restraints and lawsuits

[Just Plain Ruff]

I agree Ruff, it is very suspect. 11 months seems about the right amount of time to contact a lawyer and have the slow cogs of justice put in motion. If they were telling you what to write, they had an agenda.

Yes I was quite suspect. This same service under threat of termination had me rewrite a report to make it look like a patient was bed-ridden and required an ambulance when in fact the patient was able to ambulate to the cot without incident. Needless to say, I didn't work for them for very long. Too many cases of this type of shit going on. I'm not sure who gave a quick call to Medicare and medicaid about this, I know who it was but I can't say publicly.

[DwayneEMTP]

I'm curious under what pretext that you took him with you?

Unless you had a legal order from the police or your medical control to take him, then you violated his rights and my guess is that you're going to get a beating.

Also, unless you clearly demonstrated why you were 'forced' to restrain him, then you could have more issues.

And unless you clearly documented and demonstrated that he was altered beyond his ability to give informed consent then any treatments that you provided again violated his rights and severely overstepped your rights as a provider. More trouble still.

And no, unless you had very good, well documented reasons for strapping him down, and valid, well documented evidence of his being so significantly altered as to not be able to consent to the interventions that you were forced to provide to save his life, then you can't tie people down and force interventions on aware patients without having a lawyer involved, nor should you be able to.

A patient screaming about being claustrophobic doesn't sound terribly altered to me. Nor one with a drug overdose that's able to struggle so hard as to need several people to restrain him.

I'm not judging you, but only trying to offer a mirror for the perception that I took from your post. This sounds a bit to me like you showed up, you decided that as he mentioned harm to himself that he had given up all rights to consent, respect, and patient advocacy which then gave you the right to do whatever you wanted to do. In this case it sounds like getting him loaded and to the hospital in the least time possible was the main goal.

Again, I have no idea what happened, but I'm afraid your attitude regarding patient advocacy as well as the quality of your documentation is likely to have a significant effect on the outcome of this situation.

Good luck.

[scubanurse]

Just because someone is suicidal, does not mean they are altered beyond making informed decisions. Patient's have the right to refuse treatments, even life-saving ones.

[mikeymedic1984]

I cry "BS" on the whole thread --- only one post, claims to be a "student", but is being sued for actions in the field. Sounds like a stupid lawyer looking for way to sue.

Even if your service is the worst ever, each State has written rules/protocols/procedures for how to deal with this situation --- follow the rules, you are fine -- don't, get sued.

By the way, the use of the work "gurney" did it for me.

Edited January 14, 2014 by mikeymedic1984

[ERDoc]

I'll agree that it is a little suspect that the OP says he/she is a student and then in the post makes it sound like he/she is part of a regular crew. I wouldn't get to stuck on gurney, it is used frequently around these parts (and makes me cringe every time I hear it). This area (suicidal pts refusing treatment) is a somewhat gray area right now. Currently, suicidality is considered a mental health issue that leaves the person unable to make an informed decision. This means that they cannot refuse treatment. It is why states can involuntarily hospitalize people (5150 in California for those keeping score). So, in the OP's scenario the pt cannot refuse to be brought to the hospital. Now, as for the restraints, that is a whole other issue and is highly dependent on what local laws/protocols are. Not every suicidal person needs restraints (I'm assuming the OP means more than just the normal stretcher straps required to provide safe transport). The only time they should be used are when the pt is a physical threat to themselves or others. I don't think enough info is provided in the OP to really determine whether the restraints were needed or not. Unfortunately, in EMS there is a large proportion of providers who are complete assholes to suicide pts and don't realize that mental health issues are just as real as MIs and trauma.

[ClutzyEMT]

Hang on a second Dwayne, in North Dakota, per state protocol, I can legally transport a suicidal patient if I want.

Patients have the right to refuse treatment and/or transport if they are of legal age and are competent. Competence is defined as the capacity or ability to understand the nature and effects of one’s acts or decisions. A person is considered to be competent until proven otherwise. There are situations, however, in which the interests of the general public outweigh an individual’s right to liberty:

· The individual is threatening self-harm or suicide.

· The individual presents a threat to the community because of a contagious disease or other physical dangerousness.

· The individual presents a specific threat to innocent third parties.

In the years that I have been doing this, I have only honestly transported less than a handful of suicidal patients against their wishes but a couple that put up a fight do stand out in my memory. And they were also restrained, but I have a policy that if I have to have a patient restrained by the police, then the police get to ride along with us as well.

Although I'm not sure either if this is a "real" post or not, but assuming (yes, I know the dangers of assuming.. ass me, you, etc) that the OP has the same protocols as ND and he followed them correctly, then the lawyer and the patient really don't have much of a chance of getting anywhere with their lawsuit.

The original post sounds to me like a situation that quickly became out of control and rather than de-escalating a situation, the OP was either too inexperienced, or possibly had a "my way or no way" complex, and did not have the skills to competently take control of the situation and bring it back to a manageable level.

[Just Plain Ruff]

Here is my dream here on the city, that in posts like these, when someone posts a situation like this and we spend valuable time responding to said post, that the OP would come back and discuss with us what we spent that time responding to.

But my suspicion is that the OP decided that he should not post anymore because it might come back and bite him because he posted information about a pending lawsuit and maybe his employer found out or he just decided he didn't want to participate any more

I'm getting discouraged

[ERDoc]

Eh, I would sweat it Ruff. Even if the OP never comes back it still creates good discussions. I agree that it would be nice if the OP did come back to fill in some of the blanks. Maybe we should wait until the person has made a second post before we start answering their questions, lol.

[Just Plain Ruff]

yeah, especially since many times our tendencies for initial posters is to eat them alive if we dont' like them. But like I said, it really is just a dream, and like most dreams they don't come true and just remain that, dreams.

Hey, hows' the GPS working out for ya?

[ERDoc]

Yeah, we do eat new people pretty quickly around here. It's survival of the fittest. The GPS is pretty awesome. I got my kids some smaller ones and they love them.