Any interesting anecdotes about interference with patient care from a CNA, lifegurad, etc.?

[gonefishing]

So would you say doing CPR on a loved one is/ was enjoyable?

Not in a million years. Way to hit close to home there. What I ment was keep everyone on the same page and like the fonz. Whats the fonz like? Cool! Everyones gonna be cool!

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[EpiEMS]

@VentMonkey You're totally right about their workload - and you're also absolutely right about being non-judgemental. I try to keep the chortling for the truck (only snapped once - 20 minutes ago he was at an SPo2 of 96%? Come on, this guy is satting at 70% on 6 lpm.)

 

[Tachy55]

Yes, they do.

Anecdotally speaking you'll run into many "stereotypical" events at SNF's and con-homes in your career.

The story fish told is by no means new, or shocking. With that, when my wife and I first started dating she was in the midst of doing a CNA course (always knew she wanted to go RN). It was about equivalent to most EMT courses, and yes they require CPR cards like pretty much any healthcare provider.

Fast forward a few years later and she's working at a SNF. These "nurse assistants" are often left with 20-30?ish patients at a time on a given shift for 8-12 hours at a time. The LVN's are typically the highest qualified staff (particularly at night); you may have a pencil-pushing DON/ RN during the day. They're often subjected to the same type of injuries EMS providers are (try lifting a s/p CVA patient by yourself? She did.), and get the same crap pay in hopes of either bringing home the bacon to their families, or moving up the nursing ladder.

Many of these CNA's develop a fond, loving, and close bond with the patients they care for daily; they become like their own family members with names and such (every see the demented elderly SNF patient with the ragdoll babies, or the mind of a 3 year old?), and may even be "working" what they believe to be a person near and dear to them when we walk in the room.

Sure, I've rolled mt eyes, snapped, snickered and judged like most of us, but it doesn't make it right. Try keeping up with all the grunt work of 30 bedpans, urinals, and daily turns only to have to EMS-ers give you attitude because you're surprised, or freaked out by the code in the room next door when you may literally have "just talked to them".

All these threads about how to better our profession blah blah blah. Why don't we start by giving out pointers we've missed to our future providers? Maybe then we won't continue the "tradition" of what it is we all find so frustrating: ourselves.

They have jobs to do just like us. These days more often than not I guide them if they're nervous (I do need/ use them for CPR), and walk them through or encourage their technique; isn't that what we learn in the basics of any AHA provider course anyhow? Nah, easier to turn around and poke fun.

...rant over (for now).

Very respectable rhetoric. Thanks for that.

 

[VentMonkey]

Not in a million years. Way to hit close to home there.

My point remains. I had to watch the matriarch of our family die a slow miserable death; finally coded and died...Thanksgiving day the year I was in didactic, so yes it sucks, anyhow...

Some of these workers are hard working, sure they may not be up to par on what we do, but it isn't their specialty. They really do grow to bond with their patients, and for some of them, it's all they have; I've seen it.

I'm just trying to open up young impressionable minds to insight perhaps they never thought of; won't that do more good than poking fun at what we may not understand?

 

[gonefishing]

My point remains. I had to watch the matriarch of our family die a slow miserable death; finally coded and died...Thanksgiving day the year I was in didactic, so yes it sucks, anyhow...

Some of these workers are hard working, sure they may not be up to par on what we do, but it isn't their specialty. They really do grow to bond with their patients, and for some of them, it's all they have; I've seen it.

I'm just trying to open up young impressionable minds to insight perhaps they never thought of; won't that do more good than poking fun at what we may not understand?

Yes I see your point. They are with these people day and day out and form a bond and thats my point try to keep everything smooth and cool.

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[VentMonkey]

Yes I see your point. They are with these people day and day out and form a bond and thats my point try to keep everything smooth and cool.

Sooo, just like any code, right??

 

[gonefishing]

Sooo, just like any code, right??

Of couse lol

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[MMohler]

I remember cracking ribs for the first time. I'll never ever forget it. I try to make it an enjoyable experience.

I will forever remember this when it happens.

 

[Bullets]

Thankfully, last year our lifeguards were transitioned into the newly created municipal "department of EMS" So they get training from us at the beginning of the season and are encouraged to ride out with us once or twice. This helped greatly when we go to the beach for calls.

SNFs, just smile and wave....

 

[EpiEMS]

@Bullets, are they under medical control? What's their cert level, EMR?

 

[Tigger]

It's weird, most around here don't really have an issue with "lower certifications." I mean, they called us after all, most are happy we're there.

 

[agregularguy]

Yes, they do.

Anecdotally speaking you'll run into many "stereotypical" events at SNF's and con-homes in your career.

The story fish told is by no means new, or shocking. With that, when my wife and I first started dating she was in the midst of doing a CNA course (always knew she wanted to go RN). It was about equivalent to most EMT courses, and yes they require CPR cards like pretty much any healthcare provider.

Fast forward a few years later and she's working at a SNF. These "nurse assistants" are often left with 20-30?ish patients at a time on a given shift for 8-12 hours at a time. The LVN's are typically the highest qualified staff (particularly at night); you may have a pencil-pushing DON/ RN during the day. They're often subjected to the same type of injuries EMS providers are (try lifting a s/p CVA patient by yourself? She did.), and get the same crap pay in hopes of either bringing home the bacon to their families, or moving up the nursing ladder.

