Just Plain Ruff

Ditto, the legal morass you are asking us to address and even tacitly approve is something that no one on this forum should even begin to address with you. If you do it on your own then that's on you. But I second the idea of going to the care team involved in his care. They are the ones you should be asking this question of not us. I do wish you luck, but the first thing that needs to happen is for the entire family to be behind this effort and the Mom needs to stop enabling him and "caving". I also wonder how you are going to get him to the school, do you plan on taking him yourself or are you going to enlist professional help (EG EMS) There are some EMS Services that will help you out on this, you just have to find the right one. I do wish you the best but this isn't your call, our call or anyone elses call but the immediate family in CLOSE and I mean CLOSE collaboration with the guys medical team. My advice to you is this, if you are in EMS I would stay out of this hornet's nest. Let them deal with it and you provide support to the girlfriend when she gets upset about his blow ups. Your job is to be supportive of the girlfriend but NOT NOT NOT to get involved in the decision to sedate this guy. If you are in EMS, Do not give even the impression that sedation would be a good idea because if something were to happen, the family may turn on you like a pack of rabid dogs attacking a poor defenseless rabbit. And by NO UNCERTAIN terms should you accompany this guy to the facility, especially if you are in EMS, that's a HUGE liability on your end. But other than that, I hope little brother gets the help he needs.

Yeah, I've had three provider friends kill themselves. I've had 6 that have perished in either fires or in crashes. But more die in fires and crashes so we need to focus on those right. I had the extreme displeasure of working on one of those suicides. Something I believe could have been prevented had that provider (all 3 may have been prevented) come to someone or ME!!!!!! and said "Mike, I need help" but he didn't, he put a gun to his head and pulled the trigger. WE worked him but I'll never forget the scene. If only!!!!!!!!!!!!!!!!!!!!!!!!!!

Edited for clarity - but not the grammar - I left that for Zel Densch(inside joke) if anyone can help me here I would really appreciate it. I was until p.m. And went back and got my RN degree and finished in 2010 and have been working between the ER and recovery room until last year when I finally decided to take some time off work. But would I really want to do even the most people think I'm insane but my passion is emergency medicine in the field getting my hands dirty,and cliche sounding yes-but I want to truly be there and be a Positive and/or defing part for someone when the worst happens...not push meds all day or listen to most of my coworkers gossip like children, laugh at a patients expense or prejudge them because of whatever problem they r having or situation they r in...and most of all the complaints re having to actually wipe a rear end or heaven forbid take 5 mins to help a patient eat because their hands or body as whole wont cooperate. God forbid cause there isnt a cna available right then they have to do what they consider underming grunt work simply because u have a diploma and plastic card with R.N. behind ur name. Hospital care is becoming more subpar and more concerned with maintaing less staff for more profit and having nurses act as servant/concierge's to "VIP" patients way before taking care of a regular joe because he isnt a major monetary contributor to the CEOs pocketbook. I do love Nursing but I don't like.what it's becoming... and no offense here, but working with burnout and bitter know it all grouchy women everyday isn't my cup of tea or what I envisioned myself, life,or career becoming.More and more hospitalsr degrading to less and less stellar care with no repercussionsand th horrible attitudes r highly flu like contagious and the beaurocratic B.S. is dispicable.I have done several ambulance ride alongs out of choice.most recently I volunteered when the multiple devestating tornadoes ripped through central alabama and leveling my childhood home and 80% ofbmy hometown. I lost count of how many rides I was involved in as well as how many people I helped free from debris but I do remember exactly how many I saw that were already gone and the most significant and heartbreaking were the 2 that passed right in front of me when all I could do was pray,stay calm, and let them go in peace...my best friend of 13 years was one of them. After that i helped with search and rescue,and everyday for 3 weeks after my day job I volunteered in triage tents and shelter setups.that disaster and chaos and watching my best friend leave this earth solidified my decision. I always knew I that I picked the right path as far as being in the medical field, It just took a little longer and a lot of life experience to figure out I just made the wrong turn in the beginning . So..I apologize for the novel but what I need help with is a good fast track eMt b program that's the least expensive as possible, I'm still paying back nursing school loans.Between 2 small kids and a husband not to mention bills that still have to be paid I could use some advice.I spoke with the head of Alabama's ems division who literally said "I don't know of any fast track programs within hundreds of miles, but good luck" yep. I also called a specific regional ems director who runs the enter/paramedic program at the college I went to and all I Gordon him was "I don't know, no ones ever asked me that before but with all ur credits here it shouldn't be that big a deal considering the courses emt require but u have already taken. He actually thanked me for posing signs question.he said to let him investigate it further and he would get back with me. 8 months later and many unanswered follow up calls I placed and Im not even an inch closer to know what to do. So please, any advice would be appreciated, with the exception of those who will say I'm stupid for wanting this change, u can keep those comments to Yourself. also, traveling out of state for a few weeks is fine and I've seen a few programs that do it....but im sure some r scams so figuring which programs are actually accredited and legit and affordable is the obstacle. Thanks in advanced to anyone who can throw some good insights and wisdom my way.

