The continuing saga of nurses vs. EMTs...

StNeotser, ASN, RN · Dec 28, 2009

I've had some of the attitude from EMTs as well.

However, some have been awesome, and one guy the other day who was transporting a very difficult patient to our facility said to the patient "now Mrs X, these wonderful ladies only want to help you and see get better so you can go home. They do a very difficult job. You help them out as much as possible, OK?"

Apparently he'd been an LPN before he was a paramedic.

SaraO'Hara · Dec 28, 2009

I do try to smooth the transfer - our facility has a policy of sending chart copies, transfer sheet, etc; we also call report to the receiving ER before sending the patient. When it comes down to it, however, some patients need to be at least evaluated in the ER. Some will be relatively minor, but still needing further eval (eg near-syncope in a patient rehabbing from MI). I try to save the lights and sirens for immediately life-threatening cases - although sometimes dispatch misunderstands and we get the whole shebang!

classicdame, MSN, EdD · Dec 28, 2009

the length of education does not matter as much as the scope. EMT's do not learn what RN's learn and vice versa. So in some instances either discipline has the edge. Ignore idiots - they are in every profession. I have had CRNA's, with lots of education, who cannot do CPR. One actually told me it should not be in his job description because there are orderlies for that sort of thing. Divas abound everywhere.

Simba&NalasMom, LPN · Dec 28, 2009

I have to say that I have also had several EMTs who were patronizing and even downright rude (for some reason it's always been especially bad with firefighters; some of those guys would put a surgeon's ego to shame, haha). One time, though, I had to send a woman out b/c I was getting no urine return after replacing her s/p cath. The EMTs showed up and I started my report: "42 y/o female, g-tube, trach, dx, blah blah blah..." After they transferred the pt. to the stretcher, one of the EMT's said "I really want to thank you for giving such an efficient yet thorough report. We don't see too much of that when we have to go to nursing homes, and sometimes we can't even find the nurse." It was really nice to not only have a friendly EMT, but one who appreciated my professionalism. It also made me ponder the perceptions of both professions...I guess sometimes our attitudes are shaped by past experience. It's really sad that in our society, most of us who work in health care do so just because we want to help; however, being overworked and underappreciated often defeats that purpose.

This is not to point fingers at either profession, necessarily...I guess my point is just that there are good and bad people in every profession, and while we cannot control the attitudes and behaviors of others, we always have a choice about our own. :)

thanrye8710 · Dec 28, 2009

this is not to point fingers at either profession, necessarily...i guess my point is just that there are good and bad people in every profession, and while we cannot control the attitudes and behaviors of others, we always have a choice about our own. :)

:up: :yeah: :up: :yeahthat:

ramkatral · Dec 30, 2009

You know, this could go on forever. Each side could point at the other. I personally get along great with the nurses at our ED. In fact, our EMS base sits right beside the ED, so when not on a call, I tend to hang out at the nurses station to pass the time. That being said, you have to look at it from a EMTs point of view. We're paid crap. End of story there. A lot of times it's very frustrating to be in the same general ballpark of a field that nurses are in, and be handed the business end of a crap stick. Also, to ask questions like 'Why hasn't she had her breathing treatment' are part of the standard history gathering. Those kinda questions are built into the EMT mindset, just accept that. You gotta understand, we don't carry on long term care. I usually only ever see a patient once. Ever. I have to learn everything I can about them within a 5 minute window. Also, you can't compare what EMTs do to nurses or vice versa. EMTs receive more training in working in the pre-hospital environment. Such as hazmat, rescue operations, vehicle extrications, sometimes providing care with nothing but things lying around the house, laws regarding pre-hospital treatment. Nurses aren't taught the first things (as far as I know), about an urgent extrication in the aftermath of a MVC. Nurses on the other hand, go more in depth into pathophysiology and long term treatment. I'm sure there's more, I just personally don't know what an RN learns. But in the end, we should all learn to work together. Because what would people do WITHOUT EMTs, and what would people do WITHOUT Nurses? There would be a big mess. That's what.

getoverit, BSN, RN, EMT-P · Dec 30, 2009

Wow...more about nursing vs EMS.and just when you thought it was safe to get back in the water.....

to the OP, I'm sorry you had to deal with people that acted like jerks. It's difficult to see both sides to the story...as a paramedic, there have been times that I've had sixteen 911 calls in a row, haven't eaten in almost 18 hours, I'm exhausted and out of the 16 calls, 12-13 of them were ridiculous (e.g. "I'm afraid I might have diarrhea tomorrow", "do you have any Paxil in the ambulance", "my leg has hurt for the past eight years"....these aren't exaggerations by any means, they are actual complaints that you'll get at 2am after screaming with lights and sirens to their house). Same as in nursing when I'll have a patient get admitted to ICU and threaten to "sue somebody" if they don't get IV dilaudid, or even worse they'll assault one of the nurses (which definitely happens to medics in the back of an ambulance too). These things can all lead to just wearing you down and out.

I've also seen nurses at LTC facilities tell me that "this man must be constipated"--turns out he had a dissecting AAA, which was obvious and we coded him before we got to the truck; I've seen a nurse give a sliding scale dose of regular insulin to a patient who wasn't diabetic and then call 911, trying to blame EMS that the patient's sugar was 17. Nurses at LTC facilities run out of the patients' room when they code (so much for team collaboration in an intense situation). So these things tarnish the view of nursing for some EMS workers.

