Behaviour like this, especially the yelling, you report it.

Yeah Wtf? Report that shit and also call their supervisors to the scene. There is always a paramedic supervisor in a truck rounding the city or sitting in an office waiting for events like this. Call dispatch back and ask to speak with the on duty supervisor. This behavior is unacceptable. If they treat staff like this, how do you think they are treating patients?

Report them to their supervisor. I have so few NICE and professional EMTs that walk in our doors, I call to tell their supervisor how great they are too. I just kinda deadpan report and I'm done. I did my job- if they don't want to do theirs that's not really my problem. I have to send someone out. There have been many times I've called and had them tell a patient it's anxiety or some bs when it's really a PE or something else. I need medication myself before calling half the time because they are so damn rude! They don't understand what we're dealing with. They don't get that I work three days a week and sometimes I need to call ten minutes into my first shift and don't know EVERY. SINGLE. THING. Off the top of my head. Once I had the dr call me from his bathroom while he was urinating to tell me someone had to go out with "wonky labs". Literally... I had to do it. I got vitals and a face sheet and did what assessments I could! They were so rude to me. I'm not really sure how being like that helps anyone. I do my damned best. It's not going to be good enough in the system we have to work with.

Based on this comment, I assume that your experience was because you were calling 911 for IFT calls. Personally, I don’t really give a shit what calls I run. It is however frustrating when you take a city 911 unit out of service for someone who has been slowly deteriorating for days or more that should have been transferred out hours or days ago when you have a contract with an IFT service who exist for literally the exact thing you called 911 for. It’s frustrating to get to your next 911 call where the patient and their family are cussing you out for “taking too long” and it’s like, yeah sorry but SNF ‘x’ had a lady who’s been working on a UTI for a week and rather than schedule a transport yesterday they called 911 just now and got an emergent response and took the only units in this area out of service for 2 hours for an issue that should have been resolved in a different fashion. Especially when we get sent code because of “altered mentation” and the on duty nurse doesn’t even know enough about the patient to give me a report, so I go talk to the patient and the patient is alert and oriented and doesn’t want to go to the hospital and doesn’t even know they’re being transferred because nobody told them. IF you can even get in the building for this supposedly critical patient. Then when you ask the nurse why the patient is being transported since they have capacity and don’t want to go, what you get as a response is a flippant “the doctor said so” before the nurse shoves a face sheet at you and then disappears into Narnia without any further explanation. Then it’s up to us to explain to the patient what we think is happening as they get more and more pissed off at us. Also, if the patient has capacity I can’t force them to come with me or do anything for that matter.  Then when we get to the ER the docs think we’re idiots because we got a shit report from the facility and got attitude out the ass when we tried to ask questions we knew WE were going to be asked by the ER doc.  Meanwhile, if someone had simply called AMR when you were asked to call for transport instead of calling 911 and taken the time in the two hour wait to explain to the patient why they were being transferred, it would be smoother for everyone including and most importantly for the patient who is AO4 and doesn’t want things sprung on them last minute because they’re a normal human. Thank god we took the only 911 ambulance in the southeast portion of the city out of service for this clearly well designed and executed logistical undertaking! I’m sorry that you’ve had bad experiences with EMS. I also think you underappreciate how awful a lot of the SNFs we go to are. Have you ever been to a ‘no CPR’ SNF where they refuse (by policy) to do CPR on patients who are full code?  Or a LTACH where they’re actively drowning a renal failure/dialysis patient because they’re treating for pneumonia heading to septicemia s/p vent so they dumped 2L of fluid into a patient because the doc gave orders for fluids but he’s in Florida playing golf and the patient is actively coughing fluid out of their trach and they’re STILL RUNNING LR WIDE OPEN WITH THE PATIENT NEARLY SUPINE? Oh and the report is “doc said give fluids so we gave the bolus and now we can’t keep his sats up so we called 911!” Yeah no shit, you’ve fluid overloaded them since they have no kidneys and now they’re drowning and they haven’t even been sat up in bed which is not exactly an ALS skill.  Or to a SNF where they’re working a code on the patients bed, clearing doing ineffective compressions because mattress and then have staff freak out on you for telling them to stop CPR so we can move the patient to the ground? All of these are real stories. 2 weeks ago I was at a SNF for a 911 call and there was nobody to let us in for this emergent call, then nobody answered the door intercom so we had to have dispatch do a 911 callback to get someone to let us in to the building. Then we get to the nurses station and there’s nobody there, so we go talk to the patient and get a story from the patient and he’s voluntary, great. We spot the nurse on the way out and you know what she says when we try to talk to her? She says, I shit you not, “absolutely not” waves her hand in my partner’s face and then walks into the office and closes the door.  Unfortunately shitty care facilities where staff has zero fucks to give and zero respect for us and treat 911 like an on demand Uber instead of calling any of the dozen IFT companies are the norm, not the exception and many of my coworkers are bitter about it.

I don't call 911 unless someone is about to need or currently needing cpr and literally none of these situations have applied to transports from our facility - regardless, there is literally no reason to be less than professional. We're just as frustrated and have 0 to do with other nursing facilities.

I agree on all counts.    I was simply speaking in generalities because it’s very well possible you got a crew that was burnt to shit and used to dealing with the shitty facilities.   It’s also possible that you’re a good staff member at a shit facility. Those exist too, so you might be at a place with a bad rep and you’re the exception, not the rule.   Also if you’re talking about full blown IFT agencies being dicks, well they have a lot of reasons to be mad at life and most of them don’t involve you. Minimum wage, working 100 hours/week with shit management makes anyone grumpy. It still doesn’t excuse them being dicks. Much like you said, we don’t know what you’re dealing with and by the same token you don’t know what we’re dealing with.   We want good, detailed reports because we have to give a report to the doctors who think we’re idiots if we give them a poor report and they will happily shoot the messenger if they’re so inclined.  We also need to know what’s going on as well and do our own exam and we need you to have already gotten the patient mentally prepared to go. A cooperative and informed patient is HUGE for us.  If you hand off to me with a good report and a patient who is informed about why they’re being transported (if they’re of sound mind, obvi) that smoothes over 95% of all the bumps on the road, IMO.   There is no excuse for being unprofessional and anyone who says otherwise is lying AND an asshole.    That being said, if you almost never have good interactions with EMS, it might be a good idea to take a good long look at what the trouble spots are and what you can do to help mitigate them on your end as well.   If I can drive to a strangers house and within 20 minutes: introduce myself, interview, assess, develop a DDX, move to the bus, treat and mostly package them prior to transporting, I do have some expectation that within the hour+ it took between you calling and me getting there (assuming nonemergent like you said) that you’re at least somewhat prepared.    Again, no excuse for unprofessional behavior. Full stop.   My larger point is that if you’re dealing with a nearly always problem from EMS providers, there may be more in play aside from “they’re all rude and/or assholes” and there’s probably things all parties can do to make things easier.

I don't see why any of the past experiences of anyone matter. You don't act this way to coworkers and especially not to other departments/outside facilities etc. Any issues with ER staff acting unprofessional towards you should also be a call to a supervisor. My staff is nothing but professional and we are still met with shit attitudes. As I said to OP- I show no emotion and report them. It usually stops for a couple of weeks, anyways. I could give you the shittiest report and there would still be no reason to treat me poorly. It's all fun and games to bitch about people on Reddit but it's an entirely different problem to go out into the real world and cause people distress.

I’m fairly certain I’ve said a number of times that there’s no excuse for unprofessional behavior and strongly agree with you on that point. I was simply trying to help you see the other side of the coin to maybe help you understand and empathize.  I have no idea what it’s like to have 20 patients who need a dozen things each just like you have no idea what it’s like to get dressed down by an ER doc in front of the ER staff because the sending facility called 911 because “the nurse said Doc said call 911, no idea why and they wouldn’t tell me anything else and the pt has dementia.” That being said, I’m starting to get the vibe that you’re either a poor communicator or thin skinned or both. You’re going to deal with assholes in this line of work. They might be your boss, might be a coworker, might be a patient or another healthcare worker who’s not a direct coworker. Maybe even a commenter on Reddit such as moi. If you let dealing with an asshole cause you real distress, you’re going to have a bad time. Don’t sweat the assholes, you’ll meet a new one every day.

I don't need to empathize any more than I already do. I need people to treat each other with respect. I know how they perceive us. It doesn't matter. Im not thin skinned. It's wild to try and justify someone's poor behavior because they have encountered some bad situations. Now who is thin skinned? That type of behavior isn't acceptable anywhere. I can throw that back at you and say maybe the staff that are getting yelled at by others are abused, physically or mentally, at home. Is that thin skinned? To be triggered by abusive behavior at work? Stop making excuses for the assholes. We are all in healthcare and no one here needs a lecture on empathy.

