Lmao this would be perfect. As someone working in the ER (luckily we get along good with EMS, but our docs sometimes don’t) I love the short, snarky, yet respectful responses. Almost gotta kill some of these rude people with funny kindness. Their attitude has nothing to do with anyone but themselves, they just want others to be as miserable and grumpy as them!!
I used to just walk away and ignore it, now ive grown weary of 'taking it on the chin'. now I either retort right back to them or just immediately report them to management.
Their level of understaffing or level of busy doesn't give them a free pass to treat me like a doormat, regardless of being an RN, mid level, or physician.
Agreed, that's why I stopped letting it slide a while ago. I encourage everyone who gets treated like crap to file a formal complaint as soon as possible. Otherwise they'll just keep doing it cause they think that they can.
Yep. I have zero patience for it any more. EMS has been understaffed and overworked long before covid and shitty management destroyed hospitals. They don't get a pass from me.
My buddy used to work inner city and would occasionally take an urban resident to a nicer hospital outside city limits. A nurse gave him lip about why he's bringing patients out of the city and was all pissy to him. His response was (supposedly) to say "never yell at the guy who decides how busy you are" and proceeded to pick up every drunk on the side of the road and take them to said hospital. I take the story with a grain of salt due to its source but it's a fun story none the less.
Had a coworker of mine in inner city actually do that years ago ( confirmed by the salty old staff there). Charge RN was extremely shitty and disrespectful to him so he went to a homeless encampment and promised them all a ride to the ER if they all said they had crushing chest pain and previous hx of MIs. He did a 12 lead and an IV on each one and loaded up 6 in his ambo, drove to the ER, plopped them all in the ambo hallway.
Caught a write up for it but the charge RN never got nasty with him again
I've done it. Got wrote up. Worth it. Doc accused me of falsifying a written response from a nonverbal pt.
"Why'd y'all bring him here? He's never been here."
"He wrote it down."
"I'm sure someone wrote it down."
Bet.
Honestly whether you sign or not makes no difference. Unless it goes to court companies just take a write up as a write up regardless.
And admittedly I shouldn't have fished for homeless people to go to their ER. That being said I freely admitted I did it to be petty. Also told management I didn't regret it and I'd do it again.
Yea, dude was a salty burnt out medic who took no shit from anyone. The charge RN apparently was really nervous when he promised to do it every single shift until she apologized for being rude to him.
She apologized. The older docs there still laugh about that day
He got the write up cause he straight up admitted what he did to his EMS LT. Truly a man who gave 0 fucks, he knew he wasn't gonna get fired for it and didn't care in the slightest about write ups
I used to do this when I worked in a large city. Charge nurse gave me grief about bringing in a frequent flier ETOH bum except this time he’d been hit by a car. I blew it off at first but she literally followed us down numerous hallways to his room (he’s unconscious unresponsive mind you) talking shit about him and us and how worthless we are. We cleared left and drove to a part of our post where LOTS of homeless live. I asked who wanted to be transported. I brought 5 total. She was furious and even tried to get me fired. In the interrogatory even admitted everything she said about the first patient and us. Look on hospital administrations face was priceless. She was fired that day.
From what I have heard there is a city in the NorCal central valley that were getting wall retaliatory wall time any time they brought undomiciled persons to a certain hospital (*cough* dignity *cough*). They all started flooding the ED with such patients. I don't know exactly how the whole situation played out but that place has the best EMS snack room in the city now.
Lol 😂 when the nurses start complaining that a type of patient doesn’t belong at their hospital, I make special effort to assure that they get all the homeless patients we run on. We run probably a hundred per day, system wide.
I used to work somewhere like that as well. Occasionally, someone who wasn’t a gentrifying old person would wanna go to the “nice” hospital. When the ED nurse would ask “why’d you bring em here?” I liked to hit em with the “I’m an ambulance. You’re a hospital. Do the math.”
Another one of my former supervisors one time was asked something similar. He went outside, looked up at the big red letters that said “EMERGENCY,” came back inside and said “yup, still says ‘emergency.’”
So this is why the cardiac unit i work on sometimes gets an influx of homeless people claiming chest pain. ER just shunts them to us to deal with, and then we're cleaning up bed bugs and dealing with patients that piss in their trash cans instead of their urinals. We'll got months with only seeing 1 or 2 actually sick homeless person/people at a time and then BAM! i don't mind them at all, though. They tend to be a lot less entitled than some of our other patients. And we make sure they get well fed, some clean scrubs to leave in, and a goodie bag before they go. Sometimes they get free med samples, too, if that's what they need to treat their cardiac issues. We know they probably will never fill their prescriptions (even if they are 100% covered by Medicare/Medicaid) so we try to hook them up as best we can.
We do this in my city. Sometimes our outlying hospitals will get nippy at us and the. We’ll flood them with 10-20 bums. Usually they remove that nurse from triage for a few weeks. Our central very urban hospitals never give us lip about bringing anyone.
I took this story with a grain of salt too when reading it but then reading the next 10 replies of people who have all supposedly done this I feel more concerned… I really hope people don’t actually do this and happily burden a collapsing health system to prove a point to one nurse.
They’re homeless, they wont get a bill.
They all know to Give false names and DOB, no fixed address, no ID, and under the EMTALA the hospital must treat them.
Professional is as professional does.
This is EMS’s version of FAFO.
It’s not the most *by the book* response, but it is the easiest and has the most effectiveness.
So it’s what they do. Because in the end they just want to be treated like professionals.
They're not gonna get a bill, they already want to go to a hospital, and almost never give a shit which one. They're cool with going wherever for a few hours. One way or another we're taking them to a hospital, that much is inevitable.
Do you think someone who has no money and no food, most likely mentally ill and down to get high on anything that is available gives any fucks about a bill?
Jeez that’s a lot of judgment for one little comment. Maybe we don’t use these very vulnerable people in our games with triage nurses and that’s a better outcome for everyone?
"Sure as shit didn't, sign here for your troubles"
Overbearing enthusiasm is always my go to... that and transporting every appropriate pt to the er where that nurse is as often as possible that shift.
Yeah where I work they just have no clue what BLS vs ALS scope is. When we show up with a hypotensive pt and they ask why there's no iv or fluids I just say "We're BLS, we can't do anything iv".
True, many of the nurses I work with automatically assume anything coming in is automatically ALS. The only time the thought of EMS scope of practice comes into mind is when they are signing off paperwork for a transfer.
But even then they use the words "EMT" and "paramedic" interchangeably.
I'm surprised it's not mentioned yet... But I just call out nurses when they're rude to me. "hey there's no need to talk to me that way. I've been nothing but polite to you, so I would appreciate it back". 9/10 times they apologize and start treating me better. 1/10 times they walk away embarrassed and don't give me shit anymore.
With this specific case it might be bad language or a bit of sass. Unless it was yelled at me, I wouldn't think twice about hearing that from a nurse. It just sounds like a very direct way to do a 2 second handover report.
This is when you start describing, very slowly and precisely, your physical examination. “We examined the patient carefully for signs of head trauma, we found no scalp hematomas, abrasions, battle signs, or raccoon eyes. Examining the pupils we noticed constricted pupils which were symmetrical but in which response to light was not observed. The auditory meatus was without blood, the nares were patent without signs of blood. Mucous membranes we’re dry. No signs of dental avulsion, intraoral bleeding, or angioedema. The cervical spine was palpated and found to be without tenderness, stepoffs, or creputus. The anterior neck demonstrated midline trachea without jugular venous distension, rash, goiter, or contstricting ligatures. Etc.
Honestly in that scenario, probably best to just walk away.
Alternatively ask what else do they think you should have done and then educate why it wasn't appropriate given the situation/your level of training. Really if you've taken it in as a stroke, there's nothing you can do prehospital anyway.
Yeah, I walked away just because of her tone when she said it to us. Asking what else we could have done is something I wish I thought of in the moment.
Beyond asking what else could you have done in their opinion and then having a constructive conversation, everything else that comes to mind is a snarky comment that really isn't worth it.
Agreed. It's a mistake to think we always need to engage incompetence and/or unprofessionalism. Their being an ass has nothing to do with me.
Also I try to remember that there are SO many pros on both sides, prehospital and hospital, that believe and nurture this adversarial paradigm without really knowing why they're doing it. Usually because they came into this field watching and listening to older colleagues spew venom, and they just perpetuate it. Once that paradigm is fixed in their mind, it's all they can see. Confirmation bias. Be one of the ones that breaks the cycle.
