ER vs back of the ambulance

[DrParasite]

Had a funny story that I wanted to share with everyone.

a friend of mine is head nurse in an ER, been doing the RN thing for 10+ years, instructor in ALCS/PALS/and a bunch of other instructor certs.

she decided she wanted a new side job, so she picked up a job as a critical care nurse handling interfacility transports.

Anyways, she had her first cardiac arrest during an interfacility run. She ran it just like she would in an ER room, saying " I need you to be the scribe, you to do CPR, you to start drawing up meds, you start bagging" at which point she realized she was talking to herself since it was just her and her EMT in the back of the ambulance, and her brand new EMT was apparently unable to deal with the current situation.

All I was able to tell her was welcome to the different between working a code in a hospital with all the staff you could ever want, as well as the space and light you need, and working it in the back of a moving ambulance. it made me smile, so I figured I would share.

 

[Shishkabob]

It truly is a different beast being the only ALS provider on an arrest and having to do multiple roles at once.

 

[8jimi8]

that is what you are trained to do. what makes it so special?

Pick a hard job and cry that it's hard?


lol that's the funny thing!

 

[traumaluv2011]

Nurses tell us how easy our job is, I always tell them they need to try it before the judge it. That is a great example.

 

[johnrsemt]

There was talk in my old area of making it mandantory for all ED nurses to do a 12 hour shift on a ALS Ambulance every 6 months just to help them remember why patients don't arrive to the ED the way that the ED nurses thought they should be. Clean, not dirty or greasy patients; nice neat NOT heavily taped IV sites; etc.

I don't think they were ever able to make it mandantory; but I know quite a few nurses that did it anyway by invitation. It did help out with some of the attitudes we would get when we arrived with patients in the ED.

 

[Shishkabob]

that is what you are trained to do. what makes it so special?

Pick a hard job and cry that it's hard?


lol that's the funny thing!

I didn't say it was hard. I said it was different.


Silly nurse.

 

[8jimi8]

The real problem with codes is that they are NEVER ideal.


Sure you have the limitations or benefit of environment, or extra help.

example.

Last code i went to. The house supervisor is trying to get a line, she tries 5 times in the left arm. then moves to the right,. There are 8 scared nurses not doing anything but watching and talking in hushed tones. RT is doing POOR compressions.

I try to get the line 3 times and then ask for someone to go to the ER and get an IO. While this is happening i'm starting to look at the external jugular. The house sup, takes one look at my eye and says you better not do that.

Had i been working this arrest with a trusted partner, I'd have intubated and dropped that EJ within the first and 2nd round of compressions, or attempted to. That's what we are trained to do right?


I know its not always ideal and it seems easier to have lights and more people, but it really isn't ever ideal. unless the code is in the ICU, not everyone is trained to respond appropriately.

I'm a nurse, i've only volunteered for EMS. Not everyone has this disdain for other health care providers. You'll find that there are professionals who respect EMS, but maybe only because we are interested.

To see the rift encouraged is just tired and boring.

Why not start out by "being the better man" by stopping badmouthing first.


I guess it just could be like the girls in scrubs and in uniform. Something about knowing my girlfriend can perform a surgical airway that excites me.

i just don't get the point of nurse vs emt argument.

 

[Sasha]

Nurses tell us how easy our job is, I always tell them they need to try it before the judge it. That is a great example.

Sorry I don't see how the job of a basic is even comparable to that of a nurse...

 

[Shishkabob]

I'll stop this thread before it gets any further:


I'm better than everyone at doing a cardiac arrest. Don't believe me? Ask my patients if I ever hurt them working their code!

 

[Sasha]

I'm so good at working codes I know the patient's outcome before they even arrest.

90% of our patients are DNRs!

 

[abckidsmom]

It's just different. A smooth cardiac arrest with a few well-prepared EMS providers is a remarkable feat. I had an ROSC with about 6 medics on the scene a couple of weeks ago and it ran just like an ACLS scenario: "I'm clear, you're clear, everybody's clear...the post shock rhythm is....a sinus rhythm. Pulse? No? OK, continue CPR, let's get that second IV, and go ahead and intubate." Ha! And then those jobs were done! Remarkable!

We forgot to have a scribe, though, and had the same documentation trouble that follows most EMS arrests...what time was that second epi, anyway?

I get that this was a funny situation, OP, but it's just different all the way around, there's no real comparison.

 

[usalsfyre]

Agree it's different. While we love to beat up on the ED...how many of us would be able to take a new patient needing a workup when we have a respiratory failure patient on BiPap who will probably need intubation, a chest pain on a NTG infusion awaiting admission and a generalized non-specific "pain" patient waiting to see the MD?

 

[abckidsmom]

Agree it's different. While we love to beat up on the ED...how many of us would be able to take a new patient needing a workup when we have a respiratory failure patient on BiPap who will probably need intubation, a chest pain on a NTG infusion awaiting admission and a generalized non-specific "pain" patient waiting to see the MD?

*raises hand*

 

[usalsfyre]

You and 8jimi8 don't count.

 

[Sasha]

*raises hand*

I didnt know you were a nurse....

Sent from LuLu using Tapatalk

 

[Shishkabob]

I've done my fair share of MCIs with fatalities and multiple red patients....