How did you like doing Inter-Facility Transports

[emtbasic13]

I was wondering what was some peoples opinion on doing IFT's. Did you like doing it or not and what was your day like working for a non-emergency transport ?

[emtannie]

I am lucky to work for a service where I get to do a whole range of things - on a shift, I could do interfacility transfers, emergency calls, and a flight, all in a single 12 hour shift.

The IFT calls we get are generally either to or from a long term care facility, or from our hospital to a higher level trauma or cardiac care facility.

First, some of the things I don't like:

- some of the long term care facilities have staff who are very poor at giving historical information, and you have limited or no access to medication lists, medical history, or DNR status.

- some facilities will treat you like you have no right to ask questions, or just want the patient off their hands, and you will see poor patient care in some facilities.

- some of the facilities have staff that are incredibly hard to find - we have returned patients to facilities, and have had to page staff from the front desk, or go up and down the halls looking for staff so we can do a report and hand off the patient.

- sometimes, you are a taxi service only. You don't provide any medical care, and you are there only because family members cannot be bothered to look for any other alternative to get their family from one place to another.

Now, some of the positives:

- you will get to see a variety of things that you may not see on emergency calls, and that you may not have time to ask a lot of questions about on an emergency call. For example, transferring a dialysis patient may give you the opportunity to ask questions about their dialysis routine, some of the things that they find a problem or a good thing, or they may let you inspect and listen to their fistula if they have one - a good learning experience

- some patients are very willing to talk, and you can learn a great deal about life in general from these patients. The other day I had a patient who had been a war bride - and she loved to tell me about coming to Canada - she was so interesting to listen to.

- sometimes, the only care you will give these patients is comfort and a hand to hold, and for some of these patients, that is worth more than any medication you could provide. Seeing the smile on their face when you hold their hand, or getting a hug from them when you drop them off, is an added bonus to a day where you may not get thanked for the work you do.

- if you are transferring a patient from one health centre to a higher care centre, you may have the opportunity to talk to staff there, or be able to follow your patient through some procedures, again, being able to learn from these calls things that you wouldn't see on a regular e-call.

I will admit, I wouldn't want to work strictly IFT calls. I like the emergency calls, since they are what I originally got into EMS to do. Don't sell IFT calls short though - there are some that you can learn a great deal from.

[MedicCraig]

I love that response. It's nice to know there are still medics around who realize that we are in the business of taking care of people, whether they're 8 or 80, getting their feeding tube replaced or having the big AMI. For 26 years I've been making the transfers, 911, stand-bys, etc. And I still learn something new everyday. I enjoy talking to the older folks. Listen to their stories. They have a lot to pass on. Some have had amazing lives. One patient told me about his life growing up as a sharecropper. His parents were slaves! That's living history. He was 106 years old and still sharp. Another told me about emigrating to the US from England when she was 12. Her father was the Captain of the steam ship that brought her here. He later died when he went down with his ship off the coast of Holland. Yes, the transfers can get a little boring, but only if you choose to make that way. Try to learn something on every run. Pay attention to your patient. I've had patients arrest while taking them out of the hospital. I've had to intubate patients that were only going to diaysis. Keep your eyes open and don't get caught up in the "It's only a transfer" mentality.

[Just Plain Ruff]

I worked for a service where as a newbie you had to do the Transfer car. All you did was nursing home transports all day long for 24 hours in a row. We were in a county that was not our primary providing area so we did not EVER have a chance to run emergency.

I HATED IT. I at the time had the mentality that "I got into this line of work to save people and run the good calls".

After about 6 months got moved up to doing half and half. one day each week I'd work transfer and then the other shifts I'd do the 911 car. Loved that mix. I realized that 911 wasn't all it was cracked up to be but only hearing about the good calls I was living with rose colored glasses on.

I currently am not int he field right now as I am making significantly more money doing ER consulting than EMS and I'm trying to find a service I can provide part time work for.

If you get "stuck" doing IFT's day after day after day I am sure it gets BORING and tedious. Yes these are patients that need us surely they do but seriously, how much can you truly learn patient care wise from a patient on an IFT? I can think of the obvious points such as learning about patient history, medications and getting good stories from the military vets but patient care wise there's not a lot of new stuff to glean from Grandma Moses sitting on your cot going from the ER to the nursing home that is 1500 feet from the ED Entrance.

