Just Plain Ruff

thanks Kyle(tongue in cheek). but it's all good.

Anthony, that situation you were in was a precarious one. Fortunately for you nothing has come of her questions of you and her in the back of the ambulance but if something did come out of it and she accused you then you would be the one having to prove your innocence as everyone in the media would have gotten wind of it and they would have had a field day. I can just see it now. Headline Anthonyville "Veteran Ambulance Driver accused of (insert your own story here)" ONce that accusation is out then you and any provider out there are screwed with a foot thick pole. There is no way to clean up your name after that has been accused. Even if you were completely totally and utterly innocent you will always be seen or considered the one who did the unthinkable. It totally sucks. One accusation and an otherwise stellar career is down the crapper. I'm glad it didn't come to that. Best thing is to document the heck out of those types of dirtbags. Those types of people make me sick. Let's be safe out there people.

We have a couple of these homes in service areas I work and have worked in. I actually helped my mother place my aunt in one of those facilities. The caretaker does not even have the obligation to provide any type of medical care. He said that 911 would be called but he would provide no medical care after that. When asked about CPR knowledge and he said he was not required by law to have that class so he did not plan on pursuing getting trained. He was very apathetic to many things. He seemed like he cared about the residents but when pressed about medical care he said that he relied on the local ems providers. We placed her there and within 4 weeks she had fallen in her room and lucky me got to go get her. Fractured her hip and when we placed her in the nursing home for rehab we recieved a call to come get her stuff. They were removing her from the home due to her being in a nursing home at the time. They had already rented her room out. We were paying for her stay there out of her personal money and not insurance. The jerk said that since she was in a nursing home that he didn't have to keep her room for her. My mother was pissed and called the national office of the company and they said that what the local operators do is not their problem or concern they have carte blanche to do whatever they want. Needless to say - I don't recommend any home like this.

that sounds like you have it in hand there. Refusals really are one of the most sued over reasons out there.

I believe you also have to provide a patient with the risks and benefits of refusing care. They need to be documented on the run ticket and a copy given to the patient. I'm not sure what the legal ramifications of not providing these risks and benefits is but I would think if a patient signs a refusal you need to provide the risks and benefits. Just my two cents.

don't forget that there are some hospital based ambulance services that allow their RN's to run on the ambulance as back up crew members.

Well Kyle, I made a mistake post, should have been in a different thread. It should have been in the minimum wage thread. Thanks for pointing out my terrible error. Not to be harsh LOL, but have you never made a mistake?

Rid, true so true but when the hospital changed the diagnosis to spontaneous abortion the insurance paid right up. The physician just marked the wrong box on the diagnosis. He checked complications from elective abortion and not spontaneous abortion. There is a significant difference in those two terms. It was the classification diagnosis of Elective abortion that the insurance company said NOPE aint gonna pay. I'm not advocating that the patient get's to see the record right after I've written it. Not that at all. I'm advocating that I should be able to see it and correct any noticeable wrong information. In no way am I advocating that a patient be able to see the report immediately after you've written it. They have to follow channels like everyone else, fill out a medical records release of information at my companies business office.

I agree lady, I don't understand why physicians and medical services have such a hard time with allowing me to read my medical record. I should be able to review it for errors and misstakes just like I can review my credit report. I don't think it requires a court order to get me to read my patient care reports like a previous person posted. What happens if the provider marks down something wrong. Case in point. My wife suffered a miscarriage about 6 years ago. The physician marked the wrong diagnosis (elective abortion) when it should have been spontaneous miscarriage or Threatened miscarriage. The insurance denied all our claims since they don't pay for "Abortions". so shouldn't I or my wife have the right to dispute what is wrong with your documentation? It can directly affect what your insurance will pay for. Just a couple of random thoughts.

I'm curious as to what circumstances you would allow a patient to read your patient report or Documentation?

I'd work for minimum wage as an emt if my other job was making me enough to live. I'd work for minimum wage now as a medic but I would be able to do that due to what I make in my other job.

That had to take a long time to write out and put it into a coherent rant. Most of that is true but it sure to me sounds like a lot of anger built up in the person who penned that. not saying some of its' not true but there was a lot of anger. Would you want the person who wrote that taking care of you. I'd sure not want to piss him/her off. But other than that, it was a good read.

for those with response performance guidelines or RULES of 8:59 to a life threatening call. Let me tell a little story I was working one day and we were at the ER of a local hospital at point A We got toned out for a chest pain call at Point B which was if you take a square and put point A in the bottom right hand corner of the square and you put point B at the upper left hand corner of that square you get an idea of how far we had to drive. I pride my self in having partners who follow the rules for the response time guidelines but at times we broke the rules for specific calls. We responded on a early evening after being written up for not adhering to the specific response times which we had what they call Exception reports for 3 calls that day. We were only 10 seconds, 40 seconds and 3 minutes late on three calls all day. We got there safe is all I had to say to them but they didn't want to hear it. They were completely focused on the response time requirements and to hell with the safety of the crew. So I always told the drivers - get me there safe, take the time you need to get there safe and let me deal with the suits. Most of the times we made it there in time. Other times it was due to having 1 or two ambulances in a town of 300 square miles to cover the entire area. Rush hour traffic and traffic snarls included. I'd rather get to a patient in 10 minutes than get in a wreck or worse and not get there at all. I've been in more accidents than I can care to remember and most were while working at this one service. I think before I quit I was involved in 4 or 5 We travelled the distance in 9:03 seconds or something like that which should have taken 12 minutes or so. Much longer if it would have happened during the daylight hours. WE go in the house and find a patient having a full blown MI and we start to treat the patient. Then the fire captain came in and grabbed 2 of his fire fighters and they rushed out the door. Little did I know at the time but we had driven to the scene and our brakes were smoking and bright red and nearly to the point of catching on fire. The fire guys pulled the hose and waited for the inevitable which thankfully didn't happen. So now our ambulance is out of service, they had to call mutual aid for a truck from a neighboring city to come transport the patient. We got the 2nd and third write up of the day, one for not adhering to the time limits and the other for damaging the ambulance. My partner and I refused to sign the write ups and we both were suspended for three days. So if you have performance restrictions on response times and they penalize you for not making it to the scene of a call which would have taken 10 or 12 minutes to get there lights and sirens but you have to make it there in less than 9 minutes then your service is definately broke. It was no wonder that there was at least 1 wreck or damaged ambulance at this service about every month or so. (at least when I worked there)

