I've posted here before from "the other side", and I welcome any responses. I was an EMT in an busy urban area for 13 years and put myself through PA school. I still love EMS and have a lot of friends in the field. Today I found myself alone in our internal medicine office when an 84 year old woman walked in (NO APPOINTMENT, NO WE DID NOT "TELL HER TO COME IN") with substernal chest pain. Within 10 minutes I got an EKG, tried to put her on oxygen (tank empty--yes, I know, embarassing, will be addressed), got a copy of her demographics including insurance, meds, EKG, old EKG to compare, BP (yes, accurate). Meanwhile, I sent over the phone a demented woman with a "black and blue stomach", 2 week UTI and rash to the ED, and dealt with the guy in the next room who had two TIAs in the last week and whose son in the fire department told me over the phone that he didn't think his father needed to go to the hospital (after telling me he "sees a lot" and "checked him out last week and he was fine"). Oh, did I mention that there's an asthmatic bronchitis with a pulse ox of 94% in room three? So of the eight people that were sent for this doctor's office emergency, one medic asked me if I gave the pt ASA. No, I didn't. My bad. He rolled his eyes and turned away, obviously dismissing me as an idiot. I'm sorry, he's right, but I'm less than thirty minutes into my afternoon and I've also had to call his pt's PCP because she refused to go without that god saying so. Come over to MY side for a day. I now realize all the times I walked in with an attitude (but there were only TWO of us), and yes, some doctors were idiots...but not all. Love you all!
From the other side
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emtfarva
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I can speak for myself. I understand that you were busy. I would never Question what you did or didn't, only if you had done it. You deal with more than one Pt at one time, we deal with, most of the time, one. Thanks. Oh, next time try to remember the ASA, ok? Just kidding.^_^
Thank you for your answer. And hey, part of it was humiliation--I know I should have given her aspirin. (I felt a lot better after yelling about it over the phone to my friend who's still an EMT.) I think a couple of incidents like this (the last one I DIDN'T **** up--the medic still passed over me, pressed on the woman's chest, and said "Does that hurt?"--she got an angioplasty that night) have just made me realize it's a shame we're not all in this together. No, I don't deal with emergencies every day. I struggle with fifty or more illnesses, racking my brain at any given moment about "unilateral axillary lymphadenopathy" and its possible consequences. And I KNOW what you guys deal with. I remember the doctors who told the fulminating CHF to come in to the office. But hey, in the long run, most of us are all in this together.
Sasha
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Pay no mind, some EMTs/Paramedics are idiots who feel they are above a doctor, PA, or NP because they get to ride around in a truck all day and "You don't know how it's like on the streets, man"
I work in a clinic, we've had to call 911 twice since I've been there. I've been completely disgusted with the attitude of paramedics and EMTs who came in thinking they were above us all because we called them. It's enough to make me rethink wanting to work on a truck.
I really hope this epidemic bad attitude is just a phase. People wonder why no one takes prehospital EMS seriously when their own bad attitude is so blunt and apparent.
I work in a clinic, we've had to call 911 twice since I've been there. I've been completely disgusted with the attitude of paramedics and EMTs who came in thinking they were above us all because we called them. It's enough to make me rethink wanting to work on a truck.
I really hope this epidemic bad attitude is just a phase. People wonder why no one takes prehospital EMS seriously when their own bad attitude is so blunt and apparent.
Again, thanks for taking the time. I see both sides, having been on both sides, but I think what I didn't realize before was how asinine a bad attitude makes you look--on both sides. Every job in medicine is hard. And everyone thinks everyone else is an idiot--specialists, primary care, emergency room doctors and nurses, prehospital, and on and on ad nauseum. We all just make a tough job tougher on each other.
Agreed. Talking with someone from a different medical field gives many of insights into what they have to deal with on a daily basis, and giving attitude just makes you look like a jerk. If I have a problem with someone, I take it up with them after the run, not during it. Would this woman have taken ASA if she were at home? Anyone who watches TV knows that you should take it if you're having chest pains... (Thanks TV doctor!) Honestly, some people are just lazy & rude no matter what. It doesn't take that long to determine if ASA is indicated & administer it. Good job handling a stressful situation.
mycrofft
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Good to hear someone else who's a "bridge".
I remember my walk-in clinic
("doc in a box") time fondly, before I started seeing clients behind bars. I hear you about rude responders, but I've also seen people working in the clinics etc treat EMS like trash haulers. I prefer our local fire EMS for that reason, maturity and responsibility.
I remember my walk-in clinic
("doc in a box") time fondly, before I started seeing clients behind bars. I hear you about rude responders, but I've also seen people working in the clinics etc treat EMS like trash haulers. I prefer our local fire EMS for that reason, maturity and responsibility.