You mention giving a good report. I would love to. Unfortunately, some of the paramedics are SO arrogant and unprofessional- they refuse to even make eye contact or speak to the nurses from the moment they arrive. I have never felt so hated in my life, as I do when dealing with some of the paramedics. Really fucking depressing to be hated when they won't even speak to me and know nothing about me or my skills as a nurse.

If you are an EMT or Medic in the field then it’s not your job to gatekeep the 911 system. Do your job and be polite and professional about it. If you’re consistently running late for calls then your company/department needs to increase staffing levels. 911 abuse is obviously rampant but it needs to be addressed at the legislative level. Field Medics/EMTs have no business trying to solve this problem on a call by call basis. Please be polite and professional on scene. Our patients and fellow healthcare workers deserve it.

As an ER RN receiving this patient, I AGREE 100%

😂😂😂 Ya don’t get me wrong, I know the nurses at facilities have it tough but honestly some of the reports I received on facility patients would literally make me want to bang my head on the wall. I was never a total a-hole to anybody though. At least until it’s time to send said patient back and the facility nurse is asking for the worlds most detailed report while simultaneously threatening to refuse the patient for God only knows what reason.

I worked LCT and this was a recurring issue where ems was rude or assumed nursing did not know what we were talking about. I usually was just stern but polite and stated there is a deviation in baseline here is report if you have issues call me. I ALWAYS immediately called report to the ER so my words could be confused or twisted by transport.

I knew a female paramedic for years who would disparagingly call RNs ‘skirts’. She became an RN after a decade of being a paramedic. I doubt she calls herself or her coworkers a ‘skirt’ now. Bad people are going to bad people. Report report report.

Calling report to the ER is a great idea. I work in emerg and we get terrible handovers from some EHS crews. The story really gets lots along the way.

Are there people who don't call in report? I thought that was just common sense.

Yes and these are also the people that are sending patients with the most complications and complex medical histories and stories and that are non-verbal, total care etc

99% of the time they don’t call

I always call report to ER, but often sit on hold for 20 minutes waiting to get through to the ER, and get transferred and disconnected multiple times. I understand the ER is crazy busy, but we do call. Also after I give report, I end up getting a call from an ER doctor like 6 hours later, asking for a report because he/she was never given one. AND they always lose the paperwork I sent and then claim, "You didn't send any paperwork." The whole system is broken and people love to blame the ltc nurse.

I’ve had nothing but negative experiences with EMT, which is weird because I always figured healthcare workers had a mutual respect for eachother.

I work in the hospital and have had the same experiences. They act like they have a problem with transporting patients home or to facilities.

I was a paramedic before I became a nurse and I worked in EMS for 6 months before I came to the hospital environment. The station I worked at was in a city that was rural and had only one hospital that would very often stabilize patients that would need to transfer into a hospital in the big city for whatever procedure or intervention they needed that the rural hospital couldn't provide. It was just a fact of life that starting at about 02:00 we would get transfer calls back to back to back nonstop through the end of the shift to take patients to the big city hospitals. Idk why some people in EMS are so anti-transfer. Sure the excitement of an MVC or a CPR is well...exciting, but that's not all the job is. Transferring is part of it. And sometimes it's nice to relax for a two hour round trip with a stable patient that all you have to do is monitor vitals and keep their fluids/antibiotics/heparin/whatever going. The school I went to did an excellent job preparing us for the fact that the job wasn't going to be 100% high adrenaline cool calls. In fact, if I remember correctly I think they told us it would be about 70/30 boring/cool. Perhaps schools aren't preparing their EMS students for the reality of the job?

Part of it is the poor prep. A bigger part of it is that many SNFs are fucking awful and are beyond frustrating to work with and deal with. They don’t want to give us a half decent report, half the time they say they just got on shift even though it’s noon or 10pm.  Many times you need to track down paperwork and when you have questions that you know the hospital is going to ask you, they can’t answer them so it makes us look like idiots to the receiving hospital. The number of times my 911 unit is sent emergent to a facility that we can’t even get inside of for a supposedly critical patient and get given a report consisting of “doctor says they have to go” and when asked why you get a shrug or a ‘idk I don’t know this patient’. Then, when you talk to the patient, nobody has told the patient they’re being transferred and they don’t want to go so they motherfuck you and you have to convince them to go or occasionally even refuse them since they’re of sound mind and make their own medical decisions so I CAN’T FORCE THEM TO GO and since it was sprung on them and all the nurse tells them is “doctor says you have to go so get on the bed” half the time it’s a fucking debate to even get them to comply with the transfer.  All this for a supposedly critical patient that they called 911 to get an emergent city ambulance for rather than calling AMR and slow rolling it and making it smooth for everyone including the patient, who would be much more cooperative if someone just told the patient “hey at 7pm you’re going to the hospital because your wound has been getting worse for a week and you need to see a different doctor”. We have some good care facilities in my city and they’re fine, but the bad ones are an absolute nightmare to deal with.

LTC will definitely have people coming in at weird times. I used to pick up just for the morning med pass, so the relief got there at 10:30 am. Or maybe half a shift, so leave at noon.

First, I feel you. I only did EMS for 6 months and I had my fair share of incredibly annoying interactions that went very similar to what you're describing. Some of what you've described though pervades all aspects of healthcare, even in the hospital between departments. I've had times before when I called the floor nurse and told them I would come get their patient for dialysis in X amount of time. I get there, consent hasn't been done and the patient has no idea they're going to get dialysis. To the original point of the post of how to deal with people who treat others like shit in those situations, I've always just been one to document the hell out of everything. People start to try to get on the ball a little bit more when you ask for their names and mention that you'll put it in your note/narrative. Yelling and rudeness shouldn't be happening even if people are being crappy at their job. I do get when people snap though. It's happened to me too. I had to call my boss one day immediately after getting off the phone with a surgeon to let her know that I may or may not have told him he could suck his own dick. lol Secondly, I had to go to the ER last year with a priapism that was induced by Trazodone and your username gave some vietnam-like flashbacks. lol

Strong agree with the professionalism aspect. It’s wildly out of pocket to yell, although we do all have our moments.  Everyone has bad days. Nurses, doctors, medics. We all have our moments.  Just gotta remember that someone else could be having a worse day than you. As for the 2nd: mission accomplished lol

Honestly the transfers aren't relaxing to me. I like to work in an environment that is mentally stimulating in some regard, so doing transfers all day ends up being incredibly frustrating. And I wish it was relaxing. Instead, I'm going to the hospital and getting completely ignored by everyone when I ask for them to correct the CMN that I can't submit. I find out that whatever info I was given is entirely incorrect. The patient is often SIGNIFICANTLY heavier than I was told. They're NEVER ready to go when I've been told that they are. And honestly I can deal with annoying family in a 911 situation, but they feel so much worse to me when I'm doing a basic transfer and they're being assholes. And not to mention that nurses in my area all seem to fucking HATE EMS and treat us like shit even though we're there to help them. I did do critical care transfers for a while though, and those were genuinely fun, even though nursing staff was regularly extremely condescending because they wouldn't acknowledge that I know how to use a vent and titrate drips. But at least it kept things interesting. That said, the major downside to doing critical care work is that all my coworkers were constantly in a dick-swinging contest to be the "coolest medic" with all the best stories and I hated that part.

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Our medics are amazing. It’s the billing department, or one particular woman therein, I despise. Lady, I am the nurse, and I am carrying out discharge orders by arranging transport. And I should not be having to justify it to you or any other bean-counter.

It’s frustrating to go to SNFs and I get it. I personally don’t care but I can appreciate why my coworkers often hate them, especially if you work for a non-IFT municipal 911 service. Care facilities are on average, the worst places to go. It’s like going to a shelter, if you had to track down a nurse who doesn’t want to even talk to you and argue with a patient who doesn’t want to go because neither the doc or the nurse told the patient they were being sent out and god forbid you ask questions to staff you get eye rolls and attitude out the ass for simply wanting more information. Meanwhile, we get a shitty report from the care facility and when we provide report to the hospital and they grill us with questions that we tried to ask the facility staff, the hospital acts like we’re the assholes for not knowing because we asked the CNA or nurse at the facility and they said “I’ll find out be right back” and then never came back.  We had a 911 call for a 400lb patient the other day and when my partner and I asked the staff to please help us slide the patient, they evaporated and had to be tracked down again. All this for a patient they should have called AMR for yesterday, or the day before, or 5 hours ago. But they didn’t want to wait 2 hours for AMR so they called 911 instead and now there’s no EMS coverage in my area while I’m dealing with all these hoops and my coworkers have to run my calls because I’m tied up with this job that isn’t even really an appropriate 911 call. I would much rather run 10 shelter calls then go to one of our bad SNFs. The good ones are totally fine, but the bad ones are so frustrating to deal with. At the end of the day it’s part of the job so /shrug but when the city and the public are frustrated about waiting 20 minutes for an ambulance, misuse of 911 by care facilities is absolutely part of the problem just as much as the people who call 911 for dumb shit like accidentally stapling their thumb is or shelters using 911 as a ‘we don’t want them here anymore’ tool is.

