EMS vs Nurses

NVRob said:
Meh situational dependent, we aren't limited to 3 although at that point IV infusion would be better IMO but as long as their BP will handle it we can keep on giving it. Usually if we are far enough out to need more than 3 SL doses they will get NTG paste. It's better than 400 mcg slam then nada then 400 mcf slam then...you see what I'm gettin' at.
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Ok, "Why isn't your patient on a backboard?"*

*Let me guess, you also have one of the fancy smancy selective spinal immobilization protocols? :D
 
JPINFV said:
*Let me guess, you also have one of the fancy smancy selective spinal immobilization protocols? :D
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Maybe, maybe not.
 
After reading all of the posts I still can only sympathize with the rudeness, incompetency, and misunderstandings from nurses that you all have experienced.

I was married to my husband Medic2409 before I became a nurse. I can say that he may have had a hand in molding who I was going to be and how I would respond to EMS crews from his experiences.

I can say honestly that I always have copies of pertinent documents ready, a facesheet for the crew, ready to give report when crew arrives, and stay with the crew by my resident's side until they leave.

I work nights with little resources with a 1:63 ratio. I could run a small village on my own if someone would let me. Really, it's all about prioritizing and you all know this. I agree that many nurse's do not have this skill. I agree that there are far too many nurse's out there that do not deserve to be.

In the end, remember you have a little ol' nurse in DFW who is supporting you 100%.
 
DrParasite said:
To be honest, that annoys me, because it is detrimental to the patient. Or the cold and dead patient in the SNF who "was fine 10 minutes ago when I checked on them." Yeah they ice up and have rigor start in that 10 minutes.

What annoys me to no end is when a facility calls 911, and then isn't ready for EMS when we arrive. That means the chart isn't copied, no interventions have been done, the transfer form is all filled out or the nurse is no where to be found to give EMS a report of what is happening. it takes between 4 and 11 minutes for EMS to arrive to a life threatening emergency (from the time the 911 call is made), and most of the time, EMS is going to be in and out in less than 30 minutes.

If the nurse has the chart copied, the transfer sheet filled out, has done SOMETHING for the patient, and greets EMS at the patient's door with a report on the situation and what they have done and then steps back and lets EMS do their thing (but sticks around in case we have any questions), I am happy. Even if they don't do the right thing, at least it gives me the information to do my job properly.

I understand that almost everything a SNF nurse does is at the doctor's order (running joke is a nurse can't fart unless a doctor says she can), and they get in trouble for deviating. Personally, requesting an IFT truck from who knows where for a chest pain or seizure patient, and a 911 truck for a patient with a fever for 2 days annoys me, but I know often the doctor makes the call not the nurse.

We all have our rules and our protocols, and sometimes they suck and handcuff you more than you want, but if you (the nurse) calls me, be ready for me so I can do my job. don't hold me up because you haven't made the 911 emergency your priority, especially when you have given me a sick patient.
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What is a SNF? I know, bash me all you want...
 
Though I have had many of the same experiences as other medics and EMTs here, I partially blame EMS for the problem.

How many services go out and try and educate LTC/SNF/NH staff as to what is expected from them or how to handle the first 10 minutes of an apparent emergency? I don't know of any education programs that are administered by medics or EMTs for LPNs, RNs, etc. that work at these types of facilities. Seems like it would be worth our while for everyone, especially the patients.

Does anyone have a local education program for LPNs, CNAs, and RNs on this subject?
 
Would I be going way off topic if I mentioned that an RN actually complained to my medical director because she felt that I checked a BGL unnecessarily? Funny, I thought a receiving RN would appreciate a thorough assessment and turnover report from me.

I was so shocked when I was called into the office, I didn't know whether to laugh or cry. :(

*steps off soap box*
 
medicsb said:
Though I have had many of the same experiences as other medics and EMTs here, I partially blame EMS for the problem.

How many services go out and try and educate LTC/SNF/NH staff as to what is expected from them or how to handle the first 10 minutes of an apparent emergency? I don't know of any education programs that are administered by medics or EMTs for LPNs, RNs, etc. that work at these types of facilities. Seems like it would be worth our while for everyone, especially the patients.

Does anyone have a local education program for LPNs, CNAs, and RNs on this subject?
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LOL! I think it's called nursing school...
 
medicsb said:
Though I have had many of the same experiences as other medics and EMTs here, I partially blame EMS for the problem.

