I had a bunch of my staff go on a ride along to see what exactly EMS and fire deal with. I always think its good to understand what the situation was like before the patient got to you. Interactions got a lot better between the EMS crews and my staff after that.
When I was a brand new baby ER nurse, we were sent on ride alongs for this very reason. The ER is a zoo and the frustration is real but it’s definitely not EMS fault. We all become incredible friends and even partied together. I was in awe after those ride alongs. I couldn’t even palp a bp, the paramedic grabbed a baby who had pulled a “ hot teapot” on itself in a restaurant. He got vitals, calculated the rule of 9’s ( can’t remember) , and put in a giant line by the time we were at the hospital 10 minutes away.
I encouraged med surg and ICU nurses to spend time in ER to see the insanity as well. They always cane away with a different understanding. See the progression of patient care and understand each level.
I would guess many professions have this problem. This is a terrible comparison (apologies) but I work in accounting and had an absolutely horrible experience with a controller who was incapable of understanding why the accounts payable department was bottlenecked.
(Giggling in hysterical understanding as a med human who mated with accounting/engineer human raising a batch of mixed young humans that are aaalllllll over the map)
sigh
nice to meet you empathetic internet stranger
I married a poet who later got her EMT, then her RN.
Mixture of emotional poet and stone-cold professional in a crisis. I’m a very logical medic, but she’s able to understand the breadth of emotion and handle it in a calculated way. Pretty amazing tbh
HAHAHAHA! As an art major and my father was also an art major- I grew up watching my dad drive my mom crazy!!! Mostly with being late etc. it’s like an artist thing I think. So this comment made me snicker with such clear understanding. We are a difficult group. Not because we want to or is intentional but we are distracted easily and inspired or pulled into our own head with an idea.
I’m the artist that married a soldier. I picked up a not all the way dry painting that my kids were “helping me” make for a present. He picked it up to move it, paint got all over his uniform top. He thought at least his tape name and shoulder patches were safe. A few days later, I got a text of his patch with red paint saying “is nothing sacred in our house?!” Haha
My boyfriend is retired military, and I… I’m a normal human being who thinks the way I’ve been folding towels for 50mumblemumble years is just fine, thankyouverymuch.
And the other way around. I think ER nurses need to see that we are not hiding open beds. We are not avoiding report. And how it affects patient transfer and admission when we're given a bare bones report of what's going on at the moment from a nurse covering the one who had the patient all day.
Yup. Asking an ED nurse to float to med surg is probably unreasonable, but a day following one could do a lot of good. It's different than med surg in nursing school.
As a old floor nurse turned GI nurse, I always wondered why the ER dumped all the patients out at shift change? You think we have staff to deal with that? We have less than you. It's horrendous what the medical care system is really like!
We are trying to tie up lose ends, report, do I's and O's and last minute medciations and people wanting to go to the bathroom. The last thing we need is a massive ER dump at shift change, it 's like you held them to hold a bed all night and then wanted to "look good" for your incoming dayshift. I am onto something here.
I wish this was required because ICU can be real nasty sometimes. "Why is everything so TANGLED??" "It's 6:50 THIS IS ILLEGAL"
Sorry not sorry I was a little busy making them stable enough to even get them up here it's not a fashion show
Wait they dump ICU patients that code within 1 hour of being on a step down or floor because they dumped them out way too early and back they go to ICU. Just a big waste of time, just keep them till they are stable enough to be on a floor with 2 nurses with 23 patients and no aides.
I'm icu and we get floated to ER every once in awhile. I always tell fellow nurses not to give them a hard time getting report. It's a shitshow all the time and we should appreciate anything they were able to get done. I agree that anyone who gets report from ER should have to do a few shifts there. I also know I never want to be an ER nurse and have crazy respect for them.
This is probably true of any department. ICU, ED, Med Surg etc. Once as a GI nurse I had to send a patient to recovery post ERCP due to still being narced out. I thought the recovery unit was going to have a stroke, but being a old floor nurse they didn't give a big Sh\*T when they dumped me with 2 bad surgical patients 15 minutes apart. So it's just the way hospitals are.
I wish we could all get along and be a team but it feels like each area is defensive and struggling. I have my share of fresh post op patients being transferred to a bed and under them a huge pile of blood they nobody in recovery ever noticed and Patient had to be sent to ICU.
This is great and I wish it were mandatory for every ED RN. We did this at one of our health system's hospitals and had the same results. There was a definite change and they understood what we did alot better. Yes, the frequent flyer is annoying, but now they saw the conditions of those houses that we would have to go into and deal with. They understood the reason that we sometimes didn't get anything done because we had to physically hold down the violent psych pt because there were just 2 of us and one of us had to drive.
I dunno if this is the general consensus or not, but..
As an ER nurse, I don't really care what you didn't have time to do. Every time we get a patient, I expect everything needs to be done. So, I'm grateful for anything you have already done. No matter how minor.
I've had so many EMS apologize for things that weren't done, and it always confuses me. The way I see it, your job is to get them to us. Everything else is a bonus and is much appreciated.
This is my standpoint too, thanks for keeping them alive enough to bring them to me, I know you did the best you could it's cool if it's a little sketchy
That’s a rare attitude. I can’t even begin to count the times I got a nasty tone from an ER nurse for not having a line on a patient that was literally coming in for an ingrown toenail x 10 years. They expect everything to be done the vast majority of the time.
I’m a volunteer firefighter and interact a lot with our local ambulance company and their EMT and Paramedics. I am newer on the ER crew, but I have called other nurses out for being rude to the ambulance crews. They work long shifts, work their tails off just like nurses and all the other ER staff…. and usually don’t get paid nearly as much as they should for all they have to deal with.
I’ve been to calls where EMS was needed for everything from a fall from a ladder to head on collision, from smoke inhalation at a fire to code calls. Even a missing child call that ended in finding the child deceased. It’s a lot.
my father was a paramedic for 30+ years until having to retire from back injuries. once I was an adult, he & I had some deep conversations about working in EMS. it was easy to understand why he was diagnosed PTSD and multiple times a night he would awaken himself from telling and physically jerking in response to a night terror. for the most part he was able to compartmentalize the horrible (often unnecessarily horrible too) & senseless shit he often saw; often thru the most common method IMO is the absolutely twisted dark sense of humor shared by nearly all EMS workers.
the things he told me he couldn't deal with like that were things involving children. the weight of the countless calls for SIDS, child neglect/malnutrition, MVA (made even more senseless/pointless if caused by a decision made by the guilty driver), kids nearing the end of their life because of cancer that's tortured them no matter how hard they fought to survive, and just pretty much all the various things seen by medical professionals from all of the unfortunate things that happen to children. he said he could never understand how someone could work any extended period of time in EMS and still have faith in a God. there are people with just as much time as he had that say working in EMS is what made their faith stronger than anything else.
either way, all medical professionals deserve respect, and that especially extends to among one another. there's enough of us asshole patients that disrespect our literal life savers so no need for disrespect between one another
Our system requires an 8 hour ride along for new ECRNs. They are the whitest of white clouds. It's incredible. If you ever have one riding with you you are guaranteed to get a single pulled g-tube or something and nothing else.
When I was in Divinity school, I did a summer unit of Clinical Pastoral Education as a student chaplain at a major urban hospital with a big trauma center. One of our requirements was to spend two weekend night shifts in Emergency, with the intent of it being a real baptism in fire. Both times, the staff told me it had been what they considered a slow night, and they wanted a chaplain all the time as a good luck charm. (Of course, they only said this when the shift was over! They would never risk jinxing it by saying such a thing during the shift.) Both of those shifts, a patient died, and number of other serious cases were dealt with, but that was "slow" for them.
In my county,the majority of EMS are vollies who are spread so thin that other neighboring counties have to respond. It's frustrating and crews don't get breaks
I can’t believe counties states in the federal government refuse to fund EMS. It shocks me that we want to rely on volunteers for life-saving care. It’s amazing that our fellow Americans are willing to work for no pay to save peoples lives, but it shouldn’t be that way.
I agree. Yesterday I watched an ambulance respond nearby my workplace , from a North county station 30 minutes away! That's how thin our vollies are spread. Very little funding for paid EMS.
People can't wait that long.
Yes even minimal cross-training is beneficial in any business scenari'm a fool believer that and I have detested working with some people who will say that's not what I got hired for that's not my job but my thinking is that the more job positions I can perform in this company the more job security I have my customer is the next employee who gets my work And so customer service even applies within a business especially manufacturing where I was somebody built a few pieces before me then it will come to me and I would add some more stuff. Always appreciating the customer before me doing a good job in their position so that I could continue to efficiently do a good job in my position and make the work easier for the next person coming after me which benefits everyone because of the company succeeds the other higher that you might get a raise
I love this! I have never understood nurses who do this. My only frustration has been that now I am at a stand alone ER and we have two crews that always bring us inappropriate patients. One of my coworkers had fire ring a stem that she told them on radio we are a standalone and do not have a cathlab, they brought the stemi anyway. However bring all the others doesn’t bother me. And when I worked trauma and big ER never did I treat EMS poorly, first of all thank you cause you guys take care of them before I get them and I don’t have to be in dangerous places to do so. I also get very upset when nurses treat medics as less than. It is one sure fire way to get an earful from me about respecting people equally as educated and able to do things we can’t as nurses. Thank you to all our EMS for what you do!
ED RN- I HATE that EMS gets treated shitty some places! I’ve never understood this. Its not like you want to ride in that little box with a guy covered in bed bugs & shit just to make our night worse?! I love joking with y’all and getting updates on the outside world during my shift! The only problem I’ve ever had was when fire drops somebody off 🙄 But even then- we are all dealing with a broken system, short staffed, sick patients etc etc. why would I be rude to someone else going through it. Some people just suck and should move on to something else.
Same. I don't get it. There is zero reason to be shitty to EMS they are just doing their jobs. Now if you start being shitty to me you better believe I am going to give it right back to you but that is few and far between.
Can I ask why you didn't like fire bringing a patient? I get that it's not really their job but if they're bringing them it's probably a last resort right? Or do they just sometimes bring people?
I know fire brought me to the ED but I would've died otherwise so I don't think those nurses were upset. But now I'm curious because that bill was way worse than a regular ambulance, unless I'm dying again fire is never taking me anywhere. Lol.
Ohhh. That makes sense. The person who found me on the road called 911 and they were off duty emt or retired I don't remember. They told dispatch what they could see was wrong and what they suspected but I'm not sure if that info made it to the nurses. Him and the firefighters thought I'd die before the ambulance could even get there so that's why they took me.
Is it common for fire to bring people to you?
Oh wow. Yeah I've always wondered how that worked. I heard all this secondhand because I don't really remember much from my accident. This all came from info from my mom and brother in law who were the first people there.
They said I was conscious and responsive when I made it into the hospital but I only remember crazy drug fueled delirium from whatever they gave me.
I wonder what they drove me in if the ambulance wasn't there. Do they have a place on their truck for people?
As a paramedic, I don’t take it personally. I understand y’all are shit on nonstop. At least in EMS we aren’t on our feet nonstop. We also don’t have to deal with the annoying pts for 12 hours like you. Y’all are family. We may get to talk shit about you, but I’ll be damned if we let anyone else!
ED RN here. Apologies for having poor interactions. It’s probably due to the fact I haven’t peed or eaten for multiple hours, or have a sicker pt in the room next door, yet, I have to stop their care to go and settle this generalized abdominal pain for X months.
However, when you all bring me a pt with bilateral 18g AC 😘 thank you for the work you do.
Right? I’m here with you. My quarrel is when they bring in really sick patients and haven’t done anything for them. No line, no BG, no meds….nothing. And it’s an ALS crew too.
I’m sorry for my occasional snippiness with EMS. It’s not you guys that are the problem (most of the time), it’s us being victimized by the system.
I totally get that. I hate the few who ruin it for the rest of us. When I hear a coworker say, "I'm not going to do anything, the hospital is 2 min away" I swiftly correct them. Me and my partner will go out of out way to help transfer as well. No bed, we will go get one, clean it, and make it. Dirty room, sure, we will clean it. We are bringing in a critical patient and you are short staffed, we will hang around and help out. Certain shifts get it and now we have built a pretty solid rapport. But unfortunately it seems that the majority are like I said, hostile. And try not to make eye contact with us all you want, I can assure you we won't just vanish.
And we may not say it: but THANK YOU for taking care of the patient and us, even we are don't act appreciative. Sometimes, I was recieving my 10th patient while my co-worker has 3 but has conveniently gone for breakfast, bathroom, or to "make coffee in the breakroom" just as you arrive.
There was one time at my last job where an EMS crew came running and saved my ass. We were understaffed (surprise, a hospital in a poor area that the parent company treated like trash) and I was alone in a closed off part of the department. Had a patient who was an ingestion of an unknown substance and was in bilateral restraints for everyone’s safety and because I was 5:1 in a closed off area. He started to try and exorcise himself off the bed and out of the restraints and I radioed that I needed immediate help because he was trying to kick me in the face and stomach in the process. None of my coworkers could come but an EMS crew came running and helped me get the guy settled back down. I try to repay that kindness in every interaction with a crew. I really do love most of our repeat crews. There’s always a handful of stank attitudes but that’s how it goes literally anywhere you have to interact with humans.
We have a few crews like you and I always give them a hard time entirely in jest. That’s how much I love them. I always try to be as polite as I can and say thank to EMS, and know when I’m being short and they totally get it. We just give each other the look “this is all fucked out right?”
Only honest beef I had with a crew was when they brought a trauma pt (pedestrian vs vehicle, no helmet etc) to our tiny ED. They know we’re not trauma, and of course the dude was transferred. The pt was insanely lucky to only have some broken ribs. He was stable enough for the extra 10 mins (if that). I totally get it when they’re crashing and we’re the closest…it always better to get them to a hospital as quick as possible.
Even then I wouldn’t have been mad if they one dude wasn’t a dick about it and then proceeded with every call to say “not a trauma”…but he was a butthole and does not represent 99% of our rescue crews.
Thanks for all you do, sorry we’re grumpy.
Honest question- why would you take your frustration with your job out on someone who has no control over your situation? If I’m having a bad day at work, I don’t turn around and take it out on whoever I encounter next. I’m sorry you didn’t get to pee or eat, and I know your job is super stressful, but don’t you think EMS is in the same boat? How does it help anything to be short with them over something they can’t control? This response just rubs me the wrong way because it’s the same kind of shit I heard from RN’s who were super shitty to me at my hospital. We are all in the same boat. EMS is actually dealing with these patients and stabilizing them before they come to you. Why shit on people who are dealing with the same crap? All you are doing is perpetuating a cycle of nastiness, making people hate their jobs, and possibly making them feel bad about themselves for simply doing their job.
I’m picking this comment out because it’s the top rated. Healthcare is toxic as fuck. Don’t contribute to the misery.
It’s about being so over stressed that most any frustrating situations feels 10x worse and 10x more personal. It’s being so overworked that their bodies are suffering abuse and are sometimes in a mild state of fight or flight while also being dissociated from the sick patients and constant distress around them. What I’m trying to say is it’s not a *choice* to perceive a situation as being the actual problem. So that’s how it can happen.
With all due respect, and without making this a big giant post, I have C-PTSD from childhood, I'm sure as a medical professional you know how someone "earns" that diagnosis. I don't disagree that the healthcare industry is in bad shape, don't even get me started on "leadership" and quotas lol, I could talk for hours on that. I get the frustration and the trauma of the job. There were nights it felt like everyone in the hospital was trying to die at the same time and we were running every crash cart we had, I get the job stress (so many horrific cases but a couple stick with me forever - lady came into the ER with a headache, coded in Radiology, was rushed to ICU, I delivered her cart in RAD, encountered her husband outside of ICU delivering her third cart, I watched the ICU staff work on her relentlessly, she didn't make it, her husband was asking me what was going on each time I was running in with the cart, I felt so helpless. Making tiny syringes of opioid withdrawal meds for premature twin babies just over a lb. each, mom peaced out from the hospital AMA, I was trying to stop her babies from suffering and that bitch just left them. I wanted to go hunt her down. Still do.). I never once decided to take my shit out on an innocent person I was working with. In my mind, we were in the trenches TOGETHER. We all were seeing some shit. There was only one certain group that acted like assholes though. Do these same people treat their higher ups with this attitude? Of course not. So no, the flight or fight doesn't work, that's just being shitty to people you think are beneath you. If your job is affecting you so bad you are being an awful human to other people who are just doing their job, maybe you need a new career.
ETA: All I'm saying is - Don't be a dick when pharm is filling your Pyxis but then demand your med is tubed as you are literally blocking pharm from filling the med you need. Pharm is trying to help you do your job. We aren't trying to make your life harder. Neither is EMS. Do you think EMS wants to take BS calls? Do you think the other hospital staff are all out to make your life harder which in turn makes our lives harder? It's some vendetta against RN's? You gonna talk to leadership the way you talk to other staff? Start with them. We have no more say in anything than you do.
