# Rude nurses. How to deal with them?



## emt58 (Sep 28, 2013)

I'm a fairly new EMT and almost all of my encounters with nurses are not good and have me leaving the ER with a bad impression. I can't believe people in such a profession would act this way towards anyone involved with a patient. I understand it could be a demanding job and yeah you know your medical stuff and you're more knowledgeable than EMT's and most medics but none of them seem to have any manners. Each time before being cleared I say 'thank you' I don't even get an 'uh huh' or any sort of acknowledgement. 

Like this morning... got the patient in the room and the nurse got hateful with me because the information sheet I gave a few minutes earlier hadn't registered on her CPU yet and then was asking me the vitals and I don't remember the exact numbers so I looked on my tablet (which I'm still getting used to) and she just kinda huffed and puffed which really kind of embarrassed me in front of my patient. Pretty much got the tablet slammed into my gut after getting her signature with no goodbye, thanks, or have a nice day. I don't know if this is egotistical behavior or stress... or something else? 

One other thing I will bring up... so far it seems at my EMS job and even volunteering people think they are so high and mighty because they think they are medical geniuses and almost seem to purposely make them self look better/brag when taking about patient care or drug knowledge because they are medically trained. I mean it's good and all and I guess if I was highly trained I'd feel cool too. I don't mean to offend anyone, this is just an observation from what I've seen during my time as an EMT. Sorry to complain if that's how I'm coming off.


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## NomadicMedic (Sep 28, 2013)




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## Fish (Sep 28, 2013)

Keep being nice, they will come around.


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## VFlutter (Sep 28, 2013)

emt58 said:


> I'm a fairly new EMT and almost all of my encounters with nurses are not good and have me leaving the ER with a bad impression. I can't believe people in such a profession would act this way towards anyone involved with a patient. I understand it could be a demanding job and yeah you know your medical stuff and you're more knowledgeable than EMT's and most medics but none of them seem to have any manners. Each time before being cleared I say 'thank you' I don't even get an 'uh huh' or any sort of acknowledgement.
> 
> Like this morning... got the patient in the room and the nurse got hateful with me because the information sheet I gave a few minutes earlier hadn't registered on her CPU yet and then was asking me the vitals and I don't remember the exact numbers so I looked on my tablet (which I'm still getting used to) and she just kinda huffed and puffed which really kind of embarrassed me in front of my patient. Pretty much got the tablet slammed into my gut after getting her signature with no goodbye, thanks, or have a nice day. I don't know if this is egotistical behavior or stress... or something else?



There is no reason to be overtly rude or disrespectful in a professional environment but at the same time if you are incompetent it will not hide my discontent. 

If you dropped me off a patient and had to fumble around to find patient information or *exact *vitals then I am not going to very happy. You should be able to give a quick, concise, and accurate verbal report. Not "He was 90ish percent on a few Liters, Blood pressure was 120s over something, uhhh I think he has a history of COPD". 

For example, when I respond to a code or rapid response I expect that the primary RN knows basic information such as the patient's history, recent events, and vitals prior to coding. I want this information the second I walk in the the door. I do not want to stand there while they flip through the chart trying to find history or look in the computer for recent vitals. If they do not know any of this then I will tell them they can leave the room, and probably not in the nicest tone, since they are useless to me and now just in the way.


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## Anjel (Sep 28, 2013)

The preciseness and smooth reports come with time. The OP is obviously new. No need to be rude period. Cut the poor guy some slack. 

Around here all of the nurses are really nice to the paramedics. Not so much the EMTs until they get to know them. But they all hang out with us and go to the bar after work at 7am. 

Hang in there OP. You will get the hang of it. Just kill them with kindness.


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## FiremanMike (Sep 28, 2013)

Sheesh, really?  Exact vitals really aren't that critical, and if you value them that much, they'll be on your monitor in a few seconds when your tech gets your initial set of vitals.  If you want my exact last set of vitals and I can't remember them off hand, check the squad sheet because I called report while staring at my monitor.  Listening to my verbal report of the overall big picture of scene information, chief complaint, interventions and response to interventions is much more important than differentiating between 142/76 and sats of 93 versus "pressure was 140s over 70s and sats were in the low 90s despite blah blah interventions"..

To the OP, you just gotta suck it up.  Keep showing up and showing them you know what you're doing.  I find most nasty nurses don't last too long in the ER before they move on to an easier job.  Some nurses just never really get over the odd dynamic between prehospital and inside the ER..

It doesn't matter how long you've been doing this, you'll still get them occassionally.. I just had a nurse the other day condescendingly tell me my patient wasn't in trigemeny because there were no group of 3 PVCs anywhere on my strip.  When I explained to her that trigemeny was a PVC every third beat, she chuckled and looked away.  I just laughed inside my own brain at the thought of her telling her nurse friends later about the dumb medic and them telling her she was wrong.  On a side note, I hadn't seen her before and I haven't seen her since..


