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Wednesday, August 26, 2009

EMTs v. RNs

My morning started off hectic one day a few weeks ago.

The number on the page said "43," and I did a double take hoping it was a "7" and I was misreading the aide's handwriting. A heart rate of 43 is not compatible with life for very long.

I jetted to his room, my own heart pounding, I did my assessment. He was alert, oriented. Breathing normally. Pulse was thin, thready. I counted 52 radially. The patient denied feeling a shock from his ICD, but he was sweaty and pale and complaining of nausea and vomiting.

The patient's chart had an order from Doctor Chemo to send him out for certain parameters. He was meeting them three for three. I conferred with a nurse practitioner who agreed with me that the patient needed to go to the ER at Dr. Chemo's hospital. We also both agreed that this was not an emergency, but was urgent and had the potential to become an emergency, so we called a private ambulance company instead of 911 or a taxi cab.

I did exactly what I should have done through and through. And like a well oiled machine the other nurses chipped in to save time, one copying medical records another writing out the ED consult.

So why, when the EMTs arrived did they treat us with such derision? The Front Man was loud and boisterous. His voice echoed through the hallway, and if he saw that he was disturbing patients who were trying to sleep he gave no notice. He was condescending to all of the nurses, including me. I felt like no matter what I said it was the wrong answer.

To make matters worse he was smiling and laughing the whole time but we all got the impression that it was mostly a big joke to him and his partner. Did they expect us to join in their jokes? They laughed and made small talk right over my patient's head. My patient sat on the stretcher, silent tears in his eyes and the EMT only addressed him once. Politely, but still with an inappropriate grin and side glances at his partner.

It was as if just because it wasn't a life or death situation the EMT thought he didn't have to be present at the scene. But even when my patients' needs aren't as exciting or action packed as an MVA, they are still real needs. They are still real people who deserve to be looked at in the eye and spoken to with compassion. Not left to sit on a cot crying while you and your friend laugh about something that happened on the ride over.

I comforted my patient as best I could before they left. It's hard to be belittled in front of the patients, but I feel like the EMTs almost always manage to to just that. I wish we could be a louder voice for our patients. But how can we be, when I feel like someone needs to be a voice for the nurses too? We're just as disrespected in those situations. Whenever I complain about it I get the same answer. "You know how those EMTs are."

But the thing is, no I don't. I have plenty of friends who are EMTs who don't act like that. And saying things like that just perpetuates a system of negativity. So I'm not sure what else to do.

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