tension between EMT and LTC nurses?

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i was reading some of the prehospital forum on a different medical board hoping to get some info and insight into their job because if there is a lag time between finishing my rn prereqs i have been thinking i might enroll in the emt-b program, to get a heads up on a few skills. Anyway i was really disappointed to see the disrespectful posts regarding nurses and in particular LTC nurses. I have considered the source of course (because the board is a part of SDN), but i still was surprised at the overwhelming belief that nurses are not as well educated as paramedics or even emts. (among the ems providers this seemed to be the consensus at least) At my school the RN program not only has more gen ed requirements and (higher levels at that) but more science such as chemistry and microbiology and nutrition., so i don't quite understand where this idea of nurses knowing less is coming from. I guess i am just disappointed to see other non-doctor medical personnel downing nursing. I think that everyone has a vital role and don't see why the bashing is necessary.

i was reading some of the prehospital forum on a different medical board hoping to get some info and insight into their job because if there is a lag time between finishing my rn prereqs i have been thinking i might enroll in the emt-b program, to get a heads up on a few skills. Anyway i was really disappointed to see the disrespectful posts regarding nurses and in particular LTC nurses. I have considered the source of course (because the board is a part of SDN), but i still was surprised at the overwhelming belief that nurses are not as well educated as paramedics or even emts. (among the ems providers this seemed to be the consensus at least) At my school the RN program not only has more gen ed requirements and (higher levels at that) but more science such as chemistry and microbiology and nutrition., so i don't quite understand where this idea of nurses knowing less is coming from. I guess i am just disappointed to see other non-doctor medical personnel downing nursing. I think that everyone has a vital role and don't see why the bashing is necessary.
I have respect for LTC nurses, I have an idea what their jobs are like. Most encounters (few now) are pleasant, LTC nurses are people too. The problem I had when I frequented LTC facilities was not with the rudeness or politeness of the staff. The problem was that we would recieve a call as shortness of breath, but find that the patient was cold, with dependent lividity. WTF?!! That was a frequent scenario. Or get called to a code, and find them doing compressions on a soft bed, with a simple face mask not attached to ANY O2 source (as if that would have made a difference) and NO ventilations. Or (not the LTC facility's fault, but still annoying), getting the call for abdominal pain from a private EMS, to arrive and find that its really a g-tube replacement transfer. They would rather tie up a 911 med unit than let one of their competitors get a foot in the door at 'their' facility, cuz who knows how much candy, doughnuts, pens, coffee cups, (and yes, 'love') they hadda spread around to get the facility's business. Don't get me started on private EMS. Once again, LTC nurses are people, worthy of respect.

THERE IS A GENERAL CONSENSUS BETWEEN LTC NURSES AND EMTS. I WORK LTC PRN AND SOME OF THE EMTS ARE TOTAL A*****, BUT SOME ARE GREAT . THERE IS ONE IN PARTICULAR THAT COMES IN AND TRIES TO TALK MY ELDERLY PTS INTO REFUSING TO GO TO THE ED. WE HAVE CLASHED SEVERAL TIMES. MY MAIN NURSING IS IN THE ICU , SO I FEEL AS EDUCATED IF NOT MORE SO THAN HE.

i was reading some of the prehospital forum on a different medical board hoping to get some info and insight into their job because if there is a lag time between finishing my rn prereqs i have been thinking i might enroll in the emt-b program, to get a heads up on a few skills. Anyway i was really disappointed to see the disrespectful posts regarding nurses and in particular LTC nurses. I have considered the source of course (because the board is a part of SDN), but i still was surprised at the overwhelming belief that nurses are not as well educated as paramedics or even emts. (among the ems providers this seemed to be the consensus at least) At my school the RN program not only has more gen ed requirements and (higher levels at that) but more science such as chemistry and microbiology and nutrition., so i don't quite understand where this idea of nurses knowing less is coming from. I guess i am just disappointed to see other non-doctor medical personnel downing nursing. I think that everyone has a vital role and don't see why the bashing is necessary.

