As an active EMS provider in both ground and air transports, I deal with a lot of different EMT and Paramedics from different services and this allows me the opportunity to listen in on different conversations, be apart of different debates and hear different ideas and views from the crew members. One particular topic that always gets to me is when I hear providers say we don’t get the respect we deserve from nurses and doctors in the hospital. Yes...believe me, I know first hand that this is true on several cases as I have been disrespected by numerous nurses at beside treating me like I don’t know what I an doing, or as if I was just some glory hound who tries to talk a good talk.

Ok so there is no doubt in my mind that we deserve more respect than what we get. But what exactly are we doing to deserve it. Yea we save lives, and we are the first line of treatment that someone in trouble gets, and on several cases we have the patient’s problem fixed or narrowed down by time we get to the ED. The patients are presented to the nurse with an I.V. , 12-lead, and initial work up and for the most part there is not much left for them to do initially. What I am talking about is training, education, a unison standard of training and care. There are several people against everyone being Nationally Registered, saying its not really beneficial to their state or for practices. But with the national registry for EMT's and Paramedics, we all may receive our training from different institutions but in the end we are all taking the same standard test to be certified. It doesn’t matter if your a Paramedic or EMT in New York, Georgia, PA, or wherever, prior to holding that state patch you pass a National Standard test.

So back to what do we do to deserve respect from the Nurses and Doctors. Although I generally get no less than 200 hours of con-ed a year, am certified in Critical Care, and work as a flight paramedic, when I walk in to a room, unless im in my flight suit no one really knows what all training I have. Because its mostly optional. I am viewed as that paramedic that shows up with my uniform all wrinkled, as piss poor attitude, and have no clue or no cares about the report the nurse is giving me about my patient. BINGO! There are several Paramedics that are just "get by" paramedics, they are there for the paycheck and do nothing to hide that fact. In Pa the minimal amount of Con-ed you need in a year to maintain your Medical Command is 18 hours. That’s an ACLS class and a couple extra hours and you’re golden. No trauma lectures, not advanced training, refresher courses..nothing. These are the people that are making us "wackers" as they call us look bad and are keeping us from getting the respect we deserve. This was proven straight out to me when I started working as a flight paramedic.

As a flight paramedic for the service I fly for there is several training factors you must meet yearly in addition to your 18 hours of state con-ed. there is a minimal number of live intubations you must perform, con-ed, education days etc etc etc... Hospital staff know that we are highly trained and as a flight paramedic I probably have the same training as that nurse and then some with emphasis on critical care that my company makes sure we get. with that being said, I could walk in to the same ER, or ICU,CCU whatever wearing my street paramedic uniform and another time wearing my flight suit and can guarantee different results and respect. and it all comes down to them knowing that to get to where we are as a flight paramedic and to maintain this position we are highly trained therefore highly respected. We must aim for the same standards in EMS period. no matter if its in an ambulance on in a helicopter. People view us the same as our weakest link (you know the saying).

So think about this the next time you want to start lecturing people on how we don’t get the respect we deserve. ask What are we doing outside of saving people. recognize your lazy "just getting by" crew members and try to make a difference. Yea there are state minimals on amount of con-ed you need, but that doesn’t mean your service can set there own standards. We are always demanding more pay; pay scales can be based on training levels and so on. Once we start proving ourselves as providers and our skills and consistent education is known. We will be respected. Everyone needs to help nationally.

