EMS Liaison/Hospital Relations

[RSQCali]

So I took over as the EMS liaison for my hospital and I am trying to find ideas to better build relations between our nurses and EMS crews. I am trying to find ways to show our facilities appreciation toward EMS and below are a few projects I have already started.
Case follow-ups
STEMI/Stroke recognition board
Trying to clean up the EMS room
Stocking drinks

I socialize with the crews as much as I can and always offer if there is anything I can do. I want to find other ideas to recognize our crews. I would like to find some other ideas so hit me with what you got. What do you wish your hospital would do for you?

 

[NPO]

RN ride alongs. Some nurses don't get it, and their attitude shows it.

Case follow up, regular CE lectures, etc are all great.

Last year for EMS week one hospital rented out an indoor dirt go cart track, bought pizza and booze and set us lose.

 

[Hendrik]

These are all great ideas to improve relations. Our EMS liaison would show up at our monthly training and meet with the majority of the crews all at once. This gave her the chance to listen to everyone's ideas and individually discuss incidents that occurred during the month. Congratulations and good luck on the new assignment.

 

[RSQCali]

I would do ride alongs, but I already run lol. I'm both an EMT-I and RN. Our crews have offered ride alongs for RNs, but they don't usually take up the offer. I have offered it to many of my co-workers as well and several are interested, but dont do it due to travel, time, or lack of incentive.

 

[NPO]

I would do ride alongs, but I already run lol. I'm both an EMT-I and RN. Our crews have offered ride alongs for RNs, but they don't usually take up the offer. I have offered it to many of my co-workers as well and several are interested, but dont do it due to travel, time, or lack of incentive.

Make it a requirement.

Lack of interest is the problem.

 

[Chimpie]

... Our crews have offered ride alongs for RNs, but they don't usually take up the offer. I have offered it to many of my co-workers as well and several are interested, but dont do it due to travel, time, or lack of incentive.

Make it a requirement.

I think that's the key right there. You should try working with hospital administration. Suggest that a nurse ride with an ambulance crew as part of their shift. They might have to bring in a nurse to cover the floor, but hey, it's training right? It doesn't have to be for a full twelve hours, maybe six to eight.

 

[DrParasite]

I have offered it to many of my co-workers as well and several are interested, but dont do it due to travel, time, or lack of incentive.

We mandated that every new ER nurse spend 12 hours on a medic truck as part of their orientation. If they medic truck was slow, we occasionally pulled them onto the BLS truck (we were both located at the same station). Didn't matter how experienced the nurse was, and frequently it was eye opening for them to see what we dealt with.

They were paid for their time, and it was part of their job. Every every 6 months, annually, at their discretion, whatever you feel is appropriate.

The other thing that make a good liason is to listen to the complaints from EMS providers, and either explain to them why a nurse (or other staff member) acted a certain way, or discuss with the staff why there was an issue. Usually stupid and trivial stuff that is caused by a lack of understanding on either side. but once you fix that issue, it makes life much easier for all parties involved.

 

[EpiEMS]

Case follow-ups

I'd love more of these, particularly to see where our presumptive diagnoses match (and deviate from) the MD diagnosis. But, of course, also to see what the hospital tx was!

 

[agregularguy]

Before I left my last agency a few months ago, we had just enable a new bit of software that allowed us to see the final hospital discharge diagnosis on our patients. I loved that! We also had a binder on the wall inside the entrance to the ER that had all the STEMI cases, showed a photo of the pre/post cath, the EKG transmitted as well as some generic patient info. It then named/congratulated the EMS crews, and I loved reading those! I'll try and dig up a picture of it.

 

[DesertMedic66]

Our biggest issue with our liaison nurse (we call them PLN) is they will start out doing a good job but within 6 months it will seem as if that hospital no longer has one because they become uninvolved with EMS and crews.

 

[Summit]

Make it a requirement.

Lack of interest is the problem.

Paramedic interest in following an ED RN with 4 rotating patients at a time through a shift? (I don't mean jumping from skill opportunity to skill opportunity like during clinicals). Maybe follow their EMS patient from the ED to ICU to OR to ICU to Stepdown to Med Surg to Rehab in successive 12 hour shifts for perspective on how problems progress, grow, and complicate?

Attitude problems come from both directions.

We did this during critical care orientation. We followed a medical resident for 12 hours and they followed a CCRN for 12 hours. Eye opening for both.

I wish someone would pay me RN wages to ride a 911 ambulance. I miss running 911.

Our biggest issue with our liaison nurse (we call them PLN) is they will start out doing a good job but within 6 months it will seem as if that hospital no longer has one because they become uninvolved with EMS and crews.

Our hospital has a highly educated Paramedic as a liaison officer. I think its a good thing.

 

[BobBarker]

Is the hospital affiliated with any RN programs? It might be a good idea to offer ride-alongs to nurses in training, kind of what they do to EMT's in training. I think that would be pretty awesome.

On a semi-side note, one hospital I used to visit frequently when relatives were admitted used to give all doctors and EMS personnel 1 free cafeteria meal a day. Nurses and employees did not qualify for the free meal, but they did get a discount. That must suck.

