DwayneEMTP

Please don't say pussy... Great points Matty. Maybe it is that simple, that she caught my eye and the feelings that anyone would have about kids living in this way were focused on her then? Maybe, through impotence for being able to direct greater change our minds focus on a single change instead, and that focus is directed at whatever is most familiar? I didn't think of that before...her thin nose is out of place here, maybe it's simply the shape of her nose that made me feel that she didn't belong, and nothing deeper at all? I get that RK, but this isn't about our conscious judgements really. Do you mean to say that you don't sometimes feel one way or another just simply by looking at someone? I don't mean simply whether or not they turn you on, but a sense of value in some way? I understand that we can justify these feelings away, but I'm more interested in the unanalyzed thoughts that seem to come unbidden, know what I mean?

Please don't say bush..... Welcome Chick! "Occupation:FTO/Captain/Paramedic" and naked! You are now officially my very favorite hosemonkey!

Wait, you're either a wickedly cute boy, or a girl named Matt? (Shut up! You were all thinking it too!!) Either way, welcome. We can always use a new perspective and some fresh experiences... Good to have you! Dwayne

This kind of thing happens in a bad economy and you're forced to start scaling back your employees...

You would hope a company could forgive a mistake like this, but I'll bet he got canned...

Oh man, that's just begging for three pages of innapropriate humor...

I've had this thought stuck in my head for a couple of months now, with no real progress being made. As we've had some pretty good non EMS related conversations here, I thought I'd throw it out for your thoughts. I'm going to paste a link to my blog as an explanation. It's not a great blog and this link has errors in it, in fact maybe more errors than not, but I think it shows my thinking, as far as it goes. I'm curious to see what you think, and how you feel, about this... http://www.chasing-my-life.com/is-a-beautiful-child-more-valuable-than-one-less-beautiful/

This call was from a couple of years ago, a little more maybe, but to the best of my knowledge nothing came of it....plus, how is one going to prove that it's bullshit, and not a resolved TIA? Plus, obviously her doc was onboard with dumping patients at the ER...Podunk town, Smallville...life as usual....

Oh my God!! I think you were joking, but that never really occured to me!! We've seen many strange things happen in nursing homes, how bad would it suck to be making a stand and refusing the wrong patient in another room!! I'm going to verify that next time...Stupid, I know, but I'm going to....

(Edit, posting at the same time Mobes. ECG was unremarkable, and she had no history of cardiac issues, stroke, diabetes, CVA/TIA, etc..) That was pretty much what I did, though as I began to ask if she wanted to go in, and she refused, the nurse flipped and handed me the phone with the doc on it. I explained to the doc why I'd chosen not to transport, he said, "Yeah, go ahead and take, she should be checked out..." I said, "So do I understand you to say that you are stating that your patient is incompetent to refuse, in your professional opinion, and that you are instructing me to take her against her will?" He hung up on me... The nurse is red faced, pulls a number out of her pocket, dials it, begins yelling into the phone, explains that mom is having a stroke and the medic refuses to transport, and says, "Her daughter has POA and she says (this is true) that you had better get her to the God damned hospital right now!!!" I say that I can't transport her against her will, and refuse, to which she says that the daughter and her husband are on their way down! I tell her that the POA is useless with a patient that is competent to make their own decisions. They arrive, both are super, duper pissed off after the nurses report. I explain that it's looking after her mom that has caused this issue, not trying to avoid caring for her. I've now been on scene for over an hour, the hospital is approx. 200 yards across the parking lot. Transporting would have been much easier. She talks to her mom, her mom verifies what I've said, and the decision is made not to transport. And, miracle of miracles, the family is truly grateful that we treated her mother like an adult instead of a damaged child. 0600, called back to the nursing home where the doc has made an appt to have her transfered to the ER for evaluation. I begin to explain to him what went on, he responds, "Whatever, just take her..." We do, and that......is the rest of the story... Maybe not terribly interesting, but I truly find patient advocacy and moral and ethical issues some of the most interesting and challenging calls of all... Of course the nursing home called my boss and I got called on the carpet for refusing to transport a stroke patient...but bottom line is that she tripped, fell lightly on her ass, the nurse saw a chance to send grandma out into the sub zero weather to get her out of her hair, and no one was happy that I didn't allow it to happen.... Anyway, that's the deal...got the idea from the "would you transport" though this is a really accurate description of what took place...

