# Call me an Idiot...



## chrissyk (Mar 25, 2007)

OK, I am an EMT-B student here in the lovely midwest!! Ahh...its always enjoyable here, JK!
I go out to bar with some of my girlfriends to have a drink, a huge fight breaks out outside the bar, a friend of mine who got right in the middle, runs inside and asks me for help... a 21 year old...was unconscious, I of couse run outside to help...I was taught Airway comes first! A nurse comes up screaming 'I'm a nurse' blah, blah, blah. He-was very clearly unconscious (mind you blood is running out from his mouth--nose---the whole bit) he got knocked about 30 times against the curb. She was freaking out, like she had never seen anything like this before. I was as calm and collective as I told her you probably need to turn him over to see if he has an airway and is breathing. She proceeds to scream at me about how you cannot move him because he might have spinal damage, and she checks for a pulse *which she couldn't find* I got a pulse rate for her...as I am about ready to die laughing---she screams at me to get away from him, that I didn't know what I was doing and so forth and so on--anyone have any ideas---did I do wrong, what could I have done different???


----------



## Stevo (Mar 25, 2007)

ems rule #1 chrissyk

be the calm in the storm , don't add any more windage to it...


~S~


----------



## VentMedic (Mar 25, 2007)

Everybody in health care has a zone of comfort that is good for them. This includes nurses, RTs, PTs, EMTs and Paramedics. Hopefully people will find the area right for them before they get too far into their careers and frustrated. 

I am not referring to you. The nurse probably has not been in many emergency situations where she is the primary provider. If she is hospital based, there are Rapid Response Teams and Code Teams to take charge of emergencies.  She probably felt a sense of duty to act but truly lost sight of her skills when her adrenaline started. By probably not doing emergency medicine in her profession, nothing was coming naturally for her. She, too, is probably asking herself the same questions you are and what she could have done differently. 

Keep a cool head, learn your assessment skills in Basic.... You sound already like you're on your way for a great career.


----------



## Airwaygoddess (Mar 25, 2007)

Stevo said:


> ems rule #1 chrissyk
> 
> be the calm in the storm , don't add any more windage to it...
> 
> ...



Well said Stevo!!


----------



## EMTBandit (Mar 25, 2007)

I think Stevo and VentMedic summed it up pretty nicely.  ^_^ Well done Chrissy and you are not an idiot lol. ^_^


----------



## hangit (Mar 25, 2007)

chrissyk said:


> what could I have done different???




i would've given the nurse a back-hand, but that's just me.h34r: lol, don't sweat it, you knew what the right thing to do was.


----------



## Flight-LP (Mar 26, 2007)

I would have stayed inside and kept drinking...................


----------



## firecoins (Mar 26, 2007)

Leave the situation alone.  You are allowed to leave the situation in her hands legally.  Let her screw it up.


----------



## BossyCow (Mar 26, 2007)

Not uncommon for nurses to be out of their element when the bleeding/trauma occurs outside a controlled environment.  One of the best things EMS does is bring control to chaos.  She was 'in charge' due to her certification but out of control due to her emotional state.  Sounds like you had two patients.. one trauma, one psych!


----------



## firecoins (Mar 26, 2007)

scene safety is important.  The nurse made the scene unsafe...legally unsafe.


----------



## Guardian (Mar 26, 2007)

I would have rolled him with cspine precautions and checked for breathing, etc.  The nurse was an idiot and/or didn't have any emergency experience.  It does worry me you wanted to laugh in that situation.  Nothing really funny about someone seriously injured and an idiot nurse.


----------



## firecoins (Mar 26, 2007)

Guardian said:


> I would have rolled him with cspine precautions and checked for breathing, etc.  The nurse was an idiot and/or didn't have any emergency experience.  It does worry me you wanted to laugh in that situation.  Nothing really funny about someone seriously injured and an idiot nurse.



It sounds to me that she was both an idiot without emergency medical training.


----------



## Luno (Mar 27, 2007)

Flight-LP said:


> I would have stayed inside and kept drinking...................



I think I'm more of a humanitarian than you are, I would have described to an onlooker how to position recovery, told another to call 911, and ordered another beer, no touch, no care, no abandonment of patient or beer.


----------



## firecoins (Mar 27, 2007)

Luno said:


> I think I'm more of a humanitarian than you are, I would have described to an onlooker how to position recovery, told another to call 911, and ordered another beer, no touch, no care, no abandonment of patient or beer.



with a nurse there, there was no abandonment issue.


