Just Plain Ruff

i agree D- 5 visits a year is not that much but it's a huge deal to the old man who has pneumonia and has to sit out in the waiting room for hours so this "mystery" shopper can be seen for a fake illness. Or the guy from an MVA who has to sit on the EMS Stretcher for an hour or more waiting for a bed but he could have been on a bed and his c-spine cleared by the MD and he coudl have gotten off the board. Or the, well you fill in the blanks. If I was sick and had to wait for a bed in the ER because a mystery shpper with a fake illness is in the bed that could have been mine I would be really pissed but then again how would I ever find out. I'm still concerned about Hipaa and privacy issues here but I may be concerned over nothing though. I agree that we need to keep an eye on quality but this has been mentioned before - Press Gainey surveys I was a QI person at a small hospital for our ER. Medic too but I took on the role of QI and I compiled the press gainey reports and gave printouts to all the ED Staff and also the ER physicians. After one or two survey cycles and pointing out the discrepancies I noticed as did the staff an improvement in patient satisfaction in several areas. Confidence in the physicians care, confidence in the staff care. What didn't change over the two years that I did this QI project were dissatisfaction on waiting times in the waiting room, times it took for lab to get back and the time it took to get to a room when admitted. Unfortunately those 3 dissatisfiers will NEVER change - as these are universally the major dissatisfiers in the industry. But what I did notice is that the staff made a concerted effort to address those times and delays and inform the patients. Satisfaction increased because patients were more informed and they were more open to long waits. It also helps if you do comfort measures for patients such as have a TV in the room, fresh magazines and coffee/tea and soda machines in either the waiting room or in a central area in the ED treatment area. Families and patients who are allowed liquids become much more jovial and happy when their needs are met. Be sure to have warm blankets and such. This is how to improve satisfaction in the ER and not mystery shoppers in my opinion.

ok, this has disaster written all over it, mystery shoppers in the ED. First off, you have people posing as patients when there is nothing wrong with them. They then tie up a bed that someone could use in order to critique the staff and docs. I would be pretty upset if I'm taking care of a mystery shopper when I could be taking care of someone who is really sick. Talk about a waste of resources Plus, what happens with all the patient information that the mystery shopper hears, they are no way involved in patient care and they hear confidential patient info. Isn't that some sort of hipaa or pseudo hipaa violation? But the wastage of resources that could be used better elsewhere is what gets me

The question I have is for all of you have no problem going outside your scope of practice do you have any problem with looking for a new career???

You are right we are not doctors but many of us will take stabs at it. First off I say, go to the doctor - only they can really diagnose you and the fact that it has gotten worse is a prime indication of needing to go to the doctor. It could be several things - 1. carpal tunnel 2. compartment syndrome 3. did you get stuck in the hand with something that you can remember? If so then there might be an infection or a foreign body in your hand. I cannot reiterate this enough - GO SEE YOUR DOCTOR EAT THE FIRST 500, your hand will thank you. You can't really provide a living for you and your family if you only have one hand.

that's quite funny

fixed

There is no way that I'm gonna let a EMT push a drug. Plain and simple. It's my license and I'm not gonna lose it for something like that. That being said, I know of it having happened several times and each time it was a bad thing because one crew got caught. But I know it happens and such but I would never personally let it happen to me.

Yet you will post a fake PM that you allege came from me.

oh my, can't imagine I just wasted 30 seconds on that.

oops I misread the poll question. My answer is NO they should not have to run everything by the medic. but they do need to tell the medic what they did and if needed, WHY they did what they did.

to me we are a team. The medic is ultimately responsible for everything that happens to that patient so this might be where you have gotten the feeling that emt's should be seen and not heard but I believe that in order to run an efficient crew that you need to be partners. I have never treated my emt's as fodder and gophers. We've always sat down on our first day and got to know each other. I explain my expectations and they explain theirs. It is a two way street. Would I prefer dual medic trucks, sure if your service can afford to run dual medics but many many services cannot. There have been times where I've hated my emt partner and vice versa but in the end I've been pleased. Medics who have the attitude that Emt's should be seen and not heard have too big an ego for my book. Not that I don't like those people with that opinion it just isnt my opinion and they are entitled to their opinions just as I am entitled to mine. In closing, you are a team, be it dual medics, medic and emt or dual emt's. If you can get along then fine, if your work relationship is strained then it's time to find a new partner. It's like neighbors - you can't choose your neighbors but you can choose your work partners(sometimes. ) This is a great subject. Let's please keep it civil.