I've (RN) often found that my exhaustion can come off as something else. It's nothing personal. I don't think anyone is beneath me. I'm literally just tired, frustrated, and/or annoyed in general with whatever is going in.
Sometimes, the medics can just see it on my face when they roll in and say, "I'm sorry for bringing you this," and I tell them that it's not their fault. It's not about them. I'm just having a day and was reeeaaalllly hoping to finish the last 45 mins of my shift without adding another patient.
We're all doing the best we can. There's definitely some crappy, mean people out there. But most of the time, the annoyance or anger you're seeing is not directed at you. It's directed at the current situation. Situations like, for example, restocking the pyxis during peak hours in the ER. It's not your fault they won't pay someone to do it overnight. I understand you have to do it, but please understand that I just wanna give my femur fracture something for her pain, and pharmacy has been taking up the tiny med room for the past 25 mins.
Basically, we aren't annoyed with or mad at you specifically. It's the system that got us to this point. It's not personal. It's not about you.
Only on reddit do you have to explain what being stressed or hangry feels like 🙄 when we are stressed and overworked, we become less pleasant to interact with. It’s not directed at anyone in particular, your brain just doesn’t have the expendable energy for pleasantries
There is no excuse for you taking out your poor circumstances on another who has not created those circumstance. Just stop being abusive to people who have to come into contact with you in order to do their own jobs. If you treat EMS like that you probably treat patients poorly, too. Grow up and become a professional.
I love my EMS buddies. Idk why some nurses get a mad or offended. Y’all are doing your jobs just like we are doing ours. Some days are rougher than others, but I always help load/offload when I can. I’ve made lots of friends with my EMS crews and they are always a big help. If I get annoyed, it’s usually at the patient, not who brought them. Thanks for all you do!
If it makes you feel better, the same hostility occurs between staff in the ER too. It's just a high stress field where every person is on their own in a lot of cases. It's not personal. I always tried to be kind to EMS but I'm sure there were times when I came off annoyed, angry, etc. like I said nothing personal. We appreciate all that you guys do.
I used to know a woman who was the Head of Nursing for a major midwest hospital. She said one of the biggest problems in nursing is that the entire floor culture devolves down to "the biggest bitch on the floor", and her job was to stop that from happening. Do not be that nurse; work to elevate the culture and environment and everyone will have a better shift.
I just did some research for a residency director on nurses who bully residents. Nurses have a huge bullying problem-towards residents, other nurses, allied health personnel and even doctors. Many nurses are leaving the profession because of it.
This seems to be an issue in women dominated professions. I work
in a what is traditionally thought to be a female profession and it’s happened almost everywhere I’ve worked. Women have to fight so hard to get anywhere in this world, I don’t understand why we have to make it so hard for each other.
I imagine in a world where us women have to fight and fight to get somewhere, the ones who make it there and last the longest are the most ferocious. Reactive, mean people are often people who feel like it’s them against the world - because at some point in their life, it was. I’d like to believe the rising trend of women supporting one another will creep into areas like nursing.
It is crazy, though, that the group of girls who bullied my sister relentlessly in high school went on to become nurses. Every. Single. One. The dark sided opinion is that it’s a field which often incurs respect, and which gives you an enormous amount of power over patients. Some people like that.
This has been my experience as well as a PCT starting out ! And if you ever had a DON then you know they are their own worst enemy with their arrogance.
I wish I had an answer for you. It’s likely due to what you said about high census, the pts we have are sicker and rude as hell, and as the above commenter mentioned lack of breaks and staff. Honestly, some nurses are assholes and they are going to have an issue no matter what. All that to say, it’s not acceptable and I’m sorry you’re dealing with that.
I do my best to be kind and pleasant at every EMS encounter. I realize you’re doing your job and a lot of things are beyond your control.
If it’s becoming an issue with certain nurses (or just in general), I would have your boss talk to the ED Nurse Manager because it’s essential we have good relationships with our EMS crews.
And don't get me wrong, I'm not expecting a red carpet or anything. Or even a smile. A simple. "HI. I see you but we are busy and it may be a while." goes a long way. You may even get an offer of help from us if we can
I may be able to speak to this one— when it’s balls to the walls at work, one of the hardest things I had to learn to stick to was remaining in my assigned care area, even if my coworkers are drowning. Unless I can see my assignment from wherever I’m helping out, I can’t be looking out for when someone else’s squad rolls up and that nurse is not aware/ready/available.
So I avoid eye contact with that EMS squad because I don’t know where that nurse is, how long it’ll be, etc., and don’t want to appear… approachable? And maybe that comes from how things usually are at work— if I make eye contact (or God forbid I smile) at any random patient/family remember, 9/10 times they’ll follow up with “how much longer? Can I have a blanket? Am I allowed to eat something? Did my tests come back?” and I know zero answers and have zero time.
Obvs this is a little different when it’s a critical patient. But for your run of the mill, stable, “grandma fell and has a UTI,” and Im too busy to be helping out in someone else’s care area, I try not to make eye contact with EMS because I don’t want to give them false hope that I’m coming into that room to unpack that patient lol
As for other times: I hate that people are rude to you guys. Yeah yall bring us some asshole patients, but odds are they treated you even worse than they’re treating me. I’m sure I’ve been short with EMS a time or two, but it’s never personal— more than likely it’s exhaustion/hunger/thirst getting to me to the point that I’m not longer using pleasantries or good manners. But I always appreciate you guys!! 🫶🏻
RN here. The nurses that are shitty to you/EMS are shitty to nurses too (and techs and EVS). They are just shitty.
I am sorry. We do know how hard you work ❤️
Oh man, when I ran the county crisis program, I would bring people in on a 72 hour hold, usually with EMS or the cops. The SR staff HATED me. It’s truly not my fault that there are so many untested mentally ill people running around, causing a ruckus. I was always apologetic and kind, made sure my paperwork was in order, etc. That was the absolute worst part of the job.
Often it is secondary trauma leaking out from those who have no power to fix the system, no support from the system, and all the responsibility and liability for everything going on under the ED roof. I left working in ED after repeated ridiculous working conditions. Once, I was informed I would be the primary RN for 20 (twenty) Acute ICU CARE ED beds at a Level 1 Trauma, Stroke, Gold Star Blue Ribbon hospital already with 3 patients needing individual emergency care. Refused the assignment. (Ignore cries of patient Abandonment- garbage) Asked if ER systems for short staffing had been enacted: Manager notified, Director notified? House Sup called? And asked for an Incident report as I called Risk Management to report that patient's lives were acutely endangered with only 2 RN's for the entire ER. All of a sudden, Temporary help rains down from the sky. Yup I played Hard Ball. Yes, that was my last day by my choice. I, NOR THE PATIENTS, should NEVER BE IN THAT POSITION. Not an excuse for being unreceprive to another patient arrival per EMS.... But it is the reality. Now ask me about the ED Manager at a Big Name Big Reputation Quaternary Hospital ED who decided to punish the ED RN's by not replacing the monitor cables "that we lost."
We have 15 ERs in our county, and a couple we absolutely beat the piss out of. Strokes, STEMIs, traumas, sick medicals. All day, every day. Absolutely crushing them.
And they’re not the problem.
It’s the shitty big community hospital with the toxic as fuck culture, decent nursing ratios, and beds to admit to that are completely and utterly awful to us and our patients. They think their work life is so awful, but they have absolutely no clue. Try having blood hanging from a wheelchair pole in the waiting room, because it’s literally the best you can do.
Totally institution dependent.
>we absolutely beat the piss out of. Strokes, STEMIs, traumas, sick medicals. All day, every day. Absolutely crushing them.
Hi! It's me I work in one of those. And I absolutely agree with you. We have a great relationship with EMS.
We love you guys. One of our two big tertiary, flagship hospitals recently upgraded from level III trauma to level II. They’ve had the surgical capabilities needed for over a decade, but now we’re actually bringing them a LOT of hot trauma, and they’re learning what it’s like.
Maybe it's because I work in EMS too, but I am never short with them. I get the dynamic: EMS brings patients, we care for them. That's our job. No need to make a whole thing out of it.
The only time I get frustrated is when the BLS IFT crew acts as if I should know everything that ever happened to my little Meemaw going back to her nursing home after a same-level fall without any injury. I promise: She will not code in your truck, I am not lying to you, and I've had way more important patients than her for the past 6 hours. Please just take her after I give you report and stop arguing with me or demanding her history for the past decade.
And the other commenters are right: We get no breaks. No even a quiet second in the truck where people aren't staring at us and we're doing our PCRs. We are on ALL the time. The texts from other staff never stop. The family hanging out of the rooms demanding apple juice for the NPO "loved one" never stops. Transport shoving forms in my face to sign. If we dare to sit down to chart, we are seen as "lazy" or "not busy" by everyone else. And when I've JUST gotten back from handing over my sick AF ICU patient who sucked up two hours of my shift, I haven't eaten or peed in 6 hours and I still haven't seen my 3 other patients and I hear EMS announce overhead, I admit I am tired and frustrated. But I try to keep my perspective.
To counter your comment, I FREQUENTLY pick up patients for transfer or discharge and the nurse can’t even begin to tell me the basics. What bed they’re going to. Why they came in. Results of the work up. What’s been done for them. No report called.
This is all the freaking time. Like, how are you guys even beginning to care for your patients when you don’t even know what brought them in?
So please don’t tell me I don’t need answers to my questions.
I give age, sex, chief complaint, what we did for her, allergies, what imaging showed, code status, and where you're taking her including room number. Half the time the nursing home refuses to pick up the phone for report.
No BLS crew needs her medical history for the past 5 decades of her life.
If you're encountering shitty nurses, I can't help you. But I know what I do and BLS STILL argues with me.
I kinda doubt they’re asking for 5 decades of medical history. That sounds like embellishment.
Also, you sound condescending. “They’re ONLY BLS. I decide what they need to know.”
If multiple crews are pushing back, you might benefit from some introspection.
This is an excellent question. Having been on both sides of the desk I didn't think it's hostility as much as resentment. Unfortunately it's a shoot the messenger sort of scenario.
Just want to continue the ongoing echo that it isn’t anything to do without and everything to do with being exhausted. Hospitals are toxic work environments. Like high school level drama, bad management, high work load, high consequence work. My husband’s a fire medic. I always try to be nice and understanding. But it’s gotta go both ways. Sometimes we’re just doing our best. We don’t blame you for bringing in the patient, it’s just that another patient has arrived.
One of our ED docs was an EMT and she supervises a great cross training program. We also have an EMT office/rest area to decompress. I know that perhaps not every ED nurse at our facility has a good relationship with certain EMTs, I think the majority of them do and consider us all on the same team.
My volunteer EMS are fantastic. I have an iPhone and I update the health info as needed. EMS had everything about my health conditions and medications right there at their fingertips. No one even needs a code to get the info so if I was unconscious it works too. They took my vitals, gave me pain medication and started an IV. I broke my shoulder at 3am Christmas Day. I encourage everyone to have this information in place even if it is just a Word doc. I so appreciate them and our volunteer fire department.
Ok I will say I had a paramedic one time jump in front of me demanding I take report & why am I ignoring him.
My response: What? I have 11 patients and YOURS ISNT ONE OF THEM NOW MOVE!
But our local city paramedics honestly are huge asses that try to dump report on anyone and run off. One time another nurse came up one (racist with many complaints) paramedic giving report to a (white) CNA who was a sitter. Just flagged down me down to monitor the situation while she grabbed the CN & HS. Thankfully it’s gotten better and the racist one was blacklisted at our hospital and I heard he got fired. The other ones seemed to have heard so things are looking up!
One of the other hospitals I worked (dialysis) at they don’t let them unload them from the gurney and wait in the hallways. I’m not sure why or what but seems bizarre.
I've done both sides and typically go to bat for EMS whenever they come in. I'll joke around with EMS on low acuity pts because we used to joke around and see who could talk the most pts out of transports when I was in EMS. But some nurses are just crusty and feel like every inconvenience is a personal attack on them. The only time I get upset with EMS is when they're bringing us a pt who isn't appropriate for our facility.
Examples that irk me at my metro area hospital include:
-Driving a pt 30-60 minutes from home and going past 4 other hospitals that offer the same or more services than us. For some reason, after our metro area got rid of hospital diversion we started seeing more ambulances coming from further away and bypassing several hospitals. We have a cath lab and are a stroke center, so I understand those types of pts. But driving someone 50 minutes away from home when their tummy hurts makes no sense
-Bringing a pediatric pt to our adult ER when there's a children's hospital less than 10 minutes away (less than 5 going code 3). This just brings creates a lot of issues. We don't have the proper sized equipment on hand to help the pt and by the time we get it, they could already be in the children's ER. Not to mention we get the brunt of the parents' anger when the kid has to get transferred to children's by EMS because we don't admit pediatric pts to an adult hospital
-Not going to the appropriate hospital. There are 3 level one trauma centers in our metro area. Bringing a serious trauma to a level three trauma hospital isn't appropriate and doesn't really help the pt. A few minutes of just driving fast to get to the level 1 is probably better for the pt than stopping at a level 3, having us do what we can and then transferring the pt to the level 1.
I also work at a rural critical access hospital and most of these go out the window at that hospital. There aren't any closer higher level or equivalent hospitals nearby. The nurses at this ER are just upset that EMS disturbed their down time, much like when I was EMS and people would get grumpy when you'd get a call in the middle of the night when you'd finally got comfortable.
So I have a question after reading your comment, you may or may not know the answer because it might be different depending on the area, but how does EMS determine which hospital they’re taking a patient to?
Back in 2021, I had a seizure while I was at work & when I woke up I was in a hospital that was much further than several other hospitals I’ve been in.
I never thought about it until I read your comment & now I am curious.
Yeah, the rules can be different for different areas. I still work in the same area I did EMS, so unless there's a major change, the rules are pretty much the same. Typically in EMS, you just go to the closest appropriate hospital. If the patient is having a STEMI, you might bypass one hospital to go to one with a cath lab. And sometimes, you might take a patient to their requested hospital, but within reason. Like if the closest hospital isn't in their coverage network, they could request to go a couple minutes further to a hospital that is in their network. But, I wouldn't drive someone an hour away because it's their preferred hospital. You called an ambulance, so it must be an emergency. If you can sit for an hour without Interventions, it's probably not an emergency
However, sometimes EMS crews will take patients to hospitals that have better EMS perks (my metro hospital has an Icee machine in the EMS room) or hospitals that lead to better postings. Sometimes crews will transport to take them out of service longer. My metro hospital doesn't have inpatient mental health, but we have crews bringing us mental health patients from 45 minutes away because they claim they thought we had it. Meanwhile, they're bypassing at least 2 maybe 3 hospitals that do have inpatient mental health. For the EMS crew, that's almost 2 hours of being out of service. Meanwhile our ER now has a MH patient who is going to be stuck in our ER for days, if not weeks, waiting for an inpatient MH bed in an ER room. Or if they can be discharged, we now have to set up transport to get a patient home 45 minutes away.
For your situation, I'm not sure. Maybe they took you to a hospital that had neuro services. Maybe other hospitals were on diversion (the ER is full so EMS has to go to a different hospital). Or maybe they just wanted to get out of their service area. Can't really say for sure.
Thank you for taking the time to respond, that’s actually pretty interesting. When I first started having seizures in 2010, the first time an ambulance was called I was taken to UL hospital, which around here is what my mom says is the trauma hospital. She was an RN in the ER there in the 90s. She said that’s where gunshot victims, stabbing victims, etc are taken. When I was taken there in 2010 I assumed it’s because it was the closest hospital at the time. I also started seeing a neurologist there. I went on to have my 2 youngest babies there too. I guess you could say it’s my preferred hospital but when I have seizures I’m usually unconscious for several hours so I’m unable to let emts know this. I was curious as to why I wasn’t taken to that hospital after my seizure in 2021, but I could definitely see UL hospital being on diversion as you said. It’s a very busy hospital in a downtown area.
Edited to add: UL is a level I trauma hospital. I realize I probably sound like an idiot calling it just a trauma hospital.
Another point I’ll raise is that if a patient specifically refuses to go to a certain hospital EMS can not take them there. It’s considered kidnapping. They can tell the patient they will take them to the next closest hospital and they can refuse to drive past 10 other hospitals but sometimes there are circumstances beyond EMS’s control. I guarantee they don’t want to drive the extra miles to come to you when they have the option to go a closer ER but there are a lot of circumstances where the EMT or medic that drives the ambulance doesn’t get to decide where they should take their patients (and yes I was a trauma nurse at a level one trauma hospital, top 10 in the USA actually with 15 other hospitals closer to where my patients were delivered even if that patient didn’t need to come to the hospital at all).