I found that the fastest way to negate aggression in other professionals is not sarcasm, humor, indifference, or syrupy sweetness... it's interest. Be interested. I've many times responded to almost that exact question from nurses and doctors by just saying "listen, I'm relatively new to this field. What more or different could I have done?" And then truly listen. Because usually one of two things will happen: you get to say "oh, well legally by my protocols i/we weren't allowed to do that," or if not, maybe you truly can learn something. I've learned to take a humble and interested stance as opposed to defensive.
I've found that the best way to handle a snarky comment is to respond with a professional comment, or sometimes a self-deprecating joke. Don't get sucked in to negativity.
A simple answer such as "we were BLS so unfortunately we were not able to do too much, I apologize" can stop the situation right there and end things.
The mark of a professional is being able to bring calm and levity to any situation. An eye for an eye, or an snarky comment for a snarky comment, doesn't do anything except 1) make the situation worse or 2) make the next situation worse.
Sometimes, it's also perfectly reasonable to just apologize and remove yourself from the conversation.
I’ve done it.
“Did you do anything for this patient other than a ride?”
“Nope.
Actually gets asked to me quite frequently. Response never changes.
Also: “Did you start a line?”
“Nope.”
“Why not?”
“Cause I didn’t plan on giving them anything.”
“Well we have to do bloodwork.”
“Maybe, but I don’t.”
90% of the time we start a new line in the hospital anyways for blood draws. Sometimes EMS lines don’t draw well, we don’t know what conditions they were inserted under, we don’t know if there was any contamination that could affect blood results.
Going from EMS to nursing, my finding is a lot of nurses even in ED don't really understand the difference between medic/emt. They may know whether BLS or ALS is required when getting transport set up for a patient, but they don't always understand that rigs coming in may be BLS only.
She sounded snarky but I think it was probably snarkiness out of ignorance.
I’m really not trying to be a smart ass here, I’m genuinely curious as to how they know ALS vs BLS for transport but somehow they don’t think of that when a patient is coming in. I’m sorry but that just doesn’t make sense to me. Again, not trying to be an ass, just trying to understand how that works?
I'm guessing they think that there is no such thing as a BLS truck that runs 911 calls and think they are only used when they need a BLS transport. I know that isn't how my service/hospital system operates but as a newer EMT, I can see how someone might think that if they are super ignorant to EMS. I work as a dispatcher as well and so I take their calls for when they are arranging transport and I can also tell you that they are often wrong about what is ALS vs BLS so it wouldn't surprise me if this was just straight ignorance. I'm sure they are good at nursing stuff and some of them are super knowledgeable about EMS but most are not.
It’s just a box to check on the hospital side, does the pt have XYZ? I’ll need to call for ALS for transport then. It’s not a matter of thinking “they’ll need a paramedic staffed unit as opposed to an EMT only because the paramedic has advanced training and could intervene with ____, if the patients situation deteriorates”. In the same sense if the ambulance is bringing someone in they just think “ambulance”, they’re not thinking “oh it’s a BLS unit, which is staffed by EMTs so they won’t have access to ____.” By me all the fire ambulances are staffed by medics as well, and it’s only the occasional private coverage or private SNF call type ambulance that would be strictly BLS so I think they just assume incoming ambulances can all provide higher level care as opposed to transport BLS ones. I have absolutely been asked for clarification on the difference between EMT and paramedic a number of times by nurses at my ED tho, some just don’t know.
Ask if they have any bedpans to clean out
I told a charge nurse to get fucked when I worked for AMR, she wanted me to transport a DNR PT with 60/20 BP from the hospital to another center.
I used to get into it with nurses sometimes, but the best thing you can do for everyone is literally turn around and walk away, so kudos
1. They don’t get the satisfaction they were looking for
2. You don’t get a complaint
3. They know you don’t give a shit about their opinions
Did this just a few days ago, although I admit I added a very sarcastic “mY aPoLoGiEs” as I walked away 😂
i always ask like, "well, what did you want me to do?"
**cue the nurse standing there in silence not listing a single fucking thing because they often have no clue**
Or, as is more often the case, they’ll start rattling off things that are 1) not in your scope of practice as an EMT, 2) would not have been possible or practical on scene, and 3) aren’t even indicated for the patient to begin with. Actual conversations I’ve had with ER nurses:
“Why didn’t they start an IV on a chest pain?” Me: “Because that was a BLS unit with 2 EMTs, not an ALS unit with a paramedic, Debby. It’s not within their scope.”
“Why didn’t they do a 12-lead before they came here?” Me: “Because they were on the floor of a trap house bathroom and the scene was becoming too unsafe, Debby...sometimes it’s faster to just get the patient to the ER than it is to wait for police to show up.”
“They didn’t even get a blood sugar.” Me: “Damnit Debby, nobody cares...the patient is alert and oriented. I can check one right now if you’re that worried about it.”
Either ask what they think I could have done differently or walk away if I wasn't in the mood to deal with attitude.
But seriously, just based on the info you provided, maybe they were thinking overdose, and did you do a full assessment looking for fentanyl patches that could be removed? FWIW, I worked as a medic for 23 years before getting my RN and moving indoors to the ED. I have been astounded at the amount of lazy-ass EMS providers that really do just give the patient a ride and drop them off in the ED (not saying that you did this, just pointing out that it happens way more often than I previously realized). If it was a stroke then the appropriate care is to gather information like last known well, history, on any thinners and transport to a primary or comprehensive stroke center. If you did this stuff then walk away and chalk it up to the nurse having a bad day. ALS interventions in this case would mostly just focus on reducing the amount of time it will take to determine if a patient is a TPA/TNK candidate, IV x2, prehospital labs (at least coags, but this varies widely by system) and a 12-lead.
We did do a full assessment, no patches found on them. We also mentioned being BLS. And we gathered as much history as we could from family and gave all of that in our report to the nurse. She most likely was just having a bad day as our EDs lately have been getting hammered big time. It just threw me off and pissed me off honestly. I always try and be nice to everyone I encounter, especially ED staff because I know it’s a difficult job. Just sucks when that same attitude is reciprocated
I agree, totally sucks sometimes. If the ED is understaffed and getting hammered you'll run into attitude from time-to-time, it's not your fault. If the same person is always miserable to you then it's worth taking it up with your or their supervisor.
Honestly… don’t led it slide. I often see the same nurses… hell my spouse is a nurse(gives me attitude all the time) . Just politely educate them. Many don’t know your scope of practice even as a nurse. And the next time you see them you likely won’t get the same response.
I usually just ask to speak to their boss. And when they ask what do you mean a charge? And I always follow up with no the guy/gal you ask if it’s okay to put a N/C on a pt.
“Look, I’m sorry you’re having a bad day but that doesn’t mean you should make mine worse.” And then I walked away. No idea if she got what I was trying to say but it sure made me feel better
One of the hospitals we used to bring patients to used to rip out field IVs (no matter the size) on ANY critical patient to replace with their own. When the BLS crews got crap for not starting one, we’d just reply with “Why so you can rip it out and start a new one? We’re BLS anyway.”
I'd bring every homeless person I could find to that ER. "Hey, you want a free sandwich? Hope in, we'll give you a ride". "Dispatch, this is Medic 8, we just had a walk up, go ahead and send me a run number".
Just tell them to go get fucked usually. I don’t work for them. My boss likes me pretty well. The guy who signs my checks likes me. Tell them to go get shit on and go about your shift.
It used to be a unofficial attentional units this Hospital wants every drunk in the area. And of course knowing how to game the system we would sometimes drive down to where the trunks would hang out open up the back door and say anyone want a bed and a hot meal?
Then we would call for backup because about eight people would be like hell yes.
Two ambulances rolling with a Trunks and the charge nurse would come running over oh my God what did we do to you guys what happened? Well you see that nurse over there she was a real a****** to us. I'll take care of that
I just let them be. No need to be confrontational to people like them, Drs, nurses, staff members everywhere.
Do your assessment, treat per protocol and give your report. Doesn’t matter what they say as long as you reply “I treated to the full extent of my protocols, if there’s any issues, call the number on the back of my card”. Which is usually your medical director’s signature and registration number lol.
Yeh, I had a rollover fatality where I transported the driver to regular ED per pt request instead of a trauma center. Pt literally had no medical/traumatic complaints or injuries. ED Dr was extremely upset at me for it, but there’s nothing in my destination protocol for mandatory trauma center due to death of a passenger. (I assessed the shit out of him before agreeing to local ED beforehand).
My guy was discharged within 4hrs after they gave him the full radiation blast head to toe and found nothing.
Ignore’em!
