"That BP is NOT possible"

[rescuecpt]

Originally posted by emt3225+May 6 2005, 12:11 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (emt3225 @ May 6 2005, 12:11 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-rescuecpt@May 6 2005, 10:59 AM
Yes, I am going to Heidi's firematic services tonight, then I think as a group we might head over to the end of Bill's wake. I'm riding tomorrow so I can't go to his prayer service.

I will also be there tonight with Mineola..We are going as a group..Soo sad..Life is too short.. [/b][/quote]
I'll be with Commack Ambulance - I'm 5'5, blonde hair, blue eyes, Advanced EMT patch on my right arm, if you spot me come say hi.

 

[emt3225]

Originally posted by rescuecpt@May 6 2005, 01:37 PM

I'll be with Commack Ambulance - I'm 5'5, blonde hair, blue eyes, Advanced EMT patch on my right arm, if you spot me come say hi.

I will keep my eyes open for you. .I'm 5'3, brown hair, brown eyes and i also wear eye glasses..Hopefully i will see you tonight..

 

[coloradoemt]

Originally posted by BloodNGlory02@Mar 23 2005, 11:29 PM
I was so pissed off at that. We got to the ER, I continued to bag until the doc was ready to intubate. We stood around for about 10 min before I went to do paper work. Mind you I was still fuming. They hooked him up to their BP cuff and got 230 something over 120 something. So i KNOW my BP wasnt off. So i finished the report and the tech that came into the room was very nice, I asked her who the nurse was that took report. She pointed her out and I told her what happened. She said she does that to a lot of squads. Im contemplating writing a letter to their ER director. There is no reason for her to be telling me that a perfectly obtainable BP is NOT POSSIBLE. I've seen BP's of 200's before it is VERY possible.

Ok back to the original topic as it looks like I skipped over this topic a time or two. About all I can say is, with all of the things that can be said and done to me that may irritate me, a nurse telling me she does not believe my BP is not going to be one of them. It is also my opinion that if something this minor actually gets you pissed off and fuming maybe you need a different life path...... or classes. As far as writing a letter, I am sure you will do what you feel you must but I believe it to be an act of a small minded child seeking retribution.

 

[Jon]

Originally posted by coloradoemt+May 6 2005, 05:29 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (coloradoemt @ May 6 2005, 05:29 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-BloodNGlory02@Mar 23 2005, 11:29 PM
I was so pissed off at that. We got to the ER, I continued to bag until the doc was ready to intubate. We stood around for about 10 min before I went to do paper work. Mind you I was still fuming. They hooked him up to their BP cuff and got 230 something over 120 something. So i KNOW my BP wasnt off. So i finished the report and the tech that came into the room was very nice, I asked her who the nurse was that took report. She pointed her out and I told her what happened. She said she does that to a lot of squads. Im contemplating writing a letter to their ER director. There is no reason for her to be telling me that a perfectly obtainable BP is NOT POSSIBLE. I've seen BP's of 200's before it is VERY possible.

Ok back to the original topic as it looks like I skipped over this topic a time or two. About all I can say is, with all of the things that can be said and done to me that may irritate me, a nurse telling me she does not believe my BP is not going to be one of them. It is also my opinion that if something this minor actually gets you pissed off and fuming maybe you need a different life path...... or classes. As far as writing a letter, I am sure you will do what you feel you must but I believe it to be an act of a small minded child seeking retribution. [/b][/quote]
Yeah.... But on the same token, my looking like an a$$ because I trusted my partner to take a B/P, and he is hearing his OWN amke me look bad :angry: , and hurt deep down inside (ya hear that, PaRescue? Ya remeber 2 weeks ago?)

Jon

 

[rescuejew]

agree with colorado...to h*ll with them. You can be friends with nurses, or not friends with nurses. We are NOT techs, and we are not subordinates to NSG staff. We are our own profession with our own interventions. Nurses cant do anything without a doctors order, we can intubate, defibrillate, hang drips, push all sorts of meds (including MS), we field-diagnose and treat.

Some of my best friends are nurses, but understand the difference, we will always have the autonomy and required critical-thinking in our job, and the nurse can/will always have to walk down the hall and find the doc for orders. they are 2 vastly different careers, EMS was never intended to be a subset of nursing.

 

[emtbuff]

I agree with you rescuejaw. And yes it is kinda hard for me to always remember when testing or even quizing others in my nursing class that little part of getting orders and other little things. I am going straight on for my RN but have had a tough time with remember as an LPN you can't touch an IV for the most part where as an EMT if I need to I can change it.

You are right that nurses need to work under a doctor and can't do anything with out their permission. Which kinda stinks.

They will always be a separt profession for me.

 

[Jon]

Originally posted by emtbuff@May 8 2005, 02:22 PM
I agree with you rescuejaw. And yes it is kinda hard for me to always remember when testing or even quizing others in my nursing class that little part of getting orders and other little things. I am going straight on for my RN but have had a tough time with remember as an LPN you can't touch an IV for the most part where as an EMT if I need to I can change it.

You are right that nurses need to work under a doctor and can't do anything with out their permission. Which kinda stinks.

They will always be a separt profession for me.

Paramedics can't do advanced procedures without having a doctor's order, either - we just do a lot under "standing orders"

Jon

 

[rescuejew]

But "standing orders" are defined as using discretionary judgement. Our protocols here are the same way, they use words like "APPROPRIATE airway management" or "CONSIDER Narcan".

