ER Etiquette

[AnthonyM83]

I'm enjoying the thread on Paramedic suggestiosn for the EMTs.

I'm a pretty new EMT. I'd like to get some suggestions on...I want to say "how to get the ER staff to like you"....but a more realistic question might be "how to get the ER staff to hate you as little as possible"

So far I think I've been doing alright, but only because I had the excuse that it was my very first day...I showed it in my timidness. But that's really just going to last through my first day and not much further.

I've seen some EMTs who are extremely professional and polite, yet are really blown off by ER staff. I've also heard of some guys who don't look that professional, but apparently are (reasonably) liked by staff.

So, for anyone who has worked in the ER and interacted with EMTs, how can I best serve you? What stuff annoys you? What positive stuff do you like or will notice when EMTs do?

And for any EMTs who get along with ER staff really well, any tips?

[nsmedic393]

Just be professional, treat your patients as best as you can and lend a hand when needed without getting in the way. If they don't respect or like you for that than they can go screw.

Also remember that since you are new it may take time to win people over. As you already know hospital staff aren't usually that friendly to veteran medics let alone new ones. Be consistant and patient.

[Oilersfan1]

I agree with nsmedic393.

Cheers :occasion5:

[Dustdevil]

It is of the utmost importance that you first realise that the ER is not the real world. Nursing also is not the real world. Therefore, the normal rules of human behaviour do not apply.

Nurses are living proof that it is not only men who are shallow. ER nurses are always much friendlier to hunky firemonkeys who make 60k than they are to a fat slob, 20k a year ambulance jockey. So, as in most every other pursuit in life, looking good helps you to succeed.

Unfortunately, as much as we like to try and present ourselves as consummate professionals, don't get too carried away with this in the ER. Make sure you come across as competent, for sure. But don't get into a lot of medical discussions with the ER staff, trying to show them how much you know. They don't care. They don't work with you. As long as you don't show up with grossly inappropriate treatment in progress (NRB @ 2lpm, Salbutamol on an MI, MONA on GERD), all they care about is how easy you are to get along with. How friendly you are. And, of course, how good you look. So don't try to be their co-worker or team member. Just be competent at your job, and be their friend. If you fail at either, don't try to make up for it. You'll just compound the problem. Just stay away from them as much as possible.

[Ridryder 911]

What i have found is most EMT's are either flirtatious (which many of the nurses either prefer or totally dislike) or try to appear that they are so important because they "ran a code"... not knowing that was the second code and he/she has another one that may be circling down the drain as the speak, and a toe laceration that ringing that nurse alarm.... and the medics are complaining because they took care of one patient....

I agree with Dust on most of his perceptions except most of my ER nurses are former paramedics with several year experience if EMS. They do understand EMS. The night time crew as well is totally different at most places. In my area, most Fire Dept. medics are thought as hose jockeys, and most nurses in this area still do not know what F.D. and medicine have to do with each other.. (come to think of it, so do I) Many nurses only socialize with the LEO, because they believe it might help them not to get a citation later...only later to reply what a ego they had... LOL

There is a time to open the mouth and be personal and a time to keep quiet. Most, appreciate little small talk... "busy night, or How is it going"... be courteous, maybe assisting family in the hall, offer them a cup of coffe when ou are getting one your self, or getting equipment and paperwork out of their way.. is helpful.

Don't let things upset you... it takes time to develop relationships in work... those that are usually too quiet never get noticed or remembered, and those that are too loud are known too well. Many times we are too busy to socialize....

Hang in there... it takes time

R/r 911

[strippel]

Some ER staff might never want anything to do with you. That is the way some people are, especially in a city.

In our main ER, there are staff members who don't like me, but they listen to me . They know the care I provide. There are others who smile and are glad to see me. Some are just anti-social, and don't give a rat's butt.

As far as you, treat your patients well, with competence and compassion. The way you would like to be treated. Show professionalism (look, act, speak). Be pleasant to staff (nursing, housekeeping, food service, other EMS) and family members. Some members of the ER staff will take note.

When you bring your patient in to the ER, help move your patient from your litter, hook the patient up to any monitoring devices needed. Cover the patient, put the side rails up, and lower the hospital litter.

Give a concise report, ask if they would like any more information. If the patient has paperwork (coming from an ECF), copy all papers, and hand them to the nurse.

[BushyFromOz]

dont raid the fridge in the staff room and knock of the triage nurses lunch

dont raid the fridge in the staff room and knock off the nursing unit managers lunch

dont back the ambulance into the director of nursing's car in the car park

dont "borrow" a stethoscope then find out later its the A&E docs littman master cardiology

dont tell that guy outside to "move your effing car car", you might find out they are a hospital administrator on a day off

yes, these are actual events

[becksdad]

All really good suggestions. I can't disagree with a single one of them. Realizing that this is not a popularity contest, be competent at your job and be yourself (as long as being yourself is pleasant). Most nurses, techs, and docs are good people, although not everyone will always like you. The more you interact with them in the course of your job, the more you will figure out how best to get along with them. Perhaps one of the biggest things is know when to help and when to get out of the way. Again, the more experience you get, the better you will be at this.

And if, by chance, on a really busy night when you bring in your 5th drunk or drama alert, and a nurse jokingly tells you that you owe them chocolate.....bring 'em some chocolate! They'll love you forever!!

[ERDoc]

Don't wait for the 5th drunk, bring chocolate STAT! You will make the nurses very happy right off the bat. If you go to a hospital with residents, bring pizza, chinese food or heros (that are always looking for a free handout). That should get you off to a good start. Professional appearence helps (a lot). You aren't going to be seen as a professional if you don't look like one. Be confident and competent, but don't ever step your bounds or try to act like you know more than you really do. Most of us that work in an ER have been involved in EMS in some way and know what your limits are. We can smell lying from the parking lot. Don't question us, especially in front of a patient (unless it is something that is going to kill the pt in the next 30 seconds). Ask questions (if it is not too busy). I'm always glad to answer any question, "Hey doc, what do you make of this on the EKG?" But don't do it when I am up to my knees in melena from a hypotensive GI bleeder or have 2 codes going at the same time. Even if you know the answer to the question, don't be afraid to ask it just to break the ice. We doctors are very type A/narcisistic and love to get the chance to share our knowledge with anyone who wants listen (and sometimes those who don't). It is always worth points to help out the nurses when they are trying to get a pt settled in, but don't get in the way.

These are just a few thoughts. Hope they help.

[emtkelley]

I will be starting my clinicals and ride time soon but I have a few things that stuck with me from my basic time I spent in ER.

Don't scoff when the nurse asks you to straighten a room or change bedding. We have to start in the trenches, like everyone else. No job is "beneath" you. I cringe and wait for the stuff to hit the fan when I hear someone say "that's not my job". On the other end, dont put yourself in the position to be a janitor, either. There's a balance there.

Treat everyone with respect, you may end up working with them some day.

There will always be staff who will despise a student and you can't change that. Hang with the staff who you can learn from.

And my wise grandmother who once said "God gave you two ears and one mouth for a reason".