He looks fine to me, and he might even return to the nursing home tonight or tomorrow."

My patient was very ill, and remained hospitalized for over 1 week. I do not appreciate the cocky EMS workers who predict that the patient will be sent right back to the nursing home.

loveylilly · Jan 11, 2008

i live in a small area too, but when we call for the emts who are right next door we do give a report on whats going on with pt. i always try to be courteous but with some (not all) of the emts its as though they want to say you know nothing and i know it all...i left out that he said he is glad that my pt. had me as a nurse. i suppose thats his way of apologizing..i accept:prdnrs:

P_RN, ADN, RN · Jan 11, 2008

I'm glad he had you as his Nurse too.

txspadequeenRN, BSN, RN · Jan 11, 2008

i have worked in ft worth all my nursing career except for the last year. i guarantee you i have run into the person at some point in time (small world). i should have kept a journal of the ego's i have ran into from the local ems service...i had one once spend so much time praising himself:bowingpur i had to tell him to get out and take the patient to the hospital before she died...:scrm:

i just had to post after i read the first post and apologize if i missed something.. the op is in fort worth.. well, my husband works for the emt service for fw and i am sorry that some/most of them are rude. i just thought it was interesting that you brought this up and that there might be a chance that he has been to your ltc!

deleern · Jan 14, 2008

I Called for a "routine Transport... No lights" the Emt came in I was on the phone with family. and sent the LpN to help transfer the pt to the gurny. The LPN and the CNA all came up and told me that that "guy" was made .... He never gets told any thing.

I went down and walked into the room and asked what is the Problem. He said he is never told anything... I said there is nothing to tell.... this pt is routine transport and you are to bring him to the hospital... Where the MD will Diagnos and Treat. then i just stood there. and he just quietly loaded the pt. up i handed him the Trasfer papers. and he left...

danh3190 · Jan 14, 2008

That's the way I feel, I work the same hall every time I work, half of my patients have been there the whole time i have (15 months) so if i see a total change in their behavior, wether or not vitals are off, and the on call md says send them, I send them. Then a couple of cocky jerks show up and look at me like i have 2 heads! i sent one little lady out because she was calm and quiet, and her baseline was kicking and screaming. she wasn't complaining of anything, but just seemed off. EMT shows up, GRILLS me up and down. turns out, she was almost uroseptic! i dont know everything, but i know my residents!

I'm a paramedic who's done a lot of nursing home calls over the last 27 years. I hope the nurses don't think I'm grilling them when I ask a bunch of questions, but when I turn up in the ER with a patient and can't answer the ER nurse's questions, I feel like a stupid idiot. So I take a couple moments to try to ask the nurse questions to get me up to speed. After all they may have been with the patient 15 months, but I've only been there a couple minutes. So while watching what my EMT is doing and trying to figure out what if anything I need to be doing, I am trying to cram as much background info into my feeble brain as I can in the couple minutes I have. I'm not being rude, but I do feel rushed and often confused.

I have witnessed very rude behavior toward the nurses by some paramedics and EMTs and am mortified when I do. I try to talk with my cocky partners, but there's not much I can do beyond that. Some medics seem to believe that their 18 months or so of part-time community college education makes them hot stuff. If a medic is really outrageous, the LTC facility could probably lodge a complaint with the ambulance service manager AND the ambulance service's medical director. Enough complaints start piling up about certain individuals and something may be done.

jojotoo, RN · Jan 14, 2008

Boy! O Boy! I dont think there is a nurse out there that hasn't experienced the "Mr. Doctor Paramedic" one night we had to send a resident out who was a brittle diabetic who I had found soaking wet with sweat and registering a 20 blood sugar. Well the RN supervisor who had 40 years under her belt took care of calling the paramedics and doctor and we had worked on this guy till they got there and we had his sugar up to 70 or so and the smart alec paramedic says "Don't you people here know what normal sugar is? What are you calling us for we arent taking this guy to the hospital and with that the nurse said yes you are and I will get the doctor on the phone and the paramedic waited up at the station for the doctor to call back and when he did he proceeded to argue with the doctor!!!!! well after all this fortunately our resident came through okay they took him and while they were leaving to transport this man to the hospital they were making remarks under their breath to the tune of "This place hires idiots!" Boy did I feel like punching that guy right in the mouth ! hahahah! I dont know what gives some of those guys the attitude that they are above everyone else.

