Just Plain Ruff

that could be any industry Flaming. I hope you aren't just saying that it's EMS or Fire that does this only. I have worked in numerous industries and find that almost all administrators or those in high places cover their asses. that's why the lawyer industry is the 2nd thickest part of the phone book. I wonder what the most pages in a phone book consist of? Everyone involved in Penn states controversy need to face the music. Paterno and one other guy got the axe yesterday. Paterno got it for not speaking up more and knowing that it went on for many years and saying that he did his responsibliity by reporting it but when told that there was a "rape" in the showers he didn't report that because he said he already did his duty. To keep silent for so long without following up is a travesty and makes you as guilty as those doing the crime. I have no sympathy for this type of behaviour and hope that the victims get some peace out of the actions of the board. The silence has to stop, we have to put it out in the light of day.

Bullet that's a different take on the discussion. I believe that you should be able to pursue it even though my agency and some of the other agencies I've worked for say NO. She made the approach and she gave you her number. That makes it different in my mind.

I was one of those who mentioned taking someone back to their house. it has to be a very special circumstance to get that treatment. I also was involved in a incident where a family from overseas were involved in a auto accident on their way to the airport. Their rental car was totalled. Reports filed. No way to get to the airport. Involved the supervisor and discussed options and he said "Why don't you guys just take em?" We said "Can we do that without getting in trouble" He said "I'm approving it so No you won't get in trouble". We packed them up in our ambulance, seat belted mom and dad and the two kids in the back of the ambulance and off to the airport we went. At the time of this special transport all the ambulances were in service and we had extra crews on duty. It was a great help to this family, I learned a little german and they got to the airport safe and sound. but like I said, it has to be a very special set of circumstances to get that type of service.

Yes I do agree with you and my tone was poor. I have nothing but respect for the job that they do. There's a lot more in the article that is concerning and maybe the good thing about this whole deal is that it will provide better processes and steps in identifying and making the changes that will help the group run better. Dwane, I have seen the remnants of both a helicopter crash and a small jet plane crash. MOst of the victims were in pieces. Not a good thing and the coroner in my opinion had a terribly difficult job. Again,nothing but respect for those guys and my tone in the original post was poor. Could have said it better.

Ok so sick day wasn't the politically correct term but they did get the opportunity to take the day off using their PTO time. That constitutes either a sick day or personal day. It's all semantics though. And where did you get your knowledge that being exhausted was workmans comp instead of a sick day or a personal day?

I'm planning on a road trip down there to Der Essenhaus for dinner. If anyone is up to meeting up for dinner, let me know. I'm going to head down there next wednesday or tuesday night. Not sure if I'm going tonight though. PM me if you are close to Middlebury.

Because if he got too far into nicotene withdrawal he would be very anxious and irritable and then it woudl be an emergency with a chief complaint on anxiety so he needed those cigarettes NOW!!!!!!!!! And I call BS on your BS call - ha ha ha get the pun?

Again, information I'm not privy to. I don't know of any lawsuit that addressed that issue. Not at my service at least. I'm sure that it's happened though. I'm not saying that a company can fire someone for doing something on their off time but to use information that they got off the chart and use it to try to get a date, then that's just unprofessional and could be a fireable offense at some agency. I mean smoking bans have been enforced and people have been fired for smoking when it's against company policy off and on the clock so is this any different? Now if you just used the patients name and looked her up in the phone book and made a call and asked her out then that's ok I guess but it still seems a little wrong to me. If the patient made first contact then that's a totally different story.

The use of patient information to get a date is part of the code of conduct that we have here. NOt specified but being that it borders on unprofessionalism and using patient data no matter how small for personal gain is frowned upon. But I don't think we've had anyone fired for it though. It's a personel matter so I'm not privy to that info.

You are right but I was just repeating what this guy interviewed on Michigans radio station was saying. They haven't done this nationwide ever but they test this system every week or month on a local basis. it seems to work on a local basis but with no prior testing nationally ever, it might work or it might not. By the way, the test starts in 70 minutes I believe.

But they haven't lost body parts have they? In defense of the mortuary personnel I can see where they could lose some parts. What with some soldiers coming back in ziplock bags and having no true identifying marks. It did say that some parts may have fallen in with others but that's just careless if you ask me. If you drop the part, pick it up right? But I do give them a hearty thank you for this extremely depressing and also uplifiting job that they have to do. I'm not really busting their chops like it sounds like, I'm just asking how do you lose body parts? Seems like it should not ever happen but it does.