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## emt58 (Sep 28, 2013)

Chase said:


> There is no reason to be overtly rude or disrespectful in a professional environment but at the same time if you are incompetent it will not hide my discontent.
> 
> If you dropped me off a patient and had to fumble around to find patient information or *exact *vitals then I am not going to very happy. You should be able to give a quick, concise, and accurate verbal report. Not "He was 90ish percent on a few Liters, Blood pressure was 120s over something, uhhh I think he has a history of COPD".
> 
> For example, when I respond to a code or rapid response I expect that the primary RN knows basic information such as the patient's history, recent events, and vitals prior to coding. I want this information the second I walk in the the door. I do not want to stand there while they flip through the chart trying to find history or look in the computer for recent vitals. If they do not know any of this then I will tell them they can leave the room, and probably not in the nicest tone, since they are useless to me and now just in the way.



I understand but I think being incompetent and being new to EMS while gaining experience running calls are two very different things. All of the negative attitude starts right as I walk in, I can sense it, it's not just after fumbling around for vitals or whatnot. To them I may seem incompetent since I'm so new still learning the ins and outs of my duties and that's ok but it's still no reason to be rude. I'm sure most of us have had jobs where we wanted to scream at someone/customer but we all have to maintain professionalism... working at a hospital or ambulance service shouldn't be any different, although we should be held to a higher standard. We all have jobs to do but to me the most important thing is patient care and good manners. Being a nurse shouldn't make you better than anyone else.


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## VFlutter (Sep 28, 2013)

Anjel said:


> The preciseness and smooth reports come with time. The OP is obviously new. No need to be rude period. Cut the poor guy some slack.



Agreed however it sounds like the OP is just assuming that everyone else is the problem and that RNs are just rude for no reason when in reality it may very well be how the OP interacts with them. 

There are two sides to every story.


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## Anjel (Sep 28, 2013)

Chase said:


> Agreed however it sounds like the OP is just assuming that everyone else is the problem and that RNs are just rude for no reason when in reality it may very well be how the OP interacts with them.
> 
> There are two sides to every story.



I completely agree.


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## emt58 (Sep 28, 2013)

Thank everyone for the reply. I just have to suck it up. I'm going to move on and try and get better with time. This has taught me to be more accurate and on point with a verbal report so I will do a better job of jotting down vitals, patient history, and brief report of the call and interventions. If I can get better with the tablet while managing the patient I can multi-task better with PH care.


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## Tigger (Sep 28, 2013)

emt58 said:


> I understand but I think being incompetent and being new to EMS while gaining experience running calls are two very different things. All of the negative attitude starts right as I walk in, I can sense it, it's not just after fumbling around for vitals or whatnot. To them I may seem incompetent since I'm so new still learning the ins and outs of my duties and that's ok but it's still no reason to be rude. I'm sure most of us have had jobs where we wanted to scream at someone/customer but we all have to maintain professionalism... working at a hospital or ambulance service shouldn't be any different, although we should be held to a higher standard. We all have jobs to do but to me the most important thing is patient care and good manners. Being a nurse shouldn't make you better than anyone else.



If you expect the ED staff to be mean to you every time you come in, you are going to perceive everything they do as rude. I'm not really sure what you are "sensing" but everyone I've ever worked with that had issues with the ED staff was always looking for reasons to prove how nasty they were when in reality little if any of it was happening. Even if they are truly being rude for no reason on every encounter, if you walk in with the right attitude it won't matter as much to you. Eventually the staff will learn you're plenty competent but until then take some time to practice getting it better. 

Take a step back, think about what the staff wants from you and what you can do to get better at that. If you can, go through your report in your head before you even step through the doors. Think about how you are going to transfer the patient and whatnot. Some planning and practice will go along. As others have said, if you get lip, just kill em with kindness. No other solution is going to help in the long run.


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## emt58 (Sep 28, 2013)

Chase said:


> Agreed however it sounds like the OP is just assuming that everyone else is the problem and that RNs are just rude for no reason when in reality it may very well be how the OP interacts with them.
> 
> There are two sides to every story.



How should I be interacting? Please explain. I'm a very nice person and easy to get along with. I'm still learning, that is the problem, not a nurses or anyone else. I'm not assuming anything. Not all nurses have been overly rude to me or my partner however a good majority have.


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## emt58 (Sep 28, 2013)

Tigger said:


> If you expect the ED staff to be mean to you every time you come in, you are going to perceive everything they do as rude. I'm not really sure what you are "sensing" but everyone I've ever worked with that had issues with the ED staff was always looking for reasons to prove how nasty they were when in reality little if any of it was happening. Even if they are truly being rude for no reason on every encounter, if you walk in with the right attitude it won't matter as much to you. Eventually the staff will learn you're plenty competent but until then take some time to practice getting it better.
> 
> Take a step back, think about what the staff wants from you and what you can do to get better at that. If you can, go through your report in your head before you even step through the doors. Think about how you are going to transfer the patient and whatnot. Some planning and practice will go along. As others have said, if you get lip, just kill em with kindness. No other solution is going to help in the long run.



