Friday, January 25, 2013

Sometimes the Nurses were right.

When I started in EMS I was informed by my instructor that my biggest enemy in patient care was going to be nurses. Nurses didn't like EMS because they hated the lights and sirens. They hated that the paramedics could intubate and run off of standard orders. They hated us because of many reasons. All of which were related to jealousy. By the way my EMT had been married to a nurse that he called Cruella DeVille.

I found that most nurses that I encountered were supportive. Their biggest complaints were often involving no IV's on patients or call ins they felt were inadequate. They were my skill instructors in Intermediate and Paramedic class. They helped us constantly and we helped them. I found there was a rivalry, but it was more akin to that of the Army and Marines, friendly and for the most part productive.

In our looking forward to EMS 2.0 and the community paramedic concept, we need to learn from the nurses we know. Mainly long term impact on the patient of our treatment. Oxygen is the most abused drug on the ambulance. We consider it safe and it makes the patient think we are doing something. However Oxygen Toxicity is becoming recognized as more prevalent than previously thought.

Thinking clinically will lead to better care all around. A major problem is coming from system protocols that are not updated often. You can still be in a position of doing something that will either harm your patient or possibly harm your ability to provide for your family. This is especially true in states like Illinois that still utilize a resource hospital instead of services hiring their own medical director.

Yes, these things we can learn from nurses. It turns out that when the nurse was mad at you for bringing in a patient on 15 lpm per nonrebreather he or she was right. You were possibly harming that patient. Welcome to EMS 2.0. We have to admit we were wrong sometimes.

Thoughtfully yours.

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