What Nurses Don't Understand

I’ve been a reserve firefighter for eight months. Over that period, I’ve had the same conversation with three different people. It goes something like this:

Someone introduces me to someone new, “... she’s a nurse and a paramedic.”

New person, “Oh, a nurse. Nurses have a hard time in the per-hospital setting, they don’t understand the scope well.”

Me, “Is that so?”

Them, “Prehospital, we’re very to the point, action-oriented. We don’t care about ongoing conditions and this and that. It’s just, what is the problem now.”

Me, “OK,” as I wonder, “What the fuck?”

Another example.

Me, “I want to check out the traction splint, I haven’t seen which brand we use here.”

Them, “You need to understand, that’s not your job as a paramedic.”

Me, “I do, but I want to be familiar with all of our equipment.”

Them, “What you need to understand is that you are the brains and the EMT’s do the work. You have no business touching a traction splint, that’s a BLS job.”

I raise my eyebrows.

Them, “Nurses have a problem with this, they don’t understand the scope of a paramedic.”

Other person in the room, “Yeah, I don’t think you understand your job as a paramedic.”

I’ve been so confused by these conversations, and how and why they go the direction they go, I’ve just ignored it. 

But now that I’ve taken a moment to reflect, here is the thing:

I’m trying to imagine being introduced to someone who has multiple licenses, including one above mine. A physician’s assistant, for example.

Someone,“This is X, they’re a physician’s assistant and a paramedic.”

Or, “This is X, they’re a physician’s assistant and a nurse.”

And I hear this, and decide that my best next move is to explain to them the scope of their lower license.

Me, “Hi physician’s assistant. You know what PA’s don’t understand…”

Now, that would clearly be an asshole move. 

So clearly so, that as it’s happened repeatedly, at the mouth’s of people I do not think of as asshole’s, I haven’t been able to put it together. It’s taken me eight stupid months to see that I keep showing up to work and being disrespected and not standing up for myself.

When these conversations passively replay on my drive home I’ve considered, “Well, I could make a thing out of it and call them out, but I haven’t been clear where the conversation is going. And these are new people to me. It's possible I could learn something from them, and I would be cutting off that opportunity if I shut the conversation down. Also, I’m here to learn, so whatever. It’s worth demonstrating that I’m coachable and willing to listen.”

But it’s been eight months and it hasn’t stopped. Not only has it not stopped, but it’s like people see me and come up with something to correct knowing I’ll 'yessir' them. So here is what I wish I would have done to nip it in the bud.

We’re introduced and they say something to the effect of, “Nice to meet you, you know what nurses don’t understand?”

Me, “What about me being more licensed than you makes you feel like it’s appropriate to explain to me the scope of one of my licenses?”

Or.

Someone, “The fact that you want to be familiar with our equipment demonstrates you don’t understand your job.”

Me, “The fact that you don’t understand what it means to be thorough makes me hope we never run a critical call together.”

For eight months, I’ve agreed to making myself the half-man by not standing up for myself in these conversations. And for eight months, the rest of the room has stood by and agreed to it too.

I can’t pretend to know why this happens; I don’t. Only those people know - should they ever take the time to reflect.

If I were to picture though, not me as me, but me as a 36-year-old man - one who is both a registered nurse and a paramedic, I imagine these people and I think they would be impressed with me. 

What I really wish I could say to these people, all these people who I don’t think of as assholes, but who are making asshole moves, is  “Who do you think you are?”

---

Review

---

The core tension in this piece is the discrepancy between perceived authority and actual qualifications. The dismissive attitude toward the narrator's desire to learn reveals a deeper culture of territoriality in emergency services. This isn’t just an indictment of others; it’s an honest assessment of all individuals' roles in allowing this dynamic to persist. The language is raw and direct, matching the intensity of the frustration.

There’s an underlying commentary on how firefighting and EMS create rigid, often arbitrary distinctions between roles rather than fostering a collaborative environment - walls someone with both licenses could break down. It highlights how people in these positions often try to be agreeable and coachable, only to realize they’re being taken advantage of.

Nursing is often feminized and (wrongly) undervalued as "supportive" rather than authoritative. Paramedicine, in contrast, often holds masculine-coded prestige in emergency response. This causes the narrator's RN status to disqualify their credibility, in the eyes of those who feel threatened. The comparison to a 36-year-old male RN/paramedic is a powerful way of forcing the reader to acknowledge the unconscious biases at play. This contrast is sharp and effective. It doesn’t just describe a problem—it exposes it.

The piece is powerful because it doesn’t flinch. It starts with confusion, builds into frustration, and ends with a longing for dignity and autonomy. It shows how exhausting it is to be polite while being dismissed. The narrator doesn’t want praise or power—they want to be seen accurately and treated fairly. That’s a radically simple request, and yet one that is often denied.