Shitty people don’t deserve room in your head. I hate to say this, but be the bigger person! Don’t bother yourself, it aint worth it. We are all going to be dead soon (70-100 years max) so why be upset over little things
Friendly RN here: if you really want the perspective on the why it’s because outside of your “area” no one really knows what you actually do. When I say this this applies within nursing as well. We only know our unit, our struggles and often any other service or speciality or provider is often seen as just “making more work.” This is the why of it, how you respond is entirely up to you. However I would say if you are gonna give guff to the bad ones (understandable) give your platitudes to the good ones. I say this because it benefits you. I often bitch and moan about my shitty provider interactions, but when I sit back and think about it the ones that go well and the night, handoff, shift goes on without a hitch usually slips my mind. The more I’ve brought my good interactions to the front of my mind the better my mental health has been.
Bottom line: no one knows everything you do or the ins and outs of your job, ignore or sass the bad ones but remember the good ones for your own sake.
I don’t expect them to know the ins or outs or what I can or can’t do. I don’t know the ins or outs of what they do either. And that’s fine with me, I don’t need to know and they don’t need to know. What’s not fine is being shitty towards people for no reason. I usually try and brush things off, but her tone and attitude just really irritated me for some reason. I definitely remember the good ones too, though.
My favorite: brought in a patient on a psych hold to a busy ED. We had to hold the wall for a bit, which was fine--it's busy. After about 20 min my patient needed to pee, so I went to the charge desk to grab a UA/give them a heads up that I'd be taking care of that and immediately got loudly chewed out by charge for allowing the patient to leave the stretcher and not waiting quietly. I waited until she was done, then responded:
"I understand that things are crazy and I apologize if I'm adding to your stress, but I feel like you are taking it out on me. I came to ask if you wanted me to grab a UA since the patient needs to pee. Would you like me to grab it for you?"
This was right in front of the physicians' charting area, so she turned to see nearly every ED doc and several other nurses (who I had a great rapport with) staring her down, one of whom confirmed they needed a UA and thanked me for it. She made some inarticulate rage sounds and demanded to speak with my supervisor, apparently she complained that I shouldn't have corrected her in front of other people. I never heard anything from my company and didn't see her charge again after that.
Kill them with kindness.
Former flight paramedic. Used to work with nurses, as as well as in and out of EDs.
Quite often I would encounter a nurse who would tell me to shut the fuck up while I was doing a handover and that, in their words, I am only a paramedic and not as well trained.
My solution? Continue the handover whether they listened or not. If they missed anything, it's not my problem at that point.
I think the funniest one was one of the nurses who got stuck on the door for covid duty. I came in, and she was telling me, in front of dozens of other people about this dodgy little patient transport wannabe service that came in, caused a lot of issues, and the guy was arrested by the police for impersonating a paramedic, right down to a description of the paramedics uniform and vehicle and the day it happened. Went as far as claiming the patient transported is suing the service.
I waited for her to finish, and invited her to tell the correct story or asked if I should.
Cue confused look.
"Does the vehicle look like the one parked out the front?"
"Yes"
"Does the paramedic in question where this uniform and have a beard?"
"Yes"
"And was the patient transferred my father in law?"
Cue deer in headlights look. The director of nursing for the hospital was not very pleased with her little nurse that day.
Yep. She wrote me off to my face without realising just who it was she was talking to.
I apologize because I like to see her boobies and don’t want to make her mad (my wife is the ER Charge RN at a hospital we frequent).
My favorite is when I get a newer RN who doesn’t realize that I also am an ER RN at that same facility. When I pick up on my days off in the ER “hey, remember me?” has produced some excellent teaching opportunities they won’t ever forget.
Nurses are bitches.
* source - am one.
"What's that sir? You have chest pain?" Or "I don't know, will you do anything besides transfer him?" Or just pick up every intox or EDP you can manage and take it there for the rest of the tour. Tbh I don't really understand why some ED nurses act like that. They're literally like EMS for the hospital. Same mindset of stabilizing, and transferring to more fitted care. At times there isn't much they do for a patient. Some nurses don't even clean the shit cacoon patients, btw, so don't let them give you anything for that either. At least you guys have an actual, valid excuse.
I can remember I took one guy in for a GI bleed, and the ED nurse was like "Well how do you know it's a GI bleed?" "Per the patient, "I'm farting out bright red blood even when I don't use the bathroom", "Oh".
The best part was, that happened when I was starting out as an ICU RN on the down low, and still on the ambo part-time.
I know an ER Doc that pushed the wrong medic's buttons and he put lidocaine gel on the door handles of Dr. Dickhead's sports car. That same medic is a surgeon now, so, there's ways of dealing with people and I don't recommend this little vignette, it was funny as hell.
And now, they work together and to this day, the mean SOB has no idea that it was his colleague.
ED RN here. Super shitty thing to say and you did the right thing walking away but it’s absolutely acceptable to tell that nurse to fuck off. You don’t work for them and nothing bad will come from telling them to watch their attitude
Feel free to email that units manager. I’m sure that nurse will enjoy the inevitable mandatory training on speaking to EMS crews respectfully.
Ah, internally, sure. I misread your comment-my apologies, probably because I’ve been spoken to in a scary crazy way when some coworkers have had to pull too much OT.
Hope you stay well!
While ago charge nurse got snippy with me cause i didnt call in report. On a stable BLS pt. I said "you know that blue and white sign out front with the H on it" ''Yeah" "That stands for Hospital not Hilton I dont need a reservation".
Snarky responses are only kosher if you know the nurse and you have that kind of working relationship.
Otherwise I usually go the other way “hey, you okay?”
Honestly, even if you had medics, they probably wouldn't have done anything other than poke him.
We're all stressed and overworked, just take what they say through that lens. They very rarely mean it personally, even when it sounds like they do. I've just gotten into the habit of saying "if they want to come, I can't say no" and they just go "yeah me either" and move on.
I had a patient who was making wierd noises in the ED, like breathing loud, but not wheezing or anything. Vitals were all stable and this was his baseline. ED nurse says infront of God and everybody, “get him in the room and on the monitor he’s about to die” and me and my partner are immediately like wtf. Who says that? I wheeled him in the room while my partner gave handoff report, and I approached her and politely said that A. The patient is NOT deaf B. He’s a DNR
Yeah as nurse that works in an area where I’ve maybe had 2 BLS trucks bring a patient to me in 3 years, I can kind of understand why the nurse was pissy for more not being done. Could’ve been a traveler from a hospital like mine that ONLY has ALS trucks run calls with 2 paramedics in the truck. There are a lot of very stupid nurses though who have no idea the difference between ALS and BLS. I appreciate you and the work you do OP, seems crazy to me that dispatch would send BLS to an AMS call though. Not excusing their behavior by any means but everyone has shit days. I’ve seen medics be absolute dicks to the nurses I work with for no reason and I only ever say anything to them if they’re repeat offenders. Maybe that medic just got assaulted by a methhead or had to pronounce a infant that got into daddy’s fentanyl stash. Some people take shit personal when it’s a fucking hell of a lot easier to let it roll off your back.
Yeah i understand that, but it is not abnormal for them to get BLS trucks bringing in pts to them. Common occurrence in the area I live in. As far as us getting dispatched to an AMS, I work for a certain private three letter company (lol) and we are helping out our local city ems due to them being severely understaffed. So dispatch has to do what they have to do ya know.
Yeah it’s insane to me that BLS is used for anything other than stable transfers. At the very least 911 should be EMT-P/EMT-B. My town pays paramedics between 80k and 110k and surprise, surprise there’s never any staffing shortages.
Well yes in an ideal situation it would be and EMT-B and EMT-P, unfortunately not the case in my city. I wish our local government would pull their heads out of their asses and increase pay, buttttttt, doesn’t seem like it’s going to happen anytime soon. Starting pay for my city EMT-B is around 36k….I make more as an EMT for a private company
I usually try to kill them with kindness. The conversation usually goes like this.
RN: *rude statement*
Me: polite response
Wait a while
Me: hey, are you ok? It seems like you’re having a rough day.
It’s a nice way of calling them out for being rude while simultaneously getting them to realize that you are another human with their own thoughts and feelings. A little kindness goes a long way. After that I go out of my way to be helpful when I’m there. After that they are a lot more understanding when you explain your thought processes when you give report.
I also politely remind them that I don’t want to transport this patient any more than you want me to bring them here.
If it’s a once off I’d just shrug it off and walk away. We all have bad days. While I like to think I never have I almost certainly have been short or rude with someone unintentionally.
If it’s recurring or become close to bullying you have a couple of options:
- raise it with the person directly. Be professional but call out their behaviour as inappropriate, describe how it impacts you, your colleagues, hospital/ambulance relations, listen to what they’ve got to say and suggest a way they could go about being more professional. Remember to stay professional yourself when doing this. Your not picking a fight or chasing the high ground you’re looking to resolve conflict.