----------



## Recycled Words (Mar 27, 2007)

Meh...it's a personal pet peeve of mine when medical personnel who are unqualified to deal with a situation attempt to do so. I was on the highway with about a week left of my EMT course when there was an accident w/ injuries. I pulled over and this guy showed up acting all self-important. Turned out he was a dermatologist.

Had another issue when I was on scene responding to a possible broken arm and this random guy, a doctor is there assessing her arm, telling us what's going on, didn't seem to have the slightest idea himself. Of course, when offered to have pt care signed over to him, bet you can figure out what his answer was....


----------



## firecoins (Mar 27, 2007)

When you get a doctor or nurse on scene of an emergency who are clueless but need to be in charge, let them do it.  Unless you or a friend are the patient.


----------



## FF/EMT Sam (Mar 27, 2007)

firecoins said:


> When you get a doctor or nurse on scene of an emergency who are clueless but need to be in charge, let them do it.  Unless you or a friend are the patient.



EMS Rule #17: Until proven otherwise, all doctors on emergency scenes are gynecologists.

EMS Rule #18: The exception to rule #17 is if the patient is in labor, in which case the doctor will invariably be a dermatologist.


----------



## Jon (Mar 27, 2007)

[rant]Well... first thing that no one seems to have picked up on - How inebrieated were YOU and the Nurse... you were, after all, at a BAR. I'm VERY careful to not wear "Whacker-wear" if I will be consuming ETOh, as I've seen WAYY too many "drunken firemen" helping folks outside the local college bars... some of them are ok... most of them are as drunk, or more drunk than the person who is lying in the gutter vomiting.
[/rant]

I'm all about helping a patient like this, if I can. I would definatly stick to the "Basic first aid" level stuff... avoid trying to do chest decompression, etc


----------



## firecoins (Mar 27, 2007)

FF/EMT Sam said:


> EMS Rule #17: Until proven otherwise, all doctors on emergency scenes are gynecologists.
> 
> EMS Rule #18: The exception to rule #17 is if the patient is in labor, in which case the doctor will invariably be a dermatologist.



those were my thoughts exactly. With my luck I end up with a weight loss MD.


----------



## Flight-LP (Mar 27, 2007)

Luno said:


> I think I'm more of a humanitarian than you are, I would have described to an onlooker how to position recovery, told another to call 911, and ordered another beer, no touch, no care, no abandonment of patient or beer.



It has nothing to do with humanity. When I'm off duty, I'm off duty, period! Plus if I've been drinking, I'd want no part of that scene, from both a personal protection standpoint and from a liability standpoint. There is no abandonment, it was never her pt. to begin with. That why we have "on duty" EMS. Let them handle it. 

And yea, if my cell battery wasn't low, I might call 911. Depends on how the game on TV is going!

Beer anyone????


----------



## fm_emt (Mar 27, 2007)

FF/EMT Sam said:


> EMS Rule #17: Until proven otherwise, all doctors on emergency scenes are gynecologists.
> 
> EMS Rule #18: The exception to rule #17 is if the patient is in labor, in which case the doctor will invariably be a dermatologist.



Or psychologists, which can sometimes be useful. Unlike the "holistic medicine" types that seem to spring out of the woodworks around here sometimes.

"Ma'am, please stop rubbing tea leaves on the patient. Mmkay? Thanks."


----------



## chrissyk (Mar 28, 2007)

Guardian said:


> I would have rolled him with cspine precautions and checked for breathing, etc.  The nurse was an idiot and/or didn't have any emergency experience.  It does worry me you wanted to laugh in that situation.  Nothing really funny about someone seriously injured and an idiot nurse.



I wasn't laughing to be cruel here---I was laughing because the nurse was so intoxicated--she couldn't find a pulse and I hadn't even got 2 sips down on my first drink--and she was telling me how stupid I was!!! I really am not an insensitive person at all-there are a few exceptions: one of them being IDIOTS, STUPID PEOPLE!!

Thanks to everyone for all the comments! I appreciate it! Thanks for the advice it is really needed and appreciated! I love the EMS field, I actually feel part of a extended family!!


