Dustdevil Posted August 28, 2006 Posted August 28, 2006 I hesitate to be the one to break this news to you, but you do realise that your employer sucks, right? :?
TerrfyinFlyinSrvc Posted August 28, 2006 Posted August 28, 2006 You did the best you could with what you had to work with...and against. I think you did great just getting this guy there still alive. I mean, he didn't have a whole lot going for him. the ER Doc hates EMS, and has expressed that we as useful as tits on a boar. Well, he must see a great deal of utility in boar tits. On one hand, he says you're useless. Yet he has no problem handing you a 80yo septic, drowning, extremely hemodynamically unstable pt. No doubt if the pt had croaked off in your ambulance, the doc would have complained of and testified to your rank incompetence. General question: How many of you have refused to do a transfer of someone like this without either getting the pt. more stable or more help, be it mechanical or personnel? Would there be repercussions against you in your system? I know that transport of unstable pts between care facilities goes with the territory. But, at the same time, a doc could just be handing off a lawsuit in the sense of you accepted custody of someone you professionally knew to be in need of more care than you could ideally render. Just curious.
medic001918 Posted August 28, 2006 Posted August 28, 2006 General question: How many of you have refused to do a transfer of someone like this without either getting the pt. more stable or more help, be it mechanical or personnel? Would there be repercussions against you in your system? I have refused to transport someone without having the proper resources to handle the job, this includes other personnel to assist me. It's one thing to work an emergency situation in the field with very limited resources. It's something different to take that patient out of a hospital with significantly more resources and into an ambulance without the resources you feel you may need. Call dispatch and wait for them to get you the help you need to do the job right. A large part of our job lies in patient advocacy and ensuring you have the ability to do the job effectively is part of advocating on behalf of your patient. Shane NREMT-P
medic53226 Posted August 29, 2006 Author Posted August 29, 2006 The problem really is that they were BLS for over 25 yrs and just went medic June 1st, and now the doctor that I told you about says anything that he transfers will go paramedic because he can. Their have been some question the call, but was told that if you don't want to take the call then they will call someone else. The Dr for instance called us for a transfer at 1:00 am in the moring to transfer the pt to Indy, and went to the hospital, and as we were standing their, our supervisor called with a question and this DR response was if you don't want to take the pt then I will call someone else, matter of fact the hospital won't give us drugs that they order for the transfer. But their is no one that will do anything about this matter and it is a bad problem all around, but I was told by my Director of EMS, that if we don't feel comfortable then we don't have to take the run and if they have a problem then they can call him. By the way as for the pt after he got the dopamine, at our arrival at the larger hospital he had his eyes open and was looking around and was breating against the tube.
CoyoteMedic Posted August 29, 2006 Posted August 29, 2006 General question: How many of you have refused to do a transfer of someone like this without either getting the pt. more stable or more help, be it mechanical or personnel? Would there be repercussions against you in your system? . Actully, when I was a EMT-B, i did. I was doing a ER to ER transfer of a pedi pt who was on a NS bolus via a pump. Where I work, BLS personal are very very limited on what they are allowed to do. They can monitor IV's that are at a TKO rate, but they are not allowed to adjust IV's that are currently running, only to shut them down if they infultrate. It was one of those cases of being out of my scope at the time. But I've had my share of problems with MD's before and their looking down on EMS personel. But there are those Doc's out there that actully do respect field personel. Every bushel has a few bad apples. My 2.340958 cents
Dustdevil Posted August 29, 2006 Posted August 29, 2006 ...our supervisor called with a question and this DR response was if you don't want to take the pt then I will call someone else... And if your supervisor let this go and actually accepted the transport, he sucks. Which may explain why this employer sucks.
JPINFV Posted August 29, 2006 Posted August 29, 2006 General question: How many of you have refused to do a transfer of someone like this without either getting the pt. more stable or more help, be it mechanical or personnel? Would there be repercussions against you in your system? Had a discharge where the patient (full code) was having labored breathing. Told the nurse, she administered another breathing treatment and about half way through wanted to know if we would transport with the tx still going. My partner (another basic) said yes because, "we didn't start it, so it shouldn't be a problem, right?" I said, hell no. Advised dispatch that we would be delayed coming out. Nothing happened that time. Personally, I don't care what the "repercussions" would be. I am not risking myself, my back, or my patient for my company. I'd rather be fired then sued.
Just Plain Ruff Posted August 29, 2006 Posted August 29, 2006 I have refused to transport a number of patients in the past. all of them have been super critical and refused on the ground of not having enough help. ONe in particular, had a patient in a hospital ICU who just had a IABP (balloon pump) set up on him and they told me to take him to the cardiac center across town. They were going to send the balloon pump machine with me. I said, wait, this is way out of my realm of practice nor do I have any idea of how this thing works. Well, they hem and hawed around the issue, told me to take the guy, I said NO NO NO NO and called dispatch. Dispatch and the supervisor and the director of EMS backed me up. The hospital ended up sending a nurse with me. Well the unthinkable happened, the baloon pump air hose connector that connects the hose and the machine bent and crimped while we were getting him in the ambulance. He started to crash. I had the foresight to ask them to bring anything along that could help us out in the transfer and the doc said, take an additional connector and hose just in case. We were able to change the hose and plug it back in and the patient re-stabilized and the transfer was uneventful. I cannot imagine other than coding that guy what would have happened.
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