How many services go out and try and educate LTC/SNF/NH staff as to what is expected from them or how to handle the first 10 minutes of an apparent emergency? I don't know of any education programs that are administered by medics or EMTs for LPNs, RNs, etc. that work at these types of facilities. Seems like it would be worth our while for everyone, especially the patients.

Does anyone have a local education program for LPNs, CNAs, and RNs on this subject?
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They would probably be met with hostility. I've never really had a problem with SNF's where I ran calls. Very wealthy area, the only time I had problems were on the borders of the county where the RN/LVN's first language wasn't english.

Also a lot of RN's disappear due to the fact they're the only supervisor on duty and their ratios are awfull, they have other things to tend to. Now that doesn't happen all the time. The only reason I bring that up is because we had a RN go ghost pro on us for a "BLS 911", come to find out a 2nd pt was tanking so we kept an EMT with the more stable pt and one next door to help the nurse. Luckily back up was 2 seconds away. We had to separate because CNA's at this facility weren't allowed to do CPR, even though they hold AHA cards.
 
BF2BC EMT said:
We had to separate because CNA's at this facility weren't allowed to do CPR, even though they hold AHA cards.
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WTF?! You have to be sh*tting me?! Who's the idiot who came up with that rule? Or I guess what I am asking is why?
 
I've tried to make good relations with nurses, except ER nurses. The problem is the Filipino nurses that don't know a damn thing about the pt and try to pass blame on others. I hate ER nurses they think they are glamour models and in reality they are a bunch of bleach blonde burnt out old hags, that haven't even reached age 30. Another is the fact that Dr. Quack makes his decisions off of reports and phones or faxes orders in, instead of actually being present and assessing a pt.
 
VCEMT said:
Another is the fact that Dr. Quack makes his decisions off of reports and phones or faxes orders in, instead of actually being present and assessing a pt.
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So, you never, ever call for online medical control? It's easier to say crap like this when you normally have no prior relationship with your patients and you only have to take care of one patient at a time. However, once you start having more than one patient (who you've seen and examined prior to today) and those patients are in multiple locations, including the patients who have an appointment to see you in your office, it all of a sudden becomes a whole hell of a lot harder to drop everything to rush to a nursing home because a patient needs a medication adjusted or suddenly developed a fever. Especially at 2 am (because physicians don't always have definite off times).
 
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VCEMT said:
I've tried to make good relations with nurses, except ER nurses. The problem is the Filipino nurses that don't know a damn thing about the pt and try to pass blame on others. I hate ER nurses they think they are glamour models and in reality they are a bunch of bleach blonde burnt out old hags, that haven't even reached age 30. Another is the fact that Dr. Quack makes his decisions off of reports and phones or faxes orders in, instead of actually being present and assessing a pt.
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Word of advice, if everyone around you won't play nice...perhaps the problem isn't everyone around you...
 
PoeticInjustice said:
LOL! I think it's called nursing school...
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Where in the curriculum is patient hand-off to EMS covered? How much does nursing school even cover the management of emergencies? How much of that is even reinforced after training? I'm really curious actually, because something tells that it isn't a whole lot.
 
Wait, you mean to say that nurses who don't normally work or aren't specialized in emergency care are generally bad at providing emergnecy care? Next you're going to tell me that the sky is blue, water is wet, and EMS providers suck at chronic care.
 
JPINFV said:
Wait, you mean to say that nurses who don't normally work or aren't specialized in emergency care are generally bad at providing emergnecy care? Next you're going to tell me that the sky is blue, water is wet, and EMS providers suck at chronic care.
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And these same nurses who can't handle an emergent situation are allowed to enter a CRNA mill and run rooms unsupervised.
 
BF2BC EMT said:
And these same nurses who can't handle an emergent situation are allowed to enter a CRNA mill and run rooms unsupervised.
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Somehow, I don't think the average SNF RN is going to have plans to become a CRNA.
 
VCEMT said:
I've tried to make good relations with nurses, except ER nurses. The problem is the Filipino nurses that don't know a damn thing about the pt and try to pass blame on others. I hate ER nurses they think they are glamour models and in reality they are a bunch of bleach blonde burnt out old hags, that haven't even reached age 30. Another is the fact that Dr. Quack makes his decisions off of reports and phones or faxes orders in, instead of actually being present and assessing a pt.
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So as long as the nurse is not Filipino everything's fine, right?

Sent from my out of area communications device.
 
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