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Permalink Reply by Joey Everhart on November 19, 2007 at 9:28am

It's not so much being lawsuit shy as it is refusing pt. care. If the pt. wants to be transported then we HAVE to transport them by law. We cannot refuse care just because they have the sniffles.

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Permalink Reply by Ryan on November 19, 2007 at 10:16am

I will have to aggree with you when you talk about the ER staff getting angry about you bringing patients in. I have seen this on very many occasions. It is not right when you walk through the ER doors and the nurse's first question for you is "well why did you bring this person here" and my first repsonse everytime is "this is a hospital correct?" It seems to me that if the patient is not severe ex:code/major trauma, they dont want anythign to do with the patient. Even so they will always get grumpy. Heres an example: 45yo F pt c/o severe Chest Pain radiating to left arm, BP 84/50, gave fluid bolus and BP went to 90/56, PR 120, RR24, D-Stick 54, after treatment D-stick went to 70, This pt was not looking good at all, First of all the ER never answered the MERS(medical emergency radio system) radio, and then when we walked through the door we were screamed at for bringing the patient in. I dont agree with this at all, i mean you become a nurse become you want to. I dont understand why some of these people choose this career if they're gonna be grumpy everyday. ER staff needs to learn that this field is not all about the money!!

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Permalink Reply by Paul Montpetit on November 19, 2007 at 12:13pm

Hmmm...as both a paramedic and an er nurse something here doesn't "smell" right....I have never and I do mean never heard of any MD or RN instruct any als crew to tx and leave.....this is and would be construed as gross negligence....You as an ALS provider cannot make a diagnosis and cannot order tx for the patient. Something is grossly wrong here......We are a very expensive taxi sometimes I agree....but we still transport unless the patient refuses...and even then we are supposed to insure that the patient knows all the risks involved with their decision.......and not to be the devils advocate.....you are NOT "licensed" you are "certified".....and you are/were right to question this....I would bring it up to the Hospital where it occurred and if nec to the county EMS comittee.....Stay safe and keep the faith..............Paul

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Permalink Reply by Amanda 11-33 on February 1, 2008 at 3:47pm

Well... what to say?!?! It's a lose-lose situation when it comes to dealing with ER staff. But I personally see it from both aspects, more like 3 points of views. Currently I'm a paramedic student. So not only do I treat patients as an EMT at one service but I also treat patients as a Paramedic Student at another service. And then on top of that, I have to do clinical time at the hospital so I get to see everything that goes on after EMS leaves.

Honestly, if the Paramedic does what they should and are permitted to do in the field, by time they get to the hospital, the nurse's job is done until the doctor sees the patient. If the pt has an IV, less work for the nurse. If the nursing home pt has a catheter, less work for the nurse. Other than getting a report and taking a set of vitals, there is not much left that the nurse has to do. The tech's get all the blood for labs. Registration takes care of what they need to do. All the nurse has to do is take the report!

But what can you do... ER Nurses are threatened by Paramedics. Medics have much less class time and can do WAY more than nurses can do (with the exception of PHRN). But the nurses shouldn't complain because they work in an environment where they don't have to worry about getting soaken wet in the rain, slipping on ice, walking through knee-high snow and doing ALL their work in a small space while going 60 mph down the bumpiest, curviest roads imaginable. And they get payed WAY MORE than what Paramedics do.

So the next time it happens, just look at them and say, I did all your work for you, now shut-up and write what I tell you!

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Permalink Reply by Paul Montpetit on February 1, 2008 at 9:01pm

Come into my ER with that comment and find your butt thrown out AND reported to county and State EMS council....I am at both ends as well and I agree that at times we all get a little short...but copping an attitude like that sure won't help either now or in the future...As both an EMS provider and an ER Nurse I can sort of see both points....But professionalism has to prevail...and starting a battle that you can't possibly win isn't the way to get anything done..And sorry to tell you there is a hell of a lot more to do than what you think....must not have been paying much attention on your clinical days/nights if thats all you got out of it....I must have waisted all my time in getting my BSN and MS degrees if all I had to do was get my paramed cert. DAMN...!!! Stay safe...and don't work too hard...Paul

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Permalink Reply by Amanda 11-33 on February 1, 2008 at 9:26pm

Trust me... I pay attention. ALL the nurses and techs love me at the hospital where I'm doin' my clinical time. And believe it or not, but more times than less, I go above and beyond what I'm supposed to be doin' in the hospital. Doin' a nurse assessment is NOT what I'm to be doing but I do it neways. And cleaning rooms for more patients to come in is NOT what I'm there to do but I do it neways.

