RaceMedic Posted October 28, 2011 Posted October 28, 2011 Dfib, I have to say that even as an EMT I was taught pregnant late term females were to be transported on the left. I completely agree with your statement about the doc taking the time to explain rational, I remember it when i was first started in ems. Was a great boost knowing that the doc thought enough of me to spend the time and use it as a teaching moment. Just don't agree that an EMT would not have been taught this specific treatment. Race
DwayneEMTP Posted October 28, 2011 Posted October 28, 2011 As the doc explains, that is why I believe that the relationship between medics and the ER staff is so vital and must be defended. Certainly not defended to the extent of covering up life altering errors, but absolutely to the point that there is the necessary trust to report honestly and completely. I can't think of a single time, to tell the truth, that a ER doc has jammed me up for being honest about an error. ER docs seems to be about 3/4 doctor, 9/10 educator, 1/3 councilor, 9/17th lawyer, and 5/8 hospital politician...which seems to keep them pretty busy for the most part. I've rarely had a shitty experience with an ER doc and those that I have had I've been able to write off to being tired or behind as it wasn't consistent. But I'm confident that I've never had a doc that was willing to take the ride necessary to get caught trying to cover up an error made by some chucklehead paramedic... If fact, as it seems to be your contention Flaming that this happens all the time...what motivation do you find that a Dr or nurse in an ER would have for covering for a paramedic, or any ambulance crew in general? As the vast majority of services are not hospital based, why would they risk their careers to do so? Just curious. Dwayne
Bieber Posted October 28, 2011 Posted October 28, 2011 Note to go with my post, when I say "report" I mean verbalizing the error to the patient during patient care. NOBODY should be falsifying or omitting errors in their PCRs or during their report to the hospital, and if the patient requests the file it should be disclosed to them in its full entirety. Ultimately, I think there are very few errors that shouldn't be verbally disclosed to the patient or their family during patient contact, but there's ARE those which I think should be disclosed in a more appropriate setting (i.e. the code blue example) which may not be during patient/family contact (i.e. telling them that the line was infiltrated and none of the medications reached the systemic circulation; while it's true that the family has a right to know, will they be able to understand that a patient with an already extremely poor chance of survival would probably be no better off even if the line had been good when they're already so emotionally distraught? Or will their emotional distress cloud their judgment and result in even more distress, distrust of the medical system, and a lingering feeling that "if only they'd gotten that IV, they'd be alive right now!" mentality?)
tcripp Posted October 28, 2011 Posted October 28, 2011 (edited) Just don't agree that an EMT would not have been taught this specific treatment. Have you not ever gotten "backwards" in your thinking on a call or just simply had what I'd like to call a brain cramp. (Different than a brain fart as in nothing came out...). How many times have you called out "left" when you meant "right"? I believe what this medic now has is understanding the importance of getting the left/right spot on for this type of patient. Edited October 28, 2011 by tcripp
DFIB Posted October 28, 2011 Posted October 28, 2011 (edited) Sorry Dfib, but it was a medic. Darn, Doc I was beginnig to get all sentimental and teary eyed. He should have known better. Dfib, I have to say that even as an EMT I was taught pregnant late term females were to be transported on the left. I completely agree with your statement about the doc taking the time to explain rational, I remember it when i was first started in ems. Was a great boost knowing that the doc thought enough of me to spend the time and use it as a teaching moment. Just don't agree that an EMT would not have been taught this specific treatment. Race All EMT's are taught about supine hypotensive syndrome, eclampsia and left side transport. If the guy was a medic he most definitely should have known. I just thought the importance of positioning would more easily be lost on an EMT than a medic. ERDoc wasn’t just teaching and being nice, he was saving his butt on future calls where proper positioning would make a bigger difference.. Doctors have a pretty strong emotional effect on EMTs especially new ones. After a while a lot of EMTs could begin to feel like the Medics' bell boy. A little encouragement from the top of the food chain works wonders. Edited October 28, 2011 by DFIB
