It is the patient's choice right?

[NoOnesAngel]

So...I'm fairly sure I was in the right but I could be totally wrong...

I was enroute to p/u a pt for transport to their residence when enroute we stumbled upon a MVC. No big deal...except it was pouring the rain...and I hate getting wet. It was nothing major, a car side swiped another. Nothing serious...no serious injuries...in the beginning the Mom just wanted the daughter to go for eval...so we packaged the girl simply because she was on the side that was hit. And as I was crawling into the back the Mom decides to go, as well as her friend, whom was in the passenger side. So I called for another ambulance to transpot the 3rd pt.

Now this happened right on the state line of WVA n KY, of which I am certified in both states...and there are two hospitals equal distance from where this happened of about 3 mins either way...

So the mom stated she wanted to go to the WVA hospital. Technically the accident happened in Ky...no big deal...alot of people want to go to the WVa hospital...so we mark enroute to this hospital...at which point my boss gets on the radio...and asks if we informed LEO on scene...to which my partner responded that she had and that he had nodded his head.

We transport no problem and our boss transports the third pt to the same hospital...across the border. I get my PCR done and we leave...our other transport was cancelled.

As we pull into the station our boss gets on the radio and starts screaming about how pissed off the LEO was because we had taken the pt to the WVa hospital and that we screwed up and that we were to NEVER take another pt to the WVa hospital if they were involved in a MVA.

Now...one...I hate to be berated like that...especially in public...and I know everyone in scanner land was enjoying the hell out of that...and then on top of that...all of our other trucks heard it along with their pts.

and two...isn't it the patients choice? Both facilities are equally close...and the pts were all from WVa....Does anyone have ne insight into this?

[Asysin2leads]

It is the patient's choice, and so long as you are transporting IN to a state from another state it is well within guidelines to do so. Tell your boss he was wrong, and tell the officer to go back to writing parking tickets and leave you guys alone.

[pacman]

In one of the squads I ride for, the closest hospital is actually in the next state over, New York. We regularly transport patients there, especially since the hospital is a level II trauma center. However, we do opt to transport to the nearest NJ hospital for various reasons ( patient's request, patient is concerned about billing, patient's history, ect).

However, we almost never get serious MVAs, since its a collegiate EMS. I would assume that if we did, we'd transport to the New York hospital because its a trauma center and its the nearest hospital.

It seems to me that the police officer you dealt with was annoyed at the fact that he had to go through more paperwork because it was out of state. That, or he had to hassle more to get permission to interrogate the patients you transported.

To my understanding, the only time a police officer can determine the patient's hospital destination is if the patient is under police custody.

Even if the officer asked you to transport the patients to your in-state hospital beforehand, you still have to transport to where your patients want to go, within reason ( like distance ). Otherwise, you could be charged for kidnapping because you transported someone against their will.

[Dustdevil]

...so we packaged the girl simply because she was on the side that was hit.

That's the part you were wrong about. You said it was "no big deal", and just a sideswiping. How do you justify spinal precautions on that? Does your agency not have protocols to address who should be immobilised and who should not?

As for your destination, it is up to us whether or not it is up to the patient. We do not have to take patients to their requested facility. We can, but we don't have to. There are plenty of good reasons to take a patient to a facility other than that they choose. Just like the immobilisation issue, this should be addressed in writing ahead of time by agency policy. If it is not, then your employer sucks. You should not have to go to the Internet looking for answers to questions your employer should be providing policy on.

This is typical private ambulance nonsense. To your boss, it's all about keeping public safety happy. If a cop or firemonkey is pissed off, it's always going to be your fault, period. There is no winning with this mentality. I'm afraid you're going to have to get used to it.

[spenac]

Next time the boss starts chewing your butt on public airways. Interrupt him and politely tell him to wait till you get back as there is to much static to understand his/her professional conversation. If they still continue the public butt chewing, Interrupt and tell them to shove it. I will not tolerate anybody jumping down my throat in public. That is totally unprofessional. Sounds like you work for a lousy piece of crap of a boss.

[IUemt]

..The pitfalls of working for a private service :oops:

[Don1977]

I remember one day I was sitting at base when my supervisor then TOES975, came running out and said "come on we have an accident at the bottom of hill". Which is Pittsburgh, We responded and arrived on scene to find a car on its side no one around and another car with a female sitting in drivers eat c/o head pain, she walked towards me and collapsed I caught her layed her on a LBB strapped her, put the CID's on and we loaded and transported, from the time on scene to the time we loaded her, was 7 minutes!

As we pulled away PGH M-12 and Engine 20 arrived and there quarters is a block away. They were very pissed off we transported the patient a "Level 2" trauma patient. They said "we left the worse patient there" Funny part the 2 patients they "found" were ok, 1 walked (typical PGH) and one in w/c, but they had the worst???? anyway....

I work for a private service that does emergencies at 7 nursing homes in pittsburgh nd a borough of 5,000, we stumble across many accidents and have transported. For the record, a wheelchair van driver from my company called this MVA in. I have had the argument of what hospital to go to, I let patients choose or suggest what is better for them, like the hospital's specialty like burns, ortho, etc.

I hope I didn't go off-topic!!!

My keyboard is smoking form all this typing!!!!

[NoOnesAngel]

Sadly enough...I've caught hell for this...and I do believe I am currently being punished with an excess of BLS transports and not even being considered for any emergencies...but I believe it's the patients choice...I can not take them somewhere they do not want to go...and personally I wouldn't want to go to the KY hospital either...but thats my opinion.

:roll:

It was later revealed that the pt was driving on a suspended DL for DUI and blah blah...and the officer was ticked...I guess he felt I should of left her there??? but then I wouldn't of been doing my job...regardless of how poorly I do it...lol

[Dustdevil]

Sadly enough...I've caught hell for this...and I do believe I am currently being punished with an excess of BLS transports and not even being considered for any emergencies...but I believe it's the patients choice...

In order to learn something and progress positively from this incident, you need to understand that EMS is not about what you "believe". EMS is about making critical decisions based upon the available information. It does not appear that you are doing that. It seems as if you have got this notion in your head that it is always the patient's choice, and that nothing else matters. If that is your contention here, than you are wrong and need to let go of that belief so that you can educate yourself and grow professionally.

There are many other factors that figure in to your decision about where to transport your patients. If your employer does not provide you with specific, written guidelines from which to be making these decisions, then your employer sucks. Period. Although, it seems like you are beginning to realise that, albeit for a different reason.

And again, I am curious as to why you even backboarded that patient. Upon what medical criteria did you decide that spinal immobilisation was indicated? And, does your employer provide medical guidelines for making this determination, or do you just backboard everybody who has damage to their car?

[NoOnesAngel]

That particular day I was told that all patient's in a MVC needed to be boarded who choose to be transported...and I started to argue with this and just go about my business. The patient complained of neck n back pain so I went ahead and boarded her...It may have been wrong and it may have been silly but I never use to board every pt. It was just right there at the front of a long list of you have to's and don'ts.

I still won't...and i'm currently looking at other options for employment.

As far as written guidelines for transport...I have never seen any...but the majority of our "guidelines" are verbal reprimands...which are made clear to you and every one else in the middle of the station or on the radio.