Checking up after the fact

[EMTinNEPA]

First off, a genuine feeling of emotion is going to be a lot more helpful for a patient than holding someone's hand just because you have to do. And secondly, caring about your patients is going to translate caring in other aspects. That careless attitude is going to lead you to make generalizations and shortcuts in your assessment, treatment, and of course follow through of treatment.

It's also going to be further motivation to follow through on cases, and learn where you went wrong and you can make a difference. If you make a mistake that negatively impacts someone's life, it's a big motivation to not make the same mistake again.

The human body is not a computer, you don't just feed a question in and get an answer. It's a big enough problem that some EMTs and Medics don't care enough to gather a detailed history on an elderly person, because "it's a bull :censored::censored::censored::censored: call." People notice when the person they're talking to doesn't care, and a lot of times they will abbreviate their history because someone doesn't care to hear it.

So because I don't want to invite my patient to the next family reunion, that means that I don't know how to take a detailed history or I think that their call is "BS"?

Methinks you are missing the point.

 

[Vizior]

So because I don't want to invite my patient to the next family reunion, that means that I don't know how to take a detailed history or I think that their call is "BS"?

Methinks you are missing the point.

Just out of curiosity, how much patient contact time have you had that you feel so emotionally cold and disconnected from the patient? And knowing how to take a detailed history isn't just a series of questions, it's not a formula.

 

[ResTech]

I'll reiterate a bit of what my family physician told me during a difficult time in my life with depression and anxiety/panic disorder which really captured my attention and sticks in my mind.

"The body isn't just a shell... the mind, body, and soul are all interconnected. Any deviation of one will surely effect the others. That's why medical treatment is aimed at treating all three of these human components".

What physiological process happens when someone is anxious or scared??? Catacholamine release, right? Which translates to what? Increased heart rate, B/P, increased myocardial O2 demand, jittery feelings, sweating, and a real general sense of uncomfortableness. All of which can exacerbate many disease states. Now what happens with some compassion, hand holding, showing that u care, and reassurance? Maybe a bit of catacholamine suppression perhaps??? some alleviating of symptoms? all from showing that you genuinely care! amazing!

You really need to realize the body is more then a body... it is a mind and a soul.. mental state DOES effect the physical state... believe me I know.

 

[EMTinNEPA]

Just out of curiosity, how much patient contact time have you had that you feel so emotionally cold and disconnected from the patient? And knowing how to take a detailed history isn't just a series of questions, it's not a formula.

I work an average of 60-some hours a week with a very busy service, so I get quite a bit of patient contact, thank you. And if you have a method for getting a medical history besides questioning or reading off of paperwork, I'm all ears.

 

[EMTinNEPA]

You really need to realize the body is more then a body... it is a mind and a soul

And this is where I drop it to keep from angering a lot of people.

 

[Vizior]

I work an average of 60-some hours a week with a very busy service, so I get quite a bit of patient contact, thank you. And if you have a method for getting a medical history besides questioning or reading off of paperwork, I'm all ears.

Ah, and I'm sure you've been doing this for like 20 years. And I'm not saying you don't interview the patient and read the paperwork, but it's important to care when you're asking questions, pay attention to reactions, etc.

But you're convinced that you have the right attitude, and I don't care enough to keep arguing this. Keep that attitude, and good luck with medic school. Maybe you have the attitude your program is looking for.

 

[ResTech]

Why? You have a stance then defend it... you asked for additional information so I gave it to you. Who cares if someone gets pissed off? I don't. If you disagree... cool... I'd like to know why.

 

[EMTinNEPA]

Ah, and I'm sure you've been doing this for like 20 years.

Irrelevant.

And I'm not saying you don't interview the patient and read the paperwork, but it's important to care when you're asking questions, pay attention to reactions, etc.

Then what are you saying? Because it doesn't sound to me like anything of substance. You implied that you knew a method besides questioning and reading to get a patient's medical history and reading, then neglected to mention what it is? How do you get the information? Osmosis?

And just because I stay emotionally detached, I'm not attentive? You people sure are assuming a lot.

 

[Vizior]

Then what are you saying? Because it doesn't sound to me like anything of substance. You implied that you knew a method besides questioning and reading to get a patient's medical history and reading, then neglected to mention what it is? How do you get the information? Osmosis?

And just because I stay emotionally detached, I'm not attentive? You people sure are assuming a lot.

Alright, I'll simplify it. You're telling a girl a story, and you can tell she doesn't care. Do you finish the story in full, or do you cut out chunks of it to have it done with? When she asks you a question, are you going to answer with a yes/no answer, or something descriptive?

(That's a generic you).

 

[ResTech]

Then what are you saying? Because it doesn't sound to me like anything of substance. You implied that you knew a method besides questioning and reading to get a patient's medical history and reading, then neglected to mention what it is? How do you get the information? Osmosis?

