Your typical Lifeline call

[tskstorm]

I am very dismissive of it, 5000 EMS providers (rough estimate) cover NYC's 9-1-1 calls throughout 5 boroughs ...

NYC's population according to the 2008 Census is 8,363,710. Do the math, its a great idea but its not practical.

Our call volume already taxes our system, during peak hours lower priority jobs can easily wait for over an hour before an ambulance even begins to respond.

[Kaisu]

You seemed pretty dismissive of the idea to do preventative care, but that is your purgative.

You meant prerogative, right? (pretty funny tho - nice Freudian slip)

[HERBIE1]

I agree we shouldn't be social workers...but part of our job is prevention is it not? Do we not help install child safety seats to protect children? Do we not go around and help check smoke detectors (my county started this last year of going door to door and checking every single smoke detector after a string of deaths related to malfunctioning smoke detectors)? Do we not have slogans to buckle up? Or wear a helmet to school aged kids? Part of our jobs is to prevent injury and death.

I don't know about your area, but there is a specific training program around here run by the State Police and certain children's hospitals for installing car seats. It's a liability issue- unless you have a certification, you should NOT be doing something like that. As for public safety programs- that's NOT what was being discussed here. We provide education on every call-fire safety, proper dosing of medications, proper diet, compliance with doctors orders, seat belts- it's done all the time.

If this also includes service calls to help someone into bed to prevent them from falling and breaking a hip or worse...then so be it. It is part of the job. If you don't like it, work to fix the system instead of complain about it. Work with the patients who call once a day or week to find a better solution. When I was in EMS we had numerous frequent fliers, whenever we did transport the patient, I would make sure the hospital got a social work consult for them. If we didn't transport and it was serious like they were falling or continuously unable to get out of bed on their own or walk to their bed then I would call the elder abuse hot line to get social services involved. Be proactive. We are often the only advocates for these patients. EMS isn't all about the glory and saving that code or running that big trauma. It's often about making a difference in peoples lives sometimes on the most basic of levels.

How would "education" help deter someone from calling 911 to help find their glasses? Do you really think this person would define their problem as an emergency? All we can do is provide advice, suggestions, and if possible make proper notifications. Again, if you are running 25 or more calls a shift, tell me how it is possible to provide detailed education programs for every patient we encounter? If you have a busy system, do you really think it's appropriate use of resources to have a rig out of service, making calls to social service agencies, food pantries, mental health professionals? If this is an abuse/neglect situation, then I absolutely agree that anything that needs to be done SHOULD be done, no matter how long it takes. Real life vs idealistic.

This isn't all to say that there isn't abuse of the system, but unless we do something to educate and solve the problem the abuse is going to continue and probably get worse.

The abuse will ALWAYS exist. It's the nature of the business, and when the criteria that defines an emergency is essentially the opinion of the caller, what else can be done?

Education is fine, but abuse exists not because of a lack of education, but a lack of repercussions for the abuse. Again, any limits/penalties placed on the definitions of an emergency

WOAH... I just saw this...

When is it EVER okay to damage an alarm box for a patient???? It's the Boy Who Cried Wolf Story...and in my eyes as the patient...they have every right to sue those medics!

Agreed

Also, why is it the higher ups job to get them into a nursing home...why not be proactive and take the steps yourself??

Back up the bus here...

The higher ups are in a position to do such things. There is the potential for conflicts between the facility and the agencies involved with responding there. Same reason why unless they have an established contract/relationship with a private provider, a 911 service cannot recommend or steer a patient towards a particular company.

There are little things like laws, patient rights, next of kin, legal and family issues that need to be dealt with. You as a provider have no right to do such things and further, if you've ever had to get someone entered into a nursing home, or nearly any such situation, it's not like you simply dial up a nursing home and get a bed for someone. You can offer suggestions, explain why it may be in the patient's best interests, etc, but without knowing a patient's history, social/economic/legal issues I think it's presumptive and a potential liability to take it upon yourself to initiate such things. Let someone who KNOWS the processes involved, the steps that need to be taken, etc handle this. What if the patient does not WANT to enter an assisted living facility or nursing home? If they are competent, they can refuse anything- even if it would be in their best interests. I'm all for helping out as practical and reasonable, but let's be realistic. Often times there are family dynamics involved that severely complicate these things. Something about a road and good intentions...

Patients always need our respect. Unless you yourself have been disabled and faced what they face you have no right to judge them and treat them with a lack of respect.

WHO here is judging ANYONE?

WHO here is disrespecting anyone?

WHO here is advocating anything other than what's in the best interest of the patient, and that can be done within the bounds of common sense and reason?

[scubanurse]

Yeah ... about the car seats. I know you have to be certified. Our academy certifies FF in properly installing car seats. About the rest of it...I'm done beating a dead horse.

[HERBIE1]

I'm sorry you're too busy to do any sort of prevention. It has always been a priority of the county I worked in to do preventative activities for the community. And we are a busy county in the suburbs of D.C. Even DCFD is doing preventative care. We perhaps aren't as busy as you, but don't you think it might be a good idea to help prevent emergencies? We do it on off-duty days, we have task forces to do car seat checks to make sure they are installed properly. You seemed pretty dismissive of the idea to do preventative care, but that is your prerogative.

I think preventative care and education is an ongoing process, during every call. We educate patients and their families as to proper ways to take medication, the importance of checking blood sugars for diabetics, the importance of monitoring BP's and compliance with meds in hypertensive patients. Things like fire safety, medical screenings, home safety, etc are generally done OFF duty, especially when the service is a busy one.

[scubanurse]

Like I said... we do it on off-duty days.

[tskstorm]

I'm just curious ... does an off duty day mean a non-paid day ? I certainly don't make enough money as it is, and certainly wont work for anything less as in free. If I wanted to work for free I would volunteer and choose to only go to gsw's and stabbings and major mva's to get my adrenaline rush in, as is common practice here. (this is not a bash on volunteering) There is a difference between volunteering and working for free.

[P_Instructor]

There is a difference between volunteering and working for free.

Depends on how you look at it, but volunteering for what purpose, and working for free for whatever purpose. Basically they are the same, but differentiate upon the obtained goals met. I do see what you are saying, but I know there will be many different viewpoints to this.

[scubanurse]

I'm just curious ... does an off duty day mean a non-paid day ? I certainly don't make enough money as it is, and certainly wont work for anything less as in free. If I wanted to work for free I would volunteer and choose to only go to gsw's and stabbings and major mva's to get my adrenaline rush in, as is common practice here. (this is not a bash on volunteering) There is a difference between volunteering and working for free.

That is a whole new can of worms for a different thread. But the guys who do these programs get paid OT for it or volunteer their time for the greater good of the community.

[tskstorm]

Depends on how you look at it, but volunteering for what purpose, and working for free for whatever purpose. Basically they are the same, but differentiate upon the obtained goals met. I do see what you are saying, but I know there will be many different viewpoints to this.

When I show up to work I expect to get paid, not they can pay me some days and I work for free the others. Volunteering I expect no compensation at any time except the experiences gained.

***Disclaimer I do not Volunteer, I expect to get paid for my time, even if it is a menial wage.