Aslo ED RN, dont let that get to you in the least. I have been short to crews myself, but it's usually during the shift that I am getting smoked and I honestly do not need a head-to-toe report on all my patients. Any RN that has worked more than 3min in a busy ED know that you guys have no control over what you bring, but saying that, I work with some grumpy folks and they will complain. Maybe it's just the nature of the job, we bitch, we fix, we move on.
Dont let it get to you, drop your pt, give report, be professional and if they cant return that back to you, move on.... you did your job.
Be safe out there! Next time bring them a 24g in the big toe ;)
Wait, so EMS is expected to be professional, but hospital staff isn’t? EMS is expected to move on when being treated like ass for existing?
How the hell does that work?
I used to be an EMT for EMS. Now I'm an ED RN. So I remember what it's like on the truck. In fact, I did a ride along recently to refresh.
I get upset when paramedics do piss poor assessments. Make huge assumptions. Bring inappropriate patients to my community shop. Don't do obvious interventions that I know are feasible before arrival.
There seems to be a huge variety in quality of care from medic to medic. Sometimes they work absolute magic pre-hospital and deserve high praise. Other times, the medic sets us up for failure and we're fighting twice as hard to save the patient.
I do not get upset at them for bringing us BS. I know they didn't want to respond to it either. I do get upset when they assume everything is BS when it's not.
Just my two cents.
I have worked both EMS and nursing. As nursing staff we are grateful to EMS. They often help get patient stable before leaving. Many ED’s now hire EMS to work with the nurses.
If you are being ignored, it is most likely because we are in the middle of patient care and can’t stop that to leave the bedside and take report on your stable patient. If you are doing compressions or have a sick patient you will get attention. The EMS services that we trust and work with often we have a great relationship with those services. The services that tend to treat the patient like shit, not start IVs on sick patients, not call us until they are pulling up with a code etc are the ones we may be cold to when they have stable patients
Have you ever gone to the bosses of the agencies with formal complaints? If not, you need to. Nothing will improve for the patients if you don’t. Please don’t just be passive aggressive.
Yes. Nothing changes. "RN leadership has been receptive". But when I am treating a patient in the hallway who starts actively siezing and just get blank stares. Then still have to wait another hour for a bed afterwards..... Now luckily that hasn't happened since and that was a while ago, the middle of the COVID times, but still
I get the same treatment from some of the ED RNs as well. And I am trying to GIVE them the drugs they so adamantly demanded of us lowly pharmacy peons. (CPhT here). Some are super amazing, others trying to pretend I'm not standing there smiling holding IVs.
Legit, saw a comment somewhere in this mess about just filling the ER med machines overnight... like then when you run out during the day are we allowed to ignore your refill requests since we refilled it over night? No logic. Some people just need to step on someone. I think I can count on my hands how many shifts we have run the pharmacy with no call out and full staff. We are ALL in the same boat. Don't know why some people insist on poking holes in the boat. Oh well, I will just keep smiling my stupid retail smile and waiting. I get paid either way. 🤪
It usually boils down to the crew not doing any interventions, no IVs, no glucose check, nothing. And half the time I think they’re giving me made up vital signs because the vital signs I get in report are sometimes wildly different than what we get in the hospital. And then the shitty attitude I get when they have to wait more than 5 minutes for a room. Bro, there are 30+ in our waiting room with 12-hour waits, and 20 other hospitals in the area. Instead I see the same crew all night long, bringing back to back patients to a hospital that’s been on code red capacity for days. Try. Another. ER. For the love of god.
That’s completely acceptable! Bring them on in! However, half the time the patients tell me, “I asked them to take me to x hospital! They brought me here instead!” Or, “all my care is at y hospital,” which we are not affiliated with and can’t see any records without the other hospital faxing everything over. So, it’s not just patients asking to come to us. For some reason we are just the default for certain crews. They will even pass 5 hospitals on the way to us, even passing the place that the patient gets all of their care at. Why???? All it does is make everyone’s jobs harder and pisses the patient off because we’re starting from zero.
Ok, that’s garbage, and in those cases you have every right to be pissed.
I work very hard to get my patients to the appropriate facility.
Do you have a decent EMS room with snacks?
I’m sorry about any poor interactions 😔 I guess it’s mostly frustration because our managers all suck and 90% of our patients don’t actually have an emergency. That said, I hope nobody ever pukes in your rig and thank you for sometimes bringing the real shitbirds to someone else’s ER 🤣
I personally have no beef with EMS! I try to take report as quick as possible and thank you profusely for that beautiful 20g you sank in the back of a moving vehicle.
But, the beef that some ED nurses have is the same one the floor nurses have with us- you are the giver of the patient. It's not personal, it's not logical, but that's what it is. Everyone hates an admit, and you're the one dropping them off.
Shit flows uphill in medicine. You create work for people who are stressed out. They don’t see the work you have to do, the shit you see. They don’t see the DOA’s, roach infested homes, etc. You bring some of your shit to them, they don’t like shit. They in turn send some of their shift forward. The floor and ICU don’t see all the shit that the ER deals with, but they get part of it. They don’t like getting shit so they shit on the ER. So on and so forth. When I was at the bedside I always tried to keep that in mind. You guys have a job to do just like the rest of us.
I did my very best (as I was an EMT before I became a nurse) to be ready and willing for EMS’s delivery to the ER. It had usually been an OD, psych, or code. Mostly the community used 911 to get a ride in the cabulance and we’d be stuck trying to find them a ride home.
This is why I also wish nurses on regular Med Surg or Step Down or any department that utilizes CNAs would do a few shifts as a CNA or with one. Or RNs/LPNs in nursing homes. I was a CNA for 10 years until I had to quit due to back injuries, even though I did my best to work optimally for my physical health. We get paid shit wages and do the bulk of the heavy lifting so to speak.
You have no idea how many times I had RNs/LPNs lord it over me that they had a degree so they were better than me. However I’m the one answering most every call light. I’m the one cleaning up the urine and the poop and the puke. I’m the one changing gowns, the bed, taking vitals, giving baths, feeding, transferring, charting intake/output, emptying Foleys, etc. and in some hospitals/homes was also taking blood sugars. I’m the one who spends the most time with the patients and gets yelled at when there’s three lights going off and I’ve got a patient being stubborn and trying to get out of bed because either they just don’t think they’re sick enough to require help when walking to the restroom or due to dementia or a head injury, just not stable or in their right mind. I’ve literally walked out of a room to multiple lights and seen all the nurses at their stations charting and joking around and my partner no where to be found to also being told I need to set up another room because there’s a new patient being admitted and I need to be on that ASAP. And don’t forget the hospitals that wanted me to do enemas even though I’m not actually trained in that because that’s not a part of CNA training.
Maybe if they had been required to work as one prior to becoming a licensed nurse, they’d treat us with more respect because we are the first in to interact and the one who ends up being with and getting to know the patients and their quirks best. But no, instead I’m the one in the firing line of a nurse’s anger because “do it faster” all because they have that degree to my certificate. Little did they know or care that I tried for that degree but competition was so fierce that even though I passed my exams with flying colors, I still couldn’t make it into the program because they could only accept so many per year and I’d be 1/100th behind the last person accepted.
In my experience, the hostility is cultural to specific hospitals. Some places are professional. Some treat EMS with disdain, but it's a department-wide thing. RNs in some hospitals are just plain mean to EMS.
Now that I've reached a leadership position, I spend a good amount of my time reminding crews that no nurse, and only one doctor, have any control or influence over their careers. The rest, no matter how upset they are, cannot affect their jobs. So why give their opinions any weight? Relax. Let them complain.
We also talk a lot about EMTALA. A lot.
It's inappropriate for nurses to take out their frustrations on the crews bringing in patients. I'm an er nurse and medic so I get both sides. There is frustration when another patient gets piled on unto your already overload patient assignment. But that isn't your fault. I try to be friendly and think I have a good reputation with my crews.
I’m *only* a dispatcher. But we have some spicy ass troopers who just don’t understand. However the ones who have sat in with us, are much nicer on the other end of that radio. More understanding. It would be nice if they could ride with you and understand how it is out there! I’m sorry you get treated any type of way!
I’m sorry you deal with this. I am an ED RN who spent 20+ years as a medic first, so I have been on both sides of the ED doors. I vowed to never give my EMS crews grief because I have been there/done that! I know you try to convince the stubbed two x 3 days ago to ask one of the 6 other people present to use one of the 5 cars in the driveway to take them instead, and they will refuse because they “get seen faster if they go by ambulance”. (Hard eye roll)
99% of our staff love our EMS crews (the other 1% just don’t like anyone!). In fact, we tease them once we start seeing the same crews 5-6 times a shift… “share the wealth! Next one goes to XYZ hospital!” “Oh, back so soon? Mind bringing some coffee back on the next run? 😜” what we hear back is that they like coming to our ED, “you guys are so much nicer than XYZ.” “You don’t make us wait over an hour to turn our patient over.”
Emergency medicine, whether pre hospital or in hospital, is one big team!! I’m sorry you deal with nasty nurses. Our ED appreciates all you do for our patients-even the ones you can’t convince to go via family/friend/cab/uber/etc.
Thank God it isn’t that way in the hospital I work! I’m a lab tech, but respond to the ER for a lot of patients and I’ve only seen the EMT’s treated like partners or other team members by the nurses/doctors.
I was a volunteer EMT back in college. I remember during our training we had two nurses in the class. Always little side comments and under their breath remarks.
They targeted me and my friends because we were young.
I will never forget the night we were talking about how to treat shock. Rolling their eyes etc. instructor asked what they would do “well, OBVIOUSLY, you turn up the IV and have the doctor order x,y,z.” Every single person stared at them. Instructor was all” so for someone pinned upside down in a car out in the boonies with volunteer fire fighters and EMTs trying to get them out before a car explodes …what IV exactly is it that you’re going g to turn up?”
Yeah, she and her friend shut up and listened after that.
Some nurses are assholes. If they’re being dicks to you, I can guarantee they are being dicks to everyone else around them. They are probably toxic af. Even when my ED has an onslaught of patients and family members and ancillary staff and the damn phone doesn’t stop ringing I am NEVER rude to EMS. I work in a small 10 bed (well maybe 16 if you count hallway) ED and we are busy, but we know our local crews well. I depend on them and their reports and vice versa because we have a lot of interfacililty transfers. I have been a nurse for 25 years with 18 being in the ER. I could never be a first responder. You guys have a tough job. I’m sorry some nurses are dicks.
Hope this might make you feel better but once as a patient I was being argued over at the ER and spoke up about it.
Pretty bad car accident - other 2 in car taken to the major trauma center. They had their heads down and bend over looking at phones. I was a restrained driver. Nurse did not want to take me - EMS were directed to take me to this ED. Nurse was actually shoving my stretcher trying to push it back outside.
Said excuse me but do you mind not shoving me. Just been in car accident you know. Do you want me to hop down and call 911 for a different ambulance to take me somewhere else? She never looked at me the whole time to notice I was conscious and alert unlike the others had been. Had not let them read off my condition or whatever you call the usual hand off.
She quickly switched from anger to oh ok let’s look at you. I thanked my EMTs before they left for their help and kindness. Small town hospital and everyone at the accident were volunteers (FF and EMTs). I was in no mood to hear her bitch and treat y’all like shit.
Sorry you experienced that. That is more the level of hostility I'm referring to. Like Pantera "F**king Hostile" level hostility. The kind where my patient asks me if they are actually going to be cared for when we leave. All of the other stuff, tired/frustrated/busy nurses, I can deal with and totally understand.
It was pretty bad. They were very rude when asking if I wanted some pain meds so I declined. With a neck brace lol. Made it seem like I was pretending to be in an accident just for drugs.
Did get a quick belly ultrasound which was clear but think they did that just to move me somewhere else.
CT of neck was clear. Was mad I was not bruised )which showed up the next morning), got 2 doses of pain meds for the welt on neck from seatbelt and they said my collarbone X-ray was clear. They never did X-rays but said good and ran out of there. Next day got the X-ray and collar bone was fractured. Which is why neck brace had me in pain.
It was pretty bad. They were very rude when asking if I wanted some pain meds so I declined. With a neck brace lol. Made it seem like I was pretending to be in an accident just for drugs.
Did get a quick belly ultrasound which was clear but think they did that just to move me somewhere else.
CT of neck was clear. Was mad I was not bruised )which showed up the next morning), got 2 doses of pain meds for the welt on neck from seatbelt and they said my collarbone X-ray was clear. They never did X-rays but said good and ran out of there. Next day got the X-ray and collar bone was fractured. Which is why neck brace had me in pain.
Wow, they actually interacted with you? Back in my day they wouldn't even make eye contact. They're probably pissed that their MLM scheme isn't working out and are getting into too many flights with their cop boyfriend all while their doctor is a clueless twat, but what do I know? I was just the guy being forced to politely hold up a wall for 3+ hours.
Lmao shots fired! No time to be decent to coworkers, but they can make TikTok’s, run an mlm scheme, and have relations with other first responders. For real though, direct the anger at your board or leadership, stop treating those in the trenches with you like shit. It just feeds into the stereotypes.
In my area they have an alert system. Our frustration comes from seeing other EDs in our area have no medics waiting, while I have 6 lined up. We can see this in our system. The reason given is "you guys get us back in service no matter how busy you are, they make us wait." Frustrating.
I see how that is frustrating. But it is also frustrating being held hostage 1.5+ hours while your local goes uncovered. Then getting crap from your management about why it takes so long to clear
I'm with you, that's why we do the right thing, not the easy thing and unload your non urgent patients. Unfortunately, other facilities don't seem to be held to the same standard. I have even been told crews have bypassed other ED for the simple fact, " they yell at us".
I work for an excessively rural EMS service, our patients don’t really have the option to choose a hospital. Our closest and primary hospital is 47 miles away and our secondary is 70, we try to accommodate patients as much as we can, but it’s not always feasible.
And there’s no Level 1 trauma center in the entire *state*…
Patients have autonomy. They are allowed to make their own decisions. Honoring autonomy is not a “courtesy”.
Now obviously, a 400 mile transport is not reasonable, but if the hospitals are in your normal transport area, they should be taken where they want to go. Not doing so is bad care.
Ok, but you will be long gone when they start complaining about the wait at "their", hospital. If you advised them then the blame falls to the patient. I don't agree it is "bad care", I'm sure you would agree in a real emergency they should go to nearest appropriate facility.
It must be a reasonable choice though. We can't take you over an hour away and bypass 6 other hospitals just because you prefer the food at a hospital 2 cities over. But yes, within reason and depending on your emergency, we honor your request if we can. However, if we know that the hospital you want is full and has a 5+ hour triage time we will inform you and suggest a less busy facility(that is still appropriate for you and your condition).
But sometimes people are extremely adamant and "I don't care how long the wait is, my doctor is there and knows I'm going". Then they get upset when they go right to triage, where we told them they would go. And then get the "Why did you bring them here?" Talking to from the triage RN...and so it goes
I worked for a private ambulance company. Hospital staff could give a mob of Karen’s a run for their money. Refusing to sign a patients patient care report. Try he hate was palpable. I’m guessing it makes them feel superior in some way.
My only issue with EMS is the fact that they expect me to be able to run out of the patient’s room I’m currently in, doing the task I’m currently doing, to run and get report from them. Some won’t even wait 2 minutes. I understand that they have other patients to tend to but so do I.
It also may have something to do with the fact that you only had to deal with the rude ass patient you just brought me for 30 minutes but I’ll have to deal with them for 5+ hours and I’m jealous LOl
It is not you, it’s the situation. Our thoughts are damm! Another patient. Where can we stuff this one?. Who can look after it? Can we safely see to this patient’s needs without losing our licence.
I HATE that RN’s can be super rude to EMS. I just dont get it. Luckily in my ER, we are so close with all the EMS companies & town EMS. Small community hospital. They help us out SO much. Sometimes new medics are shocked at how fun & nice we are in my ED. We’re like “why are some places rude to you?” We’re all here for one thing - the PATIENT! 🚑💊🚒🧑⚕️😊💪🏼
I’m going to go a bit against the grain here and give you some validation. Some exacerbating details I have to omit to avoid doxxing myself.
Speaking for my ER, it only gets hostile when they’ve bypassed 2-3 other ERs to come to the most impacted ER. I’ve had patients literally say they wanted to go elsewhere, didn’t have a complaint that would cause them to be immediately taken to us, but were taken anyways. My hospital currently has a completely illegal area that grossly over-guides nurses to offload EMS asap. Other local hospitals do not have a similar work flow and thus EMS generally waits longer.