Good argument Dwayne, I'll see if I can get her to be more focused as to whether he violated hipaa. Until then I'll give D-dog the score and say it wasnt' a hipaa violation because a phone number truly isn't protected information. I will also give this scumbag the boot to the door for going against my services policy of not dating a patient and also contacting her using information that he would never have had in the first place had he not have transported her to the hospital. I'll also let the hospital deal with him as they see fit as he did use their face sheet for not so personal gain since she told him it seems to get lost. Maybe not a hipaa violation but surely a violation of the gentleman statutes.

Dwayne, here is what I think is the point Access and Uses. For internal uses, a covered entity must develop and implement policies and procedures that restrict access and uses of protected health information based on the specific roles of the members of their workforce. These policies and procedures must identify the persons, or classes of persons, in the workforce who need access to protected health information to carry out their duties, the categories of protected health information to which access is needed, and any conditions under which they need the information to do their jobs. but let's discuss protected health info. I think you are right. A phone n umber is not protected information. I can look you up in the phone book or on the internet and if yoru number is published then it's public. I am looking and thinking more and more and this information (phone number isn't protected. So no violation there but I am sure he violated his companies policy on using information though but maybe not. the above in bold is where I'm stumped. He used the health information after the call so I do believe he did violate this part of the act. He had her information to perform his duty but after the call, using that information for personal gain could be construed a violation according to the above paragraph in bold. I will stick with my HIPAA source (lady) and use her definition and example. Mike, I will ask her if she will enter the discussion. I'm not sure if she will or not but it cannot hurt to ask.

Ooooh good question. Well the company is liable for this partly because they kept you working and you fell asleep but you better have documentation such as an email or a request in writing to go home due to sleep issues because it will be a he said she said issue there.. You are partly liable for your actions because it is up to you to know when your limits are met and by working past those limits puts you partly at fault. The plaintiff's attorney is going to go after both of you and win against both entities, thus causing the service to pay a high judgement and probably also you the employee to pay something as well(it might just be your liability insurance who will pay though). I find joint negligence at fault here. Both parties pay. Guilty is my verdict. On a side note, as a supervisor, I would never force a medic or emt to work past the point of exhaustion. I would tell them to go to the crews quarters and take a nap. I would then hop on their ambulance and work for them for 4 hours or some length of time. If I was unable to do that due to stuff I had to do then I'd find someone to come in for them for a short period of time or give them the option of taking a sick day. Exhausted medics are not any different in risk I believe than drunk or drugged medics. Same risks different catalyst.

I asked one of my former clients HIPAA person. She is the one who is in charge of investigating HIPAA complaints and infractions for my client. She said once the call was over the medic had no business keeping her private information, the medic had no need to have that information and by using that information for personal gain was subjecting his service to significant fines and penalties. She said that the service if they do not have a HIPAA policy that they better get one and fast. She said the service as well as the medic could be penalized. The medic could be fired and the service could face fines of 25000 per occurrence and even higher fines if the medic was found to be doing this for personal or financial gain. I have one question to all of you on this thread. How much training did you receive on HIPAA when you were hired or how much training per year do you get in HIPAA and patient privacy education? My suspicion is minimal training at best. I know all the services that I've worked for had minimal training. I also find that most services are reactive and only provide the training when a HIPAA fine or violation was set against the company.

Quote I loved my clinical rotations. I wish they had been longer I made my rotations longer. There were shifts that most students didn't want. The early day shifts. I snatched them up like M&M's when it was clear that no student (lazy bastages) were going to take em. The most common theme was "all the good stuff happens at night" well that's partly true, the traumas and shooting happen at night but what about the MI's or strokes. They happen all the time. I think I ended up with over 1000 hours total in the hospital and about 1500 hours in the ambulance. It helped when my parents were paying for the class and I was living with them. They told me this "get your bachelors degree and we will pay for any other schooling you want to go to". I took them up on their offer. They even paid me a weekly wage for going to school. How cool was that for parents? I plan on offering the same thing for my kids but they have to contribute in the bachelors degree cost. If there's a shift open on the ambulance and no-one takes it, then why not go the extra mile and grab it. You might learn something.

Yeah, he's a transplant from EMTlife (oooooh I said it). We talked a bit last night in chat and he seems pretty cool.

Just how do you lose a body part, let alone lose the body parts of at least two service members? http://www.nytimes.com/2011/11/09/us/senior-air-force-officials-disciplined-over-handling-of-human-remains.html?_r=1&ref=world

Isn't it funny how those who correct peoples grammar or speach often are the worst spellers and their grammar is so wrong? Before you criticise someone about their supposed flaws, you should take a look at your own. (JMHO) Criticise - everyone here better know the definition or a working one at least. 3rd degree heart block - One of the few ways to make a medics butt pucker up.