If you have already stabilized your resident's blood sugar, why are you still transporting him to the ER?

I never had any trouble from the pay transport EMTs or hospital Paramedics (when a patient is d/c from another facility). But I have noticed an attitude from the 911 EMTs. Not towards the patients, but to staff. It seems if the patient is not in acute distress or visible bleeding, they feel they shouldn't be taking them. It's extremely frustrating to have to go through WHY the patient should go to the hospital when you have already contacted the MD and the family. I always give report, but I shouldn't have to justify sending them out when I have an MD order. I've seen them argue with the MD in person, which is not right.

When you have a patient that is in "no acute distress" why are you using the 911 system - -which is for emergencies, instead of arranging for a private ambulance to transport your resident?

opus13 · Jan 14, 2008

i called for a "routine transport... no lights" the emt came in i was on the phone with family. and sent the lpn to help transfer the pt to the gurny. the lpn and the cna all came up and told me that that "guy" was made .... he never gets told any thing.
i went down and walked into the room and asked what is the problem. he said he is never told anything... i said there is nothing to tell.... this pt is routine transport and you are to bring him to the hospital... where the md will diagnos and treat. then i just stood there. and he just quietly loaded the pt. up i handed him the trasfer papers. and he left...

not to be picky but the pt obviously has a reason for transport and the ems provider needs to know for a few reasons::

1. if something happens during transport i need to know susspected, current and past diagnoses

2. whent the pt arrives at the e.d. the triage nurse is going to want to know why the pt is here, when it started, and what has been done at the ltc facility. now as often as the m.d.s says they will call ahead 99% of the time when i arrive at the e.d. and say "the facility stated the m.d. was going to call" the answer is "well they didn't". so if i don't know it or if it is not on the paperwork the hospital won't know it.

3. if i don't have all the information i need to generate a run report which reqires a clinical impression/suspected diagnosis the insurance company will probably not pay, saying there is no justification for the ambulance and the pt or family will be responsible for the full bill!!

now if the transfer paperwork is correctly filled out it will normally have all that information, the emt definately should have lost the tude and just asked nicely why the pt is being transfered. i've never had a nurse not give me the information i needed if they were just asked or told why i needed it in a professional way. also no ems professional should tell a pt the look fine and don't need to go to the hospital, if they know the m.d. wants the pt evaluated at the hospital.

karl

TheCommuter, BSN, RN · Jan 14, 2008

If you have already stabilized your resident's blood sugar, why are you still transporting him to the ER?

Because (s)he has a telephone order from the physician to send the pt. to the ED. Always remember that LTC nurses do not decide to send patients out; rather, that decision is made by the MD.

danh3190 · Jan 15, 2008

Always remember that LTC nurses do not decide to send patients out; rather, that decision is made by the MD.

I'm not blaming the nurses, because they have to follow their protocols, but many times I wish the nurses were allowed to send the patient to the hospital without family permission and a MD order.

Many times I've picked up very sick patients who really needed to go to the hospital a couple hours earlier but couldn't because the nurses were waiting on callbacks from somebody.

morte, LPN, LVN · Jan 15, 2008

I'm not blaming the nurses, because they have to follow their protocols, but many times I wish the nurses were allowed to send the patient to the hospital without family permission and a MD order.
Many times I've picked up very sick patients who really needed to go to the hospital a couple hours earlier but couldn't because the nurses were waiting on callbacks from somebody.

just sent someone out a few days ago without a MD order....hung on the line for 3-4 minutes (at 4AM) no answer from the service....said the "heck" with this....did the paper work, called 911 and out they went....called the service again, finally answered, doc called back, not one of the easiest to get along with, told him what happened, he acknowledge the "quality" of the service, and said "sometimes YOU just have to make the decision......