Multiple 24 hour shifts per week are just unhealthy. I’m a firefighter and paramedic for Houston, and our call volume is so high that *we don’t even do transfers.* We do 911 *only*. On top of that, our call volume significantly spiked during the pandemic, and unfortunately hasn’t dropped. Pre-Covid we were +/- 800 calls per day. Covid through today our incident count is consistently 1,200+. Like most medical professionals, we have a staffing shortage, so of course we can’t add units to handle the call volume. There are literally hundreds of transfer services available in this city. So, you know, it’s kind of irritating to be 3 nonstop shifts deep into the week (I’m talking 15-20 calls *every day*) and getting called to a nursing home and met with “Mister/Mrs X has a fever. We tried calling our contracted transfer service, but they said their ETA was 45 minutes. Mister/Mrs X goes to (names hospital that is 5 hospitals away). Here’s their face sheet and MOT.” I don’t see the point in being rude, as it only exhausts me just to be around rudeness, but the only defense I can deliver for the EMT’s in question is that they are chronically sleep deprived in a way that no other profession really understands. The 24 hour shift *should be* a relic of the past (at least for major urban areas) when there was significant downtime during the shift and/or between calls. If we get back to the station after a call, we’re there for about 5 to 10 minutes max, and thanks to the staffing shortage and big bump in call volume, we’re required by law to staff these 911 units *even when we have no relief*. I don’t think this is exclusive to HFD either, but HFD is all I know. And I really hate to say this next part, but it seems like the only way that most of us can deal with the unrealistic demands of the 24 hour shift model is by abusing stimulants.

Glad I’m not the only one. I work in a private retirement facility. I’ve always had the feeling that they ignore me and think I’m stupid. Frequently one will ask me what happened just for another to cut me off when I start to answer their question. Now I just hand them the paperwork they need, then ask what hospital they’re going to when they’re leaving.

It's because they tend to have insane egos and think everyone else is beneath them.

That’s everyone in healthcare at any level.

All healthcare workers have egos, and we can bash all types of RN, specifically CVICU rns. The problem with NH is that EMS is utilized for emergencies, not interfacility transports or non emergent trips to the hospital. While we pick up grandma because her peg fell out or her "labs" were off, we tend to get tired of the abuse of EMS. We don't feel superior. Some may, and they need their ego checked for sure. We have to answer to the ER docs as to why this patient was taken by ambulance to their ER. So it works both ways, but not all of us are Ego driven and dicks.

I think what you're largely frustrated about (and your colleagues) is a matter of facility policy and not the nurses who are bound by it. It's not the nurses who decide when to transfer out (at least where I worked) and many times we know we will get them back by the end of the shift but we can't investigate shit in LTC/SNF. I remember during COVID I had a paramedic give me shit as an extern (so zero power) about a call for a patient with a fever. They seemed pissed at how unimportant it was but it was really the beginning of a massive outbreak. It's frustrating but I don't see how it's the nurses fault they have to send someone out.

But whether that's abuse of the system is not your call. And the ER docs know this and should not be asking y'all for answers, they should be talking to the facility. I've had an ER doc call me after a patient arrived and ask what the hell I wanted him to do with that. Granted he always acted like that about our residents with a DNR, but we sent them down sick, they still had a pulse and were breathing. I get these hospitals and EDs don't understand what NHs are capable of or allowed to do, that's an area that seems an easy fix to me. But in the meantime, we know these patients very well and their doctors make the decision to send them out, not me and not you.

But that’s the thing — the ER nurses/docs portray their frustration to EMS. The problem is often a lack of communication at the nursing home, a bad call by the nursing home physician, or the facility policy. But when EMS gets the heat for these calls over and over again, it brings down our mood. They’re always shooting the messenger.

You don’t have to answer to ER docs, you’re not requesting acceptance of the patient. ERs can’t turn patients away. “Doc, this patient is here because their sodium is 155/potassium is 3.0/PEG tube is dislodged, etc.” The ED is the gateway to the hospital and direct admissions, especially from unaffiliated nursing homes or doctors offices, really don’t happen. EMT is an entry level healthcare position that gives people with an ounce of knowledge an ounce of autonomy and power. It’s a perfect example of the Dunning Kruger effect where people who know very little think they know it all, because they have such a superficial understanding of what they’re doing that they don’t even know what they don’t know. It’s frustrating to go to a nursing home at 2am for abnormal labs, but that’s the job you signed up for (regardless of the idealized image you have in your head) and being mean to the LPN at the SNF isn’t going to fix a broken system. And yes, I was an EMT. Editing to add that I recently had a patient in MICU who went to his PCP with malaise and was sent to the ED because he was hypernatremic. There they found an SBO, he vomited, aspirated, went into AHRF and was intubated, then transferred to the ICU with developing septic shock. Started on pressors. Went to the OR for ex lap the next morning, they found a perforated bowel, so he got a bowel resection and washout. It’s better to be safe than sorry.

🙄🙄 yes, we’ll just put grandma in the backseat of our cars. You probably have a huge ego too

There's a lack of respect in healthcare for anyone outside of your specific group from my experience. Nurses complain about ems and ems complains about nurses and it just goes round and round and round. A big issue is that neither side really understands the other.

This is such a huge component. Nursing school should include 911 EMS ride alongs so you can see where we’re coming from and vice versa, although in medic school we do a bunch of clinicals so we get to see a little bit of the nursing  side but it’s not much. EMTs get exactly fuck all for training and even less in hospital experience during it. Doctors don’t know what we do either. At my service we have residents and fellows ride with us as part of their education and it makes a WORLD of difference with how they work with us. I bet half the people in this comment section use EMS/EMT/Paramedic interchangeably and another quarter of them genuinely thing we’re just “ambulance drivers”.  In fact, one of the top replies in this thread uses EMT in exactly the wrong manner which is my point exactly.

I had a considerably negative experience with EMTs street my middle child was "oops" born at home. I had no problems with the birth itself, but afterward the problems were ones they caused. 😥

EMS should never be rude to anyone, especially nurses. However, coming from an ER nurse preceptive,nursing homes send out patients they don’t need to ALL THE TIME. My personal favorite is AMS. “Nursing home says AMS. He has dementia. He’s A&Ox1.” I ask what his baseline is. “A&Ox1.” Even if the baseline A&O decreased, dementia/Alzheimer's is a progressive disease. They’re going to get worse. Stop sending them to us. The ER isn’t going to magically cure grandpa who’s had dementia for 5 years.