I will do my best to get better. I never want to be an annoyance or nuisance and make someone else's job harder.


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## FiremanMike (Sep 28, 2013)

Chase said:


> Agreed however it sounds like the OP is just assuming that everyone else is the problem and that RNs are just rude for no reason when in reality it may very well be how the OP interacts with them.
> 
> There are two sides to every story.



This is true and needs to be considered, but it also needs to be said that there are RNs with a chip on their shoulder just like there are medics with a chip on their shoulder.  No way to really tell what happened here with only 1 side.


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## CALEMT (Sep 28, 2013)

From what I've read I'm assuming that you're fairly new to EMS (no offence). When I first started the nurses came off like a holes to me. Then a couple weeks down the road after they have seen my face and saw how my reports improved they warmed up to me. I has never rude back I slapped a smile on my face said thank you and have a nice day... Like everyone else is saying I pretty much killed them with kindness and it woked. Also in that time frame I worked on my turnover reports and when I need to glance at the tough book I already have it ready just in case. Just keep improving on the things you need to work on, be kind and it will be all good.


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## Carlos Danger (Sep 28, 2013)

FiremanMike said:


> I find most nasty nurses don't last too long in the ER before they move on to an easier job.



My experience has been the exact opposite. Most of the crotchety nurses I've worked with or encountered as a paramedic were the crusty old ones who'd been doing it forever.

A busy ED is a really tough place to work. A new ED nurse is usually even more intimidated and lost than a new paramedic or EMT, and folks in that position are generally not aggressive.




emt58 said:


> Being a nurse shouldn't make you better than anyone else.



Of course it doesn't, and you won't find many people who think that it does.

Being rude is not a "nurse thing". It is an individual issue. There are plenty of individual EMT's, paramedics, cops, firefighters, doctors, etc who are rude. 

If the rudeness is really that intolerable then you should go to your management and have they try to deal with it through official channels. If it is as bad as you say, then I'm sure you aren't the only one dealing with it and it shouldn't be hard for your bosses to find enough examples to make a good case to the ED administration.

However, I would first reflect and make that you aren't exaggerating the issue. Perhaps it is as bad as you say, but I've encountered few people who were as blatantly disrespectful as what you describe.


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## Tigger (Sep 28, 2013)

emt58 said:


> I will do my best to get better. I never want to be an annoyance or nuisance and make someone else's job harder.



As you start to improve you might notice that the nurses start to soften a bit, if not that's when you know you're dealing with someone you can't please. Sometimes it's worth asking what they think you are doing wrong, other times just smile and leave. You can't please everyone.


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## VFlutter (Sep 28, 2013)

emt58 said:


> How should I be interacting? Please explain. I'm a very nice person and easy to get along with. I'm still learning, that is the problem, not a nurses or anyone else. I'm not assuming anything. Not all nurses have been overly rude to me or my partner however a good majority have.



Be confident and concise. Honestly, I could care less how nice you are or how easy you are to get along with. I want the pertinent information I need so that I can get my job done. This goes for all transfers to higher levels of care. I do not care if you are an EMT, Medic, or RN as long as you know what you are doing. I frequently get report from all of them. Like others have said it is not a certain profession it is an individual thing.


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## emt58 (Sep 28, 2013)

Chase said:


> Be confident and concise. Honestly, I could care less how nice you are or how easy you are to get along with. I want the pertinent information I need so that I can get my job done. This goes for all transfers to higher levels of care. I do not care if you are an EMT, Medic, or RN as long as you know what you are doing. I frequently get report from all of them. Like others have said it is not a certain profession it is an individual thing.



I would agree that's what I would want if I was in their shoes. My confidence level is low at the moment with barely any experience and I know I keep bringing this up but it's true. Maybe that's why I get the stink eye from RN's when giving a report. I'm not very comfortable doing things I'm not used to doing and book smarts really don't mean much. One thing about my NREMT class was that we didn't get very much hands on experience, and I knew after I got through the course and passed the exam and practicals that I wasn't going to feel alright at first. But I want to get better. I suffer from social anxiety, slight speech disorder, and ADD. It's a shame, and I know I know, some of you will probably say I don't belong in this field but I love helping people and I want this to be my career. I'm no idiot, I just have a lot to work on and things to get over. But I'm doing my best.


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## Akulahawk (Sep 28, 2013)

emt58 said:


> I would agree that's what I would want if I was in their shoes. My confidence level is low at the moment with barely any experience and I know I keep bringing this up but it's true. Maybe that's why I get the stink eye from RN's when giving a report. I'm not very comfortable doing things I'm not used to doing and book smarts really don't mean much. One thing about my NREMT class was that we didn't get very much hands on experience, and I knew after I got through the course and passed the exam and practicals that I wasn't going to feel alright at first. But I want to get better. I suffer from social anxiety, slight speech disorder, and ADD. It's a shame, and I know I know, some of you will probably say I don't belong in this field but I love helping people and I want this to be my career. I'm no idiot, I just have a lot to work on and things to get over. But I'm doing my best.