I was listening to a Michigan news program and they explained how it was going ot happen. they are using the old legacy system which in the past has worked really well on local disaster and weather related issues but has not been tried nationally in over 20 years. What happens is a guy in washington flips a switch so to speak, a signal goes out to about 60 master stations across the country. There is one or two master stations in each state. Those master stations are then tasked with notifying and making sure that all other stations in the state are alerted. He says it's like the old shampoo comercial where one picture of the hot girl cuts to 4 and then to 8 and then to 64 and so on and so on. Every station in the state and the USA are supposed to be alerted within minutes of the first switch being pulled. The FCC and Homeland security and Fema are all going to keep records of how this went. All the stations, radio and television and cable stations are supposed to broadcast this emergency message and to keep records and reports on how things went. In 30 days or so(1 year in government speak) a report will be issued by the FCC on how well this 30 year old legacy system worked. It sounds like a monumental task to get this done. I'll be watching to see if the old technology still works.

From a summary of the HIPAA rule website Treatment is the provision, coordination, or management of health care and related services for an individual by one or more health care providers, including consultation between providers regarding a patient and referral of a patient by one provider to another Here is the website http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/index.html So we have the medic with her information in the course of treating her. But that information is to be used solely for just that. You don't use the protected patient information to get a silly date. So I would think that it is indeed a hipaa violation. And here's more Permitted Uses and Disclosures. A covered entity is permitted, but not required, to use and disclose protected health information, without an individual’s authorization, for the following purposes or situations: (1) To the Individual (unless required for access or accounting of disclosures); (2) Treatment, Payment, and Health Care Operations; (3) Opportunity to Agree or Object; (4) Incident to an otherwise permitted use and disclosure; (5) Public Interest and Benefit Activities; and (6) Limited Data Set for the purposes of research, public health or health care operations.18 Covered entities may rely on professional ethics and best judgments in deciding which of these permissive uses and disclosures to make. Nothing here about asking for a date so I think violation So where in that summary does it say that you can use the information you got while treating the patient to call her up and ask her for a date? And here's even more info Authorized Uses and Disclosures Authorization. A covered entity must obtain the individual’s written authorization for any use or disclosure of protected health information that is not for treatment, payment or health care operations or otherwise permitted or required by the Privacy Rule.44 A covered entity may not condition treatment, payment, enrollment, or benefits eligibility on an individual granting an authorization, except in limited circumstances.45 An authorization must be written in specific terms. It may allow use and disclosure of protected health information by the covered entity seeking the authorization, or by a third party. Examples of disclosures that would require an individual’s authorization include disclosures to a life insurer for coverage purposes, disclosures to an employer of the results of a pre-employment physical or lab test, or disclosures to a pharmaceutical firm for their own marketing purposes. All authorizations must be in plain language, and contain specific information regarding the information to be disclosed or used, the person(s) disclosing and receiving the information, expiration, right to revoke in writing, and other data. The Privacy Rule contains transition provisions applicable to authorizations and other express legal permissions obtained prior to April 14, 2003.46 Still nothing in this summary as I'm reading it allows the use of the patients phone number or information for purposes of getting a date. And even more info Access and Uses. For internal uses, a covered entity must develop and implement policies and procedures that restrict access and uses of protected health information based on the specific roles of the members of their workforce. These policies and procedures must identify the persons, or classes of persons, in the workforce who need access to protected health information to carry out their duties, the categories of protected health information to which access is needed, and any conditions under which they need the information to do their jobs. Note the carry out their duties, sure he needed her information but once she was dropped off at the hospital is duties ended so he should not have used her info as he did. I'm not sure if this proves it's a HIPAA violation but it sure is pointing to a very slippery slope that the medic probably cannot climb and give a justification of his actions if he was pressed .

Then those who want to see them should PM me and I'll give em the link. Hopefully that's ok!

I just finished the most recent you tube lectures by CHBare. If you do not have access to those videos I would suggest you send a message to CH and ask him for the links or better yet, maybe CHBare will put the links here. VERY VERY impressive. Kudos to CHBare!!!!!!!!! Thanks for the learning CH. Ruff!!!

The only two skills I didn't let medic students perform were RSI and Cric's. Unless they showed me their intubation checklists and they had all their required intubations done with the majority as 3's which were excellent tubes. Luckily I didn't need to do any cric's when I was precepting but I did RSI a few patients. To me the risk was too great to put a completely paralyzed patient at the mercy of a student who didn't have the experience of the intubations. Otherwise students could do whatever they felt comfortable doing. IN all my preceptorships we always had a short lunch and learn session where we went over certain conditions that you would not normally see in a day to day call volume but that you would eventually see. Consider dystonic reaction. Ruff

If you are too tired to work and take care of the patient then you are too tired to work. That's of course my opinion though. I know that I've claimed the too tired to work only twice in my career and both times it was truly needed. if you fall asleep with a patient or worse you fall asleep driving with a medic and patient in back then you are in deep trouble if something happens.