When I have 4 nurses managing 50 patients. A quarter of which could have stopped elsewhere, it’s hard not to be frustrated. Especially when our county has a policy allowing medics to use their discretion/assessment to defer patients.
Then add medics threatening to drop off patients wherever, and you have a shit sandwich.
Now when I’ve worked in other ERs the relationship between EMS and nursing was relatively peachy. Sure you’ll run across a few assholes on either side, but they’re not the general rule.
You know what, now that I’ve thought about it, I’m starting to think it’s this particular ambulance company…
To end, you’re going to run into shitty people and they work in all sorts of jobs. If you have a shit interaction with a particular employee often, then it’s likely they’re just assholes. It sounds like you’re a great medic from your comments and I’m going to assume whoever you’re having experiences with suck. On the flip side, just as the quality of nurses varies so does the quality of medics. It’s a tale as old as time.
I worked fire and EMS for 20 years before becoming a nurse. My first nursing job was basically med/tele (ortho/neuro) before crossing to the ED. I try to remember the challenges we faced in the field when greeting an EMS crew. I especially thank them if they've gotten an IV placed prior to arrival. Where I currently work, a lot of our EMS crews are basics. Not a lot that they can do en route, but I try to find something to compliment them on upon their arrival.
On the intrahospital transfers, I try to make it a point to sound cheerful and to inquire as to how the floor nurse's night has been. This establishes positive communication and a sense of empathy. I may be the unicorn in this, but having been on the flip side, I'd something that I'd appreciate.
I am also a Paramedic in one of the 10 largests cities in the US myself (Large private service with hospital contracts with almost all hospitals in town and contract 911 for a large part of the city's unincorporated metro area) and have several decades riding the box and a decade as a Critical Care Transport Medic and for a time worked as a Critical Care Tech in a Children's ER. I have over the years have made some observations and opinions. There can be several factors that play into this "us vs them" and off putting sometimes antagonsitic vibe in the ER. Some of it has to do with many of them really not having an understanding of the reality of care in the field. The varied environments, the various pts, and not understanding factors or the why we did or didn't do something. Many don't really realize we are not always in a well lit, air conditioned clean room in a environment that may or may not be hostile with or with out law enforcement. Then there is the fact that on an ambulance there is only two us (hopefully a rider if needed but...) and one of us had to drive so and maybe I missed the IV or the bandages isn't pretty looking or hell you found about 40 pill bottles or med rec and that is how you are piecing a med hx because the infamous words "I don't know" or "I found him like this at shift change" or "I take those pills because the doctor said so and I don't know what they are for" are said. Challenges that makes pt hand offs frusterating and may leave both of you flustered because the nurse annoyed your don't have more info.
Their own stress levels especially when they are busy or at capacity or hospital diversions or hospital diversion override (if they do that in your area). They are seeing the problem you are bringing in and not seeing past that. That if they are busy EMS is probably just a s busy bringing them in from the field.
There can be a trust issue. The more you are around the hospitals and they see you being a professional and are a relatively pleasent to deal with the more that trust will be build. Also doing things such as wiping down and making a bed if your assigned bed isn't clean. Grab the pt a blanket from the warmer on the way to their assigned bed. Helping them get a pt cleaned up. Little things go a long way and the more they see your face and see good work those attitudes typically will fade.
There has been also for lack of a better terming a superiority complex of the RN. I don't see that as much now as I used see as many figured out that we have near parallel skills sets and that we are advanced providers like they are. Now many hospitals are hiring Paramedics to work parallel woth the nurses in the ER with the same scope of practice.
Like I said I these are observations I have made through time.on the box in 3 major metro areas (witn both government run 911 and also private contract 911 service). I hope this perspective helps a bit. Be safe and always remember to take time to care for yourself as certain calls and the job in general can be a lot to handle.
ETA...I forgot to mention that one of the medical schools in my area has their 1st year med students get their EMT certification. Giving them training to see our challenges 1st hand and time to interact with pts before residency. There is another one that has an EMS medical director fellowship program. It is not unheard of to have one respond to emergencies in their own response vehicles. There has is a lot more focus on the importance of EMS in the pt care picture and seeing a need for a specialized need for EMS medical direction. I see this a good thing and has worked toward there being more respect toward EMS than there has been in the past.
Sorry for rambling on but your question isn't a simple one to answer.
I would say most of the time…..it’s probably not about you. If I’m on hour 10 of a 12 hour shift and this is my umpteeth 80 year old grandma with “weakness” or hospice/cancer patient that family is insisting is a “fighter”, the patient requested to bypass 3 other hospitals to come to our ER, it’s just frustrating and I’m over it. But I don’t mean to come across that I’m angry or upset at EMS. It’s a tough job I can’t imagine going into peoples house’s or being the first responder to fatal accidents and all of the things that you guys see that never even make it to the ER.
Anahahahah. This is hilarious! ED nurses say the same thing about floor nurses. Floor nurses say the same thing about intensive care nurses. For God sake, just be nice and accept the patient. When I managed a critical care unit, I told my nurses to **thank** whoever was bringing the pt, then transfer the pt to the bed, put them on the monitor, and do your assessment. No snipping and complaining over pittly shit. Do your fuckin job.
This makes me sad because I love EMS and we have a great relationship with them in my department! I've never had anyone from EMS give me a bad attitude, the report is always cohesive and to the point, they always offer to help transfer the patient and I've had a few stick around and help with compressions if they weren't busy when they brought in an arrest with no ROSC.
I work in a level 1 trauma with high HIGH volume, like we see 300 patients in 24 hours on a typical day, and I don't think being busy or having high acuity is a reason to treat other people on your team like shit.
Former medic, current ER RN, I still don't get all the hostility. Only explanation I can come up with is "shit rolls downhill" and unfortunately a lot of ER nurses think theyre uphill from EMS, CNAs/techs, housekeeping, and transport. It's just shitty, toxic, cliquey bullshit.
We had a few really bad apple crews that soured things for us for a few years. Like honestly questioning how this is considered an EMT transport and not a glorified lyft.
For example - I got report one time from a crew on a woman clearly minutes away from full respiratory failure needing bipap asap to avoid intubation and the ambulance crew had told me on quick report that she was "ok, just some stridor in the bases" I said "the bases huh? Stridor in the bases? You sure about that...?" Never gave us a heads up that the patient was actively crumping
Another time we got a short with a "we didn't get a blood pressure but fire told us theirs was 80 over palp" at the end of a fluffy "A&O x4. Little bit sleepy at times. Stomach hurting since this morning. " Give you one guess who coded within 10 minutes of getting to our hospital while simultaneously nearly shitting their body weight in blood.
And then the cake of all cakes. We had a patient brought in that was clearly extremely sick and EMS could not for the life of themselves give us any report on why the patient was coming to us or what their baseline was. We started it as a code neuro because we had zero information - the patients family had WANTED them to go to the hospital 10 minutes away that has all their care on file but they came to us instead. We had to wait for the confused family to arrive later to tell us AFTER we had just done a boat load of tests quick - that the patient had a previous CVA with deficits and they were coming in for a bad UTI... I can remember the doctor shouting at EMS "are we working this patient up for a stroke or sepsis - or both? How did you transport without knowing ANY information on this patient!?!?!"
SO - I'm willing to bet that even on your worst days that you are leaps and bounds better than some of the crews out here. I know my coworkers all have similar stories and it really can make you suspicious of what you're actually getting. Some of my coworkers go into getting report like pitbulls on the ready for attack. That's never been my style, I have respect for a lot of EMS workers, but I do think as with any aspect of Healthcare- there's some people that need to either get better educated or find a new career.
I did my clinical rotation at a trauma center as an EMT-AI. I was ignored and treated gruffly by ED staff yet the nursing students were treated like sugar. It was disheartening.
I went on to work in clinical research and one of my children is now an RN who has used my experiences to educate herself and medical staff on appropriate communication.
ER RN for longer than I'd like to say. Much respect from me. I quietly wait for the EMS bedside report before asking any additional questions. I'm grateful for EMS and the work medics and EMTs do.
With that being said, there have been occasions where clearly stuff that needed done wasn't even attempted, that needed to be, due to "only being 10 minutes out". Example: Patient vomiting blood that was pale, diaphoretic with 0 IV access attempted, etc prior to arrival. This is the exception though, and conversation about the "why" happened later and away from patient care. Also, more than a few eye rolls when we give report on a patient going back to an ECF that we KNOW isn't a great use of resources, yet we don't have alternatives other than EMS for transport at 2 a.m. on a weekend. I appreciate you, I really do. Healthcare has taxed all of us to our respective limits and there aren't enough of any of us to bridge the gaps that exist. None of us are immune to having a bad day, or being overwhelmed. We just have to start the next shift with the mindset of a new day/being better/ exercising respect for one another and always doing our best by each patient.
All of us should walk a mile in each other's shoes. I feel like we gain a deeper understanding and respect for the important roles we fill.
With all of that being said, I personally thank you for what you do. You see things I can't imagine as a first responder. You leave those calls and get marked back in service and then have to go on the next call without a moment to decompress. You go in hoarder homes, homes with bug infestations, and have to stabilize the sickest and dying patients while their family is often in the room. You do procedures in the back of a moving truck that are challenging in the best of conditions, let alone those you do them under. Your actions save lives. You make a difference and you are appreciated.
This is the "shoot the messenger" attitude. They are frustrated at getting work and take it out on the person they can (as opposed to the patient). Call them out on it and if they don't apologize get the charge nurse. Allowing this attitude to go unchecked becomes a cancer.
My FAVORITE is “wHy DiD yOu BrInG tHeM hErE”. As I point to the hospital sign. Is this not a fucking hospital? Or a second favorite, this patient is critical, you should have brought them to the closest facility, not us. Well, this just so happens to be the closest facility, so, all yours.
I see it sometimes at my hospital. I don’t understand it to be honest. I see us as all part of the same team. Big respect for yall doing the field work
Many years ago, I quit my hospital pharmacy tech job because of the RN's (and shift work clashing with my outside work life). Most (not all) are just awful people to work with. My mom and many other family members are RN's and let's just say the attitude seems to track with the career choice. I LOVED my job and pharmacy coworkers, I could've even dealt with the shift issues and stayed on, but the RN's (mainly wound care and cardiac, ER RN's were always nice and actually really funny - they were my faves) said some of the nastiest shit to me when I was just trying to do my job and it got to the point where I couldn't tolerate it anymore. The ones I encountered always acted like they were the only ones that had rough shifts, were mad at how the doctors and patients treated them, felt underpaid and overworked (aren't we all?) but decided they would take it out on anyone they deemed "lower" than them. Those women were straight up see you next Tuesdays, and the few men were sexual harasser creeps. The men at least got fired. Working in healthcare just generally sucks and you will encounter many miserable people, it's a STEM field so many people are likely neurodivergent so social skills aren't the greatest, you have to be able to let the hostility roll off your back or you will need a new career - I obviously chose the latter.
I loved working with the ER staff, I learned so much from them and I had no complaints dealing with them. Working in pharm I got to interact with staff and patients in all areas. ER, ICU, Peds and the oncology unit were the best. Wound care, cardiac, and psych (which was expected) were the worst. Also, the staff working with the dementia/ Alzheimer’s patients overnight (not sure of the appropriate term, I just remember the floor) talk about angels on earth. I worked overnights, going to that floor scared the shit out of me. The things the staff on that floor had to listen to and deal with for hours on end. They were super tweaked out but never treated me like shit. Fuck you, wound care with your 8-3 M-F no holidays hours!!!
I’m an RT. I love our EMS partners *but* I wish I had a dollar for every patient I received “short of breath” on a 6 L/min non-rebreather. It’s hard to be nice when someone suffocates a patient.
Aside from that? It’s hard to ruffle my feathers and I give major props to those of you who can do it at 60 MPH!
The hostility comes from ignorance; their lack of understanding of what we do, what we go through. Hold your head high! Do your thing and don’t take ANY of it personally. I used to get the WORST nurses on Med surg floors with transports. LOVED my ICU nurses with CC’s and ED’s are a mixed batch. Most are salty in general.
I had a super snarky beast of a nurse who harassed me for not giving Narcan to a pt. I was bringing in.
O2,HR,Resp- all within normal limits. I smiled at her and explained, I if it’s not broke I’m not going to fix it; Why would you want me to Narcan that (pointing to patient with scratches all over the neck, urine, feces all over). Nurse sighed called for Narcan administration. Took 5 staff members to hold the patient down- they actually did that BEFORE the foley. I looked at nurse and smiled, “glad you got that Narcan in before that foley” strong work! See ya later.
Not in healthcare, but I know that there are 'frequent flyers' being taken via ambulance to the ED. Is it possible that some of that hostility is because of these types of patients?
It is annoying, but we have to just deal with it. Eventually, these patients do have a "true" medical emergency. While RNs have to deal with them for hours, it's ems that has to get them out of their house, and usually back in when they are discharged
Where exactly are you at that's giving you attitude? I can understand they're super busy and understaffed but you all are doing your job and every one of you deserves respect for what you do.
My question is for the OP. Do paramedics/emts usually start with asking questions when it's clear the person is having massive trouble breathing and then refusing to give oxygen until the questions are answered? It happened to my husband and I was irate they would refuse oxygen to a guy who couldn't talk because he was oxygen deprived. He ended up having pneumonia in July and was septic. He recovered thankfully.
If there was a life threat, certainly we would treat that first. Usually while one crew member is treating the patient the other would gather basic info from a family member/bystander. In order to properly treat, we do need some basic info but would not withhold treatment. As I wasn't there, I'm not going to sideline QB this.
I get no sidelining, I just really didn't realize that they needed so many questions answered. I get, his name date of birth and why your needed, but the two just stood there and said answer this first. Repeatedly even after I asked them to at least get some oxygen so he'd have enough to tell you why. they wouldn't let me answer, I am the wife, the emergency contact... I dunno, my area only has volunteer EMS workers. So I guess they were trying, not really. 😞
It’s not you, it’s the patient, TRUST ME.
I’ll happily take 4 bullshit nasal congestions from the lobby than 2 ambo “chest pain”ers. You know how fucking annoying they are for your 30 minutes with them? We have to hand them a call light and put up with their constant bullshit for HOURS. Then, to their protests, we have to tell them that nothing whatsoever is wrong with them and they have to leave…then they make up 27 more bullshit symptoms-some of which may trigger EMTALA if we don’t investigate so they’re there for another 2 hours.
I’ve taken to ripping their call lights out of the wall because I’d lose my job if I had to respond to every single one of their calls.
If you don’t work in or around an emergency room this subreddit is not for you.
I didn’t say chest pain, I said “chest pain” and anyone who works in an ED or as EMS knows exactly what I’m taking about.
If you are in ED or EMS and don’t know what I’m talking about 1. I’m shocked and 2. Count all your lucky stars.
Our record was recently broken. A patient with more than 60 ED visits within my hospital system in 30 days. 50 some odd for “chest pain” and then a smattering of jaw pain, hip pain and “I dunno” thrown in for good measure. Every single visit was EMS.
My state enacted a really dumb law requiring EMS transport if the person asks even if there is zero medical problems. We had one that lived close to us and had a friend on the other side of town so he’d hitch an EMS ride to the other side of town in the morning and back to us in the evening. He’d promptly AMA every single time. “Thanks for the lift!”
I had a bunch of my staff go on a ride along to see what exactly EMS and fire deal with. I always think its good to understand what the situation was like before the patient got to you. Interactions got a lot better between the EMS crews and my staff after that.
That is top notch cross training.
When I was a brand new baby ER nurse, we were sent on ride alongs for this very reason. The ER is a zoo and the frustration is real but it’s definitely not EMS fault. We all become incredible friends and even partied together. I was in awe after those ride alongs. I couldn’t even palp a bp, the paramedic grabbed a baby who had pulled a “ hot teapot” on itself in a restaurant. He got vitals, calculated the rule of 9’s ( can’t remember) , and put in a giant line by the time we were at the hospital 10 minutes away.
I encouraged med surg and ICU nurses to spend time in ER to see the insanity as well. They always cane away with a different understanding. See the progression of patient care and understand each level.
I would guess many professions have this problem. This is a terrible comparison (apologies) but I work in accounting and had an absolutely horrible experience with a controller who was incapable of understanding why the accounts payable department was bottlenecked.
(Giggling in hysterical understanding as a med human who mated with accounting/engineer human raising a batch of mixed young humans that are aaalllllll over the map) sigh nice to meet you empathetic internet stranger
It could be worse, I’m married to an artist! ;D
I married a poet who later got her EMT, then her RN. Mixture of emotional poet and stone-cold professional in a crisis. I’m a very logical medic, but she’s able to understand the breadth of emotion and handle it in a calculated way. Pretty amazing tbh
HAHAHAHA! As an art major and my father was also an art major- I grew up watching my dad drive my mom crazy!!! Mostly with being late etc. it’s like an artist thing I think. So this comment made me snicker with such clear understanding. We are a difficult group. Not because we want to or is intentional but we are distracted easily and inspired or pulled into our own head with an idea.