Although the book is a little "old" I suggest you read certain parts of "The 60 second EMT" as there's a pretty good section there about giving verbal reports for medical and  trauma patients. Once you've got the general format, all you have to do is "plug in" the specifics and you're off and running. Also, while some other info is a bit "old" as well, you still can learn from it, particularly things to keep an eye out for.


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## mycrofft (Sep 28, 2013)

How to adress rude nurses: learn and do the job well, don't respond to perceived insensitivities, and press onwards. As long as it's ok for the pt, it's ok.

PS: they aren't being paid to be sensitive. 

PPS: I'd be more scared of the quiet smiling nurse who watches you leave, then sits down and takes half an hour writing a detailed memo (accurate or not) about "those terrible dirty unprofessinal ambulance drivers".


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## medichopeful (Sep 28, 2013)

emt58 said:


> My confidence level is low at the moment with barely any experience and I know I keep bringing this up but it's true



The confidence will build with time, but only if you let it.  Until it's there, act confident (but not arrogant, which I don't think is the problem) even if you're not.  



> But I'm doing my best.



Which is what matters!


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## Dan216 (Sep 30, 2013)

Play some grab arm and they will come around.


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## Clipper1 (Sep 30, 2013)

Dan216 said:


> Play some grab *** and they will come around.




Yes nurses do read these forums for amusement and then may have an attitude for the next poor guy who walks in with good intentions. 

The EMT/Paramedic or several EMTs/Paramedics who came in before the OP may have been real jerk just wanting to play grab *** and that can set the mood for the shift or about EMTs/Paramedics in general.

Conduct your self as a professional with your report ready and eventually you won't have any problem.


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## usalsfyre (Sep 30, 2013)

Clipper1 said:


> Yes nurses do read these forums for amusement and then may have an attitude for the next poor guy who walks in with good intentions.


Some of them even troll it on occasion


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## DesertMedic66 (Sep 30, 2013)

We have one hospital that we hate transporting patients to. Most of the nurses are rude and look down on us. Registration can also be rude to us. What do we do? Get in and leave as fast as possible to avoid issues. The nursing staff at the hospital even give our supervisors :censored::censored::censored::censored: for no reason. 

With our other 2 hospitals it's completely different. All the staff are really nice to us. Never give us any issues. We will spend a lot of time at these hospitals talking to the nurses, doctors, registration, PAs, etc.


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## Clipper1 (Sep 30, 2013)

usalsfyre said:


> Some of them even troll it on occasion



Some EMTs even troll on nursing forums.  Do you think rolling your eyes at my post makes you better?  

You roll your eyes at a doctor, nurse or patient in the hospital, you will get noticed especially if it is just to impress your partner or other EMTs.  Conduct yourself professionally and no one will have to roll their eyes at you either.


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## MSDeltaFlt (Sep 30, 2013)

Nine times out of ten the nurses who are rude are generally over worked and under staffed.  Not going to address that one out of ten, just the other nine.  They're irritable.  They're pissy.  Not necessarily at you, just in general.  It happens.  Some may not care.  Some might and not even realize they're coming off as rude.  Sometimes what you say and what people hear you say might not be the same thing.

Get upset over, don't get upset over it.  Be offended.  Don't be offended.  The choice is completely up to you.  

All that it amounts up to being is interpersonal dynamics.  That is all.

You're not there to win any popularity contests, though it would make things run more smoothly if everyone was nicer.  Granted.  So you be you.  Stay open minded.  Be the patient advocate you want to be and let the attitudes take care of themselves.


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## VFlutter (Sep 30, 2013)

Dan216 said:


> Play some grab arm and they will come around.



I would like to see you try that with me :glare:


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## STXmedic (Sep 30, 2013)

I'll grab your butt, Chase...


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## usalsfyre (Sep 30, 2013)

Clipper1 said:


> Some EMTs even troll on nursing forums.  Do you think rolling your eyes at my post makes you better?
> 
> You roll your eyes at a doctor, nurse or patient in the hospital, you will get noticed especially if it is just to impress your partner or other EMTs.  Conduct yourself professionally and no one will have to roll their eyes at you either.


So then how should I react to the eye rolls I get when I treat my patients using current guidelines rather than something from the 1980s? 

Professionalism goes both ways. Implying that EMS forums are only good "for amusement" is a serious lack of professionalism on some people's part as well. But when you hide behind one or more aliases online I guess it's easy to lack professionalism.

As for the OPs question. Try to chat with the nurse outside of the patient's room and find out exactly they're upset about and take it into consideration. Having a good relationship with the receiving staff makes everybody's life better. However, if they're asking for stuff that is detrimental to the patient, stupid or illegal....forget it. You're accountable to your medical director and management, not the nurses.


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## MrJones (Sep 30, 2013)

Chase said:


> I would like to see you try that with me :glare:



I suppose you'll take this the wrong way, but I sincerely hope you don't....