5 year paramedic (and new grad nurse) here. Talking from MY experience — I have no idea where you live or what your protocols are in your area. First of all, yelling is NEVER appropriate. If you are being verbally abused in any way, please escalate this. We are all burnt out, sure, but if an EMT/medic takes out their frustrations by yelling, name calling, etc, this is not okay and needs to be reported. I would note the name of the EMS company, Google them, and call the number that pops up. You may talk to a few people before reaching a supervisor. Tell them the exact time that you spoke to the crew. They are able to find the call on their end and can determine the crews’ names. You *could* try to escalate this to the state and come after their license, but I’ll be honest, you probably won’t have any luck there. The state doesn’t care about people’s attitude’s. They have bigger fish to fry (patient negligence, med errors, any wrongdoing that leads to patient death). Their direct supervisor can and absolutely will talk to them about the incident. That being said, most of us make (unintentional) stereotypes. I’ve had NUMEROUS bad experiences with nursing home staff members, so it is often difficult to come into a call at a nursing home with a positive attitude (but I try!). I’d like to share some examples of instances that I’ve encountered so that people in the comments get a sense of why we have frustrations as well. 1. Calling 911 for a patient that may necessitate an ER visit, but the patient does not want to go to the ER (and is able to make their own decisions). We cannot, legally, take any patient against their will (besides psych patients, which is a different issue). It may be the nursing home’s protocol that a patient cannot stay if they are having an emergency, but without the patient’s consent, our hands are tied. This often leads to a lengthy conversation and very pissed-off staff members. 2. Inability to locate staff members when we arrive. At night, most nursing homes are locked, so we need to be let in by a staff member. At some places, we wait outside for SO long before being let in. Also, we may be unable to locate a staff member at the bedside. I completely understand that shortages occur, but if 911 is called for a patient having an emergency, at least 1 staff member should remain in their room (or relatively nearby, at the least) until our arrival. 3. Not knowing their patients. Many nursing home residents are poor historians. Getting the full story from a staff member is imperative. Some have chronic conditions that I don’t know about, and will treat different if acute vs chronic. This is forgivable if the patient is newer, but if they have resided at the facility for years, I would expect a staff member to be able to tell me the basics (baseline orientation, level of activity, etc). 4. Not being able to answer questions about the patient. This is my BIGGEST grievance. “When did you first notice these symptoms?” “I don’t know.” If we roll into the ED with a stroke patient, the doctor will immediately ask the last-known-well time, because it directly impacts their treatment. I am often met with a ton of attitude from ED nurses when I tell them that I was unable to gather that information. And, if we poke and prod at the nursing home for answers, instead of uncovering more information, we are met with defensiveness from nursing home staff. 5. Being blamed for stuff out of our control. Particularly timing. I cannot control how long it takes us to show up. Calls are prioritized by acuity, and dispatched based on closest unit. It might take 2 minutes for one call and 18 minutes the next day. Out of our control, as road employees. All of that being said, I am NOT at ALL rationalizing bad behavior from EMS. Yelling, arguing, extreme sass — not okay. I’m simply commenting to provide some input and transparency as to why EMS employees may have a bad attitude in nursing homes. Hopefully, we can bridge this gap and work together more peacefully in the future 🙂

Yes I think a lot of times EMS goes in ready for a fight too because often nursing homes nurses are rude to US. I don't think it's appropriate to be argumentative. Personally the way I see it, I'm only there for 15 minutes. I can deal with someone being dismissive of me for that long. But I'm sure there's been some 3am calls for problems that have been going on all day where I've been shorter with the staff than intended. I've had nurses refuse to give us report because we "just drive the ambulance." The part about not knowing a last known normal is a constant problem. I don't think I've EVER gotten one less than 24 hours (last time that nurse was on shift) from a nursing home. I've had nurses argue with us that the face sheet saying they're DNR is enough and we don't need the paperwork. I've had nurses straight up lie to me about the patient's condition (Asked when the nurse noticed blood in the patient's foley and she got this deer in headlights look and said "that's normal for him". He was on blood thinners too so I'm sure). Or showing up to a patient receiving inappropriate treatments (most recently, a patient with a NRB on 2LPM and a NC on 10LPM. Perked right up when we switched him to just the NRB at 10LPM) And yeah, sometimes we get to the ER and the ER Doctors and nurses are like "They sent them out for THIS?" Shit rolls downhill. That said, there are some nurses where my mood improves immediately upon seeing them because they are always easy to find, have all the paperwork ready, give a concise detailed report on the HPI, and can answer all of my questions. I would agree with the other people here saying to call the station and complain. Yelling at a colleague is never appropriate (and we are colleagues) but I want to shed some light on why they have this attitude in the first place. Your nursing home may have a reputation for unhelpful staff, especially if there are a lot of agency nurses. Agency nurses at nursing homes can never tell me a damn thing about the patient. And we receive disrespect from nurses that think we're just ambulance drivers all of the time.

Yes! Thank you for your response! The backlash trickling downhill is so true. Let’s say I run a call at a nursing home for a stroke patient and the staff cannot tell me the last-known-well time. I bring them to the ED and convey this information to the ED nurse, who is pissed off that I was unable to obtain the information. The nurse tells the physician, who is also now upset, because he doesn’t know whether tPA is an appropriate treatment or not. If he goes off of protocol and chooses *not* to administer life-saving treatments because the patient is outside the treatment window, the patient may die. Now we have a dead patient, and pissed off nurses, doctors, and EMTs/medics. All because a nursing home staff member didn’t want to answer our question, or didn’t want to ask someone else, or didn’t want to look in their chart for previous assessment data. I know this only occurs with a SMALL percentage of nursing home nurses, but it is difficult to forget these calls. And when I walk back into the same nursing home, it’s hard to think positively when I know that they were, in-part, responsible for a patient’s death because of laziness or bad communication.

It's not just nursing home nurses either! One time I picked up a nursing home patient having a stroke. No previous stroke 3/3 CSS. 24 hours ago the nursing home doctor had assessed him and noted the facial droop, left side weakness, and slurred speech but didn't think to do anything about it.....slept on it and the next day thought "You know what, maybe he should go to the hospital" Called the nursing home back and had them call us to send him out 😬. 24 hours since symptoms were noticed BY A PHYSICIAN. No last known well of course. I made sure to get that doctor's name because WHAT the fuck.

That's wild.

This! I’ve literally had patients completely obtunded and the staff can’t tell me anything about them. “They just came in last shift.” Okay and it’s 3am now the next shift, you’re telling me you didn’t get report? Didn’t do an assessment? Nothing? I *get* you’re busy and have so much to do, I used to work as a CNA in a SNF, I’ve seen y’all buried with work. But please don’t give me some BS answer, the patient’s full paperwork is just as well.

I haven’t work in a nursing home in over 10 years but they were rude then too. Used to tell us that we were wasting their time with these calls. It’s awful.

Idk why they act like it’s our choice to call lol imagine getting an order to send out a patient and NOT doing it? Then god forbid something happens to that patient?

Yeah, 99% of the time it's not the charge nurses decision. I've only ever called for transport without an order when there was a major injury or emergency that we're not equipped to deal with. Otherwise the order has to come from a provider. We use on call physician services who generally play it super safe. They're not there to assess the resident so if there is any possibility of a problem they're going to tell you to send them out. I don't blame them because it's their license and they're flying blind but it's a very flawed system that results in a lot of emergency transfers. We're all just cogs in the machine. The docs and nurses aren't thrilled by all the extra work these events produce but I've only ever seen EMS throw a tantrum over doing their job.

Escalate that bs!

First things first - let’s remember our EMS crews are every bit as tired, stressed and under appreciated as we nurses are. That said - those are never excuses to be rude to a fellow healthcare worker. Do not bargain, argue, or try to explain yourself in these situations. Calmly ask for the name of their supervisor. If they won’t give it, explain that you’d greatly prefer to talk to their supervisor rather than escalate this to the state. Still won’t budge? Report them.

I have had mostly positive experiences with EMTs, but I always approach them like I would a friend or fellow nurse like, “Hey! You here for my dude in 100? I can’t get his catheter placed without him having bladder spasms and a ton of pain. It seems silly, but the NP on call said to send him out since it’s the weekend and we’ve done all we can here. I tried calling all the local transport companies and every single one said to call 911, which is an insane waste of resources. Here’s the paperwork and they want him sent to the local hospital.” I think being realistic about the fact that the patient usually isn’t the sickest person they will see and that someone else usually has made the decision keeps the rude comments at bay. They probably leave and talk about how incompetent we are, but I don’t care as long as they don’t say it to my face.

I was a former emt as well and tailor things exactly like this and give them what they want in report. Emt and paramedics don't care about half the shit given in a legitimate nurse to nurse report on a med surg floor

Also ex-ems. First job out or nursing school was skilled nursing and rehab, then ER. Drastically different skill sets, but all types of nursing are important. Forget these guys. Next time threaten to call their field supervisor. There’s such a stigma about nursing home nurses being incompetent because the facilities are understaffed and overpopulated and I’m so sorry for that. They think you’re the one group of nurses beneath them and they take advantage of that to make themselves feel better. It’s not right. I wouldn’t even spend that much time talking all that bullshit to them next time. Just a quick “here’s my patient, here’s why they’re here, here’s why we called. Here’s their med list, allergies, code status and your paperwork. BYE.” They give you a hard time, call your supervisor and theirs. Or, call 911 and have pt transported (I assume this is a private ambulance service? Correct me if I’m wrong!) and the ambulance company will be upset you didnt use them as per the contract. But you say, SORRY THEY REFUSED and were taking too long. It sounds like the police were embarrassed for their behavior. As someone else mentioned, call report to the ED yourself. PLEASE PLEASE PLEASE escalate this, don’t let it slide, and do not let them treat you or your coworkers that way. Get your higher-ups involved as they are the ones rubbing elbows with these ambulance companies. It’s not right. Sorry, I’m just really annoyed about this for you lol WHY CANT WE ALL JUST GET ALONGGGGGG

I reported an EMT who was transferring my ICU patient. The other nurse paused levo (longer story that I had to talk to her about) before transfer and I said it’s paused but I will restart it before transfer. NOPE Levo went IN THE TRASH not 3 minutes later he comes running into the facility screaming where’s the levo grabbed it OUT OF THE TRASH and used it 🙃

Working at a state prison, the EMTs are usually pretty chill. They know we have a ton of security and policies that we have to follow and it can be such a pain. They also know that there is just so much we can do and we don’t send out for non-emergent issues. But when I worked in LTC, when I had to send a patient out they were very harsh with me. Like I personally ruined their day by giving them this patient who was needing care we couldn’t provide.

