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EMS Relations:
If You Can’t Say Something
Nice . . .
E M S
Author: Shawn M. Lacombe, RN, BSN, CEN
Section Editor: Jan R. Boatright, RN, CEN, andKathy Robinson, RN
medics, and transport/flight nurses—the patient’s
Shawn M. Lacombe, Louisiana ENA State Council, is EmergencyDepartment Manager, Rapides Regional Medical Center,Alexandria, La.
For reprints, write: Shawn M. Lacombe, RN, BSN, CEN,853 Ridgeview Dr, Pineville, LA 71360;E-mail: [email protected].
J Emerg Nurs 2004;30:59-60.
0099-1767/$30.00
Copyright n 2004 by the Emergency Nurses Association.
doi:10.1016/j.jen.2003.12.001
February 2004 30:1
ealizing the impact that the role EMTs, para-
Rinitial caregivers—have on the overall operation of
the emergency department, I would like to ask you to think
about your interactions with them.
It is December of 1990 and I am an eager new flight
nurse. One of my first patients is a critical pediatric patient
with an airway problem. I take pride in my assessments and
in providing quality care to all of my patients. The flight is
a short 40-minute trip from a small outlying facility to a
metropolitan hospital with a pediatric ICU. Throughout
the flight, I vigilantly watch this young girl’s airway,
breathing, and circulation (ABCs), prepared to intubate.
As we land, I am relieved that her condition is stable and
has not needed invasive intervention. Upon arrival to the
heliport at the receiving hospital, the pediatric ICU staff
meets us, seemingly uninterested in hearing my report.
One staff member lets me know that I did not keep this
child’s head covered. It is said in such a loud voice that I
think even the pilot probably heard it over the noise from
the blades. I feel demeaned.
I am willing to admit that I should have kept her head
protected from the December air. In fact, we use this as a
learning experience and keep hats and extra blankets on
board after this call, so patients are not being totally
exposed, even though we have a heater in the helicopter.
We will also keep such a patient’s head covered. I choose
not to fight back or to ignore the staff member.
At this time, I am no longer a flight nurse, having
hung up my wings a few years back. However, this
experience has always stayed with me and has taught me
several valuable lessons that I would like to share with all
nurses who receive ambulance and helicopter patients.
JOURNAL OF EMERGENCY NURSING 59
EMS /Lacombe
One of the lessons has to do with the aircraft’s cold
environment. After this experience, I always remembered
to protect my patients from the cold environment, wheth-
er outside in the cold air or in the emergency department.
This is something we teach in the Emergency Nursing
Pediatric Course (ENPC) and Trauma Nursing Care
Course (TNCC) and I always use this example as a lesson
learned the hard way.
The other lesson is equally important—the lesson in
protecting relationships between EMS providers and hos-
pital personnel that I learned from my experience with that
pediatric ICU staff member. I learned to watch my words
when receiving patients from EMS, whether from a scene
or from another facility. I try to believe that the EMS
provider has been working diligently to provide the best
care possible for the patient. Even though the PICU staff
member chose the wrong way to get this message across, in
my view, she really was concerned with the patient. This is
always my goal as well, so I choose not to use such sharp
remarks and instead focus on the patient and the conti-
nuity of that patient’s care. I try to focus on the patient
whom they are delivering and what next needs to be done
for that patient, and I give feedback that is as constructive
as possible. Effective communication is a vital component
to the efficient operation of an emergency department.1
There are several things that we as emergency nurses
can do to make the transition of patient care smoother and
to keep relations with EMS cordial.� Provide good customer service to EMT’s, paramed-
ics, and flight nurses. We are professionals and should
treat all our customers in a professional manner.
Prehospital staff are one of our ‘‘customers.’’� Use each experience as an opportunity, to teach, or to
learn. When a prehospital provider has missed some-
thing critical to the patient’s care, find a way to
provide him or her with this information, preferably
away from the patient and family. Make this a
teachable moment, so that the paramedic can benefit
from your expertise and perhaps future patients can
benefit as well.� Remember that we are all in the business of provid-
ing quality healthcare to our patients, in a lot of
cases, with overwhelmed staffs and departments. As
busy as we are in the hospital, so are EMS providers
working in the out-of-hospital environment. They
60
are not purposefully stacking patients in our hallways
just to keep us snowed under. They are also respond-
ing to a growing call volume and are just doing the
best they can. The last thing that they need is to be
berated for bringing another patient into our emer-
gency department!� Calls for the next ambulance response are usually
holding when EMS brings us a patient. We should
do all that we can to help EMS providers make as
quick a turnaround as possible.� Work together with your local EMS providers to
cultivate a mutually respectful relationship that
allows both the ED staff and the EMS crews to
continue to provide quality care in a safe, pleasant
environment.2 The best way we can promote our
profession is through positive experiences for all
involved. The patients and family members, as well
as the EMS and ED staff need to ‘‘feel’’ the
teamwork or camaraderie.� To quote Harry Firestone, ‘‘You get the best out of
others when you give the best of yourself.’’ To get the
best responses from prehospital personnel, we must
put our best faces forward. How can we expect
positive relations with EMS if we don’t start with
our own attitudes?
REFERENCES
1. Med Excel. EMS Relations [online]. Available from: URL: http://www.healthquestassociates.com/ems.htm. Accessed November2003.
2. University of Virginia Health System. UVA honors providersduring national EMS week [online]. Available from: URL: http://www.healthsystem.virginia.edu/internet/news/Archives00/ems.cfm.Accessed November 2003.
Submissions to this column are welcomed and encouraged.Contributions should be sent to one of the following:
Jan R. Boatright, RN, CENPriority Mobile Health, PO Box 6379, New Orleans, LA 70174
504 263-7531 . [email protected]
Kathy Robinson, RN671 Evers Grove Rd, Bloomsburg, PA 17815
JOURNAL OF EMERGENCY NURSING 30:1 February 2004