One of the biggest issues that I've seen in my 10 years as a paramedic is a lake of respect that sometimes, but not always, occurs between the LTC nurse and the paramedic.

I realize, as my mother has been a LTC nurse for many, many years that nursing facilities are not emergency rooms, and many times you all are limited with supplies and equipment to treat a patient in a medical emergency. And any paramedic that is disrespectful to you because you perhaps don't have the patient on high-flow 02 (only have NC's or SFM's in the facility)then that person is just plain ignorant of your capabilities. It does not mean that you are incompetent.

On the other side of the coin, I do not like to be treated like I am a glorified taxi service, or an "ambulance driver" either.

When we ask for allergies, medications, etc...we aren't trying to be a nuisance, or arrogant. We need to know these things, as we have licenses to protect just as you do. We have assessments to perform and document as well. If a patient is in ventricular tachycardia, and we need to administer lidocaine-the fact that the patient is allergic to novocaine is very pertinent information.

But those are my 2 cents worth, and I'm sure that most of you already know these things.

Let us have peace among us.

Specializes in Peds Cardiology,Peds Neuro,Pedi ER,PICU, IV Jedi.

As a former field medic I can only say that from my experience, LTC seems to be the place where we (as prehospital providers) find so many things WRONG with patients. Like the time we were called out to a "fall" in a nursing home to find the 84 year old patient lying in bed with an OBVIOUS femur fracture- which stemmed from a nurse and an aide trying unsuccessfully to get her into bed. We were called the day AFTER this happened.

But for me at least, those calls were few and far between. As an EMT, you feel like you really "know something." And to a certain extent that's true.

As a paramedic, you see that there's soooooo much you don't know, and the amount of responsibility you have is so great - you just hope you're up to the task of caring for people who are so ill.

I apologize to all of you who have had such bad experiences with EMTs or paramedics. The people you mention obviously have unresolved issues somewhere. They don't understand that it's not about always doing 90 with lights and sirens blaring as we bring in a traumatic arrest. It's about the more simple things - respect for your patients, your colleagues...which include nurses, and respect for yourself. None of which occurs when we constantly berate each other.

Have a great day.

vamedic4

...and many times you all are limited with supplies and equipment to treat a patient in a medical emergency. And any paramedic that is disrespectful to you because you perhaps don't have the patient on high-flow 02 (only have NC's or SFM's in the facility)then that person is just plain ignorant of your capabilities. It does not mean that you are incompetent.

If a LTC does not have a NRB, THAT is a problem...

If a LTC does not have a NRB, THAT is a problem...

Honestly, I've seen many nursing homes that do not have non-rebreathing masks. Whether it be for financial or treatment reasons, they do not keep them in stock.

They have BVM's, but not NRB's. :wink2:

At our LTC facility, I can never find supplies when I need them - they tell me that it's because the managing corporation won't let them order anything except once a month, and then there doesn't seem to be any sense or reason to what they order. I would be happy to try to work up some kind of system, but they want me to do it on my OWN time.

I don't have time to do it when I'm on duty, but they routinely run out of things like gloves, alcohol swabs, etc. I recently had to put a patient on O2 one nite, and there were NONE where there were supposed to be - I finally found some in a dusty old box on a shelf that was far out of my reach!!

When I notice that they are getting low on something, I leave a note for the DON, but that doesn't mean that she will order them! NRB? Heck no, they don't have any!!

I don't usually have a problem with the EMTs or Paramedics that come to my LTC facility. But as a general rule, I'm there to give any information the responders need to know. If it's not an emergent transfer, like dehydrated from 3 days of N/V/D or shoulder discomfort from a fall 2 days after the fall(not excrutiating pain, full ROM, no obvious Fx) but doc wants it evaluated in ER, I'll try to get family in to transport or use facility vehicle if available. Doesn't always work out, but I try.

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