flamingemt2011 Posted October 28, 2011 Author Posted October 28, 2011 (edited) If fact, as it seems to be your contention Flaming that this happens all the time...what motivation do you find that a Dr or nurse in an ER would have for covering for a paramedic, or any ambulance crew in general? As the vast majority of services are not hospital based, why would they risk their careers to do so? Just curious. Dwayne I dont think it happens all the time, but i am fairly sure it happens more than it should. Of course we would know how often it occurs if the people in this room asked their directors, and posted the numbers, but that will never happen. I believe it is one of those unspoken rules, like cops dont give cops tickets, and it is our engrained CULTURE in the medical world. I remember at one of the hospitals I worked at, we had another hospital do an illegal transfer to our facility which was a blatent COBRA/EMTALA violation. Of course the ER Nurses wanted it reported, but the CEO said NO, instead he called that hospital's CEO and let him know what happened, then that CEO owed him a big favor in the future. I have seen doctors and nurses make mistakes several times, it was usually not reported to anyone. They don't rat each other out unless they have to. I believe they see us as an extension of themselves, and as part of the team. Plus, it just creates more work for them if they do report it. With that being said, I do not think they see it as putting their careers at risk, after all, they did not make the mistake, and as you pointed out, they are not our employer. Reminds me of a story that I can use as an allegory: Newlywed is cooking dinner for husband, wants to cook a potroast. She takes the big piece of beef, and cuts the top third off and throws it away. Husband can't believe what he sees, and asks why she threw away a perfectly good piece of meat ? She says thats the way Mom always did it. He asks why, she says dont know, never asked. So wife calls mom, and asks and gets the same answer she just gave her husband, "thats the way your grandma did it, and I never asked why". So they call grandma and ask her, they get same answer, "thats the way your great grandma did it, I never asked why. So they go to the nursing home to ask great grandma why she did it, the answer was..................................... *** Cause we were poor, and only had one, very small pot. The meat wouldn't fit in it. We did not have refrigerators back then, just an icebox. **** Highlight the area between the asterisks above and change the color to read answer (currently typed in white). In medicine, we do alot of things because thats the way it was always done. Edited October 28, 2011 by flamingemt2011
hatelilpeepees Posted October 28, 2011 Posted October 28, 2011 I WOULD RATHER BE THE MAN WHO BOUGHT THE BROOKLYN BRIDGE THAN THE MAN WHO SOLD IT --- Mark Twain YOU KNOW YOU ARE AN ADULT WHEN YOU ALWAYS DO THE RIGHT THING WHEN NO ONE IS LOOKING --- unknown I get the whole lawsuit-phobia thing, but just on a human level, can someone explain why "not reporting errors to the patient/family" is the RIGHT thing to do (and I mean after investigation, not the medic telling the patient at the time of error) ?
tcripp Posted October 28, 2011 Posted October 28, 2011 I get the whole lawsuit-phobia thing, but just on a human level, can someone explain why "not reporting errors to the patient/family" is the RIGHT thing to do (and I mean after investigation, not the medic telling the patient at the time of error) ? I like the question, but am going to turn it around on you. Would you really want someone showing up on your doorstep telling you that they are the reason why your family member died? I mean, what purpose dose it serve other than to ease the conscience of the person delivering the news. If you were to show up and inform me that because of your actions, my husband is dead...NOTHING has changed for me. He is still dead. I could sue you...but he is still dead. I can forgive you...but depending on my state of mind, that probably isn't going to happen for a very long time. So, now you've done nothing more than provide me with feelings of hate and disgust when I probably should be grieving my loss. You, however, will walk away knowing that you did the right thing by telling me. Your life will forever go on as normal and without guilt because you have done the right thing. You will sleep at night and will eat well because you have done the right thing. My world will be worse off for the news. Just my two cents. 1
hatelilpeepees Posted October 28, 2011 Posted October 28, 2011 HHHHHHMMMMMMMM tcripp, good point. I guess it is similar to the whole question about whether or not to tell a kid that they are adopted, when they dont know. But, I think we can all agree that is not the reason it is not being done, we are keeping the information private to protect ourselves from lawsuit, which is where I see it as a selfish act.
Recommended Posts