Your safety is priority, then the patient care. I'm cognizent about not disrupting the scene but the cops (detectives) are competent enough at their jobs to determine what disturbances to the scene you did and what others did. Be prepared to outline your actions at the scene to the detectives, they will ask. DON'T cut through any holes in clothing Use latex gloves and your fingerprints will not be left, but remember that the latex gloves can and will smudge actual fingerprints. My best advice is if the patient is dead, leave em be, get your monitor tracing and get out. If the patient is still alive, then get them out in the way that least disturbs the scene. But again, YOU are not a cop, nor a detective and definately NOT Sherlock Holmes, your job is to take care of the patient. But remember, what you see can help the cops, so keep an eye out for things that just don't look right. And finally, this and above all things, some suicides are homicides and the assailant might just still be there and if you keep him from doing his "job" you might be a victim as well. Let the cops clear the scene first. Oh and one final thing, someone committing suicide for real, not a gesture, may just really really get pissed at you in your attempt to keep them from killing themselves and you may become a victim as well.

https://www.linkedin.com/pulse/i-experienced-americas-broken-healthcare-system-while-steven-brill Forgive the formatting but LInked in was a bit cantankerous today Title - I Experienced America's Broken Healthcare System While Looking Up From a Hospital Gurney Text of article - courtesy of Linked in - Author Steven Brill Journalist and Author, "America's Bitter Pill" I usually keep myself out of the stories I write, but the only way to tell this one is to start with the dream I had on the night of April 3, 2014. Actually, I should start with the three hours before the dream, when I tried to fall asleep but couldn’t because of what I thought was my exploding heart. Thump. Thump. Thump. If I lay on my stom­ach it seemed to be pushing down through the mattress. If I turned over, it seemed to want to burst out of my chest. When I pushed the button for the nurse, she told me there was nothing wrong. She even showed me how to read the screen of the machine monitoring my heart so I could see for myself that all was normal. But she said she understood. A lot of patients in my situation imagined something was going haywire with their hearts when it wasn’t. Everything was fine, she promised, and then gave me a seda­tive. All might have looked normal on that monitor, but there was noth­ing fine about my heart. It had a time bomb appended to it. It could explode at any moment—tonight or three years from tonight—and kill me almost instantly. No heart attack. No stroke. I’d just be gone, having bled to death. That’s what had brought me to the fourth-floor cardiac surgery unit at New York–Presbyterian Hospital. The next morning I was having open-heart surgery to fix something called an aortic aneurysm. It’s a condition I had never heard of until a week before, when a routine checkup by my extraordinarily careful doctor had found it. And that’s when everything changed. Until then, my family and I had enjoyed great health. I hadn’t missed a day of work for illness in years. Instead, my view of the world of healthcare was pretty much centered on a special issue I had written for Time magazine a year before about the astronomical cost of care in the United States and the dysfunctions and abuses in our system that generated and protected those high prices. For me, an MRI had been a symbol of profligate American healthcare—a high-tech profit machine that had become a bonanza for manufacturers such as General Electric and Siemens and for the hospitals and doctors who billed billions to patients for MRIs they might not have needed. But now the MRI was the miraculous lifesaver that had found and taken a crystal clear picture of the bomb hiding in my chest. Now a surgeon was going to use that MRI blueprint to save my life. Because of the reporting I had done for theTime article, until a week before, I had been like Dustin Hoffman’s savant character inRain Man—able and eager to recite all varieties of stats on how screwed up and avaricious the American healthcare system was. We spend $17 billion a year on artificial knees and hips, which is 55 percent more than Hollywood takes in at the box office. America’s total healthcare bill for 2014 is $3 trillion. That’s more than the next ten biggest spenders combined: Japan, Germany, France, China, the United Kingdom, Italy, Canada, Brazil, Spain, and Austra­lia. All that extra money produces no better, and in many cases worse, results. There are 31.5 MRI machines per million people in the United States but just 5.9 per million in England. Another favorite: We spend $85.9 billion trying to treat back pain, which is as much as we spend on all of the country’s state, city, county, and town police forces. And experts say that as much as half of that is unnecessary. We’ve created a system with 1.5 million people working in the health insurance industry but with barely half as many doctors pro­viding the actual care. And most do not ride the healthcare gravy train the way hospital administrators, drug company bosses, and imaging equipment salesmen do. I liked to