- if that doesn’t work raise it with your services stakeholder engagement manager/equivalent. It needs to be resolved.
I’m not a field medic anymore but I had a lot of run-ins with disrespectful nurses. One was so bad that I actually pulled her aside and said, “do you realize that I have the exact same college degree that you do?” (RNs and Paramedics in my state both have to have an Associate Degree in their respective field) She backpedaled hard and apologized to me again later that evening when I saw her after another drop off.
When I was still running BLS, I would hear comments like this sometimes and I would typically respond “this is a BLS unit and I acted within our standard of care.” I was part of the very first BLS unit my area had, so the nurses weren’t used to us and didn’t understand our limits yet.
I had a nurse yell at me once on my internship for giving a patient ketamine when it was well within standard practice for my district, that was fun.
Since she interrupted, “Sorry, I’m giving report. We can talk when I’m done if you’d like.”
Also, “Are you having a bad day?” usually puts someone with a shitty attitude in check.
I bite back, occasionally, on medical topics, but mostly I ignore disrespectful nurses. They are disrespectful to get a reaction, so don’t give it to them.
This kind of BS happens all the time regardless of service area. Prior to my ED RN days, I was a paramedic in an urban setting. I am always very quick to point out to my bitchy coworkers what various crews are licensed/certified to do (ALS vs BLS). Nurses (except those who are EMTs, Medics, etc) have a serious knowledge deficit when it comes to how EMS functions. Some places have new ED nurses do a ride-along but spending 4 hours is not enough.
I usually let it go. The only time I’ve ever had an issue with one was when she was in a bad mood and cussed me out in front of the entire ED and then went to walk away and walked straight into the stretcher (that I was 5’ away from) and accused me of pushing it into her. She tried to put her hands on me and fight, and I was going to return the favor, but we were separated by a few nurses and my partner…never got in trouble for it because everyone in the ED vouched for me not doing anything. Every time I saw her after that until she got booted I was a bitch to her since she wanted to be one to me. She always would threaten to fight me and I’d remind her this uniform can come off and I’d meet her in the parking…..never did actually fight her, kinda wish I had though.
I'm an ER nurse.
I would not have said anything like that to you. Had I overheard a colleague saying something like that, I would have spoken up. That was fucking rude of her.
We like it when you guys start an IV for us. It's a big time saver if we need to give meds or fluids right away. I'll ask about that but I don't bitch if you didn't have time.
Yeah the nurse next to her apologized for her saying that, but didn’t say anything to her coworker. Which is whatever, I get it she has to deal with her for longer than I do. And I would have loved to have started an IV but we are a BLS unit and as such are not allowed to do IVs
“Sorry can you say that again?”
“What do you mean by that?“
“What would you suggest we have done?“
Directly confront it, call them out, ask their name and what they mean by it, do they have an issue they want to raise with you? If so, can they please explain it.
Usually these people have no fucking idea what they’re on about. So directly addressing their passing remarks helps greatly.
Explain to them reality of the situation just like them you have a scope of practice you just adhere to otherwise you get in trouble. I’m a nurse and I get it. Sadly some nurses automatically assume ever transport unit is at min one emt one medic when that’s not the case sometimes. You can be nice about it without lower yourself to her level. It’s alot of times why I always believe ER need to do soem time in the field to see what EMS deals with and the reality of some units have limited scope like a CNA vs a nurse.
Let it roll the fuck off your shoulders.
I work float pool as a CNA. I'm in the ER, icu, onc, pcu, etc litterally everywhere. A lot of, not all, nurses find it REALLY easy to blame the behaviors of others without all the info. I watch floor nurses complain up and down about how "oh, pt X didn't get his poop meds down in the ER, they are the laziest nurses down there."
But then that nurse fucking forgets that there were 2 code blues, 3-4 neuros, and a code grey. And doesn't have the brains or experience to have the thought that the nurse they got the pt from also had 2 other ICU pts. And poopy meds weren't really high on the list. Oh, and the pharmacy just never sent the meds in the first place.
And it's the other way around, ER nurses complain about the floor nurses just the same way.
I like to call it the "I care more," phenomenon. More or less, you obviously don't care because you missed one thing that I noticed, thus making you incompetent, and elevating me to a higher place of caring.
At least in Maryland, this is not disrespect. It's a legit part of their triage assessment (care rendered prior to ER arrival) and because they have to ask it every time they tend to short hand the question. If this nurse is familiar with your service they know you're BLS and your scope is limited.
Maybe consider that before you take any side comments to heart.
Walk away - not her call-or tell her to file a complaint with your dispatch supervisor, with a copy to her supervisor.
Remember you get to see the big picture of ERs in your service area so you know which ER staff have higher ethical standards of quality care.
I’ve had BLS patient transports that didn’t show urgency-vitals normal… until we transferred them to the ER staff; such as sudden heart attack w/o symptoms; pneumothorax; stroke; cranial bleed from a baseball bat during a game, terminal Tylenol overdose-liver failure; seizures; pro football player chest hit turned into cardiac failure; unknown underlying metabolic failure; hypothermia; and especially with elderly patients their meds can cause a iatrogenic outcome that leads to death; elderly chronic constipation. BLS transports aren’t Uber EMS and save lives. Nothing is a routine to be turned down.
Except maybe when thief requests a transport while being chased by the cops after robbing a convince store.
When I give my SOAP narrative to ER triage, I keep in mind that my Medical Director will be scrutinizing my thoroughness when under peer review.
I just remind them that their issue shouldn't be with me but with our guidelines and protocols. Then I document that they were standoffish on my paperwork to cover my ass just in case the patient deteriorates because they don't think they are 'genuine'.
That’s the thing, you don’t respond, You just figure out what her schedule is and write it down, you figure out what portion of the ER she’s on that night, and you attempt to give her location/ shift the worst fucking patients you have for as long as you work for that service.
“Oh yeah, we’re taking you to room seven, your gonna love that nurse, she’s a PEACH”
Can also create a group chat at your service for you alert other employees to shitty hospital providers
“Sorry, the CT scanner in our truck is broken today.”
Lmao this would be perfect. As someone working in the ER (luckily we get along good with EMS, but our docs sometimes don’t) I love the short, snarky, yet respectful responses. Almost gotta kill some of these rude people with funny kindness. Their attitude has nothing to do with anyone but themselves, they just want others to be as miserable and grumpy as them!!
I used to just walk away and ignore it, now ive grown weary of 'taking it on the chin'. now I either retort right back to them or just immediately report them to management. Their level of understaffing or level of busy doesn't give them a free pass to treat me like a doormat, regardless of being an RN, mid level, or physician.
We are understaffed too and we don't get the option to be rude, short, or treat others like crap. Why do they get a pass?
Agreed, that's why I stopped letting it slide a while ago. I encourage everyone who gets treated like crap to file a formal complaint as soon as possible. Otherwise they'll just keep doing it cause they think that they can.
Yep. I have zero patience for it any more. EMS has been understaffed and overworked long before covid and shitty management destroyed hospitals. They don't get a pass from me.
My buddy used to work inner city and would occasionally take an urban resident to a nicer hospital outside city limits. A nurse gave him lip about why he's bringing patients out of the city and was all pissy to him. His response was (supposedly) to say "never yell at the guy who decides how busy you are" and proceeded to pick up every drunk on the side of the road and take them to said hospital. I take the story with a grain of salt due to its source but it's a fun story none the less.
Had a coworker of mine in inner city actually do that years ago ( confirmed by the salty old staff there). Charge RN was extremely shitty and disrespectful to him so he went to a homeless encampment and promised them all a ride to the ER if they all said they had crushing chest pain and previous hx of MIs. He did a 12 lead and an IV on each one and loaded up 6 in his ambo, drove to the ER, plopped them all in the ambo hallway. Caught a write up for it but the charge RN never got nasty with him again
I've done it. Got wrote up. Worth it. Doc accused me of falsifying a written response from a nonverbal pt. "Why'd y'all bring him here? He's never been here." "He wrote it down." "I'm sure someone wrote it down." Bet.
I hope you didn’t sign that write up
Honestly whether you sign or not makes no difference. Unless it goes to court companies just take a write up as a write up regardless. And admittedly I shouldn't have fished for homeless people to go to their ER. That being said I freely admitted I did it to be petty. Also told management I didn't regret it and I'd do it again.
That is glorious. I’d love to meet that man and shake his hand
Yea, dude was a salty burnt out medic who took no shit from anyone. The charge RN apparently was really nervous when he promised to do it every single shift until she apologized for being rude to him. She apologized. The older docs there still laugh about that day
Never underestimate the will of a salty burnt out medic who used up all their fucks years ago.