How long have you been out of Nursing school?


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## the_negro_puppy (Sep 30, 2013)

Welcome to EMS!


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## titmouse (Sep 30, 2013)

Kill them with kindness and a faux olde English accent.


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## Miscusi (Sep 30, 2013)

nurses.  

At the Emergency Dept, where it is always busy, and patients are always coming, and no one ever gets a break...  

your job gets whittled down to the essentials. 

being nice is not essential, therefore each second used to be nice is a second that can be used to save lives...

an EMT who is using more time than he needs would get on people's nerves. and when you do, and nurses are not diplomats, they may allow their emotions to show.

it is stressful, but it is what it is.

I never expect niceness at the ER. 

but when it isn't busy for some blessed reason, I find that some are actually nice. Especially when they remember you as a regular EMT that works her ER.


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## Aidey (Oct 1, 2013)

Miscusi said:


> being nice is not essential, therefore each second used to be nice is a second that can be used to save lives...



This is just.... Ugh. I say please and thank you during a code. Unless someone is elbow deep in an open chest "seconds" don't mean jack crap. In 10 years I am extremely hard pressed to think of a case that was so life and death there wasn't time for basic decency.


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## Miscusi (Oct 1, 2013)

Aidey said:


> This is just.... Ugh. I say please and thank you during a code. Unless someone is elbow deep in an open chest "seconds" don't mean jack crap. In 10 years I am extremely hard pressed to think of a case that was so life and death there wasn't time for basic decency.



you are not a nurse, I was referring to the nurses that are rude to the OP.  You prob get to sit and watch TV and browse the internet for most of your tour...


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## Tigger (Oct 1, 2013)

Miscusi said:


> you are not a nurse, I was referring to the nurses that are rude to the OP.  You prob get to sit and watch TV and browse the internet for most of your tour...



So being busy means you get to be rude?


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## JPINFV (Oct 1, 2013)

Clipper1 said:


> Yes nurses do read these forums for amusement



Seems fair... I read AllNurses when I need a little humor in my life.


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## firecoins (Oct 1, 2013)

Yes, being busy entitles ER RNs to be rude. It doesn't matter. Give them the info they want, get their signature and move on the next call.  I don't have time to contemplate whether the RN has good manners or not.  In the end, I just don't care.


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## Clipper1 (Oct 1, 2013)

Tigger said:


> So being busy means you get to be rude?



Is it possible being impatient could also be interpreted as being rude?

When was the last time you had 10 patients all wanting something at the same time and probably at least one of them who should be one to one in an ICU? Do you normally see at least 60 patients a day and maybe pass well over 100 medications?


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## Clipper1 (Oct 1, 2013)

usalsfyre said:


> So then how should I react to the eye rolls I get when I treat my patients using current guidelines rather than something from the 1980s?.


It might be your own attitude with your protocols if you are getting eye rolls. If you are unhappy with your current guidelines and prefer to go back to what you had been doing, talk to your medical director. But, change is sometimes good and you need to move forward especially in medicine.



usalsfyre said:


> Professionalism goes both ways. Implying that EMS forums are only good "for amusement" is a serious lack of professionalism on some people's part as well. But when you hide behind one or more aliases online I guess it's easy to lack professionalism.?.



Did you happen to notice the names used on this forum? That alone is good for amusement. Of course I use an alias on here just like everyone else.   If you want a professional forum you join a professional organization which has a secure forum and one which requires you post your real name and where you work. 



usalsfyre said:


> As for the OPs question. Try to chat with the nurse outside of the patient's room and find out exactly they're upset about and take it into consideration. Having a good relationship with the receiving staff makes everybody's life better. However, if they're asking for stuff that is detrimental to the patient, stupid or illegal....forget it. You're accountable to your medical director and management, not the nurses.


What in a report would you consider to be illegal, stupid or detrimental? Would you consider an RN asking about the patient's home life to be stupid or illegal? What if they noticed signs of abuse?  Do you consider asking about drugs illegal? Are you going to bring a patient into a hospital and not give any info which might help in the treatment because you thing it is illegal or stupid because of your own personal beliefs?


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## Clipper1 (Oct 1, 2013)

JPINFV said:


> Seems fair... I read AllNurses when I need a little humor in my life.



Read my previous post about forums. Nurses on that forum also know by the aliases they use it is a public forum and not really a professional one. Many posting on there are EMTs.  It, along with others are sometimes thought to give those in the profession a black eye. Do you really think this EMT forum represents professionalism in EMS?  Read some of these posts. Does bragging you drive your ambulance 100 mph or that your smear nitro paste on a co-workers toilet seat show your professionalism?


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## Clipper1 (Oct 1, 2013)

Aidey said:


> This is just.... Ugh. *I say please and thank you during a code*. Unless someone is elbow deep in an open chest "seconds" don't mean jack crap. In 10 years I am extremely hard pressed to think of a case that was so life and death there wasn't time for basic decency.