I had a herniated disk. Was treated with a series of 3 epidurals and steroids via the epidural and was back on the job in 4 weeks. still had pain, was on light duty for 3 more weeks but no residual effects. I was lucky, one of my friends same service, became totally disabled due to herniated disks. It's all in how you respond to treatment and how committed you are to make that treatment work.

Fireland, your posts have been wonderful and informative. The info you gave is spot on. thanks for the link too. I hope that many here keep it in the back of their heads or better yet in their favorites and help others out. Fireland, I hope to see more of you here. You are an asset to this community.

Ok let me rephrase some things. First don't assume anything my friend. I've worked in both types of services, urban and rural. And no I don't volunteer. the chair I was referring to was back on the previous posters comment about a sit down chair. Of course a stair chair is good to use. Please don't pass your system off as better than everywhere else which I feel you are trying to do. your original post said to lighten your belt and the way you put it was that you carried all that stuff on your belt but for those of us who know better but your post did make several people if you read their responses they thought the same thing. Of course you take the oxygen in, you take the monitor in and whatever else you feel you need to take but let's be real here, you can't take the entire truck in withyou so you take what you think you need. I think that taking a cardiac monitor in for a ankle injury or hand injury is way over the top. Unless your dispatchers are numnutz and get the information wrong then there is no reason for you to have to take a cardiac monitor in for a isolated hand or leg or ankle injury. I have taken someone down 30 flights of stairs with the power out. So yes I have done that. You seem proud that you run 20 - 40 calls in a day but to me that is overworked. New York City is a big city and sure you are going to take 3500 calls a day but the ratio of your calls versus my call volume is not much different if you take population into account. The service area I'm currently working in has a population of 30000 and we run between 11 and 20 calls in a day. So we aren't much different in call volumes calls per population. Let's see 22 million people in NYC with 3500 calls per day makes it about 1 call per every 6800 people. My call volume of 20 calls a day for 30000 people makes our call volume of about 1 call for every 6000 people so the ratios are not that far off. At times I am on the only ambulance in the entire county. So our volumes are not that far off from each other.

You my friend are a Crap stirrer. Stop making me laugh.

BeOPR, I agree with your question to the poster. "standard of Care" you mean there is a national standard of care that includes a multi tool and a o2 wrench that I have to carry on my person. what's on my belt consists of The belt itself A flashlight holder with flashlight A pager A cell phone that's it. nothing else. my scissors are in my scissor pocket on my leg My gloves are in one of the cargo pockets My multitool is no-where to be found as I've never needed one in the past 15 years Our service uses the kind of oxygen tanks with the handle built in. We do have tanks that need a o2 wrench but those tanks have the wrench attached. I don't carry a chair, EVER For a fractured ankle or that kind of call I don't carry in the monitor *edit* I do have a multitool but it's usually in the ambulance to do mini repairs. Plus the fact that you have to repair all those things on the ambulance makes me feel sorry for you and your service.

What was the strangest thing that you could not explain that happened to you or one of your patient's while taking care of them? I know many of you have stories. I'll go first Had a young woman in full liver failure. She was orange in color and she was still conscious. She asked me what I thought it would be like to die. I told her I didn't know but I hoped it wouldn't be painful. She then asked me if I thought I would go to heaven. I told her that I believed that I would. She asked me if I thought she would go to heaven and I told her I wasn't able to answer that question. She then told me "I am going to heaven and I know it" and I asked her how she knew that and she told me something that I will never ever forget. She told me "I know I am because that man over there told me so" I asked what man and she said the man sitting on the end of the bench. I asked her what he looked like and she said "he looks just like the jesus on the windows of my church" Well to tell you I was pretty well affected by that statement. She then went on to say "And he says that you are going to go to heaven too" We then prayed and I will never forget that interaction between the two of us. About a week later she passed away and I hope she made it to heaven. I think I will take that day and the way it made me feel to my grave. I get goosebumps just thinking about it.

that was Funny I don't care who you are. That's funny.

so who's opinion do you respect and value? Just curious.

Ever read the book called "The death of common sense"?

My favorite types of transfers were the VA transfers. Usually those transports took over an hour or more and the best ones were the WWII and Korean Veterans. They had stories that would make your toes curl, especially the men who were on the front lines. Vietam vets were sometimes as good but many times they would not talk of their experiences.

i agree with Spenac, show me the law too. I worked in an area that covered an area that was uncovered. It was basically no mans land but that city did not see fit to provide Ems service. If we arrived to take care of them so be it but there was no ambulance service dedicated to that town.

The guy was probably raised on entitlements and didn't have a clue that he actually had to do some type of work.