Holding someones hand

[Ridryder911]

Ironically, I had a partner the other day, explain he never wants a patient to touch him or for that goes even his partner or "anyone".. I asked why would someone ever consider ever entering the health field, not wanting to touch or be touched by anyone?

He described he does not mind touching people only and if only he has gloves on.. and he touches them, not the opposite.

I informed him, I could understand those with blood, fluid, etc.. but, not those for example, that have just lost their loved one, or apparently has no contact problems.. and I felt that he has a phobia.. that he needs to address.

He really is a smart Paramedic, but I find this behavior very odd and actually rude, when someone needs compassion, or even the humanistic touch.

I agree there are definitely times, their are people that seek behavior to get or gain attention, but there are those that need it and it is our JOB to give it. We are in the people business, and part of healing is psychological as much as it is physical.

R/r 911

 

[MedicPrincess]

Lately, many of my pts have been asking me to hold their hand because they're scared, upset, crazy, etc. From now on, I'm starting a no hand holding rule in the back of my ambulance. What do yall think about this?

In your very first post you state no hand hold. You even mention the scared and upset patient.

Yet here...

Adults on the other hand should be held to a higher standard. Why are you appeasing our adult pts who act inappropriately. You are doing a disservice by reinforcing bad behavior and helping to guarantee they will do it again and again and again.

you are talking about adults who act inappropriate.

So since you won't hold anybodies hand anymore because it reinforces inappropriate behavior, how do you deal with the little old lady who has fallen down and broken her hip, scared and in pain? Or how about the adult patient who has just been in a MVC and now they are the patient strapped down to the backboard, scared and in pain? Or the female patient who has been beaten up and raped, scared and in pain?

Are you somehow implying these types of patients are acting inappropriatley because they have had terrible events happen to them and now they need YOU to help them to feel better for just the few minutes in your life you are there?

ABSOLUTLEY! there are some patients who won't touch me, gloved hand or not. Most of our calls to the pain phone at the BP gas station are those patient. Those guys call, and will tell you they did, because they know its me and my partner on that day and we are the nicest/prettiest/blah blah make me puke. They will call for mosquito bites and want transport. They sit on the bench seat, and get very little interaction from me. Because that is behavior not to be encourage.

Holding someones hand isn't going to be the be all end all reason for someone call you. However, because you showed that LOL that easiest bit of empathy, it may be the part of that terrible day when she lost her mobility she reflects back on.

 

[Guardian]

My first comment was hasty because I was angry at all the BS handholding requests I've been getting. Plus, unconsciously, I like to be abrasive sometimes to stir up debate. When I wrote about not wanting to hold the hands of scared pts, I was talking about pts who are scared for BS reasons. Ex. Wanting to hold my hand and scream out loudy because my partner is starting a small IV. Quit being a baby, I'm not here to hold the hands of 42 y/o babies.:angry: I'm not your hand :censored::censored::censored::censored::censored:.

Anyway, ultimately, I'd like to see more ems providers treat these people how they deserve to be treated. If you got some big crybaby, don't sympathize with them. Don't try to assuage their not existent pain. Tell them the truth (ex. "I think you're full of crap" or "Grow the F up").

I'm seriously thinking about quitting inner city ems. I am fed up with the BS. Anyone else feel the same way I do?

 

[Sineath02]

I think human contact is a form of healing. I would want someone to hold my hand. It's a way of letting the patient know you care

 

[fm_emt]

paranoid people

Has anyone brought up the fact that in many aspects of our society, simply putting your hand on someones shoulder can wind up getting you sued? Imagine.. some female patient is upset, so you put your hand on her shoulder. Next thing you know you're being added to a sexual harrassment suit. Stranger things have happened.

Maybe I've been watching too many Human Resource videos, but it's certainly something to think about. I've known a few (non-EMS) people that wound up walking around at work in a paranoid haze because of similar issues.

 

[Stevo]

I like to be abrasive sometimes to stir up debate.

good, then lets have at it Guardian , i so love people with a firey tude like mine...

so let's say that we apply being real, and doling out our