The focus should be on the patient. One should not have to worry that they thanked everyone before getting the patient to the cath lab or OR.  Professionals know they are there to do a job and not win a beauty contest.  Co-workers in a code would rather know you can get equipment, open airways and do the meds rather than hanging around saying nice things to everyone and smiling over some patient's body.

You might be able to stick around and thank everyone because you only have to do charting on one patient for the short time you were with them. You don't have 4 - 10 other patients still wanting things, meds to be given, procedures to get to, phone calls to make, labs to draw and their charting to be done.  Also even after a code is called, the work does not stop for a nurse or doctor. The family and care of the body still has to be taken care of along with more charting and phone calls for that.  How many EMTs and Paramedics are going to be in a foul mood because they had to wait to deliver their patient in the ER or divert because the staff was hanging around seeing that everyone got thanked?


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## sir.shocksalot (Oct 1, 2013)

emt58 said:


> I would agree that's what I would want if I was in their shoes. My confidence level is low at the moment with barely any experience and I know I keep bringing this up but it's true. Maybe that's why I get the stink eye from RN's when giving a report. I'm not very comfortable doing things I'm not used to doing and book smarts really don't mean much. One thing about my NREMT class was that we didn't get very much hands on experience, and I knew after I got through the course and passed the exam and practicals that I wasn't going to feel alright at first. But I want to get better. I suffer from social anxiety, slight speech disorder, and ADD. It's a shame, and I know I know, some of you will probably say I don't belong in this field but I love helping people and I want this to be my career. I'm no idiot, I just have a lot to work on and things to get over. But I'm doing my best.



Book smarts do mean a lot, applying them is a process of hands-on instruction and practice. No one is comfortable dealing with something new and many people struggle to give a good report when they are stressed. Getting the stink-eye from the nurse or medic is definitely going to make your reports suffer. As some others have said, develop a good format that covers everything the nurse wants to hear and omits the things they don't then practice, practice, practice. Come up with scenarios and then practice how you'd give your report. 

As a side note, I too have ADD and feel I'm a relatively successful provider. Know your weaknesses and develop ways to cope. For my hand off reports I ensure that my whole focus is on the report before I start to give it. If I have to coordinate getting everything untangled and the patient moved while I give a report I know I will lose track of what I'm saying or will forget to say things entirely. Many with a variety of issues are very successful in this career, the only things that should indicate your "belonging" in this field is your willingness to learn and adapt as well as you desire to genuinely care for the sick and injured. Give yourself a break. As long as you work on it you'll get there with time and practice.


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## wanderingmedic (Oct 1, 2013)

I have found it makes a big difference if you are able to make friends/build a professional relationship with ONE nurse. After that everyone else seems to follow. 

There tend to be LOTs (depending on where you live of course) of ED staff that were EMT's or Medics. Find them, make friends, and ask good questions when appropriate. Don't come off as incompetent, but be eager to learn. I have found RN's who were EMTs or Medics are usually very willing to teach, you just have to be willing to learn, and be smart enough to ask questions at the appropriate times. Some humility and a sense of humor goes a long way. 

Also realize that RN's are human and can have bad days too....so their grumpiness might not be personal....all the time.


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## Tigger (Oct 1, 2013)

Clipper1 said:


> Is it possible being impatient could also be interpreted as being rude?
> 
> When was the last time you had 10 patients all wanting something at the same time and probably at least one of them who should be one to one in an ICU? Do you normally see at least 60 patients a day and maybe pass well over 100 medications?



I am not even going to respond to this. It should have been obvious that my comment was not addressed to you but rather to another poster who stated that because EMS works less it's ok for RNs to be rude to EMS. Please, stop trying to make arguments that do not exist, it does not provide for any productive discussion.


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## WTEngel (Oct 1, 2013)

I am a little bit surprised by the number of people here who seem to think that if their workload is high, or the patient is critical, it gives them license to be as crummy and ill tempered as they like.

I have been in sme pretty hair raising situations, and I can count on one hand the number of times that I have lost my composure and said something disrespectful or displayed an attitude that was not appropriate. I can also say that each time that happened I have personally made an effort to apologize to that person when the smoke cleared.

I am particularly disappointed in a few of the nurses on this board, who seem to embrace this attitude of "I don't have time for niceties, if someone is offended by my behavior, they don't have any idea of the stress I am under or the gravity of the patients's condition."

Most of the physicians, nurses, and paramedics I have worked with that display the type of attitude above are either very new, not entirely confident in who they are clinically, or just need to get over themselves.

Losing your patientce with someone, being short and catty, or acting like you don't have the time of day are all characteristics of weak leaders. The best clinical leaders I have known are cool under pressure, respectful to everyone from the CEO all the way to the janitor, and always make an effort to make colleagues and co workers feel appreciated.

Even when someone has screwed up or needs to improve at their job, there is rarely a time where tact and decorum can not be used when dealing with those around us.