point out that Medtronic, which makes all varieties of medical devices—from surgical tools to pacemakers—is so able to charge sky-high prices that it enjoys nearly double the gross profit margin of Apple, considered to be the jewel of American high-tech companies. And all of those high-tech advances—pacemakers, MRIs, 3-D mammograms—have produced an irony that epitomized how upside-down the healthcare marketplace is: This is the only industry where technology advances have increased costs instead of lowering them. When it comes to medical care, cutting-edge products are irresistible; they are used—and priced—accordingly. And because we don’t control the prices of prescription drugs the way every other developed country does, we typically spend 50 per­cent more on them than what people or governments everywhere else spend. Meanwhile, nine of the ten largest pharmaceutical companies in the world have signed settlement agreements with federal prosecu­tors, paying millions or even billions in criminal and civil penalties for violating laws involving kickbacks and illegal marketing of their prod­ucts. Nine out of ten. To prove how healthcare had become an alternative-universe econ­omy amid a country struggling with frozen incomes and crushing deficits (much of it from healthcare spending), I could recite from memory how the incomes of drug and medical device industry execu­tives had continued to skyrocket even during the recession and how much more the president of the Yale New Haven Health System made than the president of Yale University. I even knew the outsized salary of the guy who ran the supposedly nonprofit hospital where I was struggling to fall asleep: $3.58 million. Which brings me to the dream I had when I finally got to sleep. New York–Presbyterian Hospital (Emmanuel Dunand/Getty Images) As I am being wheeled toward the operating room, a man in a finely tailored suit stands in front of the gurney, puts his hand up, and orders the nurses to stop. It’s the hospital’s CEO, the $3.58-million-a-year Steven Corwin. He, too, had read the much-publicized Time piece, only he hadn’t liked it nearly as much as Jon Stewart, who had had me on his Daily Show to talk about it. “We know who you are,” he says. “And we are worried about whether this is some kind of undercover stunt. Why don’t you go to another hospital?” I don’t try to argue with him about gluttonous profits or salaries, or the back pain money, or the possibility that he was overusing his MRI or CT scan equipment. Instead, I swear to him that my surgery is for real and that I would never say anything bad about his hospital. Remembering a bait and switch billing trick common at some hospitals that I had written about (though not this one, as far as the nondreaming me knew), I even blurt out, “I don’t care if the anesthe­siologist isn’t in [my insurance] network. Just please let me go in.” A week before, I could have given hospital bosses like him the sweats, making them answer questions about the dysfunctional health­care system they prospered from. Their salaries. The operating profits enjoyed by their nonprofit, non-tax-paying institutions. And most of all, the outrageous charges—$77 for a box of gauze pads or hundreds of dollars for a routine blood test—that could be found on what they called their “chargemaster,” which was the menu of list prices they used to soak patients who did not have Medicare or private insurance. How could they explain those prices, I loved to ask, let alone explain charging them only to the poor and others without insurance, who could least afford to pay? But now I am the one sweating. I beg Corwin to let me into his operating room so I can get one of his chargemasters. If one of the nurses peering over me as he stopped me at the door had suggested it, I’d have bought a year’s supply of those $77 gauze pads. I didn’t care about the cost of the anesthesiologist, who the after­noon before had told me that her job was to keep my brain supplied with blood and oxygen during the three or four hours that they were going to stop my heart. Stop my heart? No one had told me about that. In the next part of the dream, the gurney and I are about to go through the doors to the operating room when off to the left side I see two cheerful women at a card table under a sign that proclaims “Obamacare Enrollment Center. Sign Up Now Before It’s Too Late. Preexisting Conditions Not a Problem.” Actually, on April 4, 2014, the morning of my surgery, it was al­ready four days too late to sign up for insurance under the Affordable Care Act, or Obamacare. Besides, I already had decent insurance. But at least that dream was more on point with what was happening in my real life. The day I found out about the time bomb in my chest, I was finishing reporting for a book about Obamacare and the fight over how to fix America’s healthcare system. In fact, on March 31, 2014, the day I was told about my aneurysm, I was awaiting the results of the final push by the Obama administra­tion to get people to enroll in the insurance exchanges established under Obamacare. From its historical roots, to the mind-numbing complexity of the furiously lobbied final text of the legislation, to its stumbling imple­mentation, to the bitter fights over it that persist to this day—the story of Obamacare embodies the dilemma of America’s longest