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Comment by Greg Natsch on February 23, 2009 at 8:00am
Commanding respect is not a myth. What we have here is a failure to communicate. Earn or command, as far as respect, are used in the same manner. You have to rise above the petty "abuse". Also, use your chain of command. Hospitals receive their "customers" from you. You are the delivery person. I'm damn sure if a company like UPS had their drivers being "abused", the boss would be meeting with someone to work this out.
Comment by Tom Sasso on February 9, 2009 at 10:39pm
A dose of reality (sorry, I know a lot of you won't like what I'm a bout to say), but RNs and MDs could care less about being National Registered or how many CE's we have or anything else. While education is great, I assure you that if you walked into the ER tomorrow with a "PHD in Paramedic" patch on your uniform, they wouldn't notice, and if they do, they won't care.
Want respect? be a damn good Paramedic, it is that simple.
I've seen the disrespect by RNs and MDs you speak of. But I've also gotten calls from those same RNs and MDs asking me for medical consults becasue over time they seen what I do.
I'll also add this, as a Marine reservist, a Firefighter, and now a Police officer, I don't have time to do any more than the minimal CEs... but I study my butt off on my own. I've spent months and years studying and reorganizing assessments. I'm aggressive in my care and don't hesitate to do a skill. Does it mean I'm a bad Medic because I don't do a specific class on a specific topic on a specific day? Also, know that I've seen many a Paramedic sit in a CE class and not pay attension to a damn thing and get a minimal passing score, so even if he did 200 hours of CEs a month, I don't think he would get anything from it.
It is NOT the certification, the license, the degree, the CEs, the patch or anything else. It is YOU and how you do your job. Hell, it isn't even how you look in uniform or how "Professional" you act, if you save lives people will notice. If you don't, they will notice.
Study your job like it is a passion (it should be), know your job like it is YOUR life you are going to save, and most of all, ignore your peers and the way they do it... do it better. Know that EMS is a new field so the textbooks don't have it down yet, there are no experienced providers, there is no right way to do it... it is up to you to learn the knowledge and skills. If you can do that, the respect will come.
Comment by mark on February 6, 2009 at 9:47am
Respect is something that can be earned, to demand respect or command respect is somewhat of a myth.
Comment by Ken Roberts on February 4, 2009 at 1:28pm
that is very true quote, but for how long must you go along before it simply becomes abuse. I give the ED nurses as much respect as I wish to get in return and bite my tongue on several occasions where I would love to say something. I take a second to ponder if it would be looked at as a professional response or simply an unprofessional opinion and take things from there. Several of the ED staff do treat us with great respect and at the same time a handful treat us like we should not be able to stand in the same room as them. I have decided to simply label these individuals as difficult personalities and try and avoid them when possible but I still act professionally when I have no choice but to deal with them. I am proud to say that several of the ED RN's have chosen to take the PHRN course so they may do shifts with us on the chase truck even though they are taking a pay cut when they do so. They are also some of the Nurses that treat us with great respect. Perhaps starting a committee to help resolve issues between ED and pre hospital personell may be a route you can try. Invite several people from each side to bring issues and concerns to the table or simply invite them for outings with your department to improve relations. We have done this in the past and have for the past several years had a x-mas party mixed with bith departments which has improved things a bit.
Comment by Greg Natsch on February 2, 2009 at 7:48pm
I remember the old sage NCO from my early days in the Air Force, "son, it's better to command respect, than to demand it". There are even quotes from Jesus in the bible. Shows how far back that's documented. (I'm a product of Catholic education, thus the biblical quote). Instead of whine bagging, let's act like professionals, not swaggering windbags. I've seen too many over the years that cause eyes to roll like the lottery numbers.
Comment by Duncan Hitchcock on January 31, 2009 at 6:40am
Sam Rayborn the long serving Speaker of the House in Congress (and LBJ's mentor) said, "To get along you have to go along and to go along you have to get a along."
Comment by Tim "Doc" on January 30, 2009 at 11:30pm
Well said Duncan.

When I first started working where I am currently, most of the LPNs, RNs and even some of the Pa's/MDs treated me like I was the same slacker, lazy medic who I had replaced. I delt with the constant questioning of my skills, my scope, and doubt that I could even know things that were considered above my knowledge base. However, 6 months later, every single one of them know that I am not the whacker I replaced.

I live by the basics that to get respect you have to give it, your actions speak volumes, and how you treat others will be noticed by those who you don't know are watching. I am not perfect by any means, and yes, I still screw things up alot, but by showing I can take constructive criticism, asking when I don't know, and knowing when I can't do, I earned the respect of those I work with.

I try to do the same when I am on the 911 trucks. Even when the ED is slammed, and the nurses are all p/o'd cause I brought in another frequent flyer, being polite, smiling and even offering the compliment, or showing (some times feigning) interest, you can usually win over the nurses that gripe at you.
Comment by Lane Doby on January 30, 2009 at 11:04pm
"Police officers garner respect even with the less sightly of their members. Firemen can do no wrong. EMS does plenty, and its time for people to get off their heiney's and notice. " I'd have to say that I agree with you on that point. Most people don't stand up and notice until they physically cannot stand up due to having a fractured leg, being pinned in a car, etc.
Comment by Skip Kirkwood on January 30, 2009 at 11:49am
Right on, Duncan. As usual

As for overweight LEOs, I have heard more than my share of donut shop jokes. People may afford the badge or the gun a certain amount of respect, earned or not, but professionally acting and looking cops and paramedics get more respect than non-professionally looking and acting cops and paramedics.

Gonna give 'em the bullet, Andy?
Comment by Duncan Hitchcock on January 30, 2009 at 4:54am
Time for a little personal and professional opinion here. I am a firm believer in "to be treated as a professional, you must act like a professional." The question becomes how does a professional act?

EMS personnel are not the punching bags or whipping child of the frustrated, irritated, tired or overworked nurse or doctor; ED, ICU, CCU, clinic or private office. We are members of a team with the responsibility and the training to move a patient from one place to another.

As a member of management I will not allow anyone to abuse our personnel; police, nurse, doctor or John & Mary Q. Public. Nor will I tolerate an argumentative and surly attitude from our folks. As with any confrontation there are sides and versions of the events that lead to the resulting incident. But when the matter is a result of a lack of respect for our role as a team member, the instigator must be made aware of their ultimate responsibility for the situation at hand.

It is important to teach our folks in the field to not be baited into an argument. It's important to teach them and show them that their supervisors have their back. It's important to teach them that if they are wrong, to say so, stand up and be held accountable. I have yet to meet a perfect nurse, doctor, RT, paramedic, fire fighter or person. We do and continue to make mistakes.

But we will not be chastised or berated over a patient lying on a stretcher. We will not be yelled at by a doctor, nurse or tech. We will not be belittled for our role in the patient's care and transportation between point A and point B. If it is so easy and you (doctor, nurse, etc) can do it better, then I calmly and respectfully invite you to come along with me for 24 hours. Dress as I do. Go where I go. See what I see. Work with the tools I have. And perform only those interventions that I can. And transport a patient into an ED where one or more of the staff treat you with disdain and question every thing you have done or are trying to say. Tell me then how to do my job.

Whew......Sorry for the rant. The frustrations of an old guy still trying to make a difference sometimes gets the better of me.
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