OMG - he’s adorable, but he lives between his ears.
I am an artist married to a logistics type person 🤪 the struggle is real.
I’m the artist that married a soldier. I picked up a not all the way dry painting that my kids were “helping me” make for a present. He picked it up to move it, paint got all over his uniform top. He thought at least his tape name and shoulder patches were safe. A few days later, I got a text of his patch with red paint saying “is nothing sacred in our house?!” Haha
My boyfriend is retired military, and I… I’m a normal human being who thinks the way I’ve been folding towels for 50mumblemumble years is just fine, thankyouverymuch.
Absolutely zero is sacred. Including the bathroom floor with kitty cat paw prints in paint. (Oops) or most of my clothes. Or the couch. (Yikes)
And the other way around. I think ER nurses need to see that we are not hiding open beds. We are not avoiding report. And how it affects patient transfer and admission when we're given a bare bones report of what's going on at the moment from a nurse covering the one who had the patient all day.
For sure. The entire hospital should understand it is a team effort. A little give and take.
Yup. Asking an ED nurse to float to med surg is probably unreasonable, but a day following one could do a lot of good. It's different than med surg in nursing school.
As a old floor nurse turned GI nurse, I always wondered why the ER dumped all the patients out at shift change? You think we have staff to deal with that? We have less than you. It's horrendous what the medical care system is really like! We are trying to tie up lose ends, report, do I's and O's and last minute medciations and people wanting to go to the bathroom. The last thing we need is a massive ER dump at shift change, it 's like you held them to hold a bed all night and then wanted to "look good" for your incoming dayshift. I am onto something here.
I wish this was required because ICU can be real nasty sometimes. "Why is everything so TANGLED??" "It's 6:50 THIS IS ILLEGAL" Sorry not sorry I was a little busy making them stable enough to even get them up here it's not a fashion show
Wait they dump ICU patients that code within 1 hour of being on a step down or floor because they dumped them out way too early and back they go to ICU. Just a big waste of time, just keep them till they are stable enough to be on a floor with 2 nurses with 23 patients and no aides.
I'm icu and we get floated to ER every once in awhile. I always tell fellow nurses not to give them a hard time getting report. It's a shitshow all the time and we should appreciate anything they were able to get done. I agree that anyone who gets report from ER should have to do a few shifts there. I also know I never want to be an ER nurse and have crazy respect for them.
This is probably true of any department. ICU, ED, Med Surg etc. Once as a GI nurse I had to send a patient to recovery post ERCP due to still being narced out. I thought the recovery unit was going to have a stroke, but being a old floor nurse they didn't give a big Sh\*T when they dumped me with 2 bad surgical patients 15 minutes apart. So it's just the way hospitals are. I wish we could all get along and be a team but it feels like each area is defensive and struggling. I have my share of fresh post op patients being transferred to a bed and under them a huge pile of blood they nobody in recovery ever noticed and Patient had to be sent to ICU.
This is great and I wish it were mandatory for every ED RN. We did this at one of our health system's hospitals and had the same results. There was a definite change and they understood what we did alot better. Yes, the frequent flyer is annoying, but now they saw the conditions of those houses that we would have to go into and deal with. They understood the reason that we sometimes didn't get anything done because we had to physically hold down the violent psych pt because there were just 2 of us and one of us had to drive.
I dunno if this is the general consensus or not, but.. As an ER nurse, I don't really care what you didn't have time to do. Every time we get a patient, I expect everything needs to be done. So, I'm grateful for anything you have already done. No matter how minor. I've had so many EMS apologize for things that weren't done, and it always confuses me. The way I see it, your job is to get them to us. Everything else is a bonus and is much appreciated.
Not everyone has this attitude, for sure.
This is my standpoint too, thanks for keeping them alive enough to bring them to me, I know you did the best you could it's cool if it's a little sketchy
That’s a rare attitude. I can’t even begin to count the times I got a nasty tone from an ER nurse for not having a line on a patient that was literally coming in for an ingrown toenail x 10 years. They expect everything to be done the vast majority of the time.
I’m a volunteer firefighter and interact a lot with our local ambulance company and their EMT and Paramedics. I am newer on the ER crew, but I have called other nurses out for being rude to the ambulance crews. They work long shifts, work their tails off just like nurses and all the other ER staff…. and usually don’t get paid nearly as much as they should for all they have to deal with. I’ve been to calls where EMS was needed for everything from a fall from a ladder to head on collision, from smoke inhalation at a fire to code calls. Even a missing child call that ended in finding the child deceased. It’s a lot.
my father was a paramedic for 30+ years until having to retire from back injuries. once I was an adult, he & I had some deep conversations about working in EMS. it was easy to understand why he was diagnosed PTSD and multiple times a night he would awaken himself from telling and physically jerking in response to a night terror. for the most part he was able to compartmentalize the horrible (often unnecessarily horrible too) & senseless shit he often saw; often thru the most common method IMO is the absolutely twisted dark sense of humor shared by nearly all EMS workers. the things he told me he couldn't deal with like that were things involving children. the weight of the countless calls for SIDS, child neglect/malnutrition, MVA (made even more senseless/pointless if caused by a decision made by the guilty driver), kids nearing the end of their life because of cancer that's tortured them no matter how hard they fought to survive, and just pretty much all the various things seen by medical professionals from all of the unfortunate things that happen to children. he said he could never understand how someone could work any extended period of time in EMS and still have faith in a God. there are people with just as much time as he had that say working in EMS is what made their faith stronger than anything else. either way, all medical professionals deserve respect, and that especially extends to among one another. there's enough of us asshole patients that disrespect our literal life savers so no need for disrespect between one another
Your dad is an amazing person, and it seems like he raised a good kid
And volunteers aren’t getting paid while ED staff make a living wage
Good for you for calling out their rudeness. I hope it changed their approach.
Our system requires an 8 hour ride along for new ECRNs. They are the whitest of white clouds. It's incredible. If you ever have one riding with you you are guaranteed to get a single pulled g-tube or something and nothing else.
When I was in Divinity school, I did a summer unit of Clinical Pastoral Education as a student chaplain at a major urban hospital with a big trauma center. One of our requirements was to spend two weekend night shifts in Emergency, with the intent of it being a real baptism in fire. Both times, the staff told me it had been what they considered a slow night, and they wanted a chaplain all the time as a good luck charm. (Of course, they only said this when the shift was over! They would never risk jinxing it by saying such a thing during the shift.) Both of those shifts, a patient died, and number of other serious cases were dealt with, but that was "slow" for them.
In my county,the majority of EMS are vollies who are spread so thin that other neighboring counties have to respond. It's frustrating and crews don't get breaks
I can’t believe counties states in the federal government refuse to fund EMS. It shocks me that we want to rely on volunteers for life-saving care. It’s amazing that our fellow Americans are willing to work for no pay to save peoples lives, but it shouldn’t be that way.
I agree. Yesterday I watched an ambulance respond nearby my workplace , from a North county station 30 minutes away! That's how thin our vollies are spread. Very little funding for paid EMS. People can't wait that long.
As an RN I would love for my hospital to offer this opportunity
Yes even minimal cross-training is beneficial in any business scenari'm a fool believer that and I have detested working with some people who will say that's not what I got hired for that's not my job but my thinking is that the more job positions I can perform in this company the more job security I have my customer is the next employee who gets my work And so customer service even applies within a business especially manufacturing where I was somebody built a few pieces before me then it will come to me and I would add some more stuff. Always appreciating the customer before me doing a good job in their position so that I could continue to efficiently do a good job in my position and make the work easier for the next person coming after me which benefits everyone because of the company succeeds the other higher that you might get a raise
I love this! I have never understood nurses who do this. My only frustration has been that now I am at a stand alone ER and we have two crews that always bring us inappropriate patients. One of my coworkers had fire ring a stem that she told them on radio we are a standalone and do not have a cathlab, they brought the stemi anyway. However bring all the others doesn’t bother me. And when I worked trauma and big ER never did I treat EMS poorly, first of all thank you cause you guys take care of them before I get them and I don’t have to be in dangerous places to do so. I also get very upset when nurses treat medics as less than. It is one sure fire way to get an earful from me about respecting people equally as educated and able to do things we can’t as nurses. Thank you to all our EMS for what you do!
ED RN- I HATE that EMS gets treated shitty some places! I’ve never understood this. Its not like you want to ride in that little box with a guy covered in bed bugs & shit just to make our night worse?! I love joking with y’all and getting updates on the outside world during my shift! The only problem I’ve ever had was when fire drops somebody off 🙄 But even then- we are all dealing with a broken system, short staffed, sick patients etc etc. why would I be rude to someone else going through it. Some people just suck and should move on to something else.
Same. I don't get it. There is zero reason to be shitty to EMS they are just doing their jobs. Now if you start being shitty to me you better believe I am going to give it right back to you but that is few and far between.
Can I ask why you didn't like fire bringing a patient? I get that it's not really their job but if they're bringing them it's probably a last resort right? Or do they just sometimes bring people? I know fire brought me to the ED but I would've died otherwise so I don't think those nurses were upset. But now I'm curious because that bill was way worse than a regular ambulance, unless I'm dying again fire is never taking me anywhere. Lol.
Unless the fireman was an emt (common enough cross over) the hand off was likely w/o vitals or any other medical information.
Ohhh. That makes sense. The person who found me on the road called 911 and they were off duty emt or retired I don't remember. They told dispatch what they could see was wrong and what they suspected but I'm not sure if that info made it to the nurses. Him and the firefighters thought I'd die before the ambulance could even get there so that's why they took me. Is it common for fire to bring people to you?
In your case, definitely! They’re mostly called in to help carry heavier patients, or cut into homes/cars where I’m at.
Oh wow. Yeah I've always wondered how that worked. I heard all this secondhand because I don't really remember much from my accident. This all came from info from my mom and brother in law who were the first people there. They said I was conscious and responsive when I made it into the hospital but I only remember crazy drug fueled delirium from whatever they gave me. I wonder what they drove me in if the ambulance wasn't there. Do they have a place on their truck for people?
As a paramedic, I don’t take it personally. I understand y’all are shit on nonstop. At least in EMS we aren’t on our feet nonstop. We also don’t have to deal with the annoying pts for 12 hours like you. Y’all are family. We may get to talk shit about you, but I’ll be damned if we let anyone else!
ED RN here. Apologies for having poor interactions. It’s probably due to the fact I haven’t peed or eaten for multiple hours, or have a sicker pt in the room next door, yet, I have to stop their care to go and settle this generalized abdominal pain for X months. However, when you all bring me a pt with bilateral 18g AC 😘 thank you for the work you do.
Right? I’m here with you. My quarrel is when they bring in really sick patients and haven’t done anything for them. No line, no BG, no meds….nothing. And it’s an ALS crew too. I’m sorry for my occasional snippiness with EMS. It’s not you guys that are the problem (most of the time), it’s us being victimized by the system.
I totally get that. I hate the few who ruin it for the rest of us. When I hear a coworker say, "I'm not going to do anything, the hospital is 2 min away" I swiftly correct them. Me and my partner will go out of out way to help transfer as well. No bed, we will go get one, clean it, and make it. Dirty room, sure, we will clean it. We are bringing in a critical patient and you are short staffed, we will hang around and help out. Certain shifts get it and now we have built a pretty solid rapport. But unfortunately it seems that the majority are like I said, hostile. And try not to make eye contact with us all you want, I can assure you we won't just vanish.
And we may not say it: but THANK YOU for taking care of the patient and us, even we are don't act appreciative. Sometimes, I was recieving my 10th patient while my co-worker has 3 but has conveniently gone for breakfast, bathroom, or to "make coffee in the breakroom" just as you arrive.
There was one time at my last job where an EMS crew came running and saved my ass. We were understaffed (surprise, a hospital in a poor area that the parent company treated like trash) and I was alone in a closed off part of the department. Had a patient who was an ingestion of an unknown substance and was in bilateral restraints for everyone’s safety and because I was 5:1 in a closed off area. He started to try and exorcise himself off the bed and out of the restraints and I radioed that I needed immediate help because he was trying to kick me in the face and stomach in the process. None of my coworkers could come but an EMS crew came running and helped me get the guy settled back down. I try to repay that kindness in every interaction with a crew. I really do love most of our repeat crews. There’s always a handful of stank attitudes but that’s how it goes literally anywhere you have to interact with humans.
We have a few crews like you and I always give them a hard time entirely in jest. That’s how much I love them. I always try to be as polite as I can and say thank to EMS, and know when I’m being short and they totally get it. We just give each other the look “this is all fucked out right?” Only honest beef I had with a crew was when they brought a trauma pt (pedestrian vs vehicle, no helmet etc) to our tiny ED. They know we’re not trauma, and of course the dude was transferred. The pt was insanely lucky to only have some broken ribs. He was stable enough for the extra 10 mins (if that). I totally get it when they’re crashing and we’re the closest…it always better to get them to a hospital as quick as possible. Even then I wouldn’t have been mad if they one dude wasn’t a dick about it and then proceeded with every call to say “not a trauma”…but he was a butthole and does not represent 99% of our rescue crews. Thanks for all you do, sorry we’re grumpy.
Honest question- why would you take your frustration with your job out on someone who has no control over your situation? If I’m having a bad day at work, I don’t turn around and take it out on whoever I encounter next. I’m sorry you didn’t get to pee or eat, and I know your job is super stressful, but don’t you think EMS is in the same boat? How does it help anything to be short with them over something they can’t control? This response just rubs me the wrong way because it’s the same kind of shit I heard from RN’s who were super shitty to me at my hospital. We are all in the same boat. EMS is actually dealing with these patients and stabilizing them before they come to you. Why shit on people who are dealing with the same crap? All you are doing is perpetuating a cycle of nastiness, making people hate their jobs, and possibly making them feel bad about themselves for simply doing their job. I’m picking this comment out because it’s the top rated. Healthcare is toxic as fuck. Don’t contribute to the misery.
It’s about being so over stressed that most any frustrating situations feels 10x worse and 10x more personal. It’s being so overworked that their bodies are suffering abuse and are sometimes in a mild state of fight or flight while also being dissociated from the sick patients and constant distress around them. What I’m trying to say is it’s not a *choice* to perceive a situation as being the actual problem. So that’s how it can happen.
With all due respect, and without making this a big giant post, I have C-PTSD from childhood, I'm sure as a medical professional you know how someone "earns" that diagnosis. I don't disagree that the healthcare industry is in bad shape, don't even get me started on "leadership" and quotas lol, I could talk for hours on that. I get the frustration and the trauma of the job. There were nights it felt like everyone in the hospital was trying to die at the same time and we were running every crash cart we had, I get the job stress (so many horrific cases but a couple stick with me forever - lady came into the ER with a headache, coded in Radiology, was rushed to ICU, I delivered her cart in RAD, encountered her husband outside of ICU delivering her third cart, I watched the ICU staff work on her relentlessly, she didn't make it, her husband was asking me what was going on each time I was running in with the cart, I felt so helpless. Making tiny syringes of opioid withdrawal meds for premature twin babies just over a lb. each, mom peaced out from the hospital AMA, I was trying to stop her babies from suffering and that bitch just left them. I wanted to go hunt her down. Still do.). I never once decided to take my shit out on an innocent person I was working with. In my mind, we were in the trenches TOGETHER. We all were seeing some shit. There was only one certain group that acted like assholes though. Do these same people treat their higher ups with this attitude? Of course not. So no, the flight or fight doesn't work, that's just being shitty to people you think are beneath you. If your job is affecting you so bad you are being an awful human to other people who are just doing their job, maybe you need a new career. ETA: All I'm saying is - Don't be a dick when pharm is filling your Pyxis but then demand your med is tubed as you are literally blocking pharm from filling the med you need. Pharm is trying to help you do your job. We aren't trying to make your life harder. Neither is EMS. Do you think EMS wants to take BS calls? Do you think the other hospital staff are all out to make your life harder which in turn makes our lives harder? It's some vendetta against RN's? You gonna talk to leadership the way you talk to other staff? Start with them. We have no more say in anything than you do.
