Rudeness from EMTs and Paramedics

CapeCodMermaid, RN · Jan 15, 2008

When in doubt- ship 'em out. I have no trouble sending someone without a doctor's order. I usually call 911, get all the paperwork ready-a 3 page referral and a verbal report to the EMT's and once the patient is on his way to the hospital, I call the doctor and inform him that I've sent the patient out for xyz reasons.

That said, I try to treat as much as I can in the facility. If it's mild CHF why send them out? Give 'em some IM lasix and supplemental 02 and watch 'em for a bit. If after that they don't improve then send them.

Lannister · Jan 15, 2008

Background: 20 years working in healthcare as a CNA (LTC & Hospital), EMT-B/I/P (yes I took all three of them individually in the military and worked "the bus" and the ED/CCU as a Tech in civilian healthcare), LPN (LTC), RN (Med-Surg/CCRN/EDRN), NPP (FNP/PA-C in ED/IM/Cards/Remote Med). I teach ACLS to the local EMT students and work in Cardiology and Internal Medicine and the ED Per Diem.

I has gotten so bad that I started keeping a copy of my licenses in the nursing station.

The last time this happened (about a year ago)... I called local department to speak to the director personally (He is a drinking buddy of mine) to ENSURE that the medic was disciplined or fired!!!

Personal EGOS have NO PLACE in patient care...!!!!

Lannister · Jan 15, 2008

When in doubt- ship 'em out. I have no trouble sending someone without a doctor's order. I usually call 911, get all the paperwork ready-a 3 page referral and a verbal report to the EMT's and once the patient is on his way to the hospital, I call the doctor and inform him that I've sent the patient out for xyz reasons.
That said, I try to treat as much as I can in the facility. If it's mild CHF why send them out? Give 'em some IM lasix and supplemental 02 and watch 'em for a bit. If after that they don't improve then send them.

That's cool... but

Without a "order"... YOU are "practicing medicine" WITHOUT a license to do so!!! :nono:

There ARE a few nurses (that I know well) that I WILL cover for such a act... but you should be careful...!!!

morte, LPN, LVN · Jan 15, 2008

That's cool... but
Without a "order"... YOU are "practicing medicine" WITHOUT a license to do so!!!
There ARE a few nurses (that I know well) that I WILL cover for such a act... but you should be careful...!!!

paramedics and EMTs have a saying "i would rather defend my actions with a live patient than a dead one"......

PsychNurseWannaBe, BSN, RN · Jan 15, 2008

I am surprised that there appears to be a "turf war" between two practicing individuals. The nurse should expect the EMT to play 20 questions because the EMT must in turn answer questions once they arrive at the ER.

The EMT should realize that the nurse has a medical order to send and at this point and time there is no reason for the EMT to assess if the patient is "worthy" enough to go to the ER.

I give a verbal report to the EMT along with the copy of my progress note to the EMT and then I call the hospital to give a verbal report to the ER RN.

The two practicing individuals should be working together because this is about the patient and not each others egos. However, as long as the patient is in the building they are under the care of the RN and the EMT can not get in between the nurse-patient relationship. Similarly the RN can not terminate the nurse-patient relationship because the EMT is there.

I see nothing wrong with a RN reminding the EMT that they are still the one in charge of the patient per the Nurse Practice Act. I just don't think it should have to come down to that.

TheCommuter, BSN, RN · Jan 15, 2008

However, as long as the patient is in the building they are under the care of the RN and the EMT can not get in between the nurse-patient relationship. Similarly the RN can not terminate the nurse-patient relationship because the EMT is there.

In nursing homes, an RN is legally required to be in the facility for only 8 hours per day. At most nursing homes, the DON fulfills this requirement, even though none of the patients are technically being cared for by him/her. So, I ask you: "If there's no RN in the nursing home 16hours per day, does his/her legal responsibility continue even though (s)he is at home?"