Anyway, this is just my opinion. This is the type of paramedic I have been, and this is the type of physician I hope to become. There is no single person on the team who is so important that they get to be polite only to those they deem worthy.


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## cspinebrah (Oct 1, 2013)

One thing I LOVE to do in those situations is just bare with the rudeness and at the end in a soft tone of voice and a huge smile look at them and say,"Thank you for your time and have a WONDERFUL day." 

It makes them more angry but all you did is say something polite. 

anddd you leave being the bigger person.


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## firecoins (Oct 1, 2013)

We aren't the politeness police. Give them a precise report and move on. If they are nice, great! If they aren't, just move on. I found those nurses have personal problems and are like that with everyone including the other ER staff. It's not personal ....usually.


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## VFlutter (Oct 1, 2013)

WTEngel said:


> I am a little bit surprised by the number of people here who seem to think that if their workload is high, or the patient is critical, it gives them license to be as crummy and ill tempered as they like.





WTEngel said:


> I am particularly disappointed in a few of the nurses on this board, who seem to embrace this attitude of "I don't have time for niceties, if someone is offended by my behavior, they don't have any idea of the stress I am under or the gravity of the patients's condition."



Personally I never said it was justifiable to be outright rude or unprofessional regardless of the situation. That being said, I am not going to stand there and sugarcoat the situation or not voice my concerns. But there is an appropriate way to do so. 

I am human. I am extremely busy and taking care of multiple critical patients. I never take a full lunch, rarely get to sit down, and am constantly bombarded with phone calls, alarms, and emergencies. My time is precious. Does this give me permission to be rude or unprofessional? No. Does it make me short tempered or inpatient at times? Yes, unfortunately. 

When I am admitting a transfer patient I have certain expectations for the person giving me report. I expect that they know basic relevant information and a decent report. If they do not then not only is it annoying but it delays the transfer to higher care which is not good for the patient. I will still be polite and professional but if it seems that I am impatient or annoyed that is because I am.


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## WTEngel (Oct 1, 2013)

Maybe taking the time to educate the person transferring care about exactly what you want and need when taking a patient from them would be a better expenditure of your time, rather than sitting and being annoyed.

I know it is an expectation that people should know their job, and in many cases I too find it frustrating when being unnecessarily delayed by somebody else's lack of preparation or job knowledge.

When possible, I try to take the time (less than 2 minutes in most cases) to explain to the person in question exactly how they can prevent testing my patience when we cross paths in the future. It helps them out, it helps me out, and it helps the patients out.

I can do what I mentioned above in a very productive manner, and usually everyone leaves feeling really great about the encounter.

If it is not possible at that very moment, I try and follow up if I can, or work with the education department to implement processes which directly address the issue.

This is just me though. I can understand that not everyone would be willing to go to these lengths.


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## jrm818 (Oct 1, 2013)

Dear OP,

Suck it up, crybaby.  This is clearly a problem with you.  Healthcare in general is well known to be full of nice, well-adjusted, benevolent people who work well as a team.  The problem is clearly you.  [end sarcasm]

Seriously, I think lots of people missed some basic kindergarten skills regarding playing nice in the sandbox.  Maybe these people can come hand out T-shirts in some units:

http://www.youtube.com/watch?v=6ZjipbU0Pk4

Hospitals are supposed to be a theraputic environment.  Do you think patients feel all warm and fuzzy when they see staff being jerks to each other?  Can you really tell me that you can instantly shut off the attitude when switching from interacting with a colleague to interacting with a patient?  I call BS, and anyone who is honest in reflecting on their healthcare experience knows that malevolent attitudes spill over onto patients all the time, not a plus for the whole healing process thing.

More seriously, being a jerk is dangerous.  Do you think you get a more efficient report when you smile, say hello, and make the person handing off to you comfortable, or when you bark?  Which attitude do you think encourages double checking, quick disclosure of errors, and collaborative work to solve problems?

Even more seriously, depression, suicide, drug use etc. are all overly prevalent among healthcare providers.  Yes the job is stressful by its nature, but do you really think that everyone trying to prove that "my job is really really hard...you can tell by how irritable I am" and being aloof or outright offensive with one another has nothing to do with these problems?


You don't' have to go around giving foot massages to everyone you meet....but simple (basic - KINDERGARTEN!) human interaction skills like saying and responding to "good morning", smiling when you see other people, not intentionally humiliating people when they make mistakes, and being supportive of new people could go a long way to making hospitals less miserable hellholes.  make whatever excuses you want, but if you are not pleasant to be around, YOU are part of the problem.  It takes..well...zero extra seconds to smile, 0.2 sec to say "Hi", etc.  

Everyone has off days, but in my experience many people in healthcare make it a pattern....and it's time to call it out as a bad thing.

edited to add: in summary, I don't mean to argue: "be civil" or "be professional"....I mean to suggest a more radical idea...try being actually overtly, obviously, conspicuously, gregariously NICE.  It's a goal we can all work towards, and I promise, it won't hurt a bit....