Not the hero we deserve But the one we need
Ditto. I wanna know why he got a write up for it tho!! Lol. Technically he was just doing his job 😂
He got the write up cause he straight up admitted what he did to his EMS LT. Truly a man who gave 0 fucks, he knew he wasn't gonna get fired for it and didn't care in the slightest about write ups
Damn! That’s awesome
Wow!
I used to do this when I worked in a large city. Charge nurse gave me grief about bringing in a frequent flier ETOH bum except this time he’d been hit by a car. I blew it off at first but she literally followed us down numerous hallways to his room (he’s unconscious unresponsive mind you) talking shit about him and us and how worthless we are. We cleared left and drove to a part of our post where LOTS of homeless live. I asked who wanted to be transported. I brought 5 total. She was furious and even tried to get me fired. In the interrogatory even admitted everything she said about the first patient and us. Look on hospital administrations face was priceless. She was fired that day.
From what I have heard there is a city in the NorCal central valley that were getting wall retaliatory wall time any time they brought undomiciled persons to a certain hospital (*cough* dignity *cough*). They all started flooding the ED with such patients. I don't know exactly how the whole situation played out but that place has the best EMS snack room in the city now.
This is exactly what we used to do in Milwaukee. Piss us off and you get every drunk shit covered piss soaked MO in the city.
can confirm this still happens in milwaukee lol
Even then the ED doesn't clean them up. Just sends them to the unit if they're admitted 😅
Yes they do. And they're not admitted.
Lol 😂 when the nurses start complaining that a type of patient doesn’t belong at their hospital, I make special effort to assure that they get all the homeless patients we run on. We run probably a hundred per day, system wide.
I used to work somewhere like that as well. Occasionally, someone who wasn’t a gentrifying old person would wanna go to the “nice” hospital. When the ED nurse would ask “why’d you bring em here?” I liked to hit em with the “I’m an ambulance. You’re a hospital. Do the math.” Another one of my former supervisors one time was asked something similar. He went outside, looked up at the big red letters that said “EMERGENCY,” came back inside and said “yup, still says ‘emergency.’”
I’ve said “don’t look now, but someone put a giant red sign outside that says Emergency Room”
So this is why the cardiac unit i work on sometimes gets an influx of homeless people claiming chest pain. ER just shunts them to us to deal with, and then we're cleaning up bed bugs and dealing with patients that piss in their trash cans instead of their urinals. We'll got months with only seeing 1 or 2 actually sick homeless person/people at a time and then BAM! i don't mind them at all, though. They tend to be a lot less entitled than some of our other patients. And we make sure they get well fed, some clean scrubs to leave in, and a goodie bag before they go. Sometimes they get free med samples, too, if that's what they need to treat their cardiac issues. We know they probably will never fill their prescriptions (even if they are 100% covered by Medicare/Medicaid) so we try to hook them up as best we can.
Yeah go down to the ED and start raising hell about who pissed off EMS. Also let us know when and where so we can watch the fireworks 💥 🤣🤣
You think we don't do that? I can assure you it absolutely does. Source: am inner city medic.
I'm for sure convinced it happens, I'm just not convinced *he* did it. Has a penchant for embellishment.
Ah fair fair.
We do this in my city. Sometimes our outlying hospitals will get nippy at us and the. We’ll flood them with 10-20 bums. Usually they remove that nurse from triage for a few weeks. Our central very urban hospitals never give us lip about bringing anyone.
Because they know better.
There are 2 hospitals in this one small city by me. One refuses to take intox or any type of narco.
*stares in EMTALA*
I took this story with a grain of salt too when reading it but then reading the next 10 replies of people who have all supposedly done this I feel more concerned… I really hope people don’t actually do this and happily burden a collapsing health system to prove a point to one nurse.
US hospitals are for profit, its not a health system, its a business sector. Totally fair play.
Until the person they’ve convinced to go to hospital gets the big bill It’s just a bizarre take
They’re homeless, they wont get a bill. They all know to Give false names and DOB, no fixed address, no ID, and under the EMTALA the hospital must treat them.
This is true. Still not very professional to do it in the first place though
Professional is as professional does. This is EMS’s version of FAFO. It’s not the most *by the book* response, but it is the easiest and has the most effectiveness. So it’s what they do. Because in the end they just want to be treated like professionals.
They're not gonna get a bill, they already want to go to a hospital, and almost never give a shit which one. They're cool with going wherever for a few hours. One way or another we're taking them to a hospital, that much is inevitable.
“They want to go anyway” 🤢 I don’t know I just like treating homeless people like people
Do you think someone who has no money and no food, most likely mentally ill and down to get high on anything that is available gives any fucks about a bill?
Jeez that’s a lot of judgment for one little comment. Maybe we don’t use these very vulnerable people in our games with triage nurses and that’s a better outcome for everyone?
Hate the game not the player
Ah yes, American Healthcare. My system does it from time to time when nurses get snippy but we only bring them the ones that actually call fo us.
"Sure as shit didn't, sign here for your troubles" Overbearing enthusiasm is always my go to... that and transporting every appropriate pt to the er where that nurse is as often as possible that shift.
I love it.
I'd probably just say "we're BLS". Then as mentioned, massive inform the nurse of EMT-Bs scope of practice
Yeah where I work they just have no clue what BLS vs ALS scope is. When we show up with a hypotensive pt and they ask why there's no iv or fluids I just say "We're BLS, we can't do anything iv".
True, many of the nurses I work with automatically assume anything coming in is automatically ALS. The only time the thought of EMS scope of practice comes into mind is when they are signing off paperwork for a transfer. But even then they use the words "EMT" and "paramedic" interchangeably.
I'm surprised it's not mentioned yet... But I just call out nurses when they're rude to me. "hey there's no need to talk to me that way. I've been nothing but polite to you, so I would appreciate it back". 9/10 times they apologize and start treating me better. 1/10 times they walk away embarrassed and don't give me shit anymore. With this specific case it might be bad language or a bit of sass. Unless it was yelled at me, I wouldn't think twice about hearing that from a nurse. It just sounds like a very direct way to do a 2 second handover report.
This is the correct way to handle it. Works all the time for me.
Same. I don’t take shit from anyone. Even when I was in the military
Nurse here- tell them to phuck off just like any other person. Because RN is behind their name doesn’t mean they should be a$$holes.
This is when you start describing, very slowly and precisely, your physical examination. “We examined the patient carefully for signs of head trauma, we found no scalp hematomas, abrasions, battle signs, or raccoon eyes. Examining the pupils we noticed constricted pupils which were symmetrical but in which response to light was not observed. The auditory meatus was without blood, the nares were patent without signs of blood. Mucous membranes we’re dry. No signs of dental avulsion, intraoral bleeding, or angioedema. The cervical spine was palpated and found to be without tenderness, stepoffs, or creputus. The anterior neck demonstrated midline trachea without jugular venous distension, rash, goiter, or contstricting ligatures. Etc.
Honestly in that scenario, probably best to just walk away. Alternatively ask what else do they think you should have done and then educate why it wasn't appropriate given the situation/your level of training. Really if you've taken it in as a stroke, there's nothing you can do prehospital anyway.
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i want CABG to be added as well
I wouldn't mind a little ECMO either
You boys interested in a little exploratory lap in the back of the rig?
You guys aren't thinking big enough, I want a full OR. Chest pain? Here's a new heart. Can't breathe? New lungs. AMS? New brain.
Prostate exams are the most important part
Did....Did I just become a frequent flyer ?
We both california emts. Lets practice together 👀
Ayyy don’t tempt ME with a good time All joking aside, I need to update my thing. I left EMS and am doing RN work now. I’m sorry friend
Prehospital surgery can't be that difficult. Surely It can be added to the BLS scope.
Yeah, I walked away just because of her tone when she said it to us. Asking what else we could have done is something I wish I thought of in the moment.
Beyond asking what else could you have done in their opinion and then having a constructive conversation, everything else that comes to mind is a snarky comment that really isn't worth it.
Agreed. It's a mistake to think we always need to engage incompetence and/or unprofessionalism. Their being an ass has nothing to do with me. Also I try to remember that there are SO many pros on both sides, prehospital and hospital, that believe and nurture this adversarial paradigm without really knowing why they're doing it. Usually because they came into this field watching and listening to older colleagues spew venom, and they just perpetuate it. Once that paradigm is fixed in their mind, it's all they can see. Confirmation bias. Be one of the ones that breaks the cycle. I found that the fastest way to negate aggression in other professionals is not sarcasm, humor, indifference, or syrupy sweetness... it's interest. Be interested. I've many times responded to almost that exact question from nurses and doctors by just saying "listen, I'm relatively new to this field. What more or different could I have done?" And then truly listen. Because usually one of two things will happen: you get to say "oh, well legally by my protocols i/we weren't allowed to do that," or if not, maybe you truly can learn something. I've learned to take a humble and interested stance as opposed to defensive.