running economic sinkhole and political struggle. It’s about money: Healthcare is America’s largest industry by far, employing a sixth of the country’s workforce. And it is the average American family’s largest single expense, whether paid out of their pockets or through taxes and insurance premiums. It’s about politics and ideology: In a country that treasures the mar­ketplace, how much of those market forces do we want to tame when trying to cure the sick? And in the cradle of democracy, or swampland, known as Washington, how much taming can we do when the health­care industry spends four times as much on lobbying as the number two Beltway spender, the much-feared military-industrial complex? It’s about the people who determine what comes out of Washington—from drug industry lobbyists to union activists; from senators tweaking a few paragraphs to save billions for a home state industry to Tea Party organizers fighting to upend the Washington status quo; from turf-obsessed procurement bureaucrats who fumbled the government’s most ambitious Internet project ever to the selfless high-tech whiz kids who rescued it; and from White House staffers fighting over which faction among them would shape and then imple­ment the law while their president floated above the fray to a gover­nor’s staff in Kentucky determined to launch the signature program of a president reviled in their state. But late in working on this book, on the night of that dream and in the scary days that followed, I learned that when it comes to health­care, all of that political intrigue and special interest jockeying plays out on a stage enveloped in something else: emotion, particularly fear. Fear of illness. Or pain. Or death. And wanting to do something, anything, to avoid that for yourself or a loved one. When thrown into the mix, fear became the element that brought a chronically dysfunctional Washington to its knees. Politicians know that they mess with people’s healthcare at their peril. It’s the fear I felt on that gurney, not only in my dream, but for real the morning after the dream, when I really was on the gurney on the way into the operating room. It’s the fear that continued to consume me the next day, when I was recovering from a successful defusing of the bomb. The recovery was routine. Routinely horrible. After all, my chest had just been split open with what, according to the website of Stryker, the Michigan-based company that makes it, was a “Large Bone Battery Power / Heavy Duty” sternum saw, which “has increased cutting speed for a more aggressive cut.” And then my heart had been stopped and machines turned on to keep my lungs and brain going. It’s about the fear of a simple cough. The worst, though routine, thing that can happen in the days following surgery like mine, I found out, was to cough. Coughing was torture because of how it assaulted my chest wounds. I developed a cough that was so painful that I blacked out. Not for a long time; there was a two-two count on Derek Jeter just before one of the episodes, and when I came to Jeter was about to take ball four. However, because I could feel it coming but could do nothing about it, it was terrifying to me and to my wife and kids, who watched me seize up and pass out more than once. In that moment of terror, I was anything but the well-informed, tough customer with lots of options that a robust free market counts on. I was a puddle. There were occasions during those days in the hospital when the non-drug-addled part of my brain wondered, when nurses came in for a blood test twice a day, whether once might have been enough. Some­times, I imagined what those chargemaster charges might look like, or wondered whether the cheerful guy with the wheel-around scale who came to weigh me once a day—and who told me he owned a second home as an investment—was part of the healthcare gravy train. But most of the time the other part of my brain took over, the part that remembered my terror during those blackouts and the overriding fear, reprised in dreams that persisted for weeks, that lingered in some­one whose chest had been sawed open and whose heart had been stopped. And as far as I was concerned they could have tested my blood ten times a day and weighed me every hour if they thought that was best. They could have paid as much as they wanted to that nurse’s aide with the scale or to the woman who flawlessly, without even a sting, took my blood. And the doctor who had given me an angio­gram the afternoon before the surgery and then came in the following week to check me out became just a nice guy who cared, not someone who might be trying to add on an extra consult bill. In the days that I was on my back, to have asked that nurse how much this or that test was going to cost, let alone to have grilled my surgeon—a guy I had researched and found was the master of aortic aneurysms—what he was going to charge seemed beside the point. It was like asking Mrs. Lincoln what she had thought of the play. When you’re staring up at someone from the gurney, you have no inclination to be a savvy consumer. You have no power. Only hope. And relief and appreciation when things turn out right. And you cer­tainly don’t want politicians messing around with some cost-cutting schemes that might interfere with that result. New York–Presbyterian’s marketing slogan