I'm definitely not trying to start flaming anyone, just realize what an EMT might have been through during his shift which may be 12+ hours longer than yours. Like Gila said, I encounter ineptitude on both sides of the fence. I feel the article in EMSResponder was absurd and I certainly don't agree that paramedics are different types of nurses at all. Also, the article was written 4 years ago and not much has changed or advanced since then so you can easily see the impact it had on the profession....

I feel the bottom line to help the argument between nursing and paramedics is to realize that we both should have the same ultimate goals in mind...safety and improved health of the patient. Who cares who is "in charge" or "higher medical authority"? I have a BSN and a Bachelors degree in Emergency Medicine...when I'm in a LTC facility I don't ever wonder if the RN has an associates' or BSN or anything like that....because it really doesn't matter. What's important is how we collaborate with each other. I've worked with medics who acted like a$$es to RNs and I would always apologize on their behalf because we all work together.

ZippyGBR, BSN, RN · Dec 30, 2009

part of the problem is that people sign up to EMS to be 'johnny and roy' or 'Josh ' ( depending on time frame and place in the world ....

the find the routine stuff 'boring' because they don't get to flop out their big box of drugs and do heroic things in the glare of the TV cameras

LTC facility staff do have something to answer for ( it's the exception rather than the rule to get good handovers etc)

compunding this in some places is the EMS bsed Fire services who insist of their FFs having EMT certification and make ambulance work a punishment posting and /or a right of passge to progression on the firemonkey side

ramkatral · Dec 30, 2009

I disagree with the bashing of Firefighters being EMTs. 97% of our calls, the fire department is first on the scene. I'm GLAD we have at least EMT-Bs on scene quickly. Especially for time critical cases such as cardiac arrest. If you've never had a career in the EMS field, you wouldn't understand 75% of the life in the pre-hospital environment. It's unforgiving. More so than the hospital. We have no doctors around.

eriksoln, BSN, RN · Dec 30, 2009

I don't have issues with EMTs usually. Actually, I never have. Only once did I have one get bold with me, asking for info they didn't need. That was easy to fix.

I don't let people of this nature bother me. Its easy to have a strong opinion when you have no accountability for the decision. When the pt. is under your care, you alone are accountable for them. This.......affects your decision making, obviously. More than likely, you've put more work/thought into the calls you make than just simply trying to recall from some history channel program you saw last month.

Hows the saying go, "Quiet streams run deep"?

EMT216 · Dec 30, 2009

I know this topic has been hashed and rehashed until everyone is probably sick of it, but I had an encounter with an EMT yesterday that left me so mad I had trouble sleeping last night. I had a lady with chronic COPD and pulmonary fibrosis who was so sick she was messing allover herself and smearing it all over the place because she was too weak to get to the toilet, which is totally unusual for her. Her O2 sats were in the 70's to low 80's and you could hear coorifice wheezes before you even got into her room. I pulled out a breathing treatment to give while I called the doctor but in the meantime I had another COPD patient going down the tubes so I had to call for TWO transports to the ER. SO, in the midst of all this the Albuterol was left on my med cart. They got there pretty quick, and I was telling them about the lady, and one of the EMTs (with this smug-looking smirk on his face) says, "Can you tell me why she hasn't had a breathing treatment this morning?" I was totally caught off guard but I mentioned that at this point an Albuterol neb tx wasn't going to help this woman, she needed to get to the hospital because she obviously has pneumonia. He went on to argue that it would have helped and she needed an antibiotic ordered and to be given her breathing tx's instead of the ambulance...and he just kept running his mouth. They both rolled their eyes as they were rolling her out. Turns out they admitted this woman with bilateral pneumonia, put her on IV antibiotics and all that (we don't do IVs here).
Why do these guys feel the need to be confrontational and antagonsitic? Little Man Syndrome???

Okay... first of all let me start this conversation out by saying that when we pick up pts from nursing homes... typically they are soo sick and going down the tubes because they have layed there like that for days!!! then when there o2 sat is in the 70's THEN and only THEN is it a medical emergency and this ALWAYS seems to happen at three in the morning?? my question to you super nurse is why arent these pt's taken care of prior to them falling so ill? Also when we pick these pts up, NO ONE EVER knows any info about the pt.. We pick up ur COPD'ers with o2 sats of 60-70, cyanotic and *****.. yet you have them on 2lpm o2??? ever think of calling a DR??? Before you start bashing other people and professions, MAYBE you should look inside and see what is going on inside YOUR facilty. I cannot tell you HOW many times we have saved nursing homes staff's asses taking care of THEIR emergencies.. And for that matter, We have MORE training and schooling than most of your so called LPN "nurses". So rather than saying we have little man syndrome, maybe we are just tired of picking up your slack!!!!

ramkatral · Dec 30, 2009

I can say alot of the smugness and attitude many nurses feel from EMTs is because of the same thing in return. Even though I have a very good relationship with our ED nurses, the ones I encounter at nursing homes or other LTC facilities tend to treat me as a lesser. It's quite unfair. Maybe, without you knowing it, you're giving off that same impression to the EMTs you're working with? I have found that it goes on with the nurse unaware they're doing it. As for EMT216s comments, I can both agree and disagree. Half the time I have good nurses who're ready with all the information I request. They'll be standing there with charts in hands spewing history to me. It's wonderful. And the other half there won't even be a nurse there. It'll be some administrative person fumbling through the paperwork for the information I need. I can't speak negatively about any of the nurses I work with. I can, however, say there's attitude problems on both sides of the aisle. I am guilty of popping off at some innocent nurse because I'm on the 20th hour of a 20+ call shift. It doesn't make it right, though.