Young ride alongs and EMT's

[paramedicmike]

Insults aren't going to help me understand where you're coming from.

No insults were made. You sound young. You sound immature. The idea that minors can participate in a ride along is idtiotic. These are merely observations. If you're insulted by this there's nothing I can do about it.

And I don't think I'm really sure what you believe I'm proposing. Allowing minors to observe EMS on the condition that they understand and follow patient privacy rights, and if they piss anyone on the crew off they're gone? What I've described is not my own original idea, it is happening in at least one county in the USA.

I don't think you're understanding what any of us are saying in response to your proposal.

A minor cannot enter into a legal agreement. The patient confidentiality waiver that any ride along should be signing is legally binding. Since minors can't enter into legal agreements they can't sign the waiver. Since this should be required prior to riding, they can't be on the ambulance simply for legal liability reasons.

This on top of the other clearly written responses as to why this is a bad idea.

What county in which state is running a program like this? Does this program have a web site advertising itself? Care to post a link so we can see just what, exactly, is going on?

-be safe.

[nsmedic393]

I'll respond to this first. Did you read my posts? I clearly stated that I was talking about observational ride-alongs, not minors treating patients. In fact, it is specifically called out in the ride-along waiver that riders (all riders, minors are not treated any differently other than needing parental consent) are not to touch or treat patients.

Sorry, I confused your first post with one above it in which someone stated that they were treating people.

Now, to the rest...

That is consent to be treated. You don't first close your eyes and ask if you have their consent to view them "at their sickest". Observation is not the same as treatment, and as I've said many times the ride-alongs around here are observational only.

When someone dials 911 they have the expectation that two qualified EMS providers are going to walk through the door and help them. They are not banking on inviting lay people into their home to have a look for curiosity's sake. Everything past the doorway/in the back of the ambulance is patient care to say that you are not actually touching is splitting hairs.

Of course it's not the same, it's on network television. If you really want a better example, how about an uncensored documentary similar to "Cops", available on video. Since it's uncensored, the minor would need parental consent to watch, but the same goes for my local ride-along program.

You just don't get it. I'm in my mid twenties and already I have more memories than I can count that I wish I could erase.

Have you ever been driving down the road on a nice sunny day in a great mood and suddenly have horrible visions flashing through your mind? Kinda Kills your day... Have you ever been kept up at night when they haunt your dreams?? Kinda Ruins your night..... How many different therapists have you been to?? In my relatively short career I have been ready to throw in the towel on more than one occasion. It doesn't make me weak it makes me human and I can guarantee without the maturity and coping skills that develop with life experience I would be working in a different job now.

You just don't know what you are talking about here...

If anyone is seriously interested in EMS they should wait until they have to coping skills to deal with it properly otherwise that career they want so bad could be over before it even begins.

[PatrickW]

Perhaps it is splitting hairs, and that is probably why the EMTs and the rider are all held to the same confidentiality standard.

If anyone is seriously interested in EMS they should wait until they have to coping skills to deal with it properly otherwise that career they want so bad could be over before it even begins.

I completely agree with this statement. But there are minors that do have the coping skills to deal with EMS ride-alongs, plain and simple.

[Michael]

I mean no. If someone is a non-practitioner, therefore not essential to the patient's care, and the patient asks for them to leave I believe they should, regardless of age. Within reason, of course, I'm not going to jump out of the back of the truck during a transport if a patient must be stripped and they are uncomfortable with me there, but I'd do whatever I can (look away, most likely).

Well, taking you at your word, you seem to be saying that you would place burden of evaluating the propriety of providing study material for interested children of all ages (taking you at your word) on already stressed patients who may be incapable of communicating at all. You believe each of the shocked and disoriented injured adolescents in an overturned schoolbus should have to take the initiative of opting out of your inspection? That they will each know their right to do so, or that they will be interviewed beforehand - by whom - as to their preference? What percentage do you think would say, "Hey, no prob!" when asked their preference?

I can only guess that your maturity in certain areas of life has paradoxically, and in a way fortunately, not attuned you to the fact that few patients will be as detached as you when they feel trapped by a medical emergency. There are many women who consult only women physicians, and some men consult only men physicians. Emergencies by definition disenfranchise their victims, and practitioners, that is, your would-be hosts, have a duty to anticipate what would maximize patients' emotional as well as physical comfort. The gratuitous compromise of patient privacy will violate their cardinal rule of "First, do no harm," for there are a great many people who would feel intensely uncomfortable under adolescents' and children's scrutiny. More power to you if you have never been and will never be one of them, but it is unfair to impose demands of your level of objectivity on others.

Surely none of this is new to you, so I can only suspect that, understandably, you have yet sufficiently vividly to imagine yourself in the place of those who would be severely uncomfortable with adolescents or children as audience to their medical crises, and for a variety of reasons relating to those crises, unwilling or unable to object.

As to agreements signed by minors, those are unenforceable at law. Again, I can only guess that because you yourself are trustworthy, you underestimate the liability to which those are exposed who would rely on the voluntary (because uneforceable) discretion of others your age, or 12, 11, 10, 8, or uh... 6.

