The continuing saga of nurses vs. EMTs...

[Born2BWild]

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???

[EMT216]

I agree that there are good nurses also.. The ED nurses that we deal with are typically cool.. we see them ALOT and have establised a good rapport and we also have a good open line of communication with our EMS coordinators that typically keeping the bickering to a minimum and address any complaints quickly. I just HATE it when you catch attitude from nursing home nurses that have NO idea what it is like to deal with there cocky attitudes and unpreparedness.

[southernbeegirl, BSN, RN]

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!!!!

I see you are a nursing student, only in the first year. when you are all growed up and are a real nurse, lets talk, k?

[EMT216]

Okay I am in my second year of nuring school. I have 3 qtrs left until graduation. I have been pre-hospital for 11 years. Let me guess, your an LPN or just an RN with zero experince except passing meds in a nurisng home????

[ZippyGBR, BSN, RN]

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.

this is only because the fire services in the USA wish to maintain their small coverage areas and bloated personnel and appliance counts - the USA is pecularity in the developed world in having the following

1. low standards of EMS training and in many places a complete absence of EMS education

2. dominance by fire services looking for a reason to justify their bloated establishment and fleet - especially in the light of the small coverage area and lack of proper regional coordination - what does 4 firefighters as first responders provide over an EMS first responder or a community first responder ? other than loads of extraneous bodies on scene

once again assumptions have been made over the lack of knowledge of people - as someone who has been active in EMS for longer than they have been a Nurse i think i have a fairly good grip of the issue , leaving aside the analysis of Nursing roles in pre-hospital care that was the basis for my bachelor's dissertation ...

[GilaRRT]

Okay I am in my second year of nuring school. I have 3 qtrs left until graduation. I have been pre-hospital for 11 years. Let me guess, your an LPN or just an RN with zero experince except passing meds in a nurisng home????

Once you start with personal attacks, any point you may have is lost.

You need to realise that there are bad things that occur on both sides. I can say this anecdotally as an EMT and RN of several years. I started my career as an EMT for a private service. Therefore, I did allot of nursing home calls. Some good and some bad. The LPN argument is rather inane as there are a plethora of EMT's with less than 200 hours of total training. Therefore, comparing hours of education or "levels" of nursing education is not a highly valid point.

[southernbeegirl, BSN, RN]

haha, like i said, when you are all growed up, learn how to have an intelligent conversation, learn how to spell and know what it's like to be a real nurse...then you come back and we'll talk, k? in the mean time, i fear if you dont grow up and learn to chat on a message board without reverting to name callings ESPECIALLY about things you obviously have no idea about, you will soon be needing to come up with a new, nonbanned nic.

but if you must know, i've been a nurse almost 15yrs now, about to finish up my master's degree, and have worked in LTC for many many years.

i hate to deflate that little ego of yours but you NEVER take care of "our" emergencies. when you are a real nurse then you will realize that patients, especially geriatric patients, can crash in a moment's notice. it is at that point that we need you to take them to the hospital for us and take care of them while they are with you. to do that, we will give you all the information you request, we will collaborate with you for the good of the patient's condition but i assure you, mr. i'mnotanurse yet....you have not nor will you EVER save a nurse's a.s.s.

to say that you have more training than an LPN is absurd. if you had more training then you would allready be a nurse. what you have is DIFFERENT training. your training as an EMT concentrates on emergent situations and how to care for the patient at that point. in LTC, our patients are often medically stable and with us for physical rehab. LTC facilities do not have the ability to care for a patient in an acute crisis, thus we call for an emergent transfer by either a BLS or ALS crew, depending on what we need. for you to degrade an LPN just to make yourself feel more important in your own mind is disgusting. I guarantee you that i would much rather be taken care of by a fellow nurse, be it RN or LPN, than be taken care of by someone with your selfimportant attitude that will surely cause a patient harm one day because you feel you know it all when in reality you know nothing.

it is attitudes like yours of "i am so much better than a nurse" that continues to cause this rift between EMTs and nurses rather than both sides working together for the good of the patient.

i am so grateful for the EMTs, paramedics and FF that i work with. the majority of them know their stuff, trust my judgement and we all work as a team to care for the patient. but there is always that "one", like you, that thinks he is better than God at caring for people. people like you, well...they don't last long in any role..emt or nurse....unless you change that attitude of yours, myself and many on this board will be the ones standing back and smiling when you get chewed up and spit out by a "real" nurse:smokin:

[Virgo_RN, BSN, RN]

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

Still waters run deep.