 

[NPO]

@Summit I think there would be a lot of value in medics following nurses around. Theoretically most should do this in school, but some don't and being given the opportunity to do it again after you're a bit more seasoned would be beneficial.

One of the biggest disconnects I see in EMS is prehospital providers not knowing what the expectations are for that patient once they arrive. How will their MOI/NOI be treated? What are thresholds for treatment? Will they be admitted to ICU? What things that we can do would help the ER staff? Things like that.

 

[Summit]

Is the hospital affiliated with any RN programs? It might be a good idea to offer ride-alongs to nurses in training, kind of what they do to EMT's in training. I think that would be pretty awesome.

Most RNs do not have anything to connect them directly with prehospital emergency care.

Survey asking if RNs work or have EVER worked in a specialty, only 16.5% work or have worked ED.

 

[BobBarker]

Most RNs do not have anything to connect them directly with prehospital emergency care.

Survey asking if RNs work or have EVER worked in a specialty, only 16.5% work or have worked ED.

It might open up that door, or it might not. In EMT school, they have a requirement where you have to do a minimum of 3 ride alongs with an amulance company or fire department and they also have a requirement to do 1 shift at an ER kind of like a tech. Most EMT's probably won't be techs in their career as most positions are with an ambulance or a stepping stone to 911/Fire, but it exposes them to that and how they work.

 

[Summit]

It might open up that door, or it might not. In EMT school, they have a requirement where you have to do a minimum of 3 ride alongs with an amulance company or fire department and they also have a requirement to do 1 shift at an ER kind of like a tech. Most EMT's probably won't be techs in their career as most positions are with an ambulance or a stepping stone to 911/Fire, but it exposes them to that and how they work.

The reason for EMTs to rotate to the ED is pretty unrelated to whether they will ever be a tech:

1. ED is probably their only chance to reliably have skills opportunities as ambulance shifts can be hit or miss
2. There is a direct connection between EMS care and ED care

Again, most nursing is not directly related to prehospital care. Really only ED, and most nurses never work ED. Most nurses who DO work ED do not start their nursing career in the ED. In fact, I'd say maybe 2/3s of nurses ever even rotate to ED during school! It makes sense to rotate ED nurses to the ambulance, not nursing students who are largely not taught emergency/trauma care beyond CPR. Maybe as a special opportunity for interested nursing students doing an ER practicum or elective course...

Always remember that EMS is this tiny little facet of healthcare... <2% of healthcare workers are EMS related.

 

[Bullets]

Paramedic interest in following an ED RN with 4 rotating patients at a time through a shift? (I don't mean jumping from skill opportunity to skill opportunity like during clinicals).

Dont know what your clinicals were like because i had to do 100 hours in the Adult ER. I was assigned a nurse and followed her every day for 8 twelve hour shifts. Same with 40 hours in the ICU, 20 hours in Pedi ER, 20 Hours in PICU

 

[DrParasite]

Our biggest issue with our liaison nurse (we call them PLN) is they will start out doing a good job but within 6 months it will seem as if that hospital no longer has one because they become uninvolved with EMS and crews.

since it sounds like a recurring theme, it's like a sign of a systemic or cultural issue within the PLN. meaning, either they get pulled into another area that is more advantageous to them, the PLN spot is used as a stepping stone to something else, or they are doing it in addition to their full time job as a staff RN, and they just don't give it any priority.

Our hospital has a highly educated Paramedic as a liaison officer. I think its a good thing.

I think that's a great thing, until the rest of the ER doesn't care what he thinks because he's not a nurse. or if he bring an issue to management, and they blow him off because "well, that's a nursing thing that he wouldn't understand." Like it or not, ERs (and in fact many hospital departments that deal directly with patients) are ran by nurses, and often if you want more credibility to your point, having a nurse address it is better than a medic.

One of the hospitals I used to transport to had a Tech assigned as the EMS liaison. she would meet with management monthly to discuss issues, make sure the EMS equipment area was kept need and try to keep the EMS room stocked with snacks. but she has no real authority to make any changes, so if there was a serious issue, it was better to bring it directly to management. If you did speak to her about an issue with a nurse, she wasn't likely to fight for EMS, because she still had to work with the RNs as a tech, and didn't want to step on anyones toes. Suffice it to say, she decided not to stay in that position for long.

 

[VFlutter]

Dont know what your clinicals were like because i had to do 100 hours in the Adult ER. I was assigned a nurse and followed her every day for 8 twelve hour shifts. Same with 40 hours in the ICU, 20 hours in Pedi ER, 20 Hours in PICU

That is an exceptional clinical experience however I am not sure that is the norm. We did ICU clinicals for a couple local paramedic programs and they were usually only required 1-2 ICU shifts. Some were very interested in the ICU stuff but most were just trying to skill jump and get as much done as possible.

 

[DrParasite]

we did ICU shifts, surgical/trauma ICU, cardiac ICU, burn ICU, respiratory therapy, and at least 10 ER shifts (and a whole bunch of other areas). I was more interested in seeing some cool things, and got to see an awesome GI case and one there they put in a central line and caused the patient to go into V tach. I couldn't do much but watch, but it was awesome to see what they could do.

I actually enjoyed my ICU shifts, and was told when I finish and if i decide to get my RN, to come back and the nurse would recommend me for a spot on her group.