My point is that many people who are unfamiliar with LTC do not realize that the LPN/LVN is the only licensed nurse in the building for much of the day.

CapeCodMermaid, RN · Jan 16, 2008

That's cool... but
Without a "order"... YOU are "practicing medicine" WITHOUT a license to do so!!!
There ARE a few nurses (that I know well) that I WILL cover for such a act... but you should be careful...!!!

Sending someone to the hospital via rescue is NOT practicing medicine without a license. It is a prudent thing to do given the fact that the docs sometimes take too long to call back. Of course I don't give meds without an order.

PsychNurseWannaBe, BSN, RN · Jan 16, 2008

In nursing homes, an RN is legally required to be in the facility for only 8 hours per day. At most nursing homes, the DON fulfills this requirement, even though none of the patients are technically being cared for by him/her. So, I ask you: "If there's no RN in the nursing home 16hours per day, does his/her legal responsibility continue even though (s)he is at home?"
My point is that many people who are unfamiliar with LTC do not realize that the LPN/LVN is the only licensed nurse in the building for much of the day.

Regarldess if the person is an RN or an LPN, the EMT should not be getting in spouting matches with them.

Lannister · Jan 16, 2008

Sending someone to the hospital via rescue is NOT practicing medicine without a license. It is a prudent thing to do given the fact that the docs sometimes take too long to call back. Of course I don't give meds without an order.

Of course that's clear now... :up: :up: :up: but your initial post:

... [brevity edit]... If it's mild CHF why send them out? Give 'em some IM lasix and supplemental 02 and watch 'em for a bit... [brevity edit]...

Lead me (us?) to believe that YOU are making the decision... which would be YOU... "practicing medicine without a license"...!!!

MrsCaseyRN · Mar 2, 2008

Let me start off by saying I was an EMT for a few years before becoming an RN. I don't know where it all started, but it became known in the EMT world that it was ok the treat LTC nurses like crap. I can say I never did so, because I was a nursing student, but many (not all) did. They just assumed they knew more than the nurses. The paramedics behave the same way.

Now as a nurse, in LTC, this makes my furous! :angryfire The nurses I work with rarely stand up for themselves, because they were under the impression that EMTs had much more education then they actually do. I have since gone to my DON, but this has been the way (in all LTCF in our area) and eveyone is used it. So nothing got done about it.

To give a few examples:

~Sent pt out. h/h in the 7's/20's. Need PRBCs. Emt Said this is because we don't give pt enough water. (which doesn't make sence anyway?)

~Sent pt out for seizures (has hx) BS 150 (pt had DMII) Emt said we obviously don't monitor pts BS, and the pt obviously doesn't get the right coverage, thats why the pt had a seizure.

~they frequently make comments to family that nursing staff is poor. and I know this happens at all facilities because like I said I used to be an EMT. I know that a lot of them have the over inflated egos and many of their medical ideas are wrong, yet they continue to do this, and we have to justify everything we do or get treated like garbage right to our faces.

~They frequently tell us our assessments are wrong, our nursing judgements are wrong, and often step outside their scope of practice. (They don't think we know they are doing so, but I know because I was an EMT) I had one actually tell me one time a pt didn't have to go to the hospital for an episode of chest pain because their EKG (which we did as per MD while waiting for ambulance) was normal sinus. I was like "I'm sorry, I know you are not trained to read tele" (they are not in our state) only medics and these were EMTs. I told them they should just do their job or they can call the doc and tell him they don't feel this transport is needed b/c pts EKG is RSR!!!:trout:

But we also get nasty attutides from hospital nurse too. I'm freaking sick of it :angryfire:angryfire:angryfire:angryfire

I'm tired of getting treated like a moron. Mostly from EMTs who have about 3 months of training and can't even compair to nursing education. Now when I get a nasty attitude from them, I put them in their place by reminding them of how little they know (which is mean, but I'm not going to take it anymore) and I tell them that I used to work the ER at our nearest trama center, and I know my stuff, so BACK OFF!:flmngmd:

When I'm calling in report to the ER for a pt going over, I have to slip it in each time what I used to do, or I get pooped on.:angthts:

But,even if a nurse has never worked anywhere but LTC, that doesn't give EMTs or hospital nurses the right to treat them that way.