is “Amazing Things Are Happening Here.” I’ll drink to that (although part of me did won­der why they need a marketing budget and how much it is). To me, it was, indeed, amazing that eight weeks after my bad dream I was back working out aerobically and with weights, just as I had before they had discovered the time bomb. That was more important to me than the hospital’s amazing salaries or chargemaster. That is what makes healthcare and dealing with healthcare costs so different, so hard. It’s what makes the Obamacare story so full of twists and turns—so dramatic—because the politics are so treacherous. Peo­ple care about their health a lot more than they care about healthcare policies or economics. That’s what I learned the night I was terrified by my own heartbeat and in the days after when I would have paid anything for a cough suppressant to avoid those blackouts. It’s not that this makes prices and policies allowing—indeed, encouraging—runaway costs unimportant. Hardly. My time on the gurney notwithstanding, I believe everything I have written and will write about the toxicity of our profiteer-dominated healthcare sys­tem. But now I also understand, firsthand, the meaning of what the caregivers who work in that system do every day. They do achieve amazing things, and when it’s your life or your child’s life or your mother’s life on the receiving end of those amazing things, there is no such thing as a runaway cost. You’ll pay anything, and if you don’t have the money, you’ll borrow at any mortgage rate or from any pay­day lender to come up with the cash. Which is why 60 percent of the nearly one million personal bankruptcies filed in the United States last year resulted from medical bills. Even when it’s not an emergency, even those who would otherwise be the toughest customers lose their leverage. “When I went in for knee surgery, I couldn’t have cared less about healthcare policy or cost containment,” Marna Borgstrom, the CEO of the giant Yale New Haven Health System told me. “I was just scared.” That is the perspective that anyone’s encounter with a scalpel provides—the “How can I think about the cost at a time like this?” element. Most of the politicians, lobbyists, congressional staffers, and others who collectively wrote the story of Obamacare had some kind of ex­perience like that, either themselves or vicariously with a friend or loved one. Who hasn’t? Sen. Max Baucus (AFP via Getty Images) Montana’s Max Baucus, the chairman of the all-important Senate Finance Committee, had a picture on his desk of a constituent he had befriended who had died after a long fight against a disease stemming from an industrial pollution disaster, the court settlement of which, Baucus believed, had not sufficiently provided for his medical care. Billy Tauzin, the top lobbyist for the drug industry had, he said, “a cancer where they told me I had a one percent chance of living, until a drug saved my life.” The staffer who was more personally responsible than anyone for the drafting of what became Obamacare had a mother who, in the year before the staffer wrote that draft, had to take an $8.50 an hour job as a nightshift gate agent at the Las Vegas airport. She worked every night not because she needed the $8.50—her semiretired hus­band was himself a doctor—but because a preexisting condition pre­cluded her from buying health insurance on the individual market. That meant she needed a job, any job, with a large employer. Her daughter’s draft of the new law prohibited insurers from stopping people with preexisting conditions from buying insurance on the in­dividual market. And then there was Senator Edward Kennedy, for fifty years the champion of extending healthcare to all Americans. Beyond his broth­ers’ tragic visits to two hospital emergency rooms, Ted Kennedy’s firsthand experience with healthcare began with a sister’s severe men­tal disabilities, extended to a three-month stay in a western Massachu­setts hospital following a near-fatal 1964 plane crash, and continued through his son’s long battle with cancer. Although their solutions varied, these four — as well as most of the dozens of other Obamacare players, who to some degree had these kinds of personal stories— saw and understood healthcare as an issue not only more urgent and more emotionally charged than any other, but also bedeviled by one core question: How do you pay for giving millions of new customers the means to participate in a marketplace with inflated prices—and with a damn-the-torpedoes attitude about those prices when they’re looking up from the gurney? Is that possible? Or must the marketplace be tamed or tossed aside? Or must costs be pushed aside, to deal with another day? As we’ll see, even the seemingly coldest fish among politicians — the cerebral, “no drama” Barack Obama — drew on his encounters with people who desperately needed healthcare to frame, and ultimately fuel, his push for a plan. “Everywhere I went on that first campaign, I heard directly from Americans about what a broken health care system meant to them — the bankruptcies, putting off care until it was too late, not being able to get coverage because of a pre-existing condition,” Obama would later tell me. But as Obama’s campaign began, he had not yet met many of those Americans victimized by the broken healthcare system. And it showed.