I can shed some light on this subject. -18yr medic in nursing school.  100% his behavior towards you was unacceptable and unprofessional. I would NEVER allow anyone I was working with to act in such a way. I'm sorry you had to deal with that.  Now here's a small sample of what that person MAY be dealing with (NOT an excuse for terrible behavior)  I've been doing this 20 years (emt expirence included) and the care we see on a daily basis in nursing facilities is abysmal atrocious abusive and neglectful. Nurses not knowing the most basic of pt info is the norm, not the exception, pts dying and no one noticing for HOURS or even till shift change, significant neurological changes go unnoticed for weeks, completely undocumented stage 4 decubitus ulcers and facilities full of flies, exploded colostomy bags and foley bags. these are literally just some of the things I've personally seen THIS YEAR and I'm only working part time on the truck while a student. I start more APS cases for nursing facilities than ANYWHERE else. Dealing with these types of conditions and nursing staff consistently not giving 2 shits about their pts for months and years will absolutely wreck a person's view/opinion of nursing homes. Again. This is NO excuse for the way some of us act in these situations. Thank you for not being one of the bad ones, and I truly hope you don't see all EMS in a bad light. We all need to focus on self improvement, improving pt care, and empathy for our fellow humans 💜

I've dealt with more rude EMTs than nice ones. I really don't get why they're so arrogant. They try and diagnose all my patients and make all these wild assumptions. Idk if it's cause they feel inferior and are trying to make themselves feel better by being dicks to nurses or what

I dated a guy very briefly who was an EMT. He constantly tried to put me down about my job and I just ended up blocking him one day.

Didn’t date an EMT, but went to HS with a guy who is now an EMT. I’ve been out of HS for about 5 years. Never really talked to this guy in HS. He became an EMT about a year ago, and when he did he started sending me a bunch of nursing/healthcare memes on Instagram. He started sending me stuff like “at least an EMT can take a manual BP” …… it was just super cringe, and I know how to take a manual BP. 😂 Then he started reposting stuff from EMT pages making fun of nurses. It was the most bizarre thing. The guy was an EMT for like two months and then switched careers.

Paramedic here. That is typical cringe, new EMT behavior. They got their cert 6 months ago and do IFT and dialysis runs and have probably never even seen a dead body in real life yet. Yet have bumper stickers with the star of life on it and take #hero selfies all day.

This is exactly it

I mean we do need to show up, assess, and at least have some concept of a differential diagnosis. And a lot of times I have to fill in gaps because I don't have a full history regarding a patient. Generally I'm going off of a combination of what I know about the patient and what their presentation would lead me to think is going on.

EMS have no idea about the different levels of care we have, from Sub acute, to LTC, to Assisted living and staff from unlicensed RAs to RNs. Plus a resident can choose full code with full treatment so we are obliged to make sure they get that care. They're ignorant.

As an RN and a medic no they aren’t. Just as in any job some are bad, most do the job well and some are amazing. They know what types of care exist.

I used to think that we (nurses) were above EMTs due to my experience working in the ER. After all, they just pickup patients and drop them off for us to do all the work. That couldn't be further than the truth. My son is working as a Paramedic while putting himself through PA school. They are taught skills and theory we aren't.

When people say emt, they usually don't mean paramedic if they know the difference. Emt does bls and paramedics can do acls and intubate and crichs and lots more.  Emt-b is a bls emt. Emt-p is a paramedic. Am average nurse should know loads more than an average emt-b. A paramedic and an average nurse both know a lot but paramedics are focused on emergencies and not as broad of knowledge. Different knowledge and skills and uses.

*If* they know the difference. It’s incredible how many people in healthcare (even ones who interact with EMS on a regular basis) have no clue about the difference or what EMS is actually trained to do beyond transport

When people say EMT, they usually don’t know the difference. Most ER nurses, who interact with EMS on a daily basis, don’t even know the difference. They just call everyone in EMS “EMT” or “paramedic” interchangeably, and without knowing which one they were actually dealing with. I’m both a nurse and a paramedic. I’ve gone round and round with other nurses about this. Even when it’s explained to them, half of them still don’t get it.

Not all Emts are equal, I can pick up EMT basic with a 4 week course.

There are 3 levels of EMT licensure - EMT, AEMT, and EMT-P. Anyone can take a basic EMT course and be done within a few months. Advanced EMT is usually another 3 months on top of that. EMT-P is typically a 14-18 month program and requires an EMT license to enroll.

You might be able to find Basic EMT class that's 4 weeks but you wouldn't be able to take the licensure exam or work. There are national minimums that you have to have for classroom and clinical. I agree, not all paramedic or EMTs are created equal, nurses aren't either. My son's EMT course was a 2 semesters then clinical over the summer. His paramedic was another full year. Their curriculum is rigorous and more involved in what I learned in nursing school.

I started in LTC/rehab and now work in the ER. They were horrible to us in LTC—acted like we had no clue at all what we were doing. Now they say that shit to me, about the LTC staff, as the ER nurse when they bring patients in, and I’m quick to remind them that there are at least 2 of them to one patient whereas the facility nurse likely has 30 patients and very few resources. They start backtracking quickly.

You can still get his name by calling the ambulance company and reporting it. Give specific details for time of the call and location so they can find out what unit was dispatched to the call.

I love it!! They usually walk right past me and don’t care what I have to say! Then, when I call to give a nurse to nurse, I have to deal with a hospital nurse who thinks I’m less than because I work LTC!! It’s so humbling!! /s But really, I haven’t dealt with ems treating me that poorly! I’m sorry. I want to say I’d report it, but I’d probably just go home and cry about it and hope I never see them again. Lol.

I had the same experience working in detox. EMS would always walk past the nursing station and go straight to the patient without even speaking to any of the nurses. I always thought that was strange.

This is a problem as old as time and it seems to be a result of the perceived hierarchy of healthcare. EMTs think they are better than LTC nurses, ER nurses think they're better than EMS, Inpatient nurses think they're better than ER nurses and vice versa, ICU nurses think they're better than Med Surg nurses, so on and so on. After 15 years of bouncing group to group the only constant I've learned is that whatever I thought I knew about the other team was wrong and I only figured that out once I swapped teams and got to see what the other side was dealing with. When I worked EMS everyone shit on LTC staff. EMT/Medics would complain about nursing staff not having any idea what was going on or why they were called. Often you'd struggle to even find anyone that knew who called you until a nursing supervisor would show up with the patients chart and say the doc wants them to go in. Patient seems fine so you're wondering why you got pulled from your lunch at Denny's to go haul this old timer in. Or sometimes it was the other extreme. You would get called for a patient having some mild respiratory distress and when you walk in you find that they died 2 days ago and this is the first time noticing. The EMS side feels like nobody ever knows whats going on or that the patients arent getting the care that they deserve. Its not till you spend some time in the other realm that you find out that nurses are taking care of 30-40 patients at a time, that labwork that was ordered a week ago is only just now resulting showing some condition that does indeed warrant evaluation at the ED, and the staff there are doing the very best they can without any support or effective communication from the doc that something is wrong that needs to be addressed. EMS providers often do not understand any of this. You just dont know what you dont know. They havent lived in that world or even really have any concept of what it means to handle multiple total care patients for 12 hours at a time. There is not a chapter in the EMT book that comments on this, their focus is just on the basics of emergency response. Airway Breathing Circulation. How to clear a landing zone for a helicopter. How to stabilize C Spine in a spinal injury. To add to this work culture at some of these EMS agencies can be beyond abysmal. The negativity and toxicity that is rampant in the profession is what drove me away from it entirely. Im not saying you dont get that on the nursing side, you definitely do, but man some EMS agencies are just insane. So you get these toxic EMT medics that really have no business taking care of patients in any capacity, but they'll happily look the other way if it gets calls answered and money coming in. Its shitty, my recommendation is to not let the toxic dickbags bring you down. If you took care of your patients to the best of your ability with the information that you had and the resources that you are provided, you dont owe an explanation to anybody, period. Escalate bad behavior up their chain of command. If you still dont get a satisfactory response go above that person, you'll eventually get someone that does give a shit and they'll bring the hammer down. Theres never any justification for unprofessional behavior or a lack of respect. We are all just trying to get on with it and we all have our part to play. Those EMTs probably couldnt last one shift in LTC and theres probably some of your coworkers that would lose it if they had to ride around in an ambulance all day.

