This is ludicrous!

[LilHouse]

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[emttim]

Ok, so I really need to vent here. IMO, this is absolutely insane.

Whenever I'm in the ER, I always hear nurses (esp. the male ones) complaining about the drama among coworkers. They're catty and clicky. It must be the high estrogen factor. Seriously, they're in a level 1 ER! You would think they could find some drama somewhere instead of having to create it themselves.

One of the male nurses was venting to me about it during one of my clinicals. Everyone apparently turned on him after he broke up with one of the female nurses. Middle school, anyone? I chuckled, and said "yeah, I feel for ya. Lucky for me, I don't have to work here, so the drama's not a problem for me." Oh how wrong I was...

So, I got a call today. The medical director wanted to set up a remediation due to poor performance during my clinicals.

Now I'm really stressed. I've been infiltrating a few more IVs lately, but I can't think of anything real awful. At this point, I'm thinking that I somehow administered a drug improperly and caused harm. Oh no - my worst nightmare.

I spend all day stressing out. Do you know what the problem was? I didn't harm anyone. My IV skills were average, and my other skills were great.

The nurses, several of them, wrote that I spend too much time looking for severe trauma, acute medical emergencies, and rare CCs. That's it! They felt I should stick with some of the run of the mill pts. You know what that is? That's nurse speak for "you're not doing our job for us."

Seriously though, they take vitals once per hour and each person gets two pts. The rest of the time is spent doing paperwork. I don't do paperwork, so I would have to sit and, basically, stare at the wall. Hmm....taking vitals on someone who's complaining that "my veins hurt" (seriously) or doing chest compressions on a code. They gave me a poor evaluation because I didn't forego excellent experience to spend 5 minutes of each hour with a psych pt who is simply wasting precious resources. I worked with many psych patients at my previous job, and quite frankly, I'm in the ER to actually learn. I want to help sick people - not bored ones.

I spend a large share of time working with minor cases anyway. In fact, that's where I get most of my IV starts. They're fun to chat with, examine, and administer drugs. I really do like working with everyone, including the people who don't need to be there, but it shouldn't be suprising that I want to work with the sickest ones. Seriously though, I want to be a paramedic not a nurse. Is it not suprising that I want to gain experience I'll actually use? I do want to be good at my job.

The thing is, most of the staff knows me. They usually tell me about the acute stuff, and they give me things to do (e.g. IVs) whenever they can...even when I'm not on their team. I guess next time I have to tell them I can't. I'm not thrilled by the fact that I now need to sit around and act like an EMT-B until I get out in the field again so as to avoid more drama.

It's really not a big deal, it's just they have to call a remediation anytime someone gives me a bad rating. I think I might just have to request certain preceptors - like the ones that care more about their patients than their work environment. (You can easily pick those nurses out too)

I just think it's crazy that they would give me a bad rating because I'm not handling all of their patients for them. That's not my job, and that was made clear to them long before I got there. My job is to learn, and I try to do it the best I can.

Ok, I'm done venting.

That is just simply incredible and underscores a prime example of why a lot of EMS providers don't have a particularly high amount of respect for a lot of nurses (take note I said a lot, not all since there are some good ones). I would see about contesting that because that's just simply ridiculous. You shouldn't have to do some fat slob's work for them because you actually wanted to get experience that'll help you do /your/ job later on down the road.

 

[pseudoknot]

I don't know you, but from your post it sounds like you may have a poor attitude, especially with the comment about psych patients "wasting resources." I've known EMS providers who felt that some patients or complaints were beneath them, and they usually end up irritating their coworkers and treating patients poorly. Most 911 calls aren't immediate life threats either, and you can't pick and choose based on what's exciting enough for you.

 

[emttim]

I don't know you, but from your post it sounds like you may have a poor attitude, especially with the comment about psych patients "wasting resources." I've known EMS providers who felt that some patients or complaints were beneath them, and they usually end up irritating their coworkers and treating patients poorly. Most 911 calls aren't immediate life threats either, and you can't pick and choose based on what's exciting enough for you.

From the OP's post, that doesn't sound what's going on, it sounds like the nurses just want him to do their job for him. From what I hear from people who have gone through medic school and even the instructors themselves, this unfortunately is a common occurrence.

 

[canjosh]

Yes, this is a common problem. We are not training to be nurses, yet nurses precept us when we do clinicals. It is a problem when your orientation involves where the dirty linens go, where you get clean linens, and where the vitals machine is parked. That being said, you can still learn a lot from the bread and butter patients. In fact this is actually where most paramedics need more exposure. Trauma and full arrests can be a rush--but they're easy.

 

[fiznat]

Just go to the remediation and see what they have to say, whats the big deal? Students make mistakes a lot. Remediation helps them recgonize those mistakes so that they can think better of it next time. Who cares? ...Unless you insist that you haven't made any mistakes at all, which is rediculious.

This is (I assume) paramedic school and it will be over in a matter of months anyways. Suck it up.

 

[jonb12997]

Most 911 calls aren't immediate life threats either, and you can't pick and choose based on what's exciting enough for you.

This is very true! Most likely, a lot of your time is going to be spent doing "boring" stuff, especially as the new medic. It's also totally within your medical director's right to have you redo some of your clinical times. It's his license that's on the line after all. If he trusts the nurses, then you just have to do what you have to do.

It is a problem when your orientation involves where the dirty linens go, where you get clean linens, and where the vitals machine is parked. That being said, you can still learn a lot from the bread and butter patients. In fact this is actually where most paramedics need more exposure. Trauma and full arrests can be a rush--but they're easy.

Is changing linens all that hard? Medicine is a team sport, and I bet that if everyone helps out with stuff like that and "plays the game", the nurses are going to work with you and help give you stuff. If you're going to be that medic student who's just in the corner being like, I don't care about this, this doesn't help me any, the nurses are going to get annoyed really fast and aren't going to let you in on the "good stuff", but if you help out with whatever needs to happen then hopefully they'll be more likely to work with you and let you do some more interesting stuff like IV, tubes, etc.

 

[canjosh]

You're talking to the fastest linen changer of them all buddy. Been a paramedic for 10 years now, and most of it has been in the hospital...so I've spent years doing what many would term scut. The problem I've seen is that many nurses have no interest in the quality of clinical education they provide to paramedic students. To these nurses, the student is there as an extra pair of hands to do scutwork...and they won't come find you when there is an interesting patient...they want you to only change linens, stock supplies, etc. This is the time for students to learn clinical judgment skills, and differentiation of diseases they're likely to encounter. For these reasons, I believe significant time needs to be spent in the shadows of the ED physician, or MLP.