[emtbasic13]

Thank you all for your replies. I think I will be pleased with doing IFT's for a few years. I really enjoyed some of your in puts. I feel that with either IFT or 911 you can get bored. I know emt's and medics who do 911 and are unhappy, I know emt's and medics that do IFT for years and are very pleased. I like what Medic Craaig said, its what you make of it. Both have there ups and downs.

[Chief1C]

Our service, simply put, will not do them. Period. There are plenty of transport services out there, we tell folks.

[Just Plain Ruff]

Thank you all for your replies. I think I will be pleased with doing IFT's for a few years. I really enjoyed some of your in puts. I feel that with either IFT or 911 you can get bored. I know emt's and medics who do 911 and are unhappy, I know emt's and medics that do IFT for years and are very pleased. I like what Medic Craaig said, its what you make of it. Both have there ups and downs.

pleased with doing them for a few years???? Come back here in 6 months and let us know how pleased you are.

If you are not interested in doing the 911 calls and all you want to be is a IFT person then more power to you but I'm sure you didn't get in to this line of work to drive back and forth from hospital to nursing home again and again.

If you are not interested in doing the 911 calls and just want to do the IFT's then you are one of the odd men/women out and I applaud you for only wanting to do IFT's. I suspect that in 6 months you will have a different toon.

[fiznat]

I absolutely hated doing transfers. Hated, hated, hated. I understand that EMTs and Paramedics can learn quite a bit on these types of calls by reading medical histories, discharge reports, and talking with patients, but there came a point for me where I just could not stand it any longer. The work felt brainless and boring, and it constantly made me feel like my job was reduced to something closer to livery than medicine. Luckily I was able to transfer into a different position at work where I no longer have to do transfers. Otherwise, I don't know how much longer I would have lasted.

[firemedic37]

I agree with the first couple of responces. Here is my one cents worth.

I started in 911 for three years then moved to work at a hospital based ambulance service that does mostly Inter-Facility Transfers. My biggest reason was the increase in pay. I knew when I started that I was going to hate doing long distance transfers (3 - 12 hrs round trip) and I still do. But what I knew I would enjoy is the pleasure of caring for pt's that are sometimes worried about what is going on since they are having to be transferred to a higher level of care for treatment. And I get the previleage to help them understand why they are being transferred. Also I have learned more than I have ever imagined I would know as a Paramedic. I get to work even closer to the nurses, doctors and other healthcare careers and learn more about their jobs and how it effects our job in the prehospital setting.

I still do 911 and lately a lot of them. I now know what the hospital is going to want and expect from me when I take a pt to them. It prepares me better to give my report and tell them the things they want to hear. It has given me a much better understand of a multitude of different medications that I would never have touched before if I wasn't do Inter-Facility Transports. I also get to work in the Emergency Department when we are not on the road, this is the place I can perfect my skills under the guidance of doctors.

I really have and continue to enjoy my career. I am planning on staying in the Inter-Facility Transport feild since I still do get a lot of 911 time with it. I think it would be different if I didn't get any 911.

[Mateo_1387]

emtbasic13,

I do not wish to do IFT on a full time basis. When I was first certified as an EMT-basic, I worked for 3 months at an IFT service. I did not care for it too much. My current service has two divisions, EMS and IFT. I have worked a couple overtime days on the IFT side, and actually found I enjoyed it, as it was a break from the normal.

The things I especially enjoyed about it were being able to meet people that were not worked up because of a medical emergency. It does not require serious and prompt action, except in very rare circumstances. Talking to patients and their family (if a family member rides along) was always nice. Especially if you have regular patients, they can be fun to keep up with. It is always nice when you make an impression on persons and they request you to come pick them up again.

I hope you work with fun people, as that makes a difference in how the day goes. It is not uncommon to pick people up back to back, multiple times. Depending on how busy your service is, you may or may not get scheduled breaks, or just plain down time where you just do not get calls.

Another enjoyable thing is going on out of town trips, its nice sometimes to just go to a new area and see things.

I find with dealing with the local nursing homes that if you smile, be courteous, be understanding when the nurse just can't get to you at that red hot second, that you get much more out of them in the long run. I do that on the 911 side, and after a few months, the nurses got to know me really well, knew I was not going to be an asshole to them, and would bend over backwards to help me (moving the patient, reading off their history while I am preparing the patient for transport, etc...) Make your patient's comfortable, thats just common courtesy. If you follow those things, along with getting through your 'learning the job' phase, things should go well for you.

If you are not looking for emergency calls, then you can enjoy this job quite well. I find those that just want to answer emergencies cannot handle the IFT business for lengthy periods of time. Good luck to you.

Matt