Well that does change things I believe. We now have on top of a mistake in wasting the wrong drugs, we have the possiblity of patient safety jeopardized because they had expired drugs in the cart. Did the medic not look at the expiration dates after the day she wasted them. I know that every narc box check we did we always checked the expiration dates even if we didn't use any narcs that day. I still think that drug tests are in order but they aren't gonna tell you crap if it was over a month after the fact. I think a talking to regarding being more attentive to things like this is in order but there should be no termination or suspension. I'm sure that medic is kicking theirselves in the arse due to this error and it is pretty much a guarantee that this won't happen again on their watch.

Yeah, the two counties I referred to have probably a combined population of 1/10th of Lee County or even less. There is no way that a rural county with a population of 31000 or so could staff more than 2 ambulances maybe 3. So the Lee County analogy is not really applicable in this case I don't think. Correct me if I'm wrong though. our response times are averaging about 22 minutes to arrive on scene. Total call time over an hour unless we are in the city where we are based.

unfortunately you wern't the only one, I'm guilty as well and my apologies go out too.

those are funny but evil. Can you imagine if your kid really got one of those replies. But I did get a jolly ole laugh out of it.

Jeeze Louise, Let's just drop it. Neither of you will win and this will keep going and going and going.

I can tell you what it will take to make this go away Either lock it or stop responding to it. It has gotten way off topic just like many threads seem to do here but that is what makes the City great -

I don't think I insulted you at all. and no I don't have any intention of kissing your ass and making up. I always said I thought it was funny but I didn't agree with what they did. You insulted me first which I have seen that you do on many occasions when you don't have anything better to contribute. So let's do this, you go your way and I'll go mine. I'll keep posting and you keep posting but we can agree to disagree. I think it was funny but the people involved were wrong and they need to face whatever consequences that they will face. I asked a simple question and you made some silly remarks and insults. I sort of expected as much from you. But then again, that is what makes America great, anyone can say anything about anyone and get away with it. Just remember, who insulted who first.

Dust, you dropped the ball here on your last reply. I would have thought you would have added "Who wants to see a naked soccer player anyhow(sic)" You should have added "Unless it's Mia Hamm"

So does anyone think that AMR knows about this?

Alpha, that is the reaction I was expecting. A no content answer So are you so wrapped up in your high and mighty that all you have to give is insults. I asked a legitimate question and you turn to insults. That's mighty professional of ya!!! I think you are the one who has the issue here. I did ask for your opinion because you apparantly think that there is nothing wrong with people sledding behind the ambulance on the city streets none the less. Of course its funny but only because we are not the ones gonna get in trouble. If all you can do is hurl insults then whatever. You never did give an answer, I guess I expected more but then again you have proven yourself that you cannot do anything but hurl insults. Maybe that's all you are able to do. See two can play at this game

Whit, I agree with you. Those we are better than you replies are pointless and bound to create arguments.

Ok, I agree it's hilarious to watch but I cringe at the professionalism. So now let's go down the road of discipline - AMR Corporate finds out about this, investigates it and determines it's your little amr community who is guilty. You are the supervisor or the one in charge there. What are you gonna do? AMR Corporate says it's up to you to deal out punishment. What do you do? Alpha I'm especially looking for an answer from you.

1. report this 2. file an incident report 3. Call the witness to return for debriefing 4. Get replacement meds out to the site - but this is going to take a while since it's an off site facility if I read right? 5. Determine if this has happened before? If so then harsher penalties other than "DONT DO IT AGAIN" 6. Even though you are certain no hanky panky has occurred it is incumbent on you to order a drug test. That way all I's are dotted and all T's are crossed. This will be a unpopular decision but I don't see any way out of it. Use this as a learning situation and what could be done to make it harder to not make the mistake. I'd provide labels on each of the boxes. Remedial training would be NOT to take the morphine and the Valium in at the same time. Other items that could be taken out of this is a box system, put the expired valium in a Black box and the unexpired valium in the Narc box. Put the expired Morphine in a Red box and the unexpired morphine in the narc box. Take the black box in the bathroom first and waste, sign wastage/witness it. Return to room and grab red box and repeat. No-one needs to lose their job but this sounds like it was a case of carelessness or misattention.

Guys and gals, let's stop this my epeen is bigger than your epeen. I could care less how many calls someone has ran or how big their ego is and I sure as heck care less on whether it's a rural responder or a urban responder taking care of me. Let's stop this Stupid pissing match. What I want is an ambulance that has all the equipment to take care of me and a provider that is competent in doing their job. Yes rural providers spend more time on calls that urban providers Yes urban providers run more calls than rural providers I knew that this thread would come down to pistols at 30 paces. For the urban providers who look down their noses at rural providers and for the rural providers who look down their noses at urban providers, Just SHUT UP we all do the same job it's only the environments that are different. Why do these posts always degenerate down to I'm better than you are. Waaa waaa waaa