Helpful Hints for SKILLED Nursing Facilities

[JPINFV]

I got a chance to look at EMS from the other side this past year. I actually had no complaints with the hospital, SNF/convalescent center or the hospice center. The ambulance company on the other hand left me baffled as to where the pride in one's profession has gone.

My mother had to endure 5 ambulance rides (1 ALS and 4 BLS) during the month prior to her death. I have considered forming an advocacy group for nursing home patients who have had to be transported by "bored" and/or burnt out EMTs and Paramedics. Dialysis patients would be welcome to join also.

I think the final act of inconsideration was when I had to pluck the iPod earphones from the EMTs who where "jammin" out while trying to put my mother on the stretcher and not hearing a word about her pain or discomfort. If she had not been in pain from a recent surgery I would have called a taxi because there are many taxi drivers who offer much more consideration when transporting the elderly especially in Florida. I have offered my services to that ambulance company to teach a couple of their EMT recert courses. I may use the day room at a local nursing home for classes and let the residents do the grading when it comes to assessment skills.

God, I hate burnted out and idiot EMTs. Two cases came to mine before I left my ambulance job. The first was I was working with a new hire who was fresh out of field training. Personally, I don't mind new EMTs because they generally aren't set in their ways yet. It's also important to note that it takes a lot for me to write an incident report on a partner for behavior issues. That said, if you want me to write one against you, feel free to be rude to patients and staff, answer your cell phone in front of patients [it was a discharge and he could have just as easily left the hospital room before answering], and listen to your friggen MP3 player in front of a patient while we're transporting. I get the fact that discharges are boring, but if you're going to listen to your music, at the very least sit in the captains chair.

Issue 2

God help the competiting ambulance crew if I ever find out who it was. I was dispatched to a hospice discharge. I get there and we're told the same story 3 times by the patient's hospital RN, hospice RN, and one of the family members who was getting really passive aggressive about it. Apparently the last time they discharged the patient, the other crew had the family move the patient to the gurney for them. Granted, there was somewhere around 10 family members around both at the hospital and the patient's house, but you don't just stand back and watch the family do your work for you.

[AnthonyM83]

An educated, licensed healthcare provider should NOT have to take that from the EMT-I in the yellow jumpsuit, OR his EMT-B partner, especially if they willingly took that extra shift on the designated interfacility transport ambulance to make some extra cash.

NO. The provider should not have to take that because it's unprofessional on the part of the EMT and looks bad for the EMT company. If someone pulls the education card on me, I'll go ahead and pretend I'm uneducated and take offense, so they look like jackasses to all their coworkers. I probably have more patience than 95% of my company, but if I get the sense of superiority in a conversation, you're done.

I don't respect most of the medics I've worked with because they put patients at risk everyday by sending them BLS (sometimes they die, sometimes EMTs figure it out & reroute/upgrade), but I still act respectfully toward them and when I put them down in my mind, it's b/c of their actions, not education level.

Sorry if I veered off topic a bit, but I detected a bit of that in your post...

[kristo]

I don't respect most of the medics I've worked with because they put patients at risk everyday by sending them BLS (sometimes they die, sometimes EMTs figure it out & reroute/upgrade), but I still act respectfully toward them and when I put them down in my mind, it's b/c of their actions, not education level.

Sorry if I veered off topic a bit, but I detected a bit of that in your post...

Yeah, I see what you mean. I should clarify. In this case, the EMTs were convinced of their superiority over the nurse because of their glorious EMS status, and because they are EMS, and the nurse is "just a nurse at a nursing home", they felt they were superior. All I'm saying on the education in this case is that if there would be a disagreement between an EMT and a nurse at a NH on whether a patient from said NH needed an ambulance transport or not, I think I would under most circumstances be inclined to trust the nurse's judgement - they know their patients and I think we can at least agree that their education is much more relevant in that setting.

The unprofessional behaviour was, as you mentioned, unacceptable in it self, regardless of education levels or any disagreement on what kind of transport method was warranted.

[spenac]

I think I would under most circumstances be inclined to trust the nurse's judgement - they know their patients and I think we can at least agree that their education is much more relevant in that setting.

That is funny. Perhaps different in your area but 90% of NH calls in my area are nurses just getting patient out of the way for a couple of hours.

Yes in my new job we have a nursing home that abuses EMS.

[itku2er]

:roll: :roll: :roll: :roll: :roll: :roll: :roll: :roll: :roll: :roll:

[spenac]

:shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock:

[AnthonyM83]

Yeah, I see what you mean. I should clarify.

Understood.

[kristo]

That is funny. Perhaps different in your area but 90% of NH calls in my area are nurses just getting patient out of the way for a couple of hours.

Yes in my new job we have a nursing home that abuses EMS.

Hehehe - I gotta remember that, I may have to do some more nursing practise...if a patient gets annoying, I'll send him for a trip.

[katgrl2003]

Just remember, it gets really bad around holidays. Had a few NH's call us yesterday to get patients out for a few hours. What's worse is that I've actually had nurses admit to me there is nothing wrong with their patient, they just want them out of their hair for awhile. :roll:

[CBEMT]

All I'm saying on the education in this case is that if there would be a disagreement between an EMT and a nurse at a NH on whether a patient from said NH needed an ambulance transport or not, I think I would under most circumstances be inclined to trust the nurse's judgement - they know their patients and I think we can at least agree that their education is much more relevant in that setting.

Huh.

Well, how's this for education. In my third week of EMT school I learned that the oxygen flow rate for a nasal cannula is 2-6lpm.

I also learned that patients with tracheotomies don't breath out of their mouths or noses (though I did know that one already).

Remember. Basic EMT school.

So after I got my license and responded to a nursing home for a tracheotomy patient with difficulty breathing, I was somewhat concerned that he was turning gray and had a nasal cannula in his nostrils running at 8lpm, and none of the 3 degreed RNs in the room thought that this was a problem.

"Educated" indeed....