We call for very little. There is a county southeast of us that has to call to d/c a line. I can count the number of times on one hand that I've run a call in 3 years that I've had to call for orders. We are a very autonomous system, and we've had to do some nursing education here as well: ie the whole "paramedics are worthless" attitude. We have things on standing order that nurses will never be allowed to do PERIOD.

I'm not downing nursing, it has its place, its place just isnt prehospital medicine.

 

[Jon]

Originally posted by rescuejew@May 10 2005, 01:31 PM
But "standing orders" are defined as using discretionary judgement. Our protocols here are the same way, they use words like "APPROPRIATE airway management" or "CONSIDER Narcan".

We call for very little. There is a county southeast of us that has to call to d/c a line. I can count the number of times on one hand that I've run a call in 3 years that I've had to call for orders. We are a very autonomous system, and we've had to do some nursing education here as well: ie the whole "paramedics are worthless" attitude. We have things on standing order that nurses will never be allowed to do PERIOD.

I'm not downing nursing, it has its place, its place just isnt prehospital medicine.

in PA, my understanding is that you have to call command for any time you do an ALS-level skill, even as a "gee, we just gave narcan to the Heroin OD...."


Jon

 

[rescuecpt]

In NY, you have to do a post-call 34 (call medical control) anytime you enter the ALS system. Usually takes less than 5 minutes, it's just information gathering on their part.

 

[rescuejew]

WOW! I had no idea...its just not like that down here in redneckville. Thanks for the edu-ma-cation. We dont hire EMT-Bs here, strictly an ALS system, with intermediate-paramedic or paramedic-paramedic trucks. EVERYTHING is on standing orders except for things like CaCl and Bicarb. We can 10-22, that is, cancel calls, if they dont need an ALS truck, then they just dont get one, plain and simple. (That cuts out a lot of BS)

 

[Jon]

Originally posted by rescuejew@May 10 2005, 05:21 PM
WOW! I had no idea...its just not like that down here in redneckville. Thanks for the edu-ma-cation. We dont hire EMT-Bs here, strictly an ALS system, with intermediate-paramedic or paramedic-paramedic trucks. EVERYTHING is on standing orders except for things like CaCl and Bicarb. We can 10-22, that is, cancel calls, if they dont need an ALS truck, then they just dont get one, plain and simple. (That cuts out a lot of BS)

what happens if they need a BLS truck?

Jon

 

[Jon]

Originally posted by rescuecpt@May 10 2005, 02:42 PM
In NY, you have to do a post-call 34 (call medical control) anytime you enter the ALS system. Usually takes less than 5 minutes, it's just information gathering on their part.

I think around here, they want it done ASAP... I love the times when the medics call up with a "hey, we just flew someone out..."

jon

 

[rescuecpt]

Originally posted by MedicStudentJon+May 10 2005, 06:13 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (MedicStudentJon @ May 10 2005, 06:13 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-rescuecpt@May 10 2005, 02:42 PM
In NY, you have to do a post-call 34 (call medical control) anytime you enter the ALS system. Usually takes less than 5 minutes, it's just information gathering on their part.

I think around here, they want it done ASAP... I love the times when the medics call up with a "hey, we just flew someone out..."

jon [/b][/quote]
If you run totally within standing orders, you don't have to call until afterwards. If you finish your standing orders, or within 20 minutes of pt contact if not at the hospital, you need to contact medical control.

 

[rescuejew]

JON:
If we need a BLS truck, which happens a lot in the nursing home industry, then we have a private service (Johnston Ambulance) that handles it. We'll just give em a buzz from our cell phones, state that we have evaluated the pt and feel s/he would be safe riding in BLS. It works out well. If we get a BLS call and the person has a legitimate complaint, most of the time we'll give them a ride, but lots of times there too we have to try and find the most suitable transportation for the pt, be it a friend, family member or taxi.

 

[Jon]

Originally posted by rescuejew@May 11 2005, 06:18 AM
JON:
If we need a BLS truck, which happens a lot in the nursing home industry, then we have a private service (Johnston Ambulance) that handles it. We'll just give em a buzz from our cell phones, state that we have evaluated the pt and feel s/he would be safe riding in BLS. It works out well. If we get a BLS call and the person has a legitimate complaint, most of the time we'll give them a ride, but lots of times there too we have to try and find the most suitable transportation for the pt, be it a friend, family member or taxi.

Does the BLS service arrive while you are still onscene or do you "abandon" the pt. to wait for a taxi ride??

Jon

 

[rescuejew]

I have never left a patient alone to wait for a BLS truck, there has always been a family member or RN there. JAS is usually used with nursing homes, NOT out in the community. Some nursing homes here just downright suck and they call 911 for every hangnail they find to dump patients because they dont feel like taking care of them. Calling JAS is education: select the appropriate ride, the patient is paying for it, maybe they dont need a $500 ALS ride. But Yes, I do leave befroe they get there, our call volume is high and I cant always wait for them to arrive. Its not abandonment, the patient will get to the hospital, just not by ALS. We are allowed to refuse EMS services to patients here, that isnt abandonment either. If we have evaluated them and determine they dont need it, then they dont get it. Its not like I leave some LOL sitting desolate and alone in a dark room while I check t8 to go run errands.

 

[Jon]

Ok... That is actually really cool, and I wish PA could be so progressive!

Jon