Bring em on Triemal, there's nothing they can do to me today that my bosses haven't already done to me this week.

Triemal and ERDoc, before you get all pissed at me, here is what I told her ER Doc is employed as an ER Doctor and Triemal I believe is employed by an ems agency. Nothing more and nothing less.

It's sort of like Public School, teach to the test and nothing more.

The answer is plain and simple. If you and your partner believe that you cannot lift a patient safely, then you call for a lift assist. Don't give it a second thought. I can't count the number of times I've called for a lift assist. My back is worth millions more than the temporary inconvenience of the sleep or rest of a fire crew or another one of my ems crews. My EMS crew mates also know that they can call me any time to ask for lift assists as well. Hell, if I am at home and not doing anything, they can call me on my cell and I will come help them lift the patient as well. No company gives a shit about your back, so its high time that we as providers start to!!!!! We are all one lift away from being a permanently disabled former provider. Protect your back, it's the only one you have.

Yeah, I was conversing with her the other day via pm's and PM'd her asking if she was Ventmedic and I never got a reply. Not even a reply.

so if we say Ventmedic ventmedic ventmedic does she come back like Beetlejuice?

And also make sure that you are there on time and on the right day. Do not leave until they dismiss you. Expect driver's training as well. Bring a notebook, two pens, leave your cell phone in your pocket or your car. NOTHING pissed me off more than orientee's texting on their cell phones when I was giving them information about the company and what they were to be doing for said company. Oh yeah, one other thing, deodorant and toothpaste are required items. Not saying that you don't use them but there have been orientee's who in my opinion had never seen nor heard of those two items.

I'm sure Dwayne will chime in here sometime. Especially on the colorado move thing. Dwayne come out of the third world and chime in.

He needs surgical intervention I believe. Get him to the OR STAT!!!!!!!!!

I've been a member here for many years, I can't remember how many but it's been a lot. I've seen it ebb and sway here. We had tons of posts prior to when chat was popular, then during chat being popular it seemed that everyone was chatting, then things changed and posting increased and chatting died. Now posts and chat is minimal. I think that you can honestly mark the drop in participation around the time when Dustdevil passed away.