+ OK, Tom, here's my thoughts from my point of view. Bare in mind I am not bashing you or anyone here, so bare with me as this can get a bit philosophical. What you say and people HEAR you say might not necessarily be the same thing. My partner and I can say the exact same thing with the exact same words, intonation, and syntax. And they will believe me before they will believe him because I look older, my hair gray (what little I have left), I'm bigger. I have a gut. And I have wrinkles on my face. Basically I talk with experience and authority. Because I'm old. Were the conversations not as effective as they could be? I used to think so when I first started. But after a few years I learned that most nursing home patients being sent to ER for evaluation are either stable or dead. Rarely are they dying. Dead is easy. Check rhythm/pulse. Check PMH, age, and prognosis. And either continue to work it or call it. The not dead or dying are also simple. Usually the result of an infection making their symptoms worse. Do they need a cardiac monitor or a regular bed? The dying definitely need more information. What happened? (keep it brief) Do they have a pulse? Are they breathing? Do they have a line? Do they need one? Are they a code? Are they a NO CODE? Do you have they paperwork? Even as a medic it's usually that simple for the most part. Did I have to pry information? When I first started before I learned to look at the big picture. Some of these nurses either don't know how give an EMT a bedside report or they don't have time or they don't care. And that depends on the nurse, on the day, and on the patient at that moment. Once you are able to see the big picture, odds are you won't need as much information from the nurses. Did I feel that my reports weren't taken seriously in ER? Yes, when I didn't realize what was really going on. Most of these nursing home patients we pick up we're picking up for the reason they were brought to the ER last month, and the month before that, and the month before that, and so on and so on. If you'll notice sometimes the nurses will look at the patient and might roll their eyes because they know who they are and why they're back. Now this is not every patient every day all the time. But "generally speaking" this "tends" to be the case. When you sharpen your skills: assessment, treatment, and verbal report, the ER will learn you and respect you. And when that happens this thread will become a distant memory.