[ramkatral]

Okay, first of all, EMT216, you're WAAAY out of your lane. You're acting in the very manner that started this conversation. Do you not get that? You're the one in the wrong here, and don't try to throw the nurse card at me. I am not a nurse, I am a career EMT and a part time firefighter. Lose the attitude or go find another place to start name calling. They are doing nothing more than offering counter points. If you expect to be allowed to speak, then you should be ready to listen.

Zippy, you're right. Notice I said Nurses 'without the proper training' have no business in an accident environment.

As for nurses in nursing homes, they know just as much as their counterparts in other areas. They simply are not equipped or allowed to handle acute emergent situations. It's the nature of their job. If you're unhappy with having to respond to a LTC emergency call, quit. Personally, I consider it another day at the office. I enjoy my job and all the calls that come with it. Emergency or routine, it's what I get paid to do. LPNs are just as qualified to do their job as you are yours. Get over it. CNAs, LPNs, RNs, NPs, they're all certification levels. Just like EMT-B, I, or P. Just because an EMT is a basic doesn't make his role any less important. Nurses of all levels have their places and their jobs, and we have ours. We both need each other, and we both should treat each others like brothers and sisters.

[txspadequeenRN, BSN, RN]

i could not agree more.......

haha, like i said, when you are all growed up, learn how to have an intelligent conversation, learn how to spell and know what it's like to be a real nurse...then you come back and we'll talk, k? in the mean time, i fear if you dont grow up and learn to chat on a message board without reverting to name callings especially about things you obviously have no idea about, you will soon be needing to come up with a new, nonbanned nic.

but if you must know, i've been a nurse almost 15yrs now, about to finish up my master's degree, and have worked in ltc for many many years.

i hate to deflate that little ego of yours but you never take care of "our" emergencies. when you are a real nurse then you will realize that patients, especially geriatric patients, can crash in a moment's notice. it is at that point that we need you to take them to the hospital for us and take care of them while they are with you. to do that, we will give you all the information you request, we will collaborate with you for the good of the patient's condition but i assure you, mr. i'mnotanurse yet....you have not nor will you ever save a nurse's a.s.s.

to say that you have more training than an lpn is absurd. if you had more training then you would allready be a nurse. what you have is different training. your training as an emt concentrates on emergent situations and how to care for the patient at that point. in ltc, our patients are often medically stable and with us for physical rehab. ltc facilities do not have the ability to care for a patient in an acute crisis, thus we call for an emergent transfer by either a bls or als crew, depending on what we need. for you to degrade an lpn just to make yourself feel more important in your own mind is disgusting. i guarantee you that i would much rather be taken care of by a fellow nurse, be it rn or lpn, than be taken care of by someone with your selfimportant attitude that will surely cause a patient harm one day because you feel you know it all when in reality you know nothing.

it is attitudes like yours of "i am so much better than a nurse" that continues to cause this rift between emts and nurses rather than both sides working together for the good of the patient.

i am so grateful for the emts, paramedics and ff that i work with. the majority of them know their stuff, trust my judgement and we all work as a team to care for the patient. but there is always that "one", like you, that thinks he is better than god at caring for people. people like you, well...they don't last long in any role..emt or nurse....unless you change that attitude of yours, myself and many on this board will be the ones standing back and smiling when you get chewed up and spit out by a "real" nurse:smokin:

[GilaRRT]

I do not work in a nursing home, therefore I have no personal attachment to nursing in this environment aside from my days as working as a CNA. Again, some good and bad experiences. Focusing on bad incidents without appreciating the other side is rather myopic IMHO.

EMS in the United States is plagued by multiple problems just like nursing; however, saying nursing homes are in a poor stated because of nurses is absolutely incorrect. As a nursing student, you should have spent time in a nursing home. You should know that problematic homes suffer from a plethora of problems.

[sirI, MSN, APRN, NP]

Closed for review.