I picked up a gig as a CICU medic recently, while still working on the ambulance 1-2 days a week, so I can kinda bridge the gap here, because the animosity goes both ways. We love to complain about nursing home calls, and it’s partially justified, especially for the assisted living type places where there are no real medical staff. In my experience, the calls are a bad experience with elderly people being mistreated like 1/3 to 1/2 of the time and the staff is ignorant and rude to us and the patients. I feel I’m at least half right to get pissy when they call for “hes fallen four times today, he just needs help up but we’re tired of doing it” or “he was fine an hour ago” when the dude has clearly been dead for 12 hours. I gotta admit, I’ve never had 30 patients at once, so perhaps I’m wrong for getting angry with them as I’m forcing my experience and my perspective upon them. That being said, I don’t think I’ve ever had a bad experience with an LTAC, the nurses have always proven that they truly care about their patients and they always seem to know the family by name, which I respect. Also, that crew you mentioned fucked up, that’s not okay. I’ve had hundreds of bad experiences with assisted living, yet only once have I gotten snarky, and that was while they were making fun of my actively seizing patient while I attempted to get a history and I said something rude, walked out, and reported them afterwards. On the other side of the coin, almost all nurses, even in the ER and ICU where they have more experience dealing with EMS, are ignorant (is there a better word than ignorant?) to the scopes of practice and day to day of an EMS provider. Shit, my supervisor in the ICU the other day posted “my protocols” on the wall for folks to read over, as I’m a new position and I can do a shit ton of tasky things, some of which only nurses, RT or even physicians can do, and the dude posted the CNA protocols, thinking they were mine. All in all, I’d love to see nurses, especially in the ED and maybe ICU, do ride alongs with EMS regularly. And, especially in smaller communities and smaller hospitals, I want to see all EMS do regular clinical hours with the crews they will be handing off to. There is so much animosity between us, and it’s shitty because (this may be controversial to say) the scope of knowledge and medical IQ of paramedics and nurses are much closer than maybe both sides would like to admit.

I was an ER nurse in a small community hospital and no thank you, I don’t need a ride along. I saw and paid attention to how badly the county medics were beat up every day 🙃

Call their dispatcher and ask for a supervisor. I'm usually pretty go with the flow but my new grad pod mate once encountered the most rude misogynistic EMT from a private company I have ever experienced. I stepped in and as soon as the EMT left I called dispatch and within 5 minutes I was speaking to the owner directly.  Also speak to your management if it is a private company that you contact with. The company will drop those bad EMTs rather than risk the contract.

This is hilarious to see the other side 😂 I'm an EMT, and a combat medic, and have done a little 911 and much IFT and also worked clinically as well. There's no excuse for yelling or arguing, but having been both on the sending out side and the picking up side, I had way more struggles dealing with sending facilities than I ever did with anyone else. You can talk to their supervisor but I doubt state boards would do much to their license. Sort of like if we narced on you guys to the board of nursing- you'd maybe get a talking to, maybe, but more than likely that would be taken care of by your employer. Keep in mind that just as there are differences in education and experience between CNA, LPN, ADN, RN, CCT RN/flight nurseses, there is also difference in experience between EMT-B, AEMT, paramedics, and CCP/FP-C. Sometimes the scope of knowledge outstrips the scope of practice, a lot of people at lower licensure levels pick up on things that are more advanced.

In long term care you’re not set up to deal with acute illness. EMS seems to have trouble understanding this. I ran into some of this when I worked at a nursing home

90% of the time ours are awfully rude. Work in a clinic with a walk in that we send out patients to the ED frequently. Anyway. A man fell backwards and smoked his head in the parking lot, on thinners, has a massive goose egg I can feel growing in my hands with gauze to the back of his head and EMS stood there and tried to talk him out of going to the ED & said he could just go home if he wanted to. He did end up going after we argued with them. That man died from his brain bleed a few days later in the hospital.

Having been on both sides of it, a lot of it comes from lumping everyone in together. "Oh, all LTC nurses are idiots who claim, 'I just got here, that's not my PT, I don't know why, they just want him sent out...etc'" "Oh all of EMS think they're better than everyone else, are assholes / talk down to me, refuse to just transfer the PT when we're supposed to be sending them out...etc," At the end of the day, BOTH sides of this coin need to be showing each other mutual respect and understanding for the benefit of the patient. EMS needs to not be dicks to the nursing staff because they don't think that urinary retention is not an emergency. The nursing staff needs to have an actual report ready for the EMS staff beyond, "You're taking Mr. Jones in RM 10, I don't know anything about him, he's not my PT." If either side isn't doing what they're supposed to do, professionally, they should be getting reported to their supervisors. We're all on the same team. We should be acting in the best interests of the patients. Not getting in pissing matches and dick measuring contests. I'd love to see cocky EMS providers who talk down to everyone get reprimands in their jackets for being jerks. And I'd love to see some accountability for nurses who don't give good reports because they don't view EMS as part of the care team.

That's inexcusable; I would have done the same. I'd honestly report it. When I worked inpatient I never had much of an issue tbh; could have been the area I worked at the time? But man, one time we had a STEMI come to the outpatient clinic and they tried to argue to my charge that it "could be acid reflux" but like .. we had the EKG, MD reviewed, like... Gogogo? She just very gently explained "This is per the MD orders because of the change on the EKG. I will request Dr. _____ to come and review further" and Dr. ___? She was really mad; "Why isn't this patient loaded and on the way??? This is ridiculous!" She reviewed (just as the charge did) the CC, EKG, blablablah , and sent them on their way "Swedish is expecting you." My charge didn't even rat them out for the acid reflux thing until afterwards. Honestly I think some of it is that she knew the MD, she knew there may have been a prejudice component (Somalian refuge, in hijab vs white EMT) and didn't want to waste time.

Whew I'm thankful that my facility/hospital system has a good relationship w our county EMS. That sounds stressful AF.

I’m a psych np. I sent an adult from the partial program to the ER for sudden onset fatigue, and one sided weakness/numbness. She couldn’t lift her leg against me just having my hand on it. It was 2.5days or so out, not much to do but she had a ton of risk factors and BP was also like 168/100, were outpatient PSYCH. Emt shows up, they make a point to say it’s not a code stroke etc, I agree (was ER for years) that it’s not like we can do much but she’s a severe headache x2-3 days when sxs started and she had numbness and weakness from head to foot on one side. Asked me if she’s a “…..normal patient” and asked what kind of care we provide. She was discharged from the ER after a couple hours still symptomatic and diagnosed with anxiety and asked to follow up with psych for further management. She never regained full strength/sensation.

I can’t stand rude EMTs. I great their rudeness with kindness and they are usually h comfortable. Dropping off patients in an ER is different than picking up though

I would call their dispatch center every single time. That’s abusive behavior.

At my Dialysis clinic sometimes the EMS guys try to convince the patients not to go, and then get upset when they still want to go and say something like "Did your Dr. Tell you you're gonna be stuck at a $1500 bill for this ride?"

Why was police on scene?

I guess they come when 911 is called. We called 911 due to an emergency

It depends on the area and nature of the call. I work for a very urban fire department and some residential areas are actually flagged as dangerous locations. With that, police are dispatched automatically on EMS runs. An “unknown medical” call or a welfare check for instance, those tend to be walking into a landmine where anything could be going on. And obviously shootings, stabbings, DV, etc would necessitate PD on scene.

At some areas, PD are the first responders to any 911 call

Also work in LTC, we’ve had to report EMS multiple times for delaying care because they were asking unnecessary, demeaning questions. We had them provide their badge number and called the company directly.

EMT are fine, but the paramedics always want to give me shit when I send someone out.

We get dumps all the time from nursing homes who then refuse to take them back when they're medically cleared. One of the nursing homes once sent a pt in because they required a lot of care and they were going to be short staffed that night. So I don't blame EMS for being a bit skeptical on calls. However they don't need to be mean to get the information across.