----------



## Tincanfireman (Mar 28, 2007)

We responded to a FDGB call the other day in the terminal of the airport. UOA, the patient was being attended to by another passenger who immediately stepped back when we approached, told us the patient was doing fine and had just rolled her ankle and bumped her head while deplaning.  He stayed close but never got in the way while we treated her and never tried to intervene.  After EMS transported her and we were packing up, he approached and complimented us on our care for the person, then produced his identification as the Medical Control Physician for a major fire/EMS department, not to mention the fact he was the chief of staff for trauma surgery (probably bamboozled the title a little, but you get the idea) for a Level I trauma center in the Southeastern US.  First time in over 25 years I had an honest to God ER doc in attendance, and he was a peach of a guy.  Just wanted to let y'all know it does happen... 

(FDGB= Fall Down, Go Boom)


----------



## Ridryder911 (Mar 28, 2007)

I have found those with true credentials and education, are more than happy to allow you to perform your job, and the reason we do not see very many "real ones" are they prefer not to stop (like me!). It is usually those that do not know what to do, or assume because they have a license or certification they immediately want to stop and rescue someone. 

I too have had only occasional similar incidences of where I was on the scene of a real bad trauma patient and a physician and a resident had stopped to assist. Turns out one of the physicians was a well known trauma surgeon and author. Ironically, the resident was in trauma residency from another state, and was shocked it was this "famous surgeon"..that he had studying his books!

Both of them did a excellent job, and complimented the crews afterwards, again those that do know, also know when it is appropriate to intervene and when not to.  

R/r 911


----------



## oldschoolmedic (Mar 28, 2007)

Had a cardiac arrest once upon a time (right after a church supper, in front of the whole congregation) with a doctor on scene who was more than willing to call the shots and rode with me to the ED. Thought it was okay until he starts asking me questions like, "What do you want to do next?" and "How much of this do you think he needs?" I would tell him, and he would tell me go ahead and do it, whatever it was. Luckily I had the presence of mind to keep the things I was doing right in line with our protocols because when I gave the patient report to the ED doc and introduced "Dr. So-and-so" they began exchanging professional pleasantries right up until I heard the words "...a WHAT?!? PODIATRIST.... WHAT THE HOLY HE..." The ED doc couldn't speak in complete sentences for about five minutes he was so angry. It was at this point my education truly began as to what different doctors do  . From that point on, unless I recognize the physician, I say "Hey we appreciate your help, but we've got it from here, thanks." More often than not they are glad to turn over the patient.


----------



## jalbanese (May 9, 2007)

Everyone in here summed it up pretty nicely. As my one EMT instructor once told me "Airway is most important, because if you bring in a perfectly packaged corpse it may be impressive till everyone realizes the patient is blue"

A spinal injury is definitley important to take care of. But if you aren't breathing or aspirating blood - thats worse. 

Doctors make nurses feel inferiour, nurses make techs feel inferior, techs make first responders inferior, first responders make the lay person feel inferior. Its just how the medical field works. She wanted to be on a pedistool because she works around that stuff even though she prolly has no idea what to do. Its an importance complex. Dont be too hard on urself bud you did the right thing.

Always remember your ABC's...Airway Breathing Circulation, as well as Always Be Cool


----------



## Trailpatrol (May 9, 2007)

Flight-LP said:


> I would have stayed inside and kept drinking...................



Yeah, but you're from Texas.  

I'm big enough and old (and grey) enough that most other healthcare providers don't give me many problems on-scene. Any who do always get the same litany: "MOI is _____, Airway is patent, Pt. is breathing, Pulse is ___, Spine is stablized....NOW, what would you like me to do?" Usually, at that point either EMS has arrived or they just give me a dumb look and humm and haw until EMS does get there.

A long, long time ago, (1979) when I was a medic, I lost a patient where I was second on scene after some Public Health RNs, who put a pillow under the head of a cervical spine patient. I never forgot that.


----------



## Canadian_EMT (May 9, 2007)

It is all what your comfort level is. Doctors and nurses are used to a contolled enviorment such as a hospital, where as we are used to the sometimes chaos of a bar scene. I have seen off duty doctors come up to a scene and just back up like everyone else and let us do our job!