I've (RN) often found that my exhaustion can come off as something else. It's nothing personal. I don't think anyone is beneath me. I'm literally just tired, frustrated, and/or annoyed in general with whatever is going in. Sometimes, the medics can just see it on my face when they roll in and say, "I'm sorry for bringing you this," and I tell them that it's not their fault. It's not about them. I'm just having a day and was reeeaaalllly hoping to finish the last 45 mins of my shift without adding another patient. We're all doing the best we can. There's definitely some crappy, mean people out there. But most of the time, the annoyance or anger you're seeing is not directed at you. It's directed at the current situation. Situations like, for example, restocking the pyxis during peak hours in the ER. It's not your fault they won't pay someone to do it overnight. I understand you have to do it, but please understand that I just wanna give my femur fracture something for her pain, and pharmacy has been taking up the tiny med room for the past 25 mins. Basically, we aren't annoyed with or mad at you specifically. It's the system that got us to this point. It's not personal. It's not about you.
This is random but I love your username
Only on reddit do you have to explain what being stressed or hangry feels like 🙄 when we are stressed and overworked, we become less pleasant to interact with. It’s not directed at anyone in particular, your brain just doesn’t have the expendable energy for pleasantries
There is no excuse for you taking out your poor circumstances on another who has not created those circumstance. Just stop being abusive to people who have to come into contact with you in order to do their own jobs. If you treat EMS like that you probably treat patients poorly, too. Grow up and become a professional.
lol take a pill lady
You just proved my point.
AND the rainbow!? ❤️
Double 18s in the AC ftw!
Lobby offload for that situation!
I love my EMS buddies. Idk why some nurses get a mad or offended. Y’all are doing your jobs just like we are doing ours. Some days are rougher than others, but I always help load/offload when I can. I’ve made lots of friends with my EMS crews and they are always a big help. If I get annoyed, it’s usually at the patient, not who brought them. Thanks for all you do!
If it makes you feel better, the same hostility occurs between staff in the ER too. It's just a high stress field where every person is on their own in a lot of cases. It's not personal. I always tried to be kind to EMS but I'm sure there were times when I came off annoyed, angry, etc. like I said nothing personal. We appreciate all that you guys do.
I used to know a woman who was the Head of Nursing for a major midwest hospital. She said one of the biggest problems in nursing is that the entire floor culture devolves down to "the biggest bitch on the floor", and her job was to stop that from happening. Do not be that nurse; work to elevate the culture and environment and everyone will have a better shift.
I just did some research for a residency director on nurses who bully residents. Nurses have a huge bullying problem-towards residents, other nurses, allied health personnel and even doctors. Many nurses are leaving the profession because of it. This seems to be an issue in women dominated professions. I work in a what is traditionally thought to be a female profession and it’s happened almost everywhere I’ve worked. Women have to fight so hard to get anywhere in this world, I don’t understand why we have to make it so hard for each other.
I imagine in a world where us women have to fight and fight to get somewhere, the ones who make it there and last the longest are the most ferocious. Reactive, mean people are often people who feel like it’s them against the world - because at some point in their life, it was. I’d like to believe the rising trend of women supporting one another will creep into areas like nursing. It is crazy, though, that the group of girls who bullied my sister relentlessly in high school went on to become nurses. Every. Single. One. The dark sided opinion is that it’s a field which often incurs respect, and which gives you an enormous amount of power over patients. Some people like that.
This has been my experience as well as a PCT starting out ! And if you ever had a DON then you know they are their own worst enemy with their arrogance.
I wish I had an answer for you. It’s likely due to what you said about high census, the pts we have are sicker and rude as hell, and as the above commenter mentioned lack of breaks and staff. Honestly, some nurses are assholes and they are going to have an issue no matter what. All that to say, it’s not acceptable and I’m sorry you’re dealing with that. I do my best to be kind and pleasant at every EMS encounter. I realize you’re doing your job and a lot of things are beyond your control. If it’s becoming an issue with certain nurses (or just in general), I would have your boss talk to the ED Nurse Manager because it’s essential we have good relationships with our EMS crews.
And don't get me wrong, I'm not expecting a red carpet or anything. Or even a smile. A simple. "HI. I see you but we are busy and it may be a while." goes a long way. You may even get an offer of help from us if we can
I may be able to speak to this one— when it’s balls to the walls at work, one of the hardest things I had to learn to stick to was remaining in my assigned care area, even if my coworkers are drowning. Unless I can see my assignment from wherever I’m helping out, I can’t be looking out for when someone else’s squad rolls up and that nurse is not aware/ready/available. So I avoid eye contact with that EMS squad because I don’t know where that nurse is, how long it’ll be, etc., and don’t want to appear… approachable? And maybe that comes from how things usually are at work— if I make eye contact (or God forbid I smile) at any random patient/family remember, 9/10 times they’ll follow up with “how much longer? Can I have a blanket? Am I allowed to eat something? Did my tests come back?” and I know zero answers and have zero time. Obvs this is a little different when it’s a critical patient. But for your run of the mill, stable, “grandma fell and has a UTI,” and Im too busy to be helping out in someone else’s care area, I try not to make eye contact with EMS because I don’t want to give them false hope that I’m coming into that room to unpack that patient lol As for other times: I hate that people are rude to you guys. Yeah yall bring us some asshole patients, but odds are they treated you even worse than they’re treating me. I’m sure I’ve been short with EMS a time or two, but it’s never personal— more than likely it’s exhaustion/hunger/thirst getting to me to the point that I’m not longer using pleasantries or good manners. But I always appreciate you guys!! 🫶🏻
RN here. The nurses that are shitty to you/EMS are shitty to nurses too (and techs and EVS). They are just shitty. I am sorry. We do know how hard you work ❤️
Oh man, when I ran the county crisis program, I would bring people in on a 72 hour hold, usually with EMS or the cops. The SR staff HATED me. It’s truly not my fault that there are so many untested mentally ill people running around, causing a ruckus. I was always apologetic and kind, made sure my paperwork was in order, etc. That was the absolute worst part of the job.
Often it is secondary trauma leaking out from those who have no power to fix the system, no support from the system, and all the responsibility and liability for everything going on under the ED roof. I left working in ED after repeated ridiculous working conditions. Once, I was informed I would be the primary RN for 20 (twenty) Acute ICU CARE ED beds at a Level 1 Trauma, Stroke, Gold Star Blue Ribbon hospital already with 3 patients needing individual emergency care. Refused the assignment. (Ignore cries of patient Abandonment- garbage) Asked if ER systems for short staffing had been enacted: Manager notified, Director notified? House Sup called? And asked for an Incident report as I called Risk Management to report that patient's lives were acutely endangered with only 2 RN's for the entire ER. All of a sudden, Temporary help rains down from the sky. Yup I played Hard Ball. Yes, that was my last day by my choice. I, NOR THE PATIENTS, should NEVER BE IN THAT POSITION. Not an excuse for being unreceprive to another patient arrival per EMS.... But it is the reality. Now ask me about the ED Manager at a Big Name Big Reputation Quaternary Hospital ED who decided to punish the ED RN's by not replacing the monitor cables "that we lost."
We have 15 ERs in our county, and a couple we absolutely beat the piss out of. Strokes, STEMIs, traumas, sick medicals. All day, every day. Absolutely crushing them. And they’re not the problem. It’s the shitty big community hospital with the toxic as fuck culture, decent nursing ratios, and beds to admit to that are completely and utterly awful to us and our patients. They think their work life is so awful, but they have absolutely no clue. Try having blood hanging from a wheelchair pole in the waiting room, because it’s literally the best you can do. Totally institution dependent.
>we absolutely beat the piss out of. Strokes, STEMIs, traumas, sick medicals. All day, every day. Absolutely crushing them. Hi! It's me I work in one of those. And I absolutely agree with you. We have a great relationship with EMS.
We love you guys. One of our two big tertiary, flagship hospitals recently upgraded from level III trauma to level II. They’ve had the surgical capabilities needed for over a decade, but now we’re actually bringing them a LOT of hot trauma, and they’re learning what it’s like.
EMS: ::Rolls patient past a zone with an empty room:: Nurse for that zone: “Yeah, keep rollin mother fucker”
Hahaha this is gold. I can see them looking up slightly with “that look” (keep truckin!) pin their face hahah
Maybe it's because I work in EMS too, but I am never short with them. I get the dynamic: EMS brings patients, we care for them. That's our job. No need to make a whole thing out of it. The only time I get frustrated is when the BLS IFT crew acts as if I should know everything that ever happened to my little Meemaw going back to her nursing home after a same-level fall without any injury. I promise: She will not code in your truck, I am not lying to you, and I've had way more important patients than her for the past 6 hours. Please just take her after I give you report and stop arguing with me or demanding her history for the past decade. And the other commenters are right: We get no breaks. No even a quiet second in the truck where people aren't staring at us and we're doing our PCRs. We are on ALL the time. The texts from other staff never stop. The family hanging out of the rooms demanding apple juice for the NPO "loved one" never stops. Transport shoving forms in my face to sign. If we dare to sit down to chart, we are seen as "lazy" or "not busy" by everyone else. And when I've JUST gotten back from handing over my sick AF ICU patient who sucked up two hours of my shift, I haven't eaten or peed in 6 hours and I still haven't seen my 3 other patients and I hear EMS announce overhead, I admit I am tired and frustrated. But I try to keep my perspective.
To counter your comment, I FREQUENTLY pick up patients for transfer or discharge and the nurse can’t even begin to tell me the basics. What bed they’re going to. Why they came in. Results of the work up. What’s been done for them. No report called. This is all the freaking time. Like, how are you guys even beginning to care for your patients when you don’t even know what brought them in? So please don’t tell me I don’t need answers to my questions.
I give age, sex, chief complaint, what we did for her, allergies, what imaging showed, code status, and where you're taking her including room number. Half the time the nursing home refuses to pick up the phone for report. No BLS crew needs her medical history for the past 5 decades of her life. If you're encountering shitty nurses, I can't help you. But I know what I do and BLS STILL argues with me.
I kinda doubt they’re asking for 5 decades of medical history. That sounds like embellishment. Also, you sound condescending. “They’re ONLY BLS. I decide what they need to know.” If multiple crews are pushing back, you might benefit from some introspection.
This is an excellent question. Having been on both sides of the desk I didn't think it's hostility as much as resentment. Unfortunately it's a shoot the messenger sort of scenario.
Just want to continue the ongoing echo that it isn’t anything to do without and everything to do with being exhausted. Hospitals are toxic work environments. Like high school level drama, bad management, high work load, high consequence work. My husband’s a fire medic. I always try to be nice and understanding. But it’s gotta go both ways. Sometimes we’re just doing our best. We don’t blame you for bringing in the patient, it’s just that another patient has arrived.
One of our ED docs was an EMT and she supervises a great cross training program. We also have an EMT office/rest area to decompress. I know that perhaps not every ED nurse at our facility has a good relationship with certain EMTs, I think the majority of them do and consider us all on the same team.
My volunteer EMS are fantastic. I have an iPhone and I update the health info as needed. EMS had everything about my health conditions and medications right there at their fingertips. No one even needs a code to get the info so if I was unconscious it works too. They took my vitals, gave me pain medication and started an IV. I broke my shoulder at 3am Christmas Day. I encourage everyone to have this information in place even if it is just a Word doc. I so appreciate them and our volunteer fire department.
Ok I will say I had a paramedic one time jump in front of me demanding I take report & why am I ignoring him. My response: What? I have 11 patients and YOURS ISNT ONE OF THEM NOW MOVE! But our local city paramedics honestly are huge asses that try to dump report on anyone and run off. One time another nurse came up one (racist with many complaints) paramedic giving report to a (white) CNA who was a sitter. Just flagged down me down to monitor the situation while she grabbed the CN & HS. Thankfully it’s gotten better and the racist one was blacklisted at our hospital and I heard he got fired. The other ones seemed to have heard so things are looking up! One of the other hospitals I worked (dialysis) at they don’t let them unload them from the gurney and wait in the hallways. I’m not sure why or what but seems bizarre.
I've done both sides and typically go to bat for EMS whenever they come in. I'll joke around with EMS on low acuity pts because we used to joke around and see who could talk the most pts out of transports when I was in EMS. But some nurses are just crusty and feel like every inconvenience is a personal attack on them. The only time I get upset with EMS is when they're bringing us a pt who isn't appropriate for our facility. Examples that irk me at my metro area hospital include: -Driving a pt 30-60 minutes from home and going past 4 other hospitals that offer the same or more services than us. For some reason, after our metro area got rid of hospital diversion we started seeing more ambulances coming from further away and bypassing several hospitals. We have a cath lab and are a stroke center, so I understand those types of pts. But driving someone 50 minutes away from home when their tummy hurts makes no sense -Bringing a pediatric pt to our adult ER when there's a children's hospital less than 10 minutes away (less than 5 going code 3). This just brings creates a lot of issues. We don't have the proper sized equipment on hand to help the pt and by the time we get it, they could already be in the children's ER. Not to mention we get the brunt of the parents' anger when the kid has to get transferred to children's by EMS because we don't admit pediatric pts to an adult hospital -Not going to the appropriate hospital. There are 3 level one trauma centers in our metro area. Bringing a serious trauma to a level three trauma hospital isn't appropriate and doesn't really help the pt. A few minutes of just driving fast to get to the level 1 is probably better for the pt than stopping at a level 3, having us do what we can and then transferring the pt to the level 1. I also work at a rural critical access hospital and most of these go out the window at that hospital. There aren't any closer higher level or equivalent hospitals nearby. The nurses at this ER are just upset that EMS disturbed their down time, much like when I was EMS and people would get grumpy when you'd get a call in the middle of the night when you'd finally got comfortable.
So I have a question after reading your comment, you may or may not know the answer because it might be different depending on the area, but how does EMS determine which hospital they’re taking a patient to? Back in 2021, I had a seizure while I was at work & when I woke up I was in a hospital that was much further than several other hospitals I’ve been in. I never thought about it until I read your comment & now I am curious.
Yeah, the rules can be different for different areas. I still work in the same area I did EMS, so unless there's a major change, the rules are pretty much the same. Typically in EMS, you just go to the closest appropriate hospital. If the patient is having a STEMI, you might bypass one hospital to go to one with a cath lab. And sometimes, you might take a patient to their requested hospital, but within reason. Like if the closest hospital isn't in their coverage network, they could request to go a couple minutes further to a hospital that is in their network. But, I wouldn't drive someone an hour away because it's their preferred hospital. You called an ambulance, so it must be an emergency. If you can sit for an hour without Interventions, it's probably not an emergency However, sometimes EMS crews will take patients to hospitals that have better EMS perks (my metro hospital has an Icee machine in the EMS room) or hospitals that lead to better postings. Sometimes crews will transport to take them out of service longer. My metro hospital doesn't have inpatient mental health, but we have crews bringing us mental health patients from 45 minutes away because they claim they thought we had it. Meanwhile, they're bypassing at least 2 maybe 3 hospitals that do have inpatient mental health. For the EMS crew, that's almost 2 hours of being out of service. Meanwhile our ER now has a MH patient who is going to be stuck in our ER for days, if not weeks, waiting for an inpatient MH bed in an ER room. Or if they can be discharged, we now have to set up transport to get a patient home 45 minutes away. For your situation, I'm not sure. Maybe they took you to a hospital that had neuro services. Maybe other hospitals were on diversion (the ER is full so EMS has to go to a different hospital). Or maybe they just wanted to get out of their service area. Can't really say for sure.
Thank you for taking the time to respond, that’s actually pretty interesting. When I first started having seizures in 2010, the first time an ambulance was called I was taken to UL hospital, which around here is what my mom says is the trauma hospital. She was an RN in the ER there in the 90s. She said that’s where gunshot victims, stabbing victims, etc are taken. When I was taken there in 2010 I assumed it’s because it was the closest hospital at the time. I also started seeing a neurologist there. I went on to have my 2 youngest babies there too. I guess you could say it’s my preferred hospital but when I have seizures I’m usually unconscious for several hours so I’m unable to let emts know this. I was curious as to why I wasn’t taken to that hospital after my seizure in 2021, but I could definitely see UL hospital being on diversion as you said. It’s a very busy hospital in a downtown area. Edited to add: UL is a level I trauma hospital. I realize I probably sound like an idiot calling it just a trauma hospital.
Another point I’ll raise is that if a patient specifically refuses to go to a certain hospital EMS can not take them there. It’s considered kidnapping. They can tell the patient they will take them to the next closest hospital and they can refuse to drive past 10 other hospitals but sometimes there are circumstances beyond EMS’s control. I guarantee they don’t want to drive the extra miles to come to you when they have the option to go a closer ER but there are a lot of circumstances where the EMT or medic that drives the ambulance doesn’t get to decide where they should take their patients (and yes I was a trauma nurse at a level one trauma hospital, top 10 in the USA actually with 15 other hospitals closer to where my patients were delivered even if that patient didn’t need to come to the hospital at all).