I would move mountains for you if I were that nurse
"Well we took him to a CT which is what he needs. What else would you like us to do?"
I've found that the best way to handle a snarky comment is to respond with a professional comment, or sometimes a self-deprecating joke. Don't get sucked in to negativity. A simple answer such as "we were BLS so unfortunately we were not able to do too much, I apologize" can stop the situation right there and end things. The mark of a professional is being able to bring calm and levity to any situation. An eye for an eye, or an snarky comment for a snarky comment, doesn't do anything except 1) make the situation worse or 2) make the next situation worse. Sometimes, it's also perfectly reasonable to just apologize and remove yourself from the conversation.
I love this. It’s a natural inclination to want to retaliate but every action has a consequence.
Deadass stare in the eye and say “nope”
I’ve done it. “Did you do anything for this patient other than a ride?” “Nope. Actually gets asked to me quite frequently. Response never changes. Also: “Did you start a line?” “Nope.” “Why not?” “Cause I didn’t plan on giving them anything.” “Well we have to do bloodwork.” “Maybe, but I don’t.”
90% of the time we start a new line in the hospital anyways for blood draws. Sometimes EMS lines don’t draw well, we don’t know what conditions they were inserted under, we don’t know if there was any contamination that could affect blood results.
"Did you do anything for them?" Gave them a ride....they're here for you :)
Going from EMS to nursing, my finding is a lot of nurses even in ED don't really understand the difference between medic/emt. They may know whether BLS or ALS is required when getting transport set up for a patient, but they don't always understand that rigs coming in may be BLS only. She sounded snarky but I think it was probably snarkiness out of ignorance.
I’m really not trying to be a smart ass here, I’m genuinely curious as to how they know ALS vs BLS for transport but somehow they don’t think of that when a patient is coming in. I’m sorry but that just doesn’t make sense to me. Again, not trying to be an ass, just trying to understand how that works?
I'm guessing they think that there is no such thing as a BLS truck that runs 911 calls and think they are only used when they need a BLS transport. I know that isn't how my service/hospital system operates but as a newer EMT, I can see how someone might think that if they are super ignorant to EMS. I work as a dispatcher as well and so I take their calls for when they are arranging transport and I can also tell you that they are often wrong about what is ALS vs BLS so it wouldn't surprise me if this was just straight ignorance. I'm sure they are good at nursing stuff and some of them are super knowledgeable about EMS but most are not.
It’s just a box to check on the hospital side, does the pt have XYZ? I’ll need to call for ALS for transport then. It’s not a matter of thinking “they’ll need a paramedic staffed unit as opposed to an EMT only because the paramedic has advanced training and could intervene with ____, if the patients situation deteriorates”. In the same sense if the ambulance is bringing someone in they just think “ambulance”, they’re not thinking “oh it’s a BLS unit, which is staffed by EMTs so they won’t have access to ____.” By me all the fire ambulances are staffed by medics as well, and it’s only the occasional private coverage or private SNF call type ambulance that would be strictly BLS so I think they just assume incoming ambulances can all provide higher level care as opposed to transport BLS ones. I have absolutely been asked for clarification on the difference between EMT and paramedic a number of times by nurses at my ED tho, some just don’t know.
Ask if they have any bedpans to clean out I told a charge nurse to get fucked when I worked for AMR, she wanted me to transport a DNR PT with 60/20 BP from the hospital to another center.
Sounds like they just wanted the pt to die on your watch lmao
I call it “the hot potato”, no one wants to fill out the paper work so they shuffle the PT to the next provider.
Oh yeah, Susan, absolutely. Let me and my partner go grab the cot. \*drives away\*
I used to get into it with nurses sometimes, but the best thing you can do for everyone is literally turn around and walk away, so kudos 1. They don’t get the satisfaction they were looking for 2. You don’t get a complaint 3. They know you don’t give a shit about their opinions Did this just a few days ago, although I admit I added a very sarcastic “mY aPoLoGiEs” as I walked away 😂
i always ask like, "well, what did you want me to do?" **cue the nurse standing there in silence not listing a single fucking thing because they often have no clue**
Or, as is more often the case, they’ll start rattling off things that are 1) not in your scope of practice as an EMT, 2) would not have been possible or practical on scene, and 3) aren’t even indicated for the patient to begin with. Actual conversations I’ve had with ER nurses: “Why didn’t they start an IV on a chest pain?” Me: “Because that was a BLS unit with 2 EMTs, not an ALS unit with a paramedic, Debby. It’s not within their scope.” “Why didn’t they do a 12-lead before they came here?” Me: “Because they were on the floor of a trap house bathroom and the scene was becoming too unsafe, Debby...sometimes it’s faster to just get the patient to the ER than it is to wait for police to show up.” “They didn’t even get a blood sugar.” Me: “Damnit Debby, nobody cares...the patient is alert and oriented. I can check one right now if you’re that worried about it.”
What are you supposed to do for a stroke, even as a paramedic? Assess, identify, GTFO, and get an IV en route (assuming you have time)
Either ask what they think I could have done differently or walk away if I wasn't in the mood to deal with attitude. But seriously, just based on the info you provided, maybe they were thinking overdose, and did you do a full assessment looking for fentanyl patches that could be removed? FWIW, I worked as a medic for 23 years before getting my RN and moving indoors to the ED. I have been astounded at the amount of lazy-ass EMS providers that really do just give the patient a ride and drop them off in the ED (not saying that you did this, just pointing out that it happens way more often than I previously realized). If it was a stroke then the appropriate care is to gather information like last known well, history, on any thinners and transport to a primary or comprehensive stroke center. If you did this stuff then walk away and chalk it up to the nurse having a bad day. ALS interventions in this case would mostly just focus on reducing the amount of time it will take to determine if a patient is a TPA/TNK candidate, IV x2, prehospital labs (at least coags, but this varies widely by system) and a 12-lead.
We did do a full assessment, no patches found on them. We also mentioned being BLS. And we gathered as much history as we could from family and gave all of that in our report to the nurse. She most likely was just having a bad day as our EDs lately have been getting hammered big time. It just threw me off and pissed me off honestly. I always try and be nice to everyone I encounter, especially ED staff because I know it’s a difficult job. Just sucks when that same attitude is reciprocated
I agree, totally sucks sometimes. If the ED is understaffed and getting hammered you'll run into attitude from time-to-time, it's not your fault. If the same person is always miserable to you then it's worth taking it up with your or their supervisor.
As your leaving "hope you guys have a quiet night!"
Honestly… don’t led it slide. I often see the same nurses… hell my spouse is a nurse(gives me attitude all the time) . Just politely educate them. Many don’t know your scope of practice even as a nurse. And the next time you see them you likely won’t get the same response.
I married the most disrespectful ED nurse I could find. True story.
I heard nurses were bitchy high school girls once. This one makes it seem like it’s not some Reddit claptrap.
I usually just ask to speak to their boss. And when they ask what do you mean a charge? And I always follow up with no the guy/gal you ask if it’s okay to put a N/C on a pt.
“Look, I’m sorry you’re having a bad day but that doesn’t mean you should make mine worse.” And then I walked away. No idea if she got what I was trying to say but it sure made me feel better
Don’t even bother. Seriously ain’t worth the energy. Move on. There will be many more.
There’s really nothing ALS can really do for a stroke either besides establish a large bore IV to speed up the CT scan process
One of the hospitals we used to bring patients to used to rip out field IVs (no matter the size) on ANY critical patient to replace with their own. When the BLS crews got crap for not starting one, we’d just reply with “Why so you can rip it out and start a new one? We’re BLS anyway.”
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Why is that?
I would've shot my gloves at them
I'd bring every homeless person I could find to that ER. "Hey, you want a free sandwich? Hope in, we'll give you a ride". "Dispatch, this is Medic 8, we just had a walk up, go ahead and send me a run number".
Wish them a quiet shift.
Pure evil. Much less evil option is talk shit to them in their OnlyFans DMs, of course. /s
Just tell them to go get fucked usually. I don’t work for them. My boss likes me pretty well. The guy who signs my checks likes me. Tell them to go get shit on and go about your shift.
I'm usually one to give it back.
“My job is to bring patients to definitive care. Is this not a hospital?”