Actually, not a red herring at all. That is the story that I was given by the patient AND staff, but at that point their stories disagree greatly. I see no reason not to believe the patient, as I find nothing wrong with her... Neg h/a, BGL as above, pupils equal/reactive at 3mm. Pt answers all of your questions correctly, without hesitation with a voice that's clear and concise. She says that she just fell down, barely, no big deal and as she was getting up that the staff told her to stay sitting on the bed that they were going to call an ambulance. When she said that she was fine and just wanted to go back to sleep the nurse told her that she had to go to the hospital because she fell down, company policy, no choice in the matter... The nurse is wickedly pissed off now, has the doctor on the phone, and you get the distinct impression that it's possible that the symptoms were created by the nurse to lighten her patient load on this floor...

Staff claims that when the patient's bed alarm activated that she came in and found the patient getting herself up off of the floor, that she had severe right sided facial droop, severely slurred speech. She's starting to get really pissed off that you're asking all of these questions after she's already told you to take her to the hospital. The patient denies that these symptoms ever existed.

Yeah, I'll pay another buck to see how you're going to document that! "Though unknown type/regularity of sexual activity in this 95 y/o/f, condoms delivered prophylactically secondary to online dare."

Pt appears normal to me now. No noticeable facial droop, stroke scale negative. Pt claims that she had to pee, went to get out of bed, hooked her foot in a blanket and sat down hard on her bottom. She states to having no pain from the fall, there are no apparent injured visible or to palp on her rear, hands, elbows. Her only complaint is that it's almost 1:00 am and she would like to be allowed to go back to sleep. She needs no assistance other than to be left alone. HR 86, BP 146/88, SPO2 96% r/a, BGL 97. Do you mean a better PMH/MEDS than no significant history or medications? :-) NKDA.

Me too Trish! We should be buddies and compare notes on the way to care for geriatrics like Island... And, when I say 'buddies..' ah hell, never mind.... :-)

You are dispatched to the local state run nursing home at midnight. Dispatch states that they have a 94 year old female stroke victim that needs to be transported to the ER. They are requesting no fire response, and no lights or sirens from the ambulance. You arrive on scene emergent, though quietly, (Cause you don't really like the nursing home telling you how to respond), are escorted to a room far in the back of the facility. While the nurse escorts you back she explains that the patien has sever right sided facial droop and slurred speech, that she fell out of bed while trying to go to the restroom causing the discovery of these issues. She did no further neurologic testing. Patient is on no significant medications and has no significant medical history other than walking the planet for the last 96 years. There you find what appears to be a very dignified looking elderly lady sitting up in her bed looking like she was recentely awakened... What would you like to know?

Yeah, there will be more to this story....Hopefully... If not, then there should be an investigation into the policies of this service in this regard. My guess is that this is going to turn out to be a douche bag medic that's useing this story to cover up something else... What service is brave/stupid enough to come out publically and say, "Yeah, he was freezing outside of his burning house, but that's not really our problem. Company protocol is to have the patient warm themselves next to the fire of their burning belongings, or set them in front of the ambulance exhaust instead of wasting valuable insulatorified resources.." I know some really dumb people, myself amongst them, but do you really know anyone that is that dumb? I don't think that I do...

Good to have you Brother...jump in!

I say, "Well, let's have a look at that toe....It looks all right to me but would you like to go to the hospital and have it checked out? Happy to take you..." Here is different though...a patient in the clinic... "Hurt...pain..Pain mericine.." flexing his right shoulder. Only, before the conversation is over it seems to be his left shoulder in pain. Most often patients have no real complaints, they've just come in to shop at the 'free store' for things to take back to their villages. I sometimes 'lose' things that seem to end up in the villages, but try and do so with expired or near expired stuff... Having seen this type of patient many times a day for months I give him two Panadol (Tylenol.) "Box mericine!" "No." "Condoms...want condoms.." I give him a half dozen... "Box condoms!" "No. That is all the you get. If you use those up come back tomorrow...And if you use all of those I'll want your autograph.." "Sun burn..Need mericine for sun...(sun screen)" "Brother, you seem to be in pretty bad shape...should I explain to your supervisor that you're in too much pain, too horny, and too afraid of the sun to work today?" "No...no supervisor..." "Ok then...go back to work. Come back when you need more condoms..." I'll give you a dollar and a fresh baked cookie if you have that conversation with your next patient... :-)

That is a great story...it should have been in your book! Stupid questions probably, but is there a reason that you posted that today, as opposed to yesterday or tomorrow?