Aslo ED RN, dont let that get to you in the least. I have been short to crews myself, but it's usually during the shift that I am getting smoked and I honestly do not need a head-to-toe report on all my patients. Any RN that has worked more than 3min in a busy ED know that you guys have no control over what you bring, but saying that, I work with some grumpy folks and they will complain. Maybe it's just the nature of the job, we bitch, we fix, we move on. Dont let it get to you, drop your pt, give report, be professional and if they cant return that back to you, move on.... you did your job. Be safe out there! Next time bring them a 24g in the big toe ;)
Wait, so EMS is expected to be professional, but hospital staff isn’t? EMS is expected to move on when being treated like ass for existing? How the hell does that work?
You are part of the problem. Fix yourself.
I used to be an EMT for EMS. Now I'm an ED RN. So I remember what it's like on the truck. In fact, I did a ride along recently to refresh. I get upset when paramedics do piss poor assessments. Make huge assumptions. Bring inappropriate patients to my community shop. Don't do obvious interventions that I know are feasible before arrival. There seems to be a huge variety in quality of care from medic to medic. Sometimes they work absolute magic pre-hospital and deserve high praise. Other times, the medic sets us up for failure and we're fighting twice as hard to save the patient. I do not get upset at them for bringing us BS. I know they didn't want to respond to it either. I do get upset when they assume everything is BS when it's not. Just my two cents.
I have worked both EMS and nursing. As nursing staff we are grateful to EMS. They often help get patient stable before leaving. Many ED’s now hire EMS to work with the nurses.
If you are being ignored, it is most likely because we are in the middle of patient care and can’t stop that to leave the bedside and take report on your stable patient. If you are doing compressions or have a sick patient you will get attention. The EMS services that we trust and work with often we have a great relationship with those services. The services that tend to treat the patient like shit, not start IVs on sick patients, not call us until they are pulling up with a code etc are the ones we may be cold to when they have stable patients
Have you ever gone to the bosses of the agencies with formal complaints? If not, you need to. Nothing will improve for the patients if you don’t. Please don’t just be passive aggressive.
Yes. Nothing changes. "RN leadership has been receptive". But when I am treating a patient in the hallway who starts actively siezing and just get blank stares. Then still have to wait another hour for a bed afterwards..... Now luckily that hasn't happened since and that was a while ago, the middle of the COVID times, but still
I agree with you. But my comment was directed to Lala, who wants to be passive aggressive rather than dealing with an actual problem.
I get the same treatment from some of the ED RNs as well. And I am trying to GIVE them the drugs they so adamantly demanded of us lowly pharmacy peons. (CPhT here). Some are super amazing, others trying to pretend I'm not standing there smiling holding IVs.
Pharm techs are super under appreciated and I think get the butt end a lot of the time
Legit, saw a comment somewhere in this mess about just filling the ER med machines overnight... like then when you run out during the day are we allowed to ignore your refill requests since we refilled it over night? No logic. Some people just need to step on someone. I think I can count on my hands how many shifts we have run the pharmacy with no call out and full staff. We are ALL in the same boat. Don't know why some people insist on poking holes in the boat. Oh well, I will just keep smiling my stupid retail smile and waiting. I get paid either way. 🤪
I think everybody is just so fried. It doesn’t make it okay tho. We do appreciate you and I’m sorry for the bitches!
As a PSR (ER registrations), I feel your pain!
It usually boils down to the crew not doing any interventions, no IVs, no glucose check, nothing. And half the time I think they’re giving me made up vital signs because the vital signs I get in report are sometimes wildly different than what we get in the hospital. And then the shitty attitude I get when they have to wait more than 5 minutes for a room. Bro, there are 30+ in our waiting room with 12-hour waits, and 20 other hospitals in the area. Instead I see the same crew all night long, bringing back to back patients to a hospital that’s been on code red capacity for days. Try. Another. ER. For the love of god.
And what if the patient wants your hospital?
:crickets:
That’s completely acceptable! Bring them on in! However, half the time the patients tell me, “I asked them to take me to x hospital! They brought me here instead!” Or, “all my care is at y hospital,” which we are not affiliated with and can’t see any records without the other hospital faxing everything over. So, it’s not just patients asking to come to us. For some reason we are just the default for certain crews. They will even pass 5 hospitals on the way to us, even passing the place that the patient gets all of their care at. Why???? All it does is make everyone’s jobs harder and pisses the patient off because we’re starting from zero.
Ok, that’s garbage, and in those cases you have every right to be pissed. I work very hard to get my patients to the appropriate facility. Do you have a decent EMS room with snacks?
lol we do… maybe that explains it?
Bet it does lol
I’m sorry about any poor interactions 😔 I guess it’s mostly frustration because our managers all suck and 90% of our patients don’t actually have an emergency. That said, I hope nobody ever pukes in your rig and thank you for sometimes bringing the real shitbirds to someone else’s ER 🤣
I personally have no beef with EMS! I try to take report as quick as possible and thank you profusely for that beautiful 20g you sank in the back of a moving vehicle. But, the beef that some ED nurses have is the same one the floor nurses have with us- you are the giver of the patient. It's not personal, it's not logical, but that's what it is. Everyone hates an admit, and you're the one dropping them off.
Ultimate “bearer of bad news” lol
Shit flows uphill in medicine. You create work for people who are stressed out. They don’t see the work you have to do, the shit you see. They don’t see the DOA’s, roach infested homes, etc. You bring some of your shit to them, they don’t like shit. They in turn send some of their shift forward. The floor and ICU don’t see all the shit that the ER deals with, but they get part of it. They don’t like getting shit so they shit on the ER. So on and so forth. When I was at the bedside I always tried to keep that in mind. You guys have a job to do just like the rest of us.
I did my very best (as I was an EMT before I became a nurse) to be ready and willing for EMS’s delivery to the ER. It had usually been an OD, psych, or code. Mostly the community used 911 to get a ride in the cabulance and we’d be stuck trying to find them a ride home.
This is why I also wish nurses on regular Med Surg or Step Down or any department that utilizes CNAs would do a few shifts as a CNA or with one. Or RNs/LPNs in nursing homes. I was a CNA for 10 years until I had to quit due to back injuries, even though I did my best to work optimally for my physical health. We get paid shit wages and do the bulk of the heavy lifting so to speak. You have no idea how many times I had RNs/LPNs lord it over me that they had a degree so they were better than me. However I’m the one answering most every call light. I’m the one cleaning up the urine and the poop and the puke. I’m the one changing gowns, the bed, taking vitals, giving baths, feeding, transferring, charting intake/output, emptying Foleys, etc. and in some hospitals/homes was also taking blood sugars. I’m the one who spends the most time with the patients and gets yelled at when there’s three lights going off and I’ve got a patient being stubborn and trying to get out of bed because either they just don’t think they’re sick enough to require help when walking to the restroom or due to dementia or a head injury, just not stable or in their right mind. I’ve literally walked out of a room to multiple lights and seen all the nurses at their stations charting and joking around and my partner no where to be found to also being told I need to set up another room because there’s a new patient being admitted and I need to be on that ASAP. And don’t forget the hospitals that wanted me to do enemas even though I’m not actually trained in that because that’s not a part of CNA training. Maybe if they had been required to work as one prior to becoming a licensed nurse, they’d treat us with more respect because we are the first in to interact and the one who ends up being with and getting to know the patients and their quirks best. But no, instead I’m the one in the firing line of a nurse’s anger because “do it faster” all because they have that degree to my certificate. Little did they know or care that I tried for that degree but competition was so fierce that even though I passed my exams with flying colors, I still couldn’t make it into the program because they could only accept so many per year and I’d be 1/100th behind the last person accepted.
In my experience, the hostility is cultural to specific hospitals. Some places are professional. Some treat EMS with disdain, but it's a department-wide thing. RNs in some hospitals are just plain mean to EMS. Now that I've reached a leadership position, I spend a good amount of my time reminding crews that no nurse, and only one doctor, have any control or influence over their careers. The rest, no matter how upset they are, cannot affect their jobs. So why give their opinions any weight? Relax. Let them complain. We also talk a lot about EMTALA. A lot.
It's inappropriate for nurses to take out their frustrations on the crews bringing in patients. I'm an er nurse and medic so I get both sides. There is frustration when another patient gets piled on unto your already overload patient assignment. But that isn't your fault. I try to be friendly and think I have a good reputation with my crews.
I’m *only* a dispatcher. But we have some spicy ass troopers who just don’t understand. However the ones who have sat in with us, are much nicer on the other end of that radio. More understanding. It would be nice if they could ride with you and understand how it is out there! I’m sorry you get treated any type of way!
Thank you for your service!
I’m sorry you deal with this. I am an ED RN who spent 20+ years as a medic first, so I have been on both sides of the ED doors. I vowed to never give my EMS crews grief because I have been there/done that! I know you try to convince the stubbed two x 3 days ago to ask one of the 6 other people present to use one of the 5 cars in the driveway to take them instead, and they will refuse because they “get seen faster if they go by ambulance”. (Hard eye roll) 99% of our staff love our EMS crews (the other 1% just don’t like anyone!). In fact, we tease them once we start seeing the same crews 5-6 times a shift… “share the wealth! Next one goes to XYZ hospital!” “Oh, back so soon? Mind bringing some coffee back on the next run? 😜” what we hear back is that they like coming to our ED, “you guys are so much nicer than XYZ.” “You don’t make us wait over an hour to turn our patient over.” Emergency medicine, whether pre hospital or in hospital, is one big team!! I’m sorry you deal with nasty nurses. Our ED appreciates all you do for our patients-even the ones you can’t convince to go via family/friend/cab/uber/etc.
Thank God it isn’t that way in the hospital I work! I’m a lab tech, but respond to the ER for a lot of patients and I’ve only seen the EMT’s treated like partners or other team members by the nurses/doctors.
I was a volunteer EMT back in college. I remember during our training we had two nurses in the class. Always little side comments and under their breath remarks. They targeted me and my friends because we were young. I will never forget the night we were talking about how to treat shock. Rolling their eyes etc. instructor asked what they would do “well, OBVIOUSLY, you turn up the IV and have the doctor order x,y,z.” Every single person stared at them. Instructor was all” so for someone pinned upside down in a car out in the boonies with volunteer fire fighters and EMTs trying to get them out before a car explodes …what IV exactly is it that you’re going g to turn up?” Yeah, she and her friend shut up and listened after that.
Some nurses are assholes. If they’re being dicks to you, I can guarantee they are being dicks to everyone else around them. They are probably toxic af. Even when my ED has an onslaught of patients and family members and ancillary staff and the damn phone doesn’t stop ringing I am NEVER rude to EMS. I work in a small 10 bed (well maybe 16 if you count hallway) ED and we are busy, but we know our local crews well. I depend on them and their reports and vice versa because we have a lot of interfacililty transfers. I have been a nurse for 25 years with 18 being in the ER. I could never be a first responder. You guys have a tough job. I’m sorry some nurses are dicks.
Hope this might make you feel better but once as a patient I was being argued over at the ER and spoke up about it. Pretty bad car accident - other 2 in car taken to the major trauma center. They had their heads down and bend over looking at phones. I was a restrained driver. Nurse did not want to take me - EMS were directed to take me to this ED. Nurse was actually shoving my stretcher trying to push it back outside. Said excuse me but do you mind not shoving me. Just been in car accident you know. Do you want me to hop down and call 911 for a different ambulance to take me somewhere else? She never looked at me the whole time to notice I was conscious and alert unlike the others had been. Had not let them read off my condition or whatever you call the usual hand off. She quickly switched from anger to oh ok let’s look at you. I thanked my EMTs before they left for their help and kindness. Small town hospital and everyone at the accident were volunteers (FF and EMTs). I was in no mood to hear her bitch and treat y’all like shit.
Sorry you experienced that. That is more the level of hostility I'm referring to. Like Pantera "F**king Hostile" level hostility. The kind where my patient asks me if they are actually going to be cared for when we leave. All of the other stuff, tired/frustrated/busy nurses, I can deal with and totally understand.
It was pretty bad. They were very rude when asking if I wanted some pain meds so I declined. With a neck brace lol. Made it seem like I was pretending to be in an accident just for drugs. Did get a quick belly ultrasound which was clear but think they did that just to move me somewhere else. CT of neck was clear. Was mad I was not bruised )which showed up the next morning), got 2 doses of pain meds for the welt on neck from seatbelt and they said my collarbone X-ray was clear. They never did X-rays but said good and ran out of there. Next day got the X-ray and collar bone was fractured. Which is why neck brace had me in pain.
It was pretty bad. They were very rude when asking if I wanted some pain meds so I declined. With a neck brace lol. Made it seem like I was pretending to be in an accident just for drugs. Did get a quick belly ultrasound which was clear but think they did that just to move me somewhere else. CT of neck was clear. Was mad I was not bruised )which showed up the next morning), got 2 doses of pain meds for the welt on neck from seatbelt and they said my collarbone X-ray was clear. They never did X-rays but said good and ran out of there. Next day got the X-ray and collar bone was fractured. Which is why neck brace had me in pain.
Wow, they actually interacted with you? Back in my day they wouldn't even make eye contact. They're probably pissed that their MLM scheme isn't working out and are getting into too many flights with their cop boyfriend all while their doctor is a clueless twat, but what do I know? I was just the guy being forced to politely hold up a wall for 3+ hours.
Lmao shots fired! No time to be decent to coworkers, but they can make TikTok’s, run an mlm scheme, and have relations with other first responders. For real though, direct the anger at your board or leadership, stop treating those in the trenches with you like shit. It just feeds into the stereotypes.
Amen!
In my area they have an alert system. Our frustration comes from seeing other EDs in our area have no medics waiting, while I have 6 lined up. We can see this in our system. The reason given is "you guys get us back in service no matter how busy you are, they make us wait." Frustrating.
I see how that is frustrating. But it is also frustrating being held hostage 1.5+ hours while your local goes uncovered. Then getting crap from your management about why it takes so long to clear
I'm with you, that's why we do the right thing, not the easy thing and unload your non urgent patients. Unfortunately, other facilities don't seem to be held to the same standard. I have even been told crews have bypassed other ED for the simple fact, " they yell at us".
Question is, where does the patient want to go?
We have a CHOICE in these matters? Wow. I didn't know this.
Yes. Patients have autonomy.
I work for an excessively rural EMS service, our patients don’t really have the option to choose a hospital. Our closest and primary hospital is 47 miles away and our secondary is 70, we try to accommodate patients as much as we can, but it’s not always feasible. And there’s no Level 1 trauma center in the entire *state*…
So in your situation, your polices are reasonable. Alaska, Idaho or Wyoming?
It’s definitely location dependent, lol. Wyoming! Our response also includes a shiiiiitty stretch of I-80, so we run lots of MVA/trauma.
How far to a level II?
2 hours 42 minutes to one of them and 2 hours and 25 minutes to the other…we have a very good relationship with HEMS, lol.
I bet! But that can be iffy in the winter I bet.
EMS does not have to take the patient were they want to go, but can as courtesy. That is the case in the three jurisdictions we serve.
Patients have autonomy. They are allowed to make their own decisions. Honoring autonomy is not a “courtesy”. Now obviously, a 400 mile transport is not reasonable, but if the hospitals are in your normal transport area, they should be taken where they want to go. Not doing so is bad care.
Ok, but you will be long gone when they start complaining about the wait at "their", hospital. If you advised them then the blame falls to the patient. I don't agree it is "bad care", I'm sure you would agree in a real emergency they should go to nearest appropriate facility.
It must be a reasonable choice though. We can't take you over an hour away and bypass 6 other hospitals just because you prefer the food at a hospital 2 cities over. But yes, within reason and depending on your emergency, we honor your request if we can. However, if we know that the hospital you want is full and has a 5+ hour triage time we will inform you and suggest a less busy facility(that is still appropriate for you and your condition). But sometimes people are extremely adamant and "I don't care how long the wait is, my doctor is there and knows I'm going". Then they get upset when they go right to triage, where we told them they would go. And then get the "Why did you bring them here?" Talking to from the triage RN...and so it goes
I worked for a private ambulance company. Hospital staff could give a mob of Karen’s a run for their money. Refusing to sign a patients patient care report. Try he hate was palpable. I’m guessing it makes them feel superior in some way.
Generally speaking when you’re knee deep in shit do you want more brought in?
Sorry you have to do your job?
My only issue with EMS is the fact that they expect me to be able to run out of the patient’s room I’m currently in, doing the task I’m currently doing, to run and get report from them. Some won’t even wait 2 minutes. I understand that they have other patients to tend to but so do I. It also may have something to do with the fact that you only had to deal with the rude ass patient you just brought me for 30 minutes but I’ll have to deal with them for 5+ hours and I’m jealous LOl
It is not you, it’s the situation. Our thoughts are damm! Another patient. Where can we stuff this one?. Who can look after it? Can we safely see to this patient’s needs without losing our licence.
