The C Team and Impressions: Medic and Nurse
Last night I felt like the kid that sits at the end of the bench all season long. You know the one. The loudest fan who has one of the best seats in the house, gets to wear a uniform, but never actually gets to play.
Well, I was that kid who all of the sudden hears the coach say her name. She is too shocked to believe she heard right, then finds herself with the ball, body stiff from inactivity, wondering what she should do next.
Believe it or not, all the while I was thinking about writing this post for NSR.
I guess I have some explaining to do.
Due to recent events, last night’s flight was only my second patient transport in a month. I am rusty as all hell. My clinical mind is fine, but the mechanics of working a new aircraft, a new stretcher, new placement of equipment compounded by not flying much as left me stiff and out of sorts. My doc last night was feeling the same way. Picture the Two Stooges play Flight EMS then throw them in the back of an ambulance. NOT pretty.
Okay, it really wasn’t that bad. Well, except for my smashed fingers.
Add the changes onto the necessary evil of ambulance transfers at both the receiving and accepting ends of the transport (read: fly to airport closest to sending hospital, take ambulance to hospital, drive back to the airport, fly back to hangar, take ambulance to receiving hospital) and the issues I was having were compounded.
I do have a point to this, I swear.
Here I am, transporting a ATV + ETOH = trauma and I have to interact with two separate EMS crews, ride in their ambulances with my equipment and have to function. It is a bit like a duck out of water.
So, during my patient transport, the part of my brain not involved in what I was doing, was thinking about the post I wanted to write regarding the interaction between EMTs and Nurses. I was able to remove myself and see the impressions they were leaving me and I was leaving them.
The first ambulance ride from the airport to the sending hospital was with an EMT (possibly medic) who was on scene when the patient was picked up. She was sent to retrieve us and our equipment up while the other medic finished his report. This is usually a great opportunity for us to ask the crew questions about what happened without the chaos of the ER. This is especially true because the medics know the story firsthand.
She couldn’t answer even the simple ones. I tried a few more times, using a different approach or two. No dice. All we could gather was that the patient had some sort of a head injury. So, I gave up and bumbled through attempting to help her load the stretcher into the ambulance. I felt completely uncoordinated, in the way and a bit annoyed.
My impressions? Dumb medic who couldn’t answer anything.
Her impressions (via my head)? Stupid flight nurse who couldn’t walk and chew gum, much less get her equipment into the ambulance without tripping.
Interactions at the hospital with two other medics who had cared for the patient were interesting as well. As I did my assessment, medic two gave me report (he knew more than the nurse at that point as they had just arrived at the hospital). He went out of his way to help us get the patient loaded and ready to go. Not only did he know what was going on, he intuitively knew what I was going to do before I went to do it. Very cool.
The third medic seemed so intent on getting back to doing his paperwork that he had to be refocused by medic two. He knew we needed to expedite transport and that the brawn of medic three was needed. Medic two wouldn’t let him sneak out of the room. I liked this guy. The in-hospital portion of the patient pick up went well because of his efforts.
My Impression? Knowledgeable, focused, helpful medic. The rest of this leg of the transport went without a hitch.
The flight back to the airport went, um, well, ok. The patient was agitated, needed to be sedated and that always makes for an interesting trip. One thing I learned early on is that if I think they are going to need restraints, I put them on at the beginning. Much easier to do on the ground than in the air. At least being in the air, in my own element made my bumbling nature not so noticeable. Until I lost the syringe with the Versed somewhere on the stretcher. Good thing we have more.
Our second medic crew was waiting at the hangar when we landed. We were their first run of the day, so they were cleaned, pressed and fresh. My doc and I? Yeah, not so much. Just getting the patient out of the aircraft was an experience as I got my fingers where they shouldn’t be. Yeah, that was their first impression of me. Cussing a blue streak, jumping up and down shaking my hand. Nice.
Their second impression? A discussion between me and my doc about whether or not we should delay to intubate this snoring trauma patient. So, we bumbled into the back of the rig, dug through our equipment bags, and I shoved a nasal airway in. Intubation avoided, O2 sats 100%. During this escapade we realized we left the chart and had to flip around. More cool points lost. By this time I am feeling like a complete idiot.
As I made room on the bench for the medic I realized that was indeed her impression as well.
And I quote! “Yeah, the other flight crews just get in and do their thing. This is the first time I have EVER had to ride in the back.”
Lovely. Medic’s first impressions of Flight Nurse Emily?
The patient part of the transport went fine. Despite, at least my, best efforts to trip at every opportunity.
I have the unique chance to work with medics in some awesome situations. There are good nurse and bad nurses. There are good medics and bad medics. I believe much of the bad blood between nurses and medics is based on two things: very brief interaction times and lack of understanding the others profession.
We are forced, especially in larger hospitals, to made judgments about the other in brief minutes during patient hand off. Last night I was having a bad night, and interacted with five medics I had never met before. Because I brought my “C” game, each one of them could make assumptions, and then tell the juicy tale of the stupid flight nurse. Our professions beg for stories to be told, and that would be a good one.
I also believe that nurses don’t understand the education, level of professionalism, and physical stamina it takes to be a medic. Nurses, ordinarily aren’t required to walk into an unknown person’s home, assess a potentially dangerous situation, and provide patient care. Medics don’t know what it is like to manage 4-6+ patients for HOURS at a time, all the while being pulled in 100 different directions. One of which happens to be the next ambulance that rolls through the door. It is at that moment in which the professions collide.
Yesterday? I was on the list of stupid nurses. The impression I gave was not one of competence and confidence and it showed all over the face of the last medic. The same goes in reverse for the first medic I encountered as well only this time, I was not impressed.
How should I have handled things differently? First, I shouldn’t have put my fingers under that particular part of the stretcher.
Other than than pulling the cobwebs out? Not much else. I maintained my sense of humor, was nice and apologized when necessary. The patient got to the trauma center in good shape, and besides my fingers, we were all safe and sound.
In general, I try to adopt an attitude of respect towards every single profession I encounter. Medics are incredible at what they do. I would trade a nurse for a medic if I were trapped in my car any day of the week and twice on Sunday. I would also trade a medic for a nurse if I were on a ventilator sedated in an ICU. We each have a unique knowledge base and skill set. We just need to suck it up and realize the competition between the professions is getting in the way of continuity of care.