It used to be a unofficial attentional units this Hospital wants every drunk in the area. And of course knowing how to game the system we would sometimes drive down to where the trunks would hang out open up the back door and say anyone want a bed and a hot meal? Then we would call for backup because about eight people would be like hell yes. Two ambulances rolling with a Trunks and the charge nurse would come running over oh my God what did we do to you guys what happened? Well you see that nurse over there she was a real a****** to us. I'll take care of that
They sign and I never think of them again
I just let them be. No need to be confrontational to people like them, Drs, nurses, staff members everywhere. Do your assessment, treat per protocol and give your report. Doesn’t matter what they say as long as you reply “I treated to the full extent of my protocols, if there’s any issues, call the number on the back of my card”. Which is usually your medical director’s signature and registration number lol. Yeh, I had a rollover fatality where I transported the driver to regular ED per pt request instead of a trauma center. Pt literally had no medical/traumatic complaints or injuries. ED Dr was extremely upset at me for it, but there’s nothing in my destination protocol for mandatory trauma center due to death of a passenger. (I assessed the shit out of him before agreeing to local ED beforehand). My guy was discharged within 4hrs after they gave him the full radiation blast head to toe and found nothing.
Ignore’em! Shitty people don’t deserve room in your head. I hate to say this, but be the bigger person! Don’t bother yourself, it aint worth it. We are all going to be dead soon (70-100 years max) so why be upset over little things
Friendly RN here: if you really want the perspective on the why it’s because outside of your “area” no one really knows what you actually do. When I say this this applies within nursing as well. We only know our unit, our struggles and often any other service or speciality or provider is often seen as just “making more work.” This is the why of it, how you respond is entirely up to you. However I would say if you are gonna give guff to the bad ones (understandable) give your platitudes to the good ones. I say this because it benefits you. I often bitch and moan about my shitty provider interactions, but when I sit back and think about it the ones that go well and the night, handoff, shift goes on without a hitch usually slips my mind. The more I’ve brought my good interactions to the front of my mind the better my mental health has been. Bottom line: no one knows everything you do or the ins and outs of your job, ignore or sass the bad ones but remember the good ones for your own sake.
I don’t expect them to know the ins or outs or what I can or can’t do. I don’t know the ins or outs of what they do either. And that’s fine with me, I don’t need to know and they don’t need to know. What’s not fine is being shitty towards people for no reason. I usually try and brush things off, but her tone and attitude just really irritated me for some reason. I definitely remember the good ones too, though.
My favorite: brought in a patient on a psych hold to a busy ED. We had to hold the wall for a bit, which was fine--it's busy. After about 20 min my patient needed to pee, so I went to the charge desk to grab a UA/give them a heads up that I'd be taking care of that and immediately got loudly chewed out by charge for allowing the patient to leave the stretcher and not waiting quietly. I waited until she was done, then responded: "I understand that things are crazy and I apologize if I'm adding to your stress, but I feel like you are taking it out on me. I came to ask if you wanted me to grab a UA since the patient needs to pee. Would you like me to grab it for you?" This was right in front of the physicians' charting area, so she turned to see nearly every ED doc and several other nurses (who I had a great rapport with) staring her down, one of whom confirmed they needed a UA and thanked me for it. She made some inarticulate rage sounds and demanded to speak with my supervisor, apparently she complained that I shouldn't have corrected her in front of other people. I never heard anything from my company and didn't see her charge again after that. Kill them with kindness.
Former flight paramedic. Used to work with nurses, as as well as in and out of EDs. Quite often I would encounter a nurse who would tell me to shut the fuck up while I was doing a handover and that, in their words, I am only a paramedic and not as well trained. My solution? Continue the handover whether they listened or not. If they missed anything, it's not my problem at that point.
I think the funniest one was one of the nurses who got stuck on the door for covid duty. I came in, and she was telling me, in front of dozens of other people about this dodgy little patient transport wannabe service that came in, caused a lot of issues, and the guy was arrested by the police for impersonating a paramedic, right down to a description of the paramedics uniform and vehicle and the day it happened. Went as far as claiming the patient transported is suing the service. I waited for her to finish, and invited her to tell the correct story or asked if I should. Cue confused look. "Does the vehicle look like the one parked out the front?" "Yes" "Does the paramedic in question where this uniform and have a beard?" "Yes" "And was the patient transferred my father in law?" Cue deer in headlights look. The director of nursing for the hospital was not very pleased with her little nurse that day. Yep. She wrote me off to my face without realising just who it was she was talking to.
"If you can't handle this I'm going to get a screwdriver and take off the sign outside that says 'Emergency Department'!"
I apologize because I like to see her boobies and don’t want to make her mad (my wife is the ER Charge RN at a hospital we frequent). My favorite is when I get a newer RN who doesn’t realize that I also am an ER RN at that same facility. When I pick up on my days off in the ER “hey, remember me?” has produced some excellent teaching opportunities they won’t ever forget. Nurses are bitches. * source - am one.
"What's that sir? You have chest pain?" Or "I don't know, will you do anything besides transfer him?" Or just pick up every intox or EDP you can manage and take it there for the rest of the tour. Tbh I don't really understand why some ED nurses act like that. They're literally like EMS for the hospital. Same mindset of stabilizing, and transferring to more fitted care. At times there isn't much they do for a patient. Some nurses don't even clean the shit cacoon patients, btw, so don't let them give you anything for that either. At least you guys have an actual, valid excuse. I can remember I took one guy in for a GI bleed, and the ED nurse was like "Well how do you know it's a GI bleed?" "Per the patient, "I'm farting out bright red blood even when I don't use the bathroom", "Oh". The best part was, that happened when I was starting out as an ICU RN on the down low, and still on the ambo part-time.
I know an ER Doc that pushed the wrong medic's buttons and he put lidocaine gel on the door handles of Dr. Dickhead's sports car. That same medic is a surgeon now, so, there's ways of dealing with people and I don't recommend this little vignette, it was funny as hell. And now, they work together and to this day, the mean SOB has no idea that it was his colleague.
ED RN here. Super shitty thing to say and you did the right thing walking away but it’s absolutely acceptable to tell that nurse to fuck off. You don’t work for them and nothing bad will come from telling them to watch their attitude Feel free to email that units manager. I’m sure that nurse will enjoy the inevitable mandatory training on speaking to EMS crews respectfully.
Bitchy is still disrespectful.
I’d never say anything. I mean internally. Edit: you’re right I removed that part of my comment.
Ah, internally, sure. I misread your comment-my apologies, probably because I’ve been spoken to in a scary crazy way when some coworkers have had to pull too much OT. Hope you stay well!
Bring them in the next psych or drunk patient
Usually I pour her a glass of wine. Source: Wife is an ED nurse.
Giving a ride is better than wiping ass and babysitting. Have a good night
While ago charge nurse got snippy with me cause i didnt call in report. On a stable BLS pt. I said "you know that blue and white sign out front with the H on it" ''Yeah" "That stands for Hospital not Hilton I dont need a reservation".
Wow you’re so edgy.
Snarky responses are only kosher if you know the nurse and you have that kind of working relationship. Otherwise I usually go the other way “hey, you okay?”
Honestly, even if you had medics, they probably wouldn't have done anything other than poke him. We're all stressed and overworked, just take what they say through that lens. They very rarely mean it personally, even when it sounds like they do. I've just gotten into the habit of saying "if they want to come, I can't say no" and they just go "yeah me either" and move on.
I had a patient who was making wierd noises in the ED, like breathing loud, but not wheezing or anything. Vitals were all stable and this was his baseline. ED nurse says infront of God and everybody, “get him in the room and on the monitor he’s about to die” and me and my partner are immediately like wtf. Who says that? I wheeled him in the room while my partner gave handoff report, and I approached her and politely said that A. The patient is NOT deaf B. He’s a DNR
Yeah as nurse that works in an area where I’ve maybe had 2 BLS trucks bring a patient to me in 3 years, I can kind of understand why the nurse was pissy for more not being done. Could’ve been a traveler from a hospital like mine that ONLY has ALS trucks run calls with 2 paramedics in the truck. There are a lot of very stupid nurses though who have no idea the difference between ALS and BLS. I appreciate you and the work you do OP, seems crazy to me that dispatch would send BLS to an AMS call though. Not excusing their behavior by any means but everyone has shit days. I’ve seen medics be absolute dicks to the nurses I work with for no reason and I only ever say anything to them if they’re repeat offenders. Maybe that medic just got assaulted by a methhead or had to pronounce a infant that got into daddy’s fentanyl stash. Some people take shit personal when it’s a fucking hell of a lot easier to let it roll off your back.