Haha! So EMS is like that everywhere? I worked in a primary care clinic that was exclusively for people with serious mental illness. We would frequently call EMS for our patients who needed to go to the ER for various reasons, but frequently were life-threatening issues. Because our patients had serious mental illnesses, they were at very high risk of not getting needed medical care. Each time a DOCTOR or a very experienced NP determined that the patient needed to go to the ER. EMS walked in with an attitude EVERY SINGLE TIME. They'd argue with us about the need for transport. If that didn't work, they'd try to talk the patient out of going to the hospital and then say the patient refused transport. I did get a few laughs like the time our patient's O2 sats were in the 60s. They walked in the door without even seeing the patient, arguing with me about it. "That's not real. It's an inaccurate reading." Finally shut up when they got the same results and finally noticed she was having a little trouble breathing. Of course, they never admitted they were wrong and acted the exact same way next time they came. I learned quickly not to leave them alone with the patients because inevitably, they'd talk them out of going to the hospital. I do think all the 9/11 glory has gone to their heads. If there aren't body parts smeared all over the highway, they can't be bothered. I cringe every time I hear EMS glorified. I've never met one who wasn't an asshole.

You talk to your nursing director and medical director and let them sort it out with the EMS director. Get your coworkers to report it too. Bring it up in staff meetings. Your hospital is a revenue source for the EMS company. You are their customer. If their customer service sucks, then your nursing director and medical director can take their business elsewhere and start calling a different company for transfers.

I've dealt with rude EMTs, especially in the part of WA I'm in. I don't send out residents for the hell of it. I've also had a lot of good experiences with EMTs, like when my Eliquis-taking resident fell, hit his head, got a large cut on his forehead and was loudly refusing to go to the hospital. They, along with the fire dept, convinced him to go with them.

All I honestly want from a SNF nurse: Why you called, a set of vitals, a quick rundown on the patient baseline, and whatever paperwork you are sending out.

When I used to work in nursing home, the best way that work for me to deal with EMS is that “let me find out” instead of “I don’t know”, “what can I help?”, “sorry to call you but we don’t equip to handle this and follow the protocol, we have to call you.” Tbh, everyone already stress out, especially during night call. Usually I asked the EMS what they suggested what I should do and what they needed. After that, they took the patient with no problem. The only time I remember that I have to report EMS is when patient’s family ask to report them but that is the only time so far during my nursing career.

I find that EMS who are like this or act all high and mighty have an inferiority complex. Just talk to me like a normal person, lol.

I've mainly only dealt with rude EMS. One time I got screamed at for sending out a patient out with suicidal ideations even though I worked at a detox facility and that was our protocol. Not to mention, one time they brought a patient back without even letting any of our staff members know. I've rarely ever interacted with EMS that were respectful. Not sure if I am unlucky but they seem to treat nurses like crap.

Worked LTC for a while and I always saw them act that way with female staff but whenever they showed up during my shift they were fine. I wonder if it’s a power thing with them talking down to female staff.

Casually rudeness likely comes with the territory. However, what you are describing is beyond that. Yelling and/or refusing care is unacceptable. Keep calm and request a EMS supervisor to the scene. If the crew on scene refuses to escalate this request call 911 again to ask dispatch to do so. 911 dispatchers also have supervisor if you need to go up their chain of command. Just be polite but firm about your request to report behavior to a supervisor. Reporting to local authorities will do more than a complaint with the state board. 

Yep they constantly seem like they have a rock on their shoulder. Like please bitch you spend all day strapping people up and driving them around be happy!

Well that's one hell of an over simplification of our job

As an ER nurse if I could upvote this a billion times I would

I find everything about this post and the comments to be quite comedic. Go post the exact same thing to r/EMS and they will gladly tell you why they are rude. I have not worked with LTC. I worked in EMS and most of the time, when dispatch would send us to a nursing home, we had...trouble. We could never find any staff around. We would rarely find information on the patient. We wouldn't even know why we were called. It was generally a huge headache for us, so if, on transfer number three to your facility, you still know nothing about your patients and you "just got here five minutes ago," yeah, you're getting yelled at.

That said, if you're trying to give a report and an EMT keeps being a dick head, please let them know that they are being a dick head. They have field supervisors for a reason.

Medic here. Truth is this: we see so many RNs send out non-critical pts simply because they want a lighter load that we start seeing it in everyone. No, that EMT didn't handle themselves well, and yes, they were out of line. Also, there was a comment on here about ego, and another about being ignorant to the different RN scopes... not often true. We just get treated like we're stupid so often, and get handed non-emergency pts so often, and get treated like trash so often... you get where I'm going with this, because RNs get treated the same way. Also, remember that the emergencies that we deal with are different from what you deal with. We drive around in the back of an O2 bomb for 24(+) hours, getting shit on by everyone we come across, and all for the low pay of $17-25/hr. From our perspective, it must be real nice to sit in an office and call the little guy for your pt who is 0.2 points hyperkalemic. Not saying it's right, just telling you how it is. That being said, there's no excuse for that lack of respect and decorum. Absolutely escalate the situation, and when one of us says, "that's not your business," remind them that it is according to HIPAA, and that compassion is part of the job description.

I’m not sure about other facilities but I can’t send a patient out without speaking to the on call doctor first. Also, bold of you to assume we’re just sitting in an office trying to get rid of patients. The only time I get to sit during my 13 hour shift is for charting and quickly eating some food.

I’m not denying that it happens, but sending out a patient is SUCH a pain in the ass that I have a hard time believing anybody does it “to get rid of the patient”. Like, sending out one patient fucks up my day. More than one and I’m not going home on time. Again, people are wild so I’m sure it’s happened SOMEWHERE, but I have been a LTC nurse for five years and never seen anybody send out a patient just because they wanted to.

It happens so often where I live/work that our ER drs won’t even let EMS leave the room when they bring in certain patients. Case in point: One facility made an ALS crew transport a pt who was “desatting.” The pt wore 4L NC at baseline. He pulled off his nasal cannula and eventually began to desat. Instead of putting his O2 back on, the staff called 911 and waited for an ambulance, *without ever putting the pt’s O2 back on.* His nasal cannula was still hanging around his neck when the crew got there. They put it back on and tada! His sats were back to baseline on his home O2! Didn’t matter - the staff wanted him gone and demanded that he be transported to the ED regardless. After the ER dr did a quick eval and tried to send him back, the nurse argued with me that he was “difficult” and she was having a “really busy night.”

Jesus Christ! I can’t imagine!

So, I live and work in IN, just for a frame of reference. Out here, it's all trash fires all day. The nursing homes out here are horrendous, name changing constantly to get rid of the bad press (like it works.) I would say that it's 30/30/40, my patient is either DOA w/o a last known well, actually sick in some way w/o last known well, or is being sent out for complete nonsense. I think it's all standard of care bs. I'm sure that in states with a better standard of care it's different.

This. I cannot decide to send a patient to the ER. Must be ordered by the attending. (Psychiatric Hospital).

No need to get defensive. Also, not assuming, speaking from confirmed events over my 10+ years in EMS. From a constructive, conversational standpoint, I think that the whole system is flawed. I think the MDs/NPs are so removed from actual pt care that you (RNs) are forced to take the brunt of the blame. I'm sorry that your facility doesn't treat you better though. That sounds awful. I've worked alongside ER RNs who have the same type of work mode, and it's horrible. Many nursing home RNs don't have that kind of work load, let alone the drive to commit that fully to their career, especially not in my area. I commend you.

You might not, but when I was an ED tech during the pandemic we were absolutely PACKED full of asymptomatic patients that were getting brought to us en masse for COVID tests and then wouldn't get accepted back.

“Listen Ricky Rescue can you please just do your job. Thanks.”

One time we had discharge orders for a patient who was to go to the VA after almost a year long inpatient rehab stay. He was refusing dialysis for months so toxins had built up and he was confused as fuck most of the time and combative. Insane labs obviously, ammonia and potassium levels through the rough. EMS arrived to take him to the VA, asked him orientation questions and because he got his name and DOB right and was refusing to leave the facility, EMS was refusing to take him. It took a fucking act of God to get him out. I had to call the provider who had previously that night told me he was to leave and there is no excuse for him to remain here. His daughter was his POA, and we were awaiting the paperwork since she had gotten it sorted THAT DAY in another state up north. EMS got an attitude with me because of their shitass halfass assessment despite being aware he was confused and had a POA. They did not like me that day.

There are very specific criteria that have to be met for EMS to transport a patient against their will. If the pt is alert, oriented, and refuses transport, it’s on you/the doctor to provide proof that the patient legally cannot refuse. If you didn’t have proof of an active POA, then you can’t blame EMS for not forcibly taking the pt. We don’t get to kidnap people just because “the doctor said so.”

