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firedoc5

Difficulty With a Nurse

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Capt,

Heck no I didn't let her start the IV lol. I was as polite as I could have been and asked her to move. I don't like making a scene in front of my patients unless it is absolutely necessary. If I'm calm, the crew is calm, and the patient is calm.

If she had refused to move though, I would have definitely had a patrol intercept with us on the way to the hospital, or meet us at the hospital. However there wasn't really a need for me to be a smart ass, though I came pretty close when I saw her reach for the cath...

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One thing I constantly ask EMS crews to do is to screw the radio report if they know I am on. I think radio report is generally useless and prefer a bed side report face to face with the crew and patient at the time of care delivery. All I care to know is if the patient is ok, bad, or dead. Other than that, no dissertation on the radio please. I know more than a few EMT's who have been taken back by this concept.

Take care,

chbare.

That is exactly the way we do it here. Forgive my ignorance, but I thought it was the standard everywhere. then I thought, " this is EMS, there isn't a standard" :oops:. Over the radio we give V/S, C/C, age and sex as well as ETA. I always ask if they require further information, you know, just in case, but the usual answer is " See you in 10".

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I have been to many places where EMS reports are literally minutes long. I remember a recent report where the EMT literally gave us an entire run down of a sick patients day at the nursing home. Woke up feeling sick, fever on and off, staff called doc, orders for tylenol, did not work, still has fever, called doc again, bla, bla, bla...

Give me the down and dirty over the radio, and we can talk details face to face at the bedside. Fellow nurses hate my style. When I call for a bed admit, I immediately ask to talk with the receiving nurse and give report after receiving a room assignment. I tell them the down and dirty and then I am headed up to the room. Many nurses want a full name, entire med list, a 5 paragraph expository essay on the patients psychosocial background, and a few sensless questions thrown in for the heck of it. I say, you will get all of that in a face to face report. It is simply faster to get the room and get the patient out of the ER. IMHO

Take care,

chbare.

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I have been to many places where EMS reports are literally minutes long. I remember a recent report where the EMT literally gave us an entire run down of a sick patients day at the nursing home. Woke up feeling sick, fever on and off, staff called doc, orders for tylenol, did not work, still has fever, called doc again, bla, bla, bla...

The sad part is that there are plenty of systems that require a long radio report. Orange County, CA, for example, requires the medic units to essentially repeat their entire PCR to the MICN [the MICN calls the receiving facility when contact is made. There is a criteria for "ALS No Contact" though which involves the medics reporting directly to the receiving facility]. For BLS calls, though, it was age, sex, PMD, CC, ETA, and pertinent info [not normally needed though].

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I was in colorado springs about 2 years ago and we were doing the unveiling of a computer project and I was listening to a radio report re: a mva patient.

The report was 12 minutes long. that was just the medic's report. granted the patient sounded like they were fubared but 12 minutes long.

The doctor walked away from the radio after he heard enough in 1 minute to call a trauma alert.

The medic got silence when he was done.

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When doing a call up just get to the point, keep with what is immediately relative.

For awhile our system tried out contacting the resource hospital on the way to an emergency, no matter what the nature of the call was and to obtain a run number. That didn't last too long, which we knew it wouldn't. The nurses were constantly having to drop whatever they were doing to run back and forth to the radio. Finally the only time we would contact the hospital on the way to a call was that if we were going on a MVA with possible multiple injuries or a possible full arrest, and that was usually only to ask permission to follow ACLS protocols, and that we'd contact them back as soon as possible.

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Try the KISS principal: Keep It Simple, Stupid!

"Bringing in a (Nature of Call), (Age sex VS if available), ETA. (If requested, MOI)".

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Sure there are downright nasty nurses. But really think about all the knuckleheads that you've worked with over the years and imagine that the nurse sees you as one in the same until you prove yourself otherwise.

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Couple of things, being licensed as both. Control the scene, don't let the scene control you. Three people in the back of the unit not including my partner is two too many. Sorry family or not. If she raised the stink of being a nurse and a sibling, then I would inform her that she should obviously know better and as well that she/he is NOT licensed away from their facility. But thanks... anyway :wink:

do you need to re-phrase that ... an RN is an RN regardless becasue they are a registered health care professional - their core scope of practice does not rely on being employed or being employed by any specific employer ...

maybe it's different in leftpondia but in rightpondia we've had a few problems with none -registered staff trying to 'remove' sober, competent Nurses or Doctors from the scene of incidents despite the fact that once a registered Health Professional is hands on to a patient they and they alone can decide if and when to release care of a patient - as any come back will be on them for inapprorpaite delegation of care ...

however trying to hijack your supplies is a different matter ...

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