A lack of respect

The most difficult part of our job is the mental game we must play. While there are many players in this game, one of the most frustrating relationships we become involved in revolves around our interaction with emergency room personnel.

Nurse Ratched seems to be the one that always answers the med report and is there with a disheartening frown upon arrival to ask why you brought the patient to their facility. In all reality, does she really think that you will muster up some acceptable reason why you decided to ruin her night instead of taking your poor elderly patient that groans with every bump in the road to her facility instead of one that is 20 miles across town? While I'm often tempted to tell the nurse that I saw the vacancy sign on out front or that I told the patient Nurse Ratched's hospital is the best one when the patient asked me, I tend to just put on a smile and say the patient requested transport here.

If this struggle isn't bad enough, the normal response that my med report on the radio receives is to explain how long I must wait once i arrive and that I should transport elsewhere. I'm not certain why these responses and questions continue as they always end the same, with my arrival at their emergency room. I guess it makes them feel better or justified and anyone that knows me can vouch for the fact that I'm here to make the ER's life easier.

This battle of egos continues with my repeated requests for how long it will be for a room as I am ignored, being ignored by the receiving nurse while I'm giving her report after the patient is in their bed and then by the physician that wants to question my treatment when they have access to my protocol and are completely aware of what treatment we commonly provide.

Is there a reason that this game must continue? We have enough to do and enough pressure without having to play this game.

▶ Reply to This

Replies to This Discussion

Permalink Reply by Nathan on November 18, 2012 at 7:16pm

Boom.

The Crux....

If you want to be respected one must earn it. If we want to be respected we must earn it. We havent really earned it as a whole yet.... Ive worked both sides. There are a TON of EMS providers coming in I was ashamed to be associated with. They called themselves Paramedics but.....

Skip Kirkwood said:

I generally agree with you, Leigh, but (particularly going back to the beginning of this thread) there are way too many folks in EMS who demonstrate lack of professionalism to ED staffs and others every day. If all we are concerned about is ourselves, that shows, and other health care professionals (who have been trained from day one to be "patient centered" don't respect that. They also don't respect our opposition to education - particularly enough education do to what we do safely and effectively. In other professions, they call "doing stuff" without sufficient education and training "dangerous" and "irresponsible" - and they generally don't allow it.

I know of way too many "paramedics" who, the first time they intubate a patient, they do it in an uncontrolled, unsupervised environment, where the patient "takes their chances" on the skill of the provider. A responsible profession wouldn't allow that.

▶ Reply

Permalink Reply by Deborah Siegel on November 18, 2012 at 7:51pm

Guess I am incredibly lucky as I have a local hospital that has a great Nursing staff in the ED. I also completed my EMT-I clinical time in that ED and got to know the nurses, I busted my butt during my clinical shifts and earned their respect, now when I come in with a patient they are familiar with me, we have a great relationship.

▶ Reply

Permalink Reply by Leigh Lloyd on November 19, 2012 at 12:37pm

not to sound like I am arguing with you on this, I like to fall back on call Medical Control,,, when in doubt call "Medical Control" most of the time here in our small commuinity the person that answers the phone is a Nurse, when asked for medications shouldn't that be up to the doctor? Nurses don't want to give orders for medications even when all criteria is met, which falls back to they don't think we are qualified to do what we do. Honestly I really think that what nurses do is VERY important, and so is what we do, we should all be a team and work together and make the patient the center of care. I am sure that the outcome will be tons better if we could all put aside our problems with one another and remember we all have a part to play in making the outcome what it is.

Skip Kirkwood said:

I generally agree with you, Leigh, but (particularly going back to the beginning of this thread) there are way too many folks in EMS who demonstrate lack of professionalism to ED staffs and others every day. If all we are concerned about is ourselves, that shows, and other health care professionals (who have been trained from day one to be "patient centered" don't respect that. They also don't respect our opposition to education - particularly enough education do to what we do safely and effectively. In other professions, they call "doing stuff" without sufficient education and training "dangerous" and "irresponsible" - and they generally don't allow it.

I know of way too many "paramedics" who, the first time they intubate a patient, they do it in an uncontrolled, unsupervised environment, where the patient "takes their chances" on the skill of the provider. A responsible profession wouldn't allow that.

▶ Reply

Permalink Reply by Skip Kirkwood on November 19, 2012 at 5:23pm

The practice of nurses giving "orders" to paramedics is antiquated at best and in some states unlawful at worst. Paramedics by design are physician extenders (as we practice in the US), so if it it must be that paramedics must consult with someone before giving a drug or performing a procedure, it should be a physician.

For what it's worth, if paramedics in this day and age can't do their job by following a protocol, the system needs some work. Paramedics should be sufficiently trained to treat 99% of their patients without consulting someone at a hospital.