But many in EMS have expectations of everything coming to a standstill when they walk in and they should be greeted with coffee and donuts. This probably comes from watching to much TV like "ER" where the whole ED staff is outside waiting for them to hold their hands or make dates with them as they are walking into the ED together.
When they do not get the attention they believe they deserve immediately, they give attitude. If they can find fault with someone else which gives them an opportunity to cover up their own insecurities, they jump on it. Or, the Paramedics may be overwhelmed by being where there are so many patients in one area when they enter a facility such as a busy clinic or hospital ED, they lose it and start snapping at others. Even the sometimes chaotic scenes on the street do not compare to the continous, but controlled, chaos inside busy clinics and EDs.
Few realize how many patients each care provider in a clinic, nursing home or hospital has at one time and how many people are wanting a NOW conversation with them or needs attention simultaneously.
When they do not get the attention they believe they deserve immediately, they give attitude. If they can find fault with someone else which gives them an opportunity to cover up their own insecurities, they jump on it. Or, the Paramedics may be overwhelmed by being where there are so many patients in one area when they enter a facility such as a busy clinic or hospital ED, they lose it and start snapping at others. Even the sometimes chaotic scenes on the street do not compare to the continous, but controlled, chaos inside busy clinics and EDs.
Few realize how many patients each care provider in a clinic, nursing home or hospital has at one time and how many people are wanting a NOW conversation with them or needs attention simultaneously.
emtfarva
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Vent, I agree with you. I just really hate when, after an emergent response, go to a SNF and have to search for a nurse or have to stand at the nurses station and look stupid. I understand that the SNF may be busy, but when you call for an ambulance, have someone standing ny to let us know where to go. I should also find fault with call takers, who should ask for this info when they are booking the call.
TransportJockey
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My fiance just read your post and it makes her want to finish her pre reqs for PA school even more. She will be working as an EMT to put herself through PA school similar, it sounds like, to the OP.
Mountain Res-Q
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Blunders aside, we are supposed to be professional when we show up on every call, no matter what our personnal thoughts are. I worked a lot of transfers in my time on Ambulance. Usually to and from SNFs. I know that the staff at these places deal with their own set of crap, just like we do. So every time I walked through the doors, no matter how bad my day was, I always had a smile and joked around with the staff. If I could show some respect for their skills and brighten their day a little then maybe they would do likewise. In the end you end up making friends with other professionals, because in the end we (ambulance, air ambulance, Fire, SAR, Rescue, Law, Hospital, Clinic, etc...) are all on the same team in some manner or another. Hopefully we are all there to help and make a POSITIVE difference in someone elses day.
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Do you know how many situations they are handling at one time so that you don't have to take more of their patients to the hospital? Managing long term patients in not an easy task. These patients are very brittle and if a nurse doesn't take a few minutes to ensure all the safe guards are in place, a patient can easily have a life ending injury, med error or aspiration.
NHs do not have enough staff for just being door handlers. Not everything can come to a halt. Also, unless it is a 911 call, the ambulance companies may not give them an exact time for your arrival. Unfortunately, even when it is a 911 call, someone down the hall may decide they need attention also by pulling out their IV, NG or foley.
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el Murpharino
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Some EMS providers have this undeserving sense of entitlement, as if they should be placed on a pedestal of sorts. Maybe it's because we get to park in special spots and use red lights from time to time...although I'm sure it's just immature people who lack a bit in the compassion/empathy department. May their careers be filled with patients having projectile vomit and explosive diarrhea.
Tell her to go for it!! I want to make clear I never regret my years in EMS, but I can honestly say there's almost never a day I get up and don't want to go into work as a PA. I absolutely love it--the endless variety, a constant intellectual challenge (don't get me wrong, of course there are moments and patients that try me). I also love after all the years in EMS actually being able to get to know my patients (not just the routine drunks) and follow their progress. Good luck to her and I'm always available to answer any questions anyone has.
You know, that's a brilliant attitude--because everyone works better when they don't feel attacked, and like you said, respect generally ends up being mutual. It makes me sad when I really feel a sense of dread when I have to call 911. Also, who knows when you might need someone else--in a crash, as your doctor, for a recommendation or reference. It's a small world.
Mountain Res-Q
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I feel the same way about some of the agencies I work witih from time to time. We get dipatched through the Sheriff's Office, and when I have to call them up via phone, I feel like they don't give a damn unless what you are doning is making their life easier. Or the Fire Department. having to work with them on a call is horrible, because they look down on us because we volunteer our time and are authorized to go on calls (water rescues & high angle rope call) that they can't. The attitudes that exist between various agencies in a lot of places just doesn't make sence. Unless your actions killed someone, everyone else needs to realize that they are just as likely to make minor mistakes one day (and probably have). WHY CAN'T WE ALL JUST GET ALONG?
