Things you LIKE and DISLIKE about your job.

[MetalMedic]

I don't get the nurse vs. paramedic thing, I really don't. I've had to fight (hard) for the EMS side of things and bring perspective in my nursing classes... the sad part is, a lot of my instructors just plain don't understand what EMS really does. And they don't care to, in some cases, either.

An example of what happened to me last week:

** Disclaimer I know that CNA and RN's are different

Get a call for chest pain. I arrive and identify myself. Found a 80-90 year old pt on the floor of adult child's home. Pt is surrounded by grandchildren and adult child is taking BP. Adult child identifies themself as a CNA and explains they are unable to get a BP. Past history of heart issues. I notice pt is slightly gray and incontient of urine which is not baseline. Pulse is thready. Chest pain is radiating to arm and shoulder. I want to get the pt out NOW. Dispatch called to have Paramedic intercept if they don't meet us at scene. CNA gets in my face as we're moving PT asking if PT spouse can ride and if they can ride. I explain only one rider is allowed and spouse is it as we have 3 trained personel set to be in back. We package and move the pt to the ambulance. I get in the back and the CNA is standing in front of me having gone in the side door. CNA is again informed they will NOT be riding with us and then proceeds to put up a stink. CNA had asked driver, EMR and I if they could ride and were told no by all of us. CNA intercepted Paramedic on his way into the ambulance on scene and he had told them yes. CNA finally leaves ambulance after Paramedic is informed we have 3 trained people in the back. We ride lights and sirens to the Hospital, CNA in their car tailgaiting us. We park in the ambulance only parking area, CNA follows to same area. They are too far behind us and is not able to get in the ambulance entrance and proceeds to argue with security throwing their credentials in Security's face and is almost asked to leave the hospital. Just after spouse signs paperwork, PT codes and RN runs out of the room asking for a crash cart.

What the CNA didn't understand is what we do in the field is so different from what goes on in the hospital. The CNA's actions hindered the care of their parent. Instead of stepping back and letting us do what we needed to do, they threw a fit because they wanted to ride along. Now I know that some of it was situational, but if we as EMS walk in and say, "We need to go now." It's a serious issue.

I've spent time shadowing ED RN's and it really made me open my eyes as to what goes on from their end, but I don't know many RN's who will sit in the back of the ambulance for a day and see it from our perspective. I feel that RN's assume that we can or should diagnose conditions. Yes a broken ankle is pretty obvious, but we just don't have a way to come in with a difinitive answer of why some medical conditions are happening... which is why they are in the hospital.

Edited March 29, 2012 by MetalMedic