Pox, where the hell have you been??

MG, I hear you, and that's cool, right? I see some cleavage and treat you better, hopefully you feel better, I KNOW that I feel better, no one is harmed, everyone goes away in better spirits...Win/win? Obviously, (or hopefully so), I'm speaking within the bounds of the professional arena. But your response to RKS kind of makes my point. You choose to try and fit into EMS by proving that you don't need the help of men, when Island, who's been doing this since long before I was born, claims that he wouldn't take such foolish chances. Do you want to know why men still rule EMS? Because women, too often, try and compete as men. Men are like big dumb dogs most times. Women could own EMS if they's stop competing and start manipulating...Sounds bad? Nah...it's the way the world works when it's working right. When I was doing clinicals there was a lady basic on the truck. She was maybe 5'8" (170ish cm) and around 250lbs (you do the math..) She had the most amazing personality and for about a month, every day that she came into work she had her hair and make-up done in the fashion of one of the old pin-up girls. I mean, perfectly so! You could have just about picked out the poster that she was copying. Like they used to paint on the bombers? Stunning! And you know what? It paid big dividends, though I don't think that that is why she did it. Cops, firemen, dorky medic students, difficult to manage patients, male and female in every category just paid attention to her. They listened when she spoke, tried to anticipate what she might need...it was awesome! And though I only spent about 160hrs of shift time with her, I also never saw any sign, from either sex (and a few undetermined) that anyone considered her less professional for it. Why would a woman choose not to ustilize that? How did we end up in a society where, if you want to try to be equal to a man that it demands that you choose not to use the inherant tools at your disposal? That doesn't sound superior, or equal to me, it just sounds idiotic...And what moron decided that 'man' was the best standard to try and equal? I don't even like most of us... If I could get everyone's cooperative attention by spending my day going, "Oops! Dang it, did my wee wee slip out again?" the friggin thing would be sunburned and calloused from all of the time I'd spend "ooopsing"... And before someone says it, I KNOW that this isn't an earth shattering topic. I KNOW that we can't fix it...but I like the conversation anyway...Hell, where I am, this is practically porn....so bite me.

I'm glad that everyone can have such fun with my sexually deprived delimas... But Rural, surely you know that that's not true? You may choose to try and be asexual on scene, and if that's true, then that's too bad, as women bring a unique energy as well as a separate set of strengths to anything that they do. I think that we lose much of that when we try and deny our inherant plumbing. True, right? The guys that you know that get all wishy washy and overly sensitive about things may be viewed in the media as a "better" person, but they've in fact lost some of their potency by denying some of the masculinity. Speaking in mature terms, not comparing Pee Wee Herman to the macho swaggering asshole. (Speaking in each case of mentally/emotionally sound examples of each sex.) And there are many places, particularly in EMS, where a woman is a much better choice for a situation than a man, yet she loses much of that when she chooses to be "macho", walking like a cow, speaking like a drill sargent, doesn't she? If we have a scale of all possible human interactions, all human activities, I think that you would be able to slide up and down that scale and at each instance decide if a man, or a woman, would be a better fit for creating the best possible outcome in regard to that 'thing', (with skads of overlap of course) but, should you go through and then add up each place that a man was superior and each place a woman, I think that at the end of the day we'd find, pretty much, a zero balance. Don't allow anyone to convince you that attempting to be apparently asexual is a strength. It really isn't. Anyway.....Rural, if we're lucky enough to convince you to stick around you'll probably find that sitting in the jungle for weeks at a time causes me to try and expound on things that aren't terribly relavant, and most often well above my ability to have an intelligent opinion. This would be a 'week 5' rant here... Thanks for playing... Dwayne

Those are good...