[PatrickW]

Well, taking you at your word, you seem to be saying that you would place burden of evaluating the propriety of providing study material for interested children of all ages (taking you at your word) on already stressed patients who may be incapable of communicating at all. You believe each of the shocked and disoriented injured adolescents in an overturned schoolbus should have to take the initiative of opting out of your inspection? That they will each know their right to do so, or that they will be interviewed beforehand - by whom - as to their preference? What percentage do you think would say, "Hey, no prob!" when asked their preference?

I can only guess that your maturity in certain areas of life has paradoxically, and in a way fortunately, not attuned you to the fact that few patients will be as detached as you when they feel trapped by a medical emergency. There are many women who consult only women physicians, and some men consult only men physicians. Emergencies by definition disenfranchise their victims, and practitioners, that is, your would-be hosts, have a duty to anticipate what would maximize patients' emotional as well as physical comfort. The gratuitous compromise of patient privacy will violate their cardinal rule of "First, do no harm," for there are a great many people who would feel intensely uncomfortable under adolescents' and children's scrutiny. More power to you if you have never been and will never be one of them, but it is unfair to impose demands of your level of objectivity on others.

Surely none of this is new to you, so I can only suspect that, understandably, you have yet sufficiently vividly to imagine yourself in the place of those who would be severely uncomfortable with adolescents or children as audience to their medical crises, and for a variety of reasons relating to those crises, unwilling or unable to object.

As to agreements signed by minors, those are unenforceable at law. Again, I can only guess that because you yourself are trustworthy, you underestimate the liability to which those are exposed who would rely on the voluntary (because uneforceable) discretion of others your age, or 12, 11, 10, 8, or uh... 6.

I'm sorry, I think there was some miscommunication on my part. When you posed your original question I thought you were asking about adult EMTs having to strip a patient while there is a minor rider observing only (non-practitioner). That is where I got my "no minimum age" answer from, I did not mean to imply that I believe a 12 year old with no training should be performing any sort of inspection on a patient.

[Michael]

Then, Patrick, you have yet to answer any of my questions, including the first. But then, I can't answer them either, except "the age of majority or greater."

[PatrickW]

Patrick, enjoying your enthusiasm, dedication, and your obvious ability to think clearly, may I ask you: Do you think there should be any age requirement of a non-practitioner for whose inspection a suffering patient should be obliged to be strip naked as the sole alternative to refusing all medical attention in an life-threatening situation? If so, what age do you think that minimum should be, and why?

Assuming that I am reading your question correctly this time, 18. Simply because in the USA that is the age of majority, and that it is also be the minimum age for becoming an EMT.

[Michael]

Assuming that I am reading your question correctly this time, 18.

So you've changed your mind (which would be another impressive sign of your precocity)?

[paramedicmike]

As I stated in the post you just quoted, the parent/guardian must sign the waiver and take responsibility. The waiver is legally binding, all that is changed is who is legally held accountable if the waiver is broken. You can argue all you want that the rider should be the one legally responsible for making sure confidentiality is followed, but the bottom line is that the waiver is legally binding.

The post I quoted said nothing about the parents signing the confidentiality waiver. It mentioned maintaining patient privacy, yes. But not who was ultimately responsible.

And if the parent is the one ultimately responsible, where is the protection for patient privacy? The person legally responsible won't even be on the call. The minor could care less as there will be no legal action taken against him/her. Would you want to be the patient in a situation where the people walking through your door aren't legally responsible for maintaining your privacy?

To be perfectly honest with you, right now I don't feel comfortable sharing the precise details about the program's location. It doesn't have a web site (the service does, the program doesn't). I'd honestly be surprised if this program is the only or one of the only in the country. If so, I got incredibly lucky!

Why not? Do you not feel comfortable sharing because none of what you've said is true? Are you afraid they're going to find out what you've said here? Are you afraid someone will find out and take legal action against the department effectively ending the program? You're here raving about this program. The least you should do is identify the department.

Perhaps it is splitting hairs, and that is probably why the EMTs and the rider are all held to the same confidentiality standard.

There is no privacy standard in this case because the person responsible for maintaining the privacy (the parent as you insist) isn't even there. Further, as has been discussed, there is no legal action taken against the minor as s/he isn't the one ultimately responsible.

But there are minors that do have the coping skills to deal with EMS ride-alongs, plain and simple.

And minors are the only one who will argue that they are capable. Just as they'll argue that they're capable of driving a car at 16. Just as they'll argue they should be allowed to consume alcohol. Just as they'll argue they should be allowed to do all sorts of things they shouldn't be doing because they're not mature enough.

It's not up to you to say you're mature enough. You can't say that. It's up to those around you who are mature enough to judge whether or not your actions up to that point warrant any extra trust be given.

The trust and responsiblity for something like this is something earned. It's not handed out like candy. And a minor is not in a position where they've had the experience to have earned that much trust.

-be safe.

[PatrickW]

So you've changed your mind (which would be another impressive sign of your precocity)?

No, I think I mis-read your question to begin with :oops:

My original answer was under the thought that by non-practitioner, you mean untrained rider. Am I now correct in assuming that non-practitioner includes untrained riders and EMTs alike? Sorry about the confusion!