Waste of time, or what?

[chappy]

So, recently, I transported a pt from a hospice house to a hospital. The pt was a woman who is not quite eligible for social security, very ambulatory on hospice care for a dx of cancer in multiple systems.

As I was getting my pt's history, I discovered that she was allergic to many things such as bee stings, penicillin, ASA, Advil, acetaminophen (yes, she said acetaminophen) and some others. I held back a chuckle as she recited the list of things to which she was allergic because I had the inside scoop. Since she was coming from a hospice house, I had her MAR. I could see exactly what medications she had been prescribed. So, restraining my laughter, I said, "Ma'am, it says here that you take Tylenol-3, is that right?"

She said "Yes, I have to have that number three for pain." :

Oh, ok," I said. Then I asked her, "what happens when you take acetaminophen?"

She said, "I tried that acetaminophen once and they had to rush me to the hospital and put a tube in my throat so I could breath. Then they kept me in the hospital all day with that tube in my throat."

"Oh, okay," I said, "don't worry, I won't give you any of that. Why are are you going to the hospital today."

She answered, "Some dumb@#$ nurse thought she saw me sucking on a ink pen and now they want me to go pee in a cup so I can stay."

As she went on ranting about how that nurse didn't like her anyway, I politely said, "I'm gonna sit right behind you for a few minutes, let me know if you need anything."

So, this cancer patient is prescribed MS and tylenol 3 for pain. With cancer, I get that. She was also prescribed Methadone. Hmmm. And she's not allergic to "Tylenol-3" but is allergic to acetaminophen. Getting the picture? The hospice people thought they saw her smoking crack. So, when all was said and done, our PARAMEDIC ambulance was out of service for three hours so this granny could go get a positive on her pee test.

HELLO - with all she's taking by prescription, she ain't gonna pass no drug test. Why bother?!?!

If this weren't such a colossal waste of time, resources and taxpayer money, I'd laugh. More importantly, that is potentially three hours of napping I will never get back. But, seriously, here is an end-of-life woman who has every appearance of a serial drug abuser, who takes numerous opiates for various reasons. WHO CARES IF SHE'S DOING A LITTLE CRACK ON THE SIDE AND WHY ARE WE THE PEOPLE PAYING FOR A TEST WE KNOW SHE WILL FAIL???

Edited April 14, 2014 by chappy

[island emt]

Your point would be ???

It's Ok to rant , but thats what we do in case you haven't figured it out yet.

[ClutzyEMT]

Maybe instead of reading the patient's MAR and "getting the inside scoop" before you started chuckling at her you could have had a conversation with her and gotten down to the real reason she was being such a "colossal waste of time and resources of a PARAMEDIC unit"...........

Sometimes all our patients really need are a pair of understanding ears and someone who actually cares about them.........

Now back to your regularly scheduled nap.......wouldn't want you to miss your 'compassion' sleep.............

[ERDoc]

Did they send this woman to the ER for her drug test? If so, I agree with OP. This is a colossal waste of time and resources. This is nothing more than a dump from the sending facility. We have a facility that does similar stupid shit. If this pt showed up in the ER, I wouldn't even unload her. Quick exam and ask if she has any complaints or wants to be seen? No? OK, back you go. The facilities desire to screw over the pt is not an indication for unnecessary testing in the ER nor is it medically indicated.

[ClutzyEMT]

I obviously misread the first part. I apologize for missing that part. My bad.

I will agree it is a waste of time and resources if that is the case, but will stand by my desire to see all patients treated with compassion.

After reading it more s.l.o.w.l.y. this time, apparently she doesn't have a say in how, when, or where she gets transported and it's the facility that is pulling the strings NOT the patient......so does the patient deserve less compassion because of it?

[ERDoc]

No, she deserves the compassion. I'm not a big fan of people who smoke crack, but damn. This woman is near the end, let her have whatever fun she wants. You also can't force her to go against her will.

[ClutzyEMT]

At a former job I worked where we ran both 911 calls and non-emergent transports (as well as got the joy of driving one of the three wheelchair vans on our "call days") we were constantly hauling a crack head. Sometimes it was in the w.c van and sometimes it was in the ambulance when she overdosed or fell out....after about a year of this I ended up getting to know her (against my better judgement) and found out that she had served oversea's and when she came home she couldn't adjust to "normal" life. She filed for divorce, it got a little messy and drawn out with custody disputes, etc. On her 39th birthday she came home after work to find her fifteen year old daughter hanging from her staircase with a note saying she was sorry that they (her parents) were fighting because of her. She said she started drinking and when that didn't help she moved on to other things. She had been in treatment four times. Self admitted three out of the four times.

A year before I left that service she called 911 and my unit was paged to an "open line"....we found her bled out, apparently she had read the book "Suicide, doing it right the first time"......

I'm not a big fan of crack addicts either Doc....

I'm not saying they ALL have a reason.....but some do.....it's not up to us to judge them.

[ERDoc]

Holy crap, Klutzy, that is a horrible story. I think we need a little palate cleanser right now.

OP, some transports are complete BS as it sounds like this one was. Remember, it is not the pt that called and they should not be the target of your anger. Blame the people that called. We once had EMS bring in a guy from the local NH that was sent because he pinched a nurse. The complaint on the form from the NH was, "Aggressive behavior and altered mental status." When EMS brought him in he was laughing and making jokes. I asked him if he had any complaints which he denied. I asked him about the "aggressive behavior," and he said something like, "Hell yeah I pinched them. Those girls are bitches and deserved it. If they would just listen to me I would stop doing it."

"Sir, do you want to be here?"

"Nope, I want to go home and go to sleep."

"Okay, have a good night."

We got a call from the charge nurse from the NH who was pissed and told us that if he pinched anyone else that she would be sending him back.

[ClutzyEMT]

Was paged out to a kitten that thought it was frog call once too...........okay....maybe not.......

Well said, blame the facility, not the patient....

Guess I could have just said that............. but it sounded better coming from you

[Just Plain Ruff]

Damn, I woke up today and went to work, I will work until 7pm tonight at a job I really like and I will not get a nap, so quit your bitching about not getting a nap.