What he was saying was... that when talking to a person or interviewing a patient... they can tell when you are truly concerned with what they are telling you. It's more then just spouting off questions... its about engaging yourself with the patient so they feel like you CARE about their problem and what they are saying. Patient's can tell the difference.

You ever have a conversation with someone who you could tell from the start that they could really care less what u are saying? Kinda the same point I think he was trying to make.

 

[EMTinNEPA]

Why? You have a stance then defend it... you asked for additional information so I gave it to you. Who cares if someone gets pissed off? I don't. If you disagree... cool... I'd like to know why.

I have pm'd you my response.

 

[EMTinNEPA]

Alright, I'll simplify it. You're telling a girl a story, and you can tell she doesn't care. Do you finish the story in full, or do you cut out chunks of it to have it done with? When she asks you a question, are you going to answer with a yes/no answer, or something descriptive?

(That's a generic you).

I care what the patient's medical history is since it is important to my treatment. The fact that they're just another patient to me has no bearing on the type of care I provide.

And I finish the story in full, just to annoy her. Besides, not like any girl cares what I have to say anyway.

 

[ResTech]

EMS as with all healthcare professions... isn't about you. Its not just a job.... in other words its not self serving. That's great you can deliver appropriate treatment but your doing it for your patient... not as a reward to yourself.

There is such a thing as provider-patient relationship. To totally withdrawal yourself from that relationship is really a disservice to yourself, your patient, and EMS in general.

Besides, not like any girl cares what I have to say anyway.

If I were a girl, I wouldn't care what an uncaring, uncompassionate, borderline _______ guy had to say either

 

[triemal04]

EMTinNEPA-

First off, I don't mean this as insulting or confrontational, so don't get to upset over it. It's an honest questions. Have you ever actually sat down and thought about what EMS and medicine in general really is, and what practicing it truly entails? Not what you perceive it to be, or would like it to be, but what it really is? I'm asking because, based on your posts here and the attitude you seem to have about pt care, pt's, and medicine, it's seems that you don't. (though I suppose that could be a side-effect of this being an anonymous internet forum) I could be wrong, but with what you display, it's easy to understand why you have been fired from a previous job and why you may not be suited for this profession.

Medicine, even the most general form, is more than just caring for the physical aspects of a person. Sympathy, empathy and compassion all play a part in what we do; doesn't mean that we should be throwing ourselves into the pt's life after everything is done, but while they are under our care (and that may extend beyond when we leave them at the hospital) it means we shouldn't be acting like robots or treating them as nothing more than a number. If you really think different I pity the first time you have to treat someone having a true anxiety attack, or mental breakdown of any sort. It's not just the body we have to care for, and if you act like it is, you are ignoring a large part of our job; making our pt's feel better, either through medical interventions, or simply talking with them.

Why do you think a psychology course is included in most degree programs? Because there is more to medicine than drugs and physical interventions. And to be able to utilize more than that means that you need...yep, you guessed it, empathy/sympathy/compassion.

Look at other similar (in what they do, not the level of care) medical professions; RN's, MD's, PA's and the like; what is their demeanor when they interact with their pt's? Why do they follow-up with the pt's? Why do they do more than just the physical aspect of treating someone? Maybe because it's the right thing to do? Because it's almost a requirement to be a professional provider of medicine?

Either way. Good luck with your career, however short or long it may be.

 

[EMTinNEPA]

EMS as with all healthcare professions... isn't about you. Its not just a job.... in other words its not self serving. That's great you can deliver appropriate treatment but your doing it for your patient... not as a reward to yourself.

There is such a thing as provider-patient relationship. To totally withdrawal yourself from that relationship is really a disservice to yourself, your patient, and EMS in general.



If I were a girl, I wouldn't care what an uncaring, uncompassionate, borderline _______ guy had to say either

I never said it was about me. I never claimed to be treating patients for my own sake. I do it to preserve life, because life is definitely better than the alternative.

And my problems with the female species began long before I was like this.

 

[EMTinNEPA]

EMTinNEPA-

First off, I don't mean this as insulting or confrontational, so don't get to upset over it. It's an honest questions. Have you ever actually sat down and thought about what EMS and medicine in general really is, and what practicing it truly entails? Not what you perceive it to be, or would like it to be, but what it really is? I'm asking because, based on your posts here and the attitude you seem to have about pt care, pt's, and medicine, it's seems that you don't. (though I suppose that could be a side-effect of this being an anonymous internet forum) I could be wrong, but with what you display, it's easy to understand why you have been fired from a previous job and why you may not be suited for this profession.

Medicine, even the most general form, is more than just caring for the physical aspects of a person. Sympathy, empathy and compassion all play a part in what we do; doesn't mean that we should be throwing ourselves into the pt's life after everything is done, but while they are under our care (and that may extend beyond when we leave them at the hospital) it means we shouldn't be acting like robots or treating them as nothing more than a number. If you really think different I pity the first time you have to treat someone having a true anxiety attack, or mental breakdown of any sort. It's not just the body we have to care for, and if you act like it is, you are ignoring a large part of our job; making our pt's feel better, either through medical interventions, or simply talking with them.