If u knew nething about me, you would know that I'm not just gonna stop at being a Paramedic. I'm slowly climbing the ladder and one day I'm goin to be a Physician of Emergency Medicine.

And the whole bit about medic's copping an attitude... we wouldn't have to get an attitude or get mad & upset if the nurses treated us like the health care professionals we are. Don't say it doesn't happen because it happens EVERYDAY. We ALL have to work together... and certain people fail to realize that. So the medics get a complex when they are constantly gettin attitude from the place where they take their patients.

It's NEVER gonna stop! But whether it's the nurse or the medic's fault... at the end of the day, you chose to work where you are working and at whatever level you may be. Don't take it out on others if you hate your job or can't stand certain aspects of it.

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Permalink Reply by Joe Stoltz on February 1, 2008 at 9:26pm

There are times when we get to the ER and the staff acts like it's an imposition when we show up with a patient. But that has gotten better over the last few years and there haven't been any recent experiences.

I have a little speech prepared in case it ever happens again, though. Parts of it go like this:

We are all components of the health care system.
We treat them in the field and bring them to you.
You diagnose, treat definitively and release. Or keep for further evaluation.
We have to do our thing and you have to do yours.
We bring you CUSTOMERS.

(and if all else fails) Take me to your leader.

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Permalink Reply by Marc Hansen on February 7, 2008 at 2:29am

Cut the ER staff a little slack we all b**ch and moan when we have to haul someone to an ER that we know doesnt need to go. Now try to see it from the RN's side. We have to deal with 1 or 2 of those types of pts a shift nad the ER has to deal with those 1 or 2 but from 10 or 20 trucks. I'm pretty sure we would all be a little cross too.
Neat little trick I've picked up is when your slow bring in coffee, or a bucket of wings or pizza and drop it off for ER staff. You only have to do it once or twice and they remember you as a friend. It might cost me $30 every second or third month but when the gator shuffling starts I dont catch an attitude from the staff and dont wait a half hour or so for someone to give report to.
Think of the RN's as the starving kids on a Sally Struthers commercial--for the price of a cup of coffee every 24 hour shift you can make an RN a better person!

***The preceding message was brought to you by someone that has never worked for an ER, is not a nurse and to the best of my knowledge am not related to an ER nurse***

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Permalink Reply by Joe Stoltz on February 7, 2008 at 9:02pm

And are you also prepared to state that "NO ER nurses were harmed during the typing of this message?"

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Permalink Reply by Barry on February 7, 2008 at 9:48pm

I actually was on a call working a full arrest and the doctor at the receiving hospital wanted to pronounce the patient while they were still in the ambulance on the way in. His logic? "The patient will probably die anyway." 38 years old with no medical history. Apparently the doctor didn't realize that we as EMS personel are capable of bringing back a patient in full arrest. Another time I was diverted to a trauma center when my patient had no complaints of injury after an accident, but just wanted to get looked at as a precatuion. Or there are the times when they actually argue with us over the radio as to whether or not they are our closest hospital. It's almost as though they don't trust us or our judgement. I once brought a patient in to my closest hospital and they asked why we always feel the need to bring patients to their facility. After explaining that they were the closest, they told us that it wouldn't hurt to start going somewhere else. I understand that they do get busy, but sometimes I think it's a matter of laziness, and their lack of willingness to want to treat patients. Not all hospitals are bad, and not all give us problems. Most are actually very good and have doctors, nurses, and ER techs that are very good to work with. But it's the few that do give us problems that leave us with sour feelings.

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