I worked in the hospital and was an EMT and never disrespected someone by assuming they were stupid. And I NEVER assume someone was stupid because they work in LTC.

Does anyone else have this problem? This is very normal in the medical community in my area. :nono:

facetiousgoddess · Mar 2, 2008

https://allnurses.com/forums/f22/rudeness-emts-paramedics-268561.html

Hi Casey,

The Commuter started a thread on this on the LTC forum. Excellent thread and the EMTs/Paramedics participated in a constructive manner, sharing their frustrations.

Be interesting to see if responses differ in the general discussion forum.

Tres

who posted on the other thread...and is in a different county now with awesome EMTs.

KarenGeorgeBSRN · Mar 2, 2008

Casey,

Welcome to nursing and LTC. However, do not bother nor

waste positive energy. You are welcome to correct said EMT

in particular in your documentation on the transported patient.

Keep it simple and honest.

Thanks,

Karen G.

Let me start off by saying I was an EMT for a few years before becoming an RN. I don't know where it all started, but it became known in the EMT world that it was ok the treat LTC nurses like crap. I can say I never did so, because I was a nursing student, but many (not all) did. They just assumed they knew more than the nurses. The paramedics behave the same way.
Now as a nurse, in LTC, this makes my furous! :angryfire The nurses I work with rarely stand up for themselves, because they were under the impression that EMTs had much more education then they actually do. I have since gone to my DON, but this has been the way (in all LTCF in our area) and eveyone is used it. So nothing got done about it.
To give a few examples:
~Sent pt out. h/h in the 7's/20's. Need PRBCs. Emt Said this is because we don't give pt enough water. (which doesn't make sence anyway?)
~Sent pt out for seizures (has hx) BS 150 (pt had DMII) Emt said we obviously don't monitor pts BS, and the pt obviously doesn't get the right coverage, thats why the pt had a seizure.
~they frequently make comments to family that nursing staff is poor. and I know this happens at all facilities because like I said I used to be an EMT. I know that a lot of them have the over inflated egos and many of their medical ideas are wrong, yet they continue to do this, and we have to justify everything we do or get treated like garbage right to our faces.
~They frequently tell us our assessments are wrong, our nursing judgements are wrong, and often step outside their scope of practice. (They don't think we know they are doing so, but I know because I was an EMT) I had one actually tell me one time a pt didn't have to go to the hospital for an episode of chest pain because their EKG (which we did as per MD while waiting for ambulance) was normal sinus. I was like "I'm sorry, I know you are not trained to read tele" (they are not in our state) only medics and these were EMTs. I told them they should just do their job or they can call the doc and tell him they don't feel this transport is needed b/c pts EKG is RSR!!!:trout:
But we also get nasty attutides from hospital nurse too. I'm freaking sick of it :angryfire:angryfire:angryfire:angryfire
I'm tired of getting treated like a moron. Mostly from EMTs who have about 3 months of training and can't even compair to nursing education. Now when I get a nasty attitude from them, I put them in their place by reminding them of how little they know (which is mean, but I'm not going to take it anymore) and I tell them that I used to work the ER at our nearest trama center, and I know my stuff, so BACK OFF!:flmngmd:
When I'm calling in report to the ER for a pt going over, I have to slip it in each time what I used to do, or I get pooped on.:angthts:
But,even if a nurse has never worked anywhere but LTC, that doesn't give EMTs or hospital nurses the right to treat them that way.
I worked in the hospital and was an EMT and never disrespected someone by assuming they were stupid. And I NEVER assume someone was stupid because they work in LTC.
Does anyone else have this problem? This is very normal in the medical community in my area.