Why do you think a psychology course is included in most degree programs? Because there is more to medicine than drugs and physical interventions. And to be able to utilize more than that means that you need...yep, you guessed it, empathy/sympathy/compassion.

Look at other similar (in what they do, not the level of care) medical professions; RN's, MD's, PA's and the like; what is their demeanor when they interact with their pt's? Why do they follow-up with the pt's? Why do they do more than just the physical aspect of treating someone? Maybe because it's the right thing to do? Because it's almost a requirement to be a professional provider of medicine?

Either way. Good luck with your career, however short or long it may be.

Medicine is the preservation of life. It is our natural instinct to fear death, and in that fear, we developed ways to keep that eventual point as far in the future as we can.

You have never been on a call with me, you have never watched me treat a patient, and you have never read one of my charts, so you have no room to comment on what type of provider I am.

And you are wrong. I was fired from my previous position because I am anti-volunteer. Volunteers from a neighboring service found out about this, complained to my supervisors, and my supervisors canned me to save face. To quote my direct superior: "We don't want you representing us." THAT is why I was fired... politics, not a reflection of my aptitude as a provider.

Medicine [med uh sin] –noun
1. any substance or substances used in treating disease or illness; medicament; remedy.
2. the art or science of restoring or preserving health or due physical condition, as by means of drugs, surgical operations or appliances, or manipulations: often divided into medicine proper, surgery, and obstetrics.
3. the art or science of treating disease with drugs or curative substances, as distinguished from surgery and obstetrics.
4. the medical profession.

I see nothing but physical there.

And I have been on more psychological emergencies and done more transports to psychiatric hospitals than I can count.

Those other medical professions check up on patients because they have to. The patient may be in the hospital for weeks or months and they have to continually reassess their status. The most time we will ever spend with a patient in the pre-hospital or IFT environment is a few hours.

 

[triemal04]

Just because it's rather important and this thread will probably get locked soon...

You are absolutely right, I don't know you, only you as you come across here, which, as I mentioned, may be another manifestation of the problem with anonymous forums aka "internet balls." Unfortunately, it's that personality that I see, and based on that, I really do think you may want to seriously think about what this profession and the medical field entails, and seriously think about if it is right for you or not. Again, I don't mean this as an attack or insult, but maybe you should consider it.

I don't know why you were fired...though the reason given seems appropriate I hate to say. Again, based on your personality here.

What is this thing you have with posting definitions? I can find 5 different dictionaries, and, depending on the word, find 5 definitions for each word that don't always match. Do you really think that proves something? Do you really believe that that is all there is to medicine? If so, reread that paragraph above...it's applicable. I guess psychiatry isn't medicine? Preventative medicine? More beyond that? Do you really think that all that happens in any branch is someone walks in, injects someone/does something/gives them something and walks out? Holy hell man, spend some time in a hospital...even better, spend some time in a psych ward and see how the staff interacts with the pt's. Like it or not, there is more to medicine than you think there is, and there always will be.

Far as being on so many psych emergencies...ok...did you do anything for those people? Or did you just drive them to the hospital? Did you actually do your job and provide appropriate care (which, like it or not means that sometimes you will have to show compassion and be able to empathize with people) for them? Or just take them in? It doesn't matter how often you do something if it's being done wrong.

And those other professions that I mentioned...not all are with the pt's for prolonged periods of time. Checking on how a pt turns out after they move to a different ward/floor isn't completely unusual...it happens...like it or not, people actually care. Get used to it.

I know this isn't going to change your mind, but maybe it'll get you thinking about what it is that you think you want to do.

 

[Scout]

I'm going to have to ask about this magical HIPAA beast at some point.


Are you saying if i drop an ?MI into a hospital i cant talk to the ER doc or cardoligist and see what was actually happening? or any other speciality or such? REALLY???

 

[VentMedic]

I'm going to have to ask about this magical HIPAA beast at some point.


Are you saying if i drop an ?MI into a hospital i cant talk to the ER doc or cardoligist and see what was actually happening? or any other speciality or such? REALLY???

HIPAA does not restrict conversations between healthcare providers involved in the care of a patient.

Hospitals can restrict giving out information if they do not know who you are and why you are interested regardless of you uniform. It is not uncommon for someone in the medical profession to be asked by a friend or a neighbor to check up on another friend or a neighbor by using their title or uniform even though they have had no involvement in any aspect of that patient's care.

 

[triemal04]

Forgot about this and it's to late to edit.

The most time we will ever spend with a patient in the pre-hospital or IFT environment is a few hours.

So that means we should provide a lower quality of care?