Plus a million to WTEngel's post too.


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## Akulahawk (Oct 1, 2013)

When giving report... I'm going to lead off with something like "Good morning, I have a..." and give a quick & concise report about the patient so that the receiving person has a good idea what's going on and where to start doing their own assessment. I conclude it with (as a prehospital provider) "my full report will be along shortly, any questions? See you in a few minutes." all that added a whopping 6 seconds to my report while providing the nice-nice stuff that people look for. And yes, I'm all business when I give or get report. 

When getting report from an nurse (when doing any sort of IFT, even if to the ED), I make life easy for them. I ask them to give report as if they were giving report to another RN. Why? It's something they're used to and something I can translate...  I've met too many RNs that don't quite know what I need when giving report to transport, so I accommodate their unease. 

Some people might be amazed what you can get others to do if you simply ask them, and say "please" and "thank you" while doing it... Yes, I can let my inner a-hole out if necessary, but if I'm having to do that, something's failed and I have to give orders, not requests. Doing that also means I'm going to generate a LOT of complaints. On the whole, it's better to be "nice" even if you're having a bad day.


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## Clipper1 (Oct 1, 2013)

Maybe we should look at some of the numerous rants on this forum made by EMTs and Paramedics who have no patience for patients or other professionals like FFs and Police.

How many have bragged about slamming narcan on a patient because the didnt like getting called to some junkie? How many have treated NH patients and staff rudely because the got a BS call rather than a cool trauma? How many times have you dumped the patient off in the ER at 0300 while being in a foul mood because you were awakened? How many have taken out their frustration on the patient and ER staff when you got a call during a game or when you were in the middle of writing some rant on EMTlife? 

We see over 50 ambulances come through our ED in a shift. I can tell you less than half are all rosy cheer when they come in. Many times we get half assed reports because the patient was just some BS waste of your time to you.

For every EMT story who has been so wronged by an RN, the RN can probaby give over a dozen stories right back at you.  The posts by some of the members of this forum are so filled with such a dislike for nurses, FFs, police and patients that this is almost a laughable topic.


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## Clipper1 (Oct 1, 2013)

WTEngel said:


> Maybe taking the time to educate the person transferring care about exactly what you want and need when taking a patient from them would be a better expenditure of your time, rather than sitting and being annoyed.
> 
> I know it is an expectation that people should know their job, and in many cases I too find it frustrating when being unnecessarily delayed by somebody else's lack of preparation or job knowledge.
> 
> ...



 You seem to have a lot of extra time. Maybe you should try to mentor the EMTs and Paramedics working in your own agency instead of expecting RNs to do this.  Get involved in their education and field orientation.  Too many EMTs are set up to fail by their own companies by not being given enough orientation or education.


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## WTEngel (Oct 1, 2013)

I guess that makes it alright then clipper. Since there are so many unprofessional EMTs and paramedics hanging around, and nurses have to put up with them all the time, it makes sense that everyone should just go ahead and be a jerk to one another.

You're right, the topic is laughable. The point that is laughable, however, is your insistence on clinging to the losing argument of "EMTs and paramedics do x, so who are they to question anything anybody else does."

I briefly went ove this thread with my wife, a charge nurse with 10 years experience at one of the largest pedi ICUs in Texas, and she said, in no uncertain terms, that if any nurses acted the way some of you are "defending", whether it be because of a bad day, or just their generally poor disposition, their attitude would be corrected post haste. In a professional environment, this type of behavior simply shouldn't be tolerated.

I may only speak for myself, but if my colleague ever acted the way some of you describe, I would be embarrassed to ride with them and report them up the chain of command immediately.

You keep bringing up these anecdotal stories of EMS personnel doing unprofessional things, yet it has nothing to do with the OP. No one is trying to generalize all nurses here (at least I'm not anyway) so I see no reason why you should generalize all EMS personnel.

Since you seem to have so much disdain for what goes on around here, what keeps you coming back?


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## WTEngel (Oct 1, 2013)

Clipper1 said:


> You seem to have a lot of extra time. Maybe you should try to mentor the EMTs and Paramedics working in your own agency instead of expecting RNs to do this.  Get involved in their education and field orientation.  Too many EMTs are set up to fail by their own companies by not being given enough orientation or education.



I am actively involved in the second largest paramedic education program in North Texas. I also FTO'd and precepted for years. Additionally, when I finish medical school, I plan on becoming an EMS medical director. Suffice it to say, I am effecting change in my profession, and plan to continue doing so.

As far as extra time goes, I have a feeling I spend far less time coaching those around me than you do complaining about those around you.

Your attitude is poor, your interpersonal skills lacking, and your argument happens to be a losing proposition. These are all signs that you are outmatched, outsmarted, and ultimately out of your league. 

The time for coaching is long gone in your case. You happen to be the rare exception that proves the rule...nearly everyone can be coached, but some people just aren't worth it.


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## ffemt8978 (Oct 1, 2013)




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