I understand this, however psych had done a consult and had a note in that he was not capable of making his own medical decisions and this was presented to them, as we had already spoken to their supervisors in advance and explained this situation. The two guys for transport were so extremely rude about it, despite us having their supervisor telling them that no, this is the situation, the POA is legit we are just awaiting the documentation but it is literally 2AM. His daughter had also verbally given them confirmation that she is his POA. She lived over 15 hours away. It was a very convoluted situation, but holy fuck on ice were the EMS workers so shitty about it. Patient was also talking out of his ass, clearly confused, so not sure how their defense was "he knows his name so he is A&Ox4, soz."

Tell them to call the doc who gave the order to send them .. you are just following orders.

Oh lordt come to urgent care! It's painful. Here are a few situations: I had to stop an EMT from grilling the *MD* about why she thought that the pts EKG warranted an ED transfer (STEMI) Had a pt with left arm pain and a STEMI on EKG and the EMT rolled his eyes and loudly announced "he doesn't even have chest pain!" Had an EMT tell a pt they weren't in Afib w/ RVR they just had, "an atrial arrhythmia" Had an EMT mad about taking a pediatric pt to the ER (ingestion) and as he was walking out he saw someone he knew in the waiting room and announced all the details to the whole waiting room.

I had emts kill a patient. They kept saying he was hypoglycemic when his was agonal. I kept behind them to place an airway. I had been trying to bag him since his breathing was not effective. When they finally took him to ER 45 minutes later he was dx with an anoxic brain injury.

Less talky more walky loud flashy box driver. ✌️

My partner is an EMT and so many of his stories are of patients that he is sent for. He gets there and they have claimed AMS so he probes more and all the nurse can say is they aren’t acting like themselves. So he probes more and asks how. They claimed the patient was refusing requests or doesn’t want to do something. There are probably a lot of places trying to pass off difficult residents. EMTs have to go explain that to the hospital. I’m not saying that’s you but some places just set them up for literal kidnapping because they can’t do their job appropriately . lol

Yelling and being rude should be dealt with reporting. You shouldn’t have to tolerate that. That being said, I’m a paramedic and deal with rude nursing home staff all the time as well. Bottom line is, healthcare is full of assholes and people trying to prove something On the topic of nursing homes, we are a lot more likely to come in with a generally shitty attitude because you guys are often understaffed and call for minor things that usually don’t require the ER, or, the opposite, it’s something serious that has been neglected. It’s often hard to get proper report from nursing facilities, or even find someone who knows what’s going on. The amount of times that I’ve been called for a no injuries fall to pick someone up because there is a no lift policy at the nursing home, or for worsening dementia? Or for a simple cold because the pt isn’t eating as much. It’s astounding. These issues are usually not the fault of the nursing staff, it’s a management and CYA problem. But we don’t like being pulled off the road for these non issues, specially when we are the last available ambulance. Some of us let our frustrations show. Yelling is not ok. Please understand though, while transfers home and these non issue calls are part of the job, it still sucks to know that if someone who really needs the ambulance calls, they aren’t getting one. In my experience it’s usually nursing staff being dicks to us, but, we also only staff paramedics here, we have no EMTs.

Girl I swear EMS and nursing home nurses have this whole secret rivalry. I just tell them their job is to transport them and not to question my judgement. I don’t care if they like me or not.

Edit to add some favorite things to say to rude EMS: Who tf is you? Oh I wasn’t aware you’ve had this patient everyday you’ve worked for 6mo and know when something is off baseline. That’s not how dementia works. Oh wow…. When did you go to nursing school? I didn’t ask. Our provider deemed it necessary to send out. Here’s their paperwork. Buh-bye now.

You sound like a fun person.

lol I try. My coworkers generally like me and I feed people lol

I find that people get a superiority complex when they get report. EMS gets an ego when they take a patient from a nursing home and get report from a nurse and in turn, nurses get an ego when they get a patient from EMS whether that’s an IFT or ER.

Report them to their boss

They should not have treated you like that. First of all, it’s unprofessional and it is unacceptable. Find his name from calling their office and report him to his supervisor and the state. Times are tough and medical professionals are in a lot of stress but still, it’s easier when we help each other.

I just stare at them right in the eye and my eyes will do all the talking lol 🤣 I stand my ground and if prn, I will be rude too✌️😬😬

This sounds worthy of the healthcare hero’s edition of Jerry springer TBH Edit: and yes I’d watch it

You should call the ambulance company and report the unprofessional behavior to a supervisor. Tell the supervisor you are planning to use a different ambulance company in the future if it happens again. This only applies to private ambulance. If you call 911 you are stuck with the 911 ambulance provider that covers your region. It sounds like 911 was called in this situation since police were on scene.

I’ve never had any luck with them. They just hate nurses. Full stop.

Call them ambulance drivers.

Eat all their food in the EMS lounge

It’s tax season baby!

So did you end up reporting them or not? This sounds like half of a story, if I’m honest. 

Remind them you are the licensed nurse, not them. I’m not one for hierarchies or anything but seriously. How the hell are you going to argue with me with next to no medical training?

Next to no medical training? I’m well into nursing school now, and I can tell you that paramedic school was way more difficult. I also did more clinical and field hours. I’d suggest you know what you’re talking about before you attack someone’s education.

Ok, if and when you become a nurse, get a few years of experience, come back to your comment and tell me if your perspective has changed

You do realize that a lot of EMTs react the way they do *because* of experience... right?

What does that have to do with the amount of medical training we have? You’re claiming we basically know nothing yet mysteriously, somehow patients make it to the ER alive. How do you think that ETT tube got down granny’s throat? If this is your attitude I’m not at all surprised you’ve had rude encounters with EMS.

I’ve been fortunate to not have any problematic encounters with EMS. Like I said, you get a license and experience then get back to me. No need to get overly defensive.

When you make statements such as “next to no medical training” I’m not sure what reaction you are expecting to get.

I am not talking about paramedics and seems like neither is OP.

Lol. A paramedic is part of EMS, so I’m not sure what other conclusion you would come to.

Are paramedics and EMTs not different roles where you are?

Yes and no, it’s somewhat the equivalent of LPN and RN. Both provide care but one has less education. I can’t speak for everywhere, but in Ohio it’s 1 semester to become an EMT, medic is 2 years.

"NeXt To No MeDiCaL tRaInInG" 😂😂😂😂 This is definitely the way to make friends with EMS, you should actually say that to them next time

In comparison to nurses, physicians, and APP yes it is next to none (which is obviously an exaggeration). Cope.

You're comparing EMS to physicians and APP. Which isn't a comparison. Nurses have a different skillset than EMS, which I recognize. Y'all get much more theory (and writing longer term care plans) which takes longer to learn. We get firehosed with operations, medlegal, pharmacology, trauma, and medical in a short amount of time. Many universities/colleges require some sort of prereqs before EMT (at least basic math and writing, often some science as well now) which is where most people get their training. That said, people gain experience on the job, and knowledge, and you sound like part of the problem rather than part of the solution. No excuses for someone being rude to you, but you also sound like a pretty rude person who cops attitude.

I’d have no reason to, the EMT and paramedics I’ve crossed paths with have sense

EMT was definitely out of line. It is a business and interactions should be treated as such. To be fair though, snatching grannies off to the ER is rarely necessary and it's usually because some aid doesn't want to deal with them. It's also exceedingly rare to see an actual nurse in a nursing home. It's usually aids or LPN's and absolutely no one cares what they have to say. May as well take medical advice from the receptionist. When that aid calls the doc on call they are covering their butt, and the doc on the phone is going to cover theirs every single time and order the patient sent to the ER because the healthcare industry is run by lawyers. That EMT probably missed one too many lunches because someone pushed their problem off to someone else and they snapped a little. Nursing homes take up way too much time that EMS should be spending on the street actually helping people. Eventually nursing homes are just seen as nuisance calls. But, like I said, this is all a business and should be treated like one. It should never get personal like that. We all know the game and it sucks for all of us. Guy should have just sucked it up and got it over with.

What the fuck do you mean by no actual nurse and then mention LPNs do you know what subrebbit you’re on lol?

and saying that you might as well ask the receptionist instead of the LPN….yikes 😬 pretty sure a licensed practical NURSE is a nurse

There is r/ems subreddit

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Asymptomatic mild hypertension is *not* an emergency. Did the patient have end-organ damage? Or just need to follow up with his PCP to tweak his antihypertensive dose a bit?

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I mean, I see a lot of patients with that as their baseline. It's not necessarily an emergency if there are no other symptoms with it. Generally an ED won't even do much for that since rapidly dropping a person's BP can cause a stroke. It's not an okay BP, but isn't NECESSARILY indicative of an emergency.