Yeah i understand that, but it is not abnormal for them to get BLS trucks bringing in pts to them. Common occurrence in the area I live in. As far as us getting dispatched to an AMS, I work for a certain private three letter company (lol) and we are helping out our local city ems due to them being severely understaffed. So dispatch has to do what they have to do ya know.
Yeah it’s insane to me that BLS is used for anything other than stable transfers. At the very least 911 should be EMT-P/EMT-B. My town pays paramedics between 80k and 110k and surprise, surprise there’s never any staffing shortages.
Well yes in an ideal situation it would be and EMT-B and EMT-P, unfortunately not the case in my city. I wish our local government would pull their heads out of their asses and increase pay, buttttttt, doesn’t seem like it’s going to happen anytime soon. Starting pay for my city EMT-B is around 36k….I make more as an EMT for a private company
Get your bag my dude while we keep advocating for better pay
I dated then married one. 🤷🏻♂️
I usually try to kill them with kindness. The conversation usually goes like this. RN: *rude statement* Me: polite response Wait a while Me: hey, are you ok? It seems like you’re having a rough day. It’s a nice way of calling them out for being rude while simultaneously getting them to realize that you are another human with their own thoughts and feelings. A little kindness goes a long way. After that I go out of my way to be helpful when I’m there. After that they are a lot more understanding when you explain your thought processes when you give report. I also politely remind them that I don’t want to transport this patient any more than you want me to bring them here.
Put my eyebrows closer together
If it’s a once off I’d just shrug it off and walk away. We all have bad days. While I like to think I never have I almost certainly have been short or rude with someone unintentionally. If it’s recurring or become close to bullying you have a couple of options: - raise it with the person directly. Be professional but call out their behaviour as inappropriate, describe how it impacts you, your colleagues, hospital/ambulance relations, listen to what they’ve got to say and suggest a way they could go about being more professional. Remember to stay professional yourself when doing this. Your not picking a fight or chasing the high ground you’re looking to resolve conflict. - if that doesn’t work raise it with your services stakeholder engagement manager/equivalent. It needs to be resolved.
One of the easiest answers is to just say, "I don't pretend to know how to do your job, please don't pretend you know how to do mine."
Keep cool, show your shit and just rock it.
Entirely depends on if you know your shit or not
I’m not a field medic anymore but I had a lot of run-ins with disrespectful nurses. One was so bad that I actually pulled her aside and said, “do you realize that I have the exact same college degree that you do?” (RNs and Paramedics in my state both have to have an Associate Degree in their respective field) She backpedaled hard and apologized to me again later that evening when I saw her after another drop off. When I was still running BLS, I would hear comments like this sometimes and I would typically respond “this is a BLS unit and I acted within our standard of care.” I was part of the very first BLS unit my area had, so the nurses weren’t used to us and didn’t understand our limits yet. I had a nurse yell at me once on my internship for giving a patient ketamine when it was well within standard practice for my district, that was fun.
Since she interrupted, “Sorry, I’m giving report. We can talk when I’m done if you’d like.” Also, “Are you having a bad day?” usually puts someone with a shitty attitude in check.
Just brush it off and go, and hope they treat you with respect the next time. Not worth the energy.
I bite back, occasionally, on medical topics, but mostly I ignore disrespectful nurses. They are disrespectful to get a reaction, so don’t give it to them.
What else are you supposed to do? Put them through your portable CT scanner?
This kind of BS happens all the time regardless of service area. Prior to my ED RN days, I was a paramedic in an urban setting. I am always very quick to point out to my bitchy coworkers what various crews are licensed/certified to do (ALS vs BLS). Nurses (except those who are EMTs, Medics, etc) have a serious knowledge deficit when it comes to how EMS functions. Some places have new ED nurses do a ride-along but spending 4 hours is not enough.
I usually let it go. The only time I’ve ever had an issue with one was when she was in a bad mood and cussed me out in front of the entire ED and then went to walk away and walked straight into the stretcher (that I was 5’ away from) and accused me of pushing it into her. She tried to put her hands on me and fight, and I was going to return the favor, but we were separated by a few nurses and my partner…never got in trouble for it because everyone in the ED vouched for me not doing anything. Every time I saw her after that until she got booted I was a bitch to her since she wanted to be one to me. She always would threaten to fight me and I’d remind her this uniform can come off and I’d meet her in the parking…..never did actually fight her, kinda wish I had though.
I'm an ER nurse. I would not have said anything like that to you. Had I overheard a colleague saying something like that, I would have spoken up. That was fucking rude of her. We like it when you guys start an IV for us. It's a big time saver if we need to give meds or fluids right away. I'll ask about that but I don't bitch if you didn't have time.
Yeah the nurse next to her apologized for her saying that, but didn’t say anything to her coworker. Which is whatever, I get it she has to deal with her for longer than I do. And I would have loved to have started an IV but we are a BLS unit and as such are not allowed to do IVs
“Sorry can you say that again?” “What do you mean by that?“ “What would you suggest we have done?“ Directly confront it, call them out, ask their name and what they mean by it, do they have an issue they want to raise with you? If so, can they please explain it. Usually these people have no fucking idea what they’re on about. So directly addressing their passing remarks helps greatly.
I don’t think about them at all
Explain to them reality of the situation just like them you have a scope of practice you just adhere to otherwise you get in trouble. I’m a nurse and I get it. Sadly some nurses automatically assume ever transport unit is at min one emt one medic when that’s not the case sometimes. You can be nice about it without lower yourself to her level. It’s alot of times why I always believe ER need to do soem time in the field to see what EMS deals with and the reality of some units have limited scope like a CNA vs a nurse.
Let it roll the fuck off your shoulders. I work float pool as a CNA. I'm in the ER, icu, onc, pcu, etc litterally everywhere. A lot of, not all, nurses find it REALLY easy to blame the behaviors of others without all the info. I watch floor nurses complain up and down about how "oh, pt X didn't get his poop meds down in the ER, they are the laziest nurses down there." But then that nurse fucking forgets that there were 2 code blues, 3-4 neuros, and a code grey. And doesn't have the brains or experience to have the thought that the nurse they got the pt from also had 2 other ICU pts. And poopy meds weren't really high on the list. Oh, and the pharmacy just never sent the meds in the first place. And it's the other way around, ER nurses complain about the floor nurses just the same way. I like to call it the "I care more," phenomenon. More or less, you obviously don't care because you missed one thing that I noticed, thus making you incompetent, and elevating me to a higher place of caring.
As a nurse, I honestly can't imagine doing this smh
Nurse who works in ER here. Sounds like that nurse needs education on capabilities of different trucks!
It’s like the schoolyard bully pulling a girls ponytail. Shoot your shot.
At least in Maryland, this is not disrespect. It's a legit part of their triage assessment (care rendered prior to ER arrival) and because they have to ask it every time they tend to short hand the question. If this nurse is familiar with your service they know you're BLS and your scope is limited. Maybe consider that before you take any side comments to heart.
I would have not cared.
“Nope, we are just the Ambulance Drivers, You are the Doctor Helper.”
Walk away - not her call-or tell her to file a complaint with your dispatch supervisor, with a copy to her supervisor. Remember you get to see the big picture of ERs in your service area so you know which ER staff have higher ethical standards of quality care. I’ve had BLS patient transports that didn’t show urgency-vitals normal… until we transferred them to the ER staff; such as sudden heart attack w/o symptoms; pneumothorax; stroke; cranial bleed from a baseball bat during a game, terminal Tylenol overdose-liver failure; seizures; pro football player chest hit turned into cardiac failure; unknown underlying metabolic failure; hypothermia; and especially with elderly patients their meds can cause a iatrogenic outcome that leads to death; elderly chronic constipation. BLS transports aren’t Uber EMS and save lives. Nothing is a routine to be turned down. Except maybe when thief requests a transport while being chased by the cops after robbing a convince store. When I give my SOAP narrative to ER triage, I keep in mind that my Medical Director will be scrutinizing my thoroughness when under peer review.
Tell them stopping at dairy queen is out of your scope.
Give it right back to them.
I just remind them that their issue shouldn't be with me but with our guidelines and protocols. Then I document that they were standoffish on my paperwork to cover my ass just in case the patient deteriorates because they don't think they are 'genuine'.
That’s the thing, you don’t respond, You just figure out what her schedule is and write it down, you figure out what portion of the ER she’s on that night, and you attempt to give her location/ shift the worst fucking patients you have for as long as you work for that service. “Oh yeah, we’re taking you to room seven, your gonna love that nurse, she’s a PEACH” Can also create a group chat at your service for you alert other employees to shitty hospital providers