----------



## LIFEGUARDAVIDAS (May 9, 2007)

Recurrent situations on every beach in the world:

1) 85% of the times... 
_"It's OK, I'm a DOCTOR, let me take care of it." :glare: 

2) 10% of the time, a doctor a bit more humble will show up...
_"I'm a DOCTOR! Let me help you!"
    My response in those cases:
_"Sure! Tell those bystanders to back off for me, thanks!" B) 

3) 5% of the times, a doctor who actually would be useful (ER/Trauma specialist) shows up and without pretending to take control of the situation will offer his/her assistance...
_"?????????"   (Missing an example. Sorry it has never happened to me but I want to believe that that actually happens, sometimes, looking forward to it) ^_^


----------



## old hand (May 20, 2007)

Recycled Words said:


> Turned out he was a dermatologist.
> 
> ....



You should have told him if acne breaks out you would give him a call.


----------



## firetender (May 20, 2007)

Guardian said:


> I would have rolled him with cspine precautions and checked for breathing, etc. The nurse was an idiot and/or didn't have any emergency experience. It does worry me you wanted to laugh in that situation. Nothing really funny about someone seriously injured and an idiot nurse.


 
Sorry, Guardian, we're in the midst of such incredible absurdity from so many angles, to not laugh is to not be alive. Taking life too seriously, even amongst us who are dedicated to saving lives, actually limits our effectiveness because those without a sense of humor live in a world of judgment. Living there prevents you from seeing what is really in front of you. When you live there, your relationship is with yourself and yourself only. 

This is a relationship business. I'd say it's a connection business, except I think you'd freak!

I'd enjoy seeing you lighten up!  

...and I also want to say, regardless of what you bring to this table, you're being yourself and honest and presenting a viewpoint that is very real and far too often not spoken. I see it as extremely valuable. That's what we're supposed to be doing...

But I'd add one extremely important point to that, we are here to affect each other and to be affected by each other so that the people we serve can benefit.


----------



## smacphee (May 24, 2007)

Something similar happened to me.  My friend was driving me and we saw a motorcyclist on the ground, motorcycle totalled.  I jump out, there are plenty of people around but they are on the sidewalk.  There was a woman there wo claimed to work at a hospital and one other guy squating down next to the patient.  I came out, offered my help but nobody responded.  Nobody was holding c-spine and the woman was taking a pulse rate off of the corotid.  She was freaking out big time, yelling at everybody.  So I just held proper c-spine with the helmet still on.  The guy was in pain, moaning, and had some memory problems, didn't know what he said 30 seconds earlier and didn't know what happened.  When Fire/PD showed up, everybody else split, including the 2 other people next to me.  Fire took over and I got to shake hands with the battalion chief and give him my name.  
I felt like slapping that lady because she wasn't doing anything correctly.


----------



## Mercy4Angels (May 27, 2007)

i would have told her i was an EMT, I know what im doing and if she was comfortable with the fact or me leaving this mans life in her hands then legally i can do that cause she is higher medical authority. now where the heck is my beer ?


----------



## emtingham (May 29, 2007)

*what could i have don different*

I asked the same question as a new emt. However; my pt died due to head injury on scene. Age 15. But I kept calm and kept trying (her mom was on the scene of the accident). The medics told me that by trying, kept mom calmer. I feel you have done well. I have learned that nurses on scene don't play well with EMS.


----------



## mfrjason (Jun 7, 2007)

Stevo is right Chrissy, if you are calm while  treating someone than the patient will be calm but if you are all excited,which seemed like the nurse was,you can mistakes alot faster,and in the EMS world mistakes are unacceptable. Dont worry about that nurse. GOOD JOB!


----------



## gnh2276 (Jun 9, 2007)

I would say kudos to you scene safety and your safety are #1 after that you are 100% right airway FIRST and I had to laugh where you said " she said she was a nurse and bla bla bla" that was something my instructor harped on if a nurse comes on scene tell them you are all set same with doctors some will say they are a doctor and kid you not you will find out they are a proctologist. Again kudos to you you did good.


----------



## gnh2276 (Jun 9, 2007)

mfrjason said:


> Stevo is right Chrissy, if you are calm while  treating someone than the patient will be calm but if you are all excited,which seemed like the nurse was,you can mistakes alot faster,and in the EMS world mistakes are unacceptable. Dont worry about that nurse. GOOD JOB!



Having been a combat life saver we train and train and train some more and when we are tired of that we train as we fight so that when in combat (which I have had the unfortunate opportunity of doing) its a clear head and you NEVER second guess yourself case in point your instructor is doing a great job and is a great teacher if you are able to stay calm in a stressful situation.


----------