Many of these CNA's develop a fond, loving, and close bond with the patients they care for daily; they become like their own family members with names and such (every see the demented elderly SNF patient with the ragdoll babies, or the mind of a 3 year old?), and may even be "working" what they believe to be a person near and dear to them when we walk in the room.

Sure, I've rolled mt eyes, snapped, snickered and judged like most of us, but it doesn't make it right. Try keeping up with all the grunt work of 30 bedpans, urinals, and daily turns only to have to EMS-ers give you attitude because you're surprised, or freaked out by the code in the room next door when you may literally have "just talked to them".

All these threads about how to better our profession blah blah blah. Why don't we start by giving out pointers we've missed to our future providers? Maybe then we won't continue the "tradition" of what it is we all find so frustrating: ourselves.

They have jobs to do just like us. These days more often than not I guide them if they're nervous (I do need/ use them for CPR), and walk them through or encourage their technique; isn't that what we learn in the basics of any AHA provider course anyhow? Nah, easier to turn around and poke fun.

...rant over (for now).

I know the rest of the thread has already kinda moved past this post, but I really wanted to highlight this post because I really like it.
I know both I and my crew mates have previously **** on CNAs for their quality of care (which don't get me wrong, sometimes goes beyond the negligent scope) but your post really brought that into perspective. In the end, we both have jobs to do, and some of them take care of a lot more patients at once than I do most days! We all are trying to provide care for our patients, whether it be at the CNA level, EMT level, Medic level or one of those levels with aspirations to go higher. While yes, they are usually definitely lacking in certain parts of prehospital care, that's what we're there for, not them. So if they've never done CPR properly, teach them! Never bagged properly? Teach them! We get the opportunity to see and do a lot more emergent pre-hospital care than they do.. instead of being all pissy with them, take that time to teach them. That way, in the future, while they will still be calling you for emergent care, maybe they'll have made more of a difference than standing around doing inadequate CPR (if any)

 

[hometownmedic5]

I can't really say I've had trouble with lower level providers. As said, they called us and are usually pretty good about getting out of the way once we turn up.

Now, higher level providers, that's another kettle of fish entirely. While not a daily occurrence, I think we've all come across a dr or nurse(more nurses in my experience) who hurts so much more than they help things. I try to get them to back off as professionally as possible, until it becomes a problem and then they get told point blank to get out of the way.

 

[Bullets]

@Bullets, are they under medical control? What's their cert level, EMR?

No, but to be a Lt or Captain they require EMT. About half are EMTs who volunteer with a squad. Those who aren't get the Red Cross first aid class. NJ doesn't recognize EMR as a level of training

 

[EpiEMS]

Just thinking out loud here...I have a lot of friends and family members who are physicians. Aside from the EM folks, they all tell me that they would be basically useless at an out of hospital emergency scene - so they'd rather leave it to us. The only one of them whom I think might be underrating his abilities is the critical care peds doc...

NJ doesn't recognize EMR as a level of training

Oh, NJ, magical NJ. So there is no oversight for providers below EMT?

 

[Bullets]

Oh, NJ, magical NJ. So there is no oversight for providers below EMT?

For what? There is no level of care below EMT in the eyes of the state DOH. You could take ARCs First Aid Class but it's not a recognized certification. No one offers the national EMR class. Lifeguards etc are basically good Samaritans under the law.

 

[EpiEMS]

For what? There is no level of care below EMT in the eyes of the state DOH. You could take ARCs First Aid Class but it's not a recognized certification. No one offers the national EMR class. Lifeguards etc are basically good Samaritans under the law.

That's interesting - just kinda strange that there is no EMR level. Don't NJ volley services often have "driver only" members? So wouldn't you want them to be at least EMRs?

 

[Bullets]

That's interesting - just kinda strange that there is no EMR level. Don't NJ volley services often have "driver only" members? So wouldn't you want them to be at least EMRs?

No, i want them to be EMTs. In this state, there is no need for EMR. We have to many hospitals and are too densely populated to warrant EMRs. EMT is 120 hours of class, how much more watered down can you make it? Just give everyone the Boy Scout merit badge at that point. Even PDs encourage their officers to go to EMT class

 

[SAREMT]

I have no idea what this person's certification was or where she worked, but I one time was screamed at by a "nurse" that I didn't know what I was doing and that I couldn't possibly be getting a blood pressure without a stethoscope while I palpated a blood pressure in the middle of a crowd at a large music festival (only BLS gear). I found that to be pretty humorous.

 

[rescue1]

I have no idea what this person's certification was or where she worked, but I one time was screamed at by a "nurse" that I didn't know what I was doing and that I couldn't possibly be getting a blood pressure without a stethoscope while I palpated a blood pressure in the middle of a crowd at a large music festival (only BLS gear). I found that to be pretty humorous.

I remember blowing the minds of upper year medical students when I demonstrated how to palp a BP at a clinic event. It's not really something docs would learn until intern year and beyond, but at the time it was pretty funny.