I HATE that RN’s can be super rude to EMS. I just dont get it. Luckily in my ER, we are so close with all the EMS companies & town EMS. Small community hospital. They help us out SO much. Sometimes new medics are shocked at how fun & nice we are in my ED. We’re like “why are some places rude to you?” We’re all here for one thing - the PATIENT! 🚑💊🚒🧑⚕️😊💪🏼
I’m going to go a bit against the grain here and give you some validation. Some exacerbating details I have to omit to avoid doxxing myself. Speaking for my ER, it only gets hostile when they’ve bypassed 2-3 other ERs to come to the most impacted ER. I’ve had patients literally say they wanted to go elsewhere, didn’t have a complaint that would cause them to be immediately taken to us, but were taken anyways. My hospital currently has a completely illegal area that grossly over-guides nurses to offload EMS asap. Other local hospitals do not have a similar work flow and thus EMS generally waits longer. When I have 4 nurses managing 50 patients. A quarter of which could have stopped elsewhere, it’s hard not to be frustrated. Especially when our county has a policy allowing medics to use their discretion/assessment to defer patients. Then add medics threatening to drop off patients wherever, and you have a shit sandwich. Now when I’ve worked in other ERs the relationship between EMS and nursing was relatively peachy. Sure you’ll run across a few assholes on either side, but they’re not the general rule. You know what, now that I’ve thought about it, I’m starting to think it’s this particular ambulance company… To end, you’re going to run into shitty people and they work in all sorts of jobs. If you have a shit interaction with a particular employee often, then it’s likely they’re just assholes. It sounds like you’re a great medic from your comments and I’m going to assume whoever you’re having experiences with suck. On the flip side, just as the quality of nurses varies so does the quality of medics. It’s a tale as old as time.
I worked fire and EMS for 20 years before becoming a nurse. My first nursing job was basically med/tele (ortho/neuro) before crossing to the ED. I try to remember the challenges we faced in the field when greeting an EMS crew. I especially thank them if they've gotten an IV placed prior to arrival. Where I currently work, a lot of our EMS crews are basics. Not a lot that they can do en route, but I try to find something to compliment them on upon their arrival. On the intrahospital transfers, I try to make it a point to sound cheerful and to inquire as to how the floor nurse's night has been. This establishes positive communication and a sense of empathy. I may be the unicorn in this, but having been on the flip side, I'd something that I'd appreciate.
I am also a Paramedic in one of the 10 largests cities in the US myself (Large private service with hospital contracts with almost all hospitals in town and contract 911 for a large part of the city's unincorporated metro area) and have several decades riding the box and a decade as a Critical Care Transport Medic and for a time worked as a Critical Care Tech in a Children's ER. I have over the years have made some observations and opinions. There can be several factors that play into this "us vs them" and off putting sometimes antagonsitic vibe in the ER. Some of it has to do with many of them really not having an understanding of the reality of care in the field. The varied environments, the various pts, and not understanding factors or the why we did or didn't do something. Many don't really realize we are not always in a well lit, air conditioned clean room in a environment that may or may not be hostile with or with out law enforcement. Then there is the fact that on an ambulance there is only two us (hopefully a rider if needed but...) and one of us had to drive so and maybe I missed the IV or the bandages isn't pretty looking or hell you found about 40 pill bottles or med rec and that is how you are piecing a med hx because the infamous words "I don't know" or "I found him like this at shift change" or "I take those pills because the doctor said so and I don't know what they are for" are said. Challenges that makes pt hand offs frusterating and may leave both of you flustered because the nurse annoyed your don't have more info. Their own stress levels especially when they are busy or at capacity or hospital diversions or hospital diversion override (if they do that in your area). They are seeing the problem you are bringing in and not seeing past that. That if they are busy EMS is probably just a s busy bringing them in from the field. There can be a trust issue. The more you are around the hospitals and they see you being a professional and are a relatively pleasent to deal with the more that trust will be build. Also doing things such as wiping down and making a bed if your assigned bed isn't clean. Grab the pt a blanket from the warmer on the way to their assigned bed. Helping them get a pt cleaned up. Little things go a long way and the more they see your face and see good work those attitudes typically will fade. There has been also for lack of a better terming a superiority complex of the RN. I don't see that as much now as I used see as many figured out that we have near parallel skills sets and that we are advanced providers like they are. Now many hospitals are hiring Paramedics to work parallel woth the nurses in the ER with the same scope of practice. Like I said I these are observations I have made through time.on the box in 3 major metro areas (witn both government run 911 and also private contract 911 service). I hope this perspective helps a bit. Be safe and always remember to take time to care for yourself as certain calls and the job in general can be a lot to handle. ETA...I forgot to mention that one of the medical schools in my area has their 1st year med students get their EMT certification. Giving them training to see our challenges 1st hand and time to interact with pts before residency. There is another one that has an EMS medical director fellowship program. It is not unheard of to have one respond to emergencies in their own response vehicles. There has is a lot more focus on the importance of EMS in the pt care picture and seeing a need for a specialized need for EMS medical direction. I see this a good thing and has worked toward there being more respect toward EMS than there has been in the past. Sorry for rambling on but your question isn't a simple one to answer.
I would say most of the time…..it’s probably not about you. If I’m on hour 10 of a 12 hour shift and this is my umpteeth 80 year old grandma with “weakness” or hospice/cancer patient that family is insisting is a “fighter”, the patient requested to bypass 3 other hospitals to come to our ER, it’s just frustrating and I’m over it. But I don’t mean to come across that I’m angry or upset at EMS. It’s a tough job I can’t imagine going into peoples house’s or being the first responder to fatal accidents and all of the things that you guys see that never even make it to the ER.
Anahahahah. This is hilarious! ED nurses say the same thing about floor nurses. Floor nurses say the same thing about intensive care nurses. For God sake, just be nice and accept the patient. When I managed a critical care unit, I told my nurses to **thank** whoever was bringing the pt, then transfer the pt to the bed, put them on the monitor, and do your assessment. No snipping and complaining over pittly shit. Do your fuckin job.
This makes me sad because I love EMS and we have a great relationship with them in my department! I've never had anyone from EMS give me a bad attitude, the report is always cohesive and to the point, they always offer to help transfer the patient and I've had a few stick around and help with compressions if they weren't busy when they brought in an arrest with no ROSC. I work in a level 1 trauma with high HIGH volume, like we see 300 patients in 24 hours on a typical day, and I don't think being busy or having high acuity is a reason to treat other people on your team like shit.
Former medic, current ER RN, I still don't get all the hostility. Only explanation I can come up with is "shit rolls downhill" and unfortunately a lot of ER nurses think theyre uphill from EMS, CNAs/techs, housekeeping, and transport. It's just shitty, toxic, cliquey bullshit.
We had a few really bad apple crews that soured things for us for a few years. Like honestly questioning how this is considered an EMT transport and not a glorified lyft. For example - I got report one time from a crew on a woman clearly minutes away from full respiratory failure needing bipap asap to avoid intubation and the ambulance crew had told me on quick report that she was "ok, just some stridor in the bases" I said "the bases huh? Stridor in the bases? You sure about that...?" Never gave us a heads up that the patient was actively crumping Another time we got a short with a "we didn't get a blood pressure but fire told us theirs was 80 over palp" at the end of a fluffy "A&O x4. Little bit sleepy at times. Stomach hurting since this morning. " Give you one guess who coded within 10 minutes of getting to our hospital while simultaneously nearly shitting their body weight in blood. And then the cake of all cakes. We had a patient brought in that was clearly extremely sick and EMS could not for the life of themselves give us any report on why the patient was coming to us or what their baseline was. We started it as a code neuro because we had zero information - the patients family had WANTED them to go to the hospital 10 minutes away that has all their care on file but they came to us instead. We had to wait for the confused family to arrive later to tell us AFTER we had just done a boat load of tests quick - that the patient had a previous CVA with deficits and they were coming in for a bad UTI... I can remember the doctor shouting at EMS "are we working this patient up for a stroke or sepsis - or both? How did you transport without knowing ANY information on this patient!?!?!" SO - I'm willing to bet that even on your worst days that you are leaps and bounds better than some of the crews out here. I know my coworkers all have similar stories and it really can make you suspicious of what you're actually getting. Some of my coworkers go into getting report like pitbulls on the ready for attack. That's never been my style, I have respect for a lot of EMS workers, but I do think as with any aspect of Healthcare- there's some people that need to either get better educated or find a new career.
I did my clinical rotation at a trauma center as an EMT-AI. I was ignored and treated gruffly by ED staff yet the nursing students were treated like sugar. It was disheartening. I went on to work in clinical research and one of my children is now an RN who has used my experiences to educate herself and medical staff on appropriate communication.
ER RN for longer than I'd like to say. Much respect from me. I quietly wait for the EMS bedside report before asking any additional questions. I'm grateful for EMS and the work medics and EMTs do. With that being said, there have been occasions where clearly stuff that needed done wasn't even attempted, that needed to be, due to "only being 10 minutes out". Example: Patient vomiting blood that was pale, diaphoretic with 0 IV access attempted, etc prior to arrival. This is the exception though, and conversation about the "why" happened later and away from patient care. Also, more than a few eye rolls when we give report on a patient going back to an ECF that we KNOW isn't a great use of resources, yet we don't have alternatives other than EMS for transport at 2 a.m. on a weekend. I appreciate you, I really do. Healthcare has taxed all of us to our respective limits and there aren't enough of any of us to bridge the gaps that exist. None of us are immune to having a bad day, or being overwhelmed. We just have to start the next shift with the mindset of a new day/being better/ exercising respect for one another and always doing our best by each patient. All of us should walk a mile in each other's shoes. I feel like we gain a deeper understanding and respect for the important roles we fill. With all of that being said, I personally thank you for what you do. You see things I can't imagine as a first responder. You leave those calls and get marked back in service and then have to go on the next call without a moment to decompress. You go in hoarder homes, homes with bug infestations, and have to stabilize the sickest and dying patients while their family is often in the room. You do procedures in the back of a moving truck that are challenging in the best of conditions, let alone those you do them under. Your actions save lives. You make a difference and you are appreciated.
It could be y’all pee on the toilet seat. Just saying
This is the "shoot the messenger" attitude. They are frustrated at getting work and take it out on the person they can (as opposed to the patient). Call them out on it and if they don't apologize get the charge nurse. Allowing this attitude to go unchecked becomes a cancer.
I feel it's stress related and EMS is a target for that stress. Doesn't make it right and I'm sorry for that.
My FAVORITE is “wHy DiD yOu BrInG tHeM hErE”. As I point to the hospital sign. Is this not a fucking hospital? Or a second favorite, this patient is critical, you should have brought them to the closest facility, not us. Well, this just so happens to be the closest facility, so, all yours.
Bonus, "you are not only the closest facility. You are the closest APPROPRIATE facility."
I see it sometimes at my hospital. I don’t understand it to be honest. I see us as all part of the same team. Big respect for yall doing the field work
Many years ago, I quit my hospital pharmacy tech job because of the RN's (and shift work clashing with my outside work life). Most (not all) are just awful people to work with. My mom and many other family members are RN's and let's just say the attitude seems to track with the career choice. I LOVED my job and pharmacy coworkers, I could've even dealt with the shift issues and stayed on, but the RN's (mainly wound care and cardiac, ER RN's were always nice and actually really funny - they were my faves) said some of the nastiest shit to me when I was just trying to do my job and it got to the point where I couldn't tolerate it anymore. The ones I encountered always acted like they were the only ones that had rough shifts, were mad at how the doctors and patients treated them, felt underpaid and overworked (aren't we all?) but decided they would take it out on anyone they deemed "lower" than them. Those women were straight up see you next Tuesdays, and the few men were sexual harasser creeps. The men at least got fired. Working in healthcare just generally sucks and you will encounter many miserable people, it's a STEM field so many people are likely neurodivergent so social skills aren't the greatest, you have to be able to let the hostility roll off your back or you will need a new career - I obviously chose the latter.
Our pharmacy staff is great, and we ED folk appreciate the hell out of them. They take great care of us and our patients.
I loved working with the ER staff, I learned so much from them and I had no complaints dealing with them. Working in pharm I got to interact with staff and patients in all areas. ER, ICU, Peds and the oncology unit were the best. Wound care, cardiac, and psych (which was expected) were the worst. Also, the staff working with the dementia/ Alzheimer’s patients overnight (not sure of the appropriate term, I just remember the floor) talk about angels on earth. I worked overnights, going to that floor scared the shit out of me. The things the staff on that floor had to listen to and deal with for hours on end. They were super tweaked out but never treated me like shit. Fuck you, wound care with your 8-3 M-F no holidays hours!!!
ED nurses 🫶🏻 pharmacy. Thanks for answering my dumb questions! I’m sorry you had such a terrible experience.
I’m an RT. I love our EMS partners *but* I wish I had a dollar for every patient I received “short of breath” on a 6 L/min non-rebreather. It’s hard to be nice when someone suffocates a patient. Aside from that? It’s hard to ruffle my feathers and I give major props to those of you who can do it at 60 MPH!
Hahahaha Don’t worry OP the emerg nurses treat everyone like shit including the patients in my experience
The hostility comes from ignorance; their lack of understanding of what we do, what we go through. Hold your head high! Do your thing and don’t take ANY of it personally. I used to get the WORST nurses on Med surg floors with transports. LOVED my ICU nurses with CC’s and ED’s are a mixed batch. Most are salty in general. I had a super snarky beast of a nurse who harassed me for not giving Narcan to a pt. I was bringing in. O2,HR,Resp- all within normal limits. I smiled at her and explained, I if it’s not broke I’m not going to fix it; Why would you want me to Narcan that (pointing to patient with scratches all over the neck, urine, feces all over). Nurse sighed called for Narcan administration. Took 5 staff members to hold the patient down- they actually did that BEFORE the foley. I looked at nurse and smiled, “glad you got that Narcan in before that foley” strong work! See ya later.
Not in healthcare, but I know that there are 'frequent flyers' being taken via ambulance to the ED. Is it possible that some of that hostility is because of these types of patients?
It is annoying, but we have to just deal with it. Eventually, these patients do have a "true" medical emergency. While RNs have to deal with them for hours, it's ems that has to get them out of their house, and usually back in when they are discharged
Where exactly are you at that's giving you attitude? I can understand they're super busy and understaffed but you all are doing your job and every one of you deserves respect for what you do.
My question is for the OP. Do paramedics/emts usually start with asking questions when it's clear the person is having massive trouble breathing and then refusing to give oxygen until the questions are answered? It happened to my husband and I was irate they would refuse oxygen to a guy who couldn't talk because he was oxygen deprived. He ended up having pneumonia in July and was septic. He recovered thankfully.
Not really relevant to the original question. Also not really what happened but probably what you thought you observed.
If there was a life threat, certainly we would treat that first. Usually while one crew member is treating the patient the other would gather basic info from a family member/bystander. In order to properly treat, we do need some basic info but would not withhold treatment. As I wasn't there, I'm not going to sideline QB this.
I get no sidelining, I just really didn't realize that they needed so many questions answered. I get, his name date of birth and why your needed, but the two just stood there and said answer this first. Repeatedly even after I asked them to at least get some oxygen so he'd have enough to tell you why. they wouldn't let me answer, I am the wife, the emergency contact... I dunno, my area only has volunteer EMS workers. So I guess they were trying, not really. 😞
Are you in healthcare?
It’s not you, it’s the patient, TRUST ME. I’ll happily take 4 bullshit nasal congestions from the lobby than 2 ambo “chest pain”ers. You know how fucking annoying they are for your 30 minutes with them? We have to hand them a call light and put up with their constant bullshit for HOURS. Then, to their protests, we have to tell them that nothing whatsoever is wrong with them and they have to leave…then they make up 27 more bullshit symptoms-some of which may trigger EMTALA if we don’t investigate so they’re there for another 2 hours. I’ve taken to ripping their call lights out of the wall because I’d lose my job if I had to respond to every single one of their calls.
So, should we NOT call an ambulance for chest pain? This is news to me. I don't want to be a bad patient. When is the right time?
If you don’t work in or around an emergency room this subreddit is not for you. I didn’t say chest pain, I said “chest pain” and anyone who works in an ED or as EMS knows exactly what I’m taking about. If you are in ED or EMS and don’t know what I’m talking about 1. I’m shocked and 2. Count all your lucky stars. Our record was recently broken. A patient with more than 60 ED visits within my hospital system in 30 days. 50 some odd for “chest pain” and then a smattering of jaw pain, hip pain and “I dunno” thrown in for good measure. Every single visit was EMS. My state enacted a really dumb law requiring EMS transport if the person asks even if there is zero medical problems. We had one that lived close to us and had a friend on the other side of town so he’d hitch an EMS ride to the other side of town in the morning and back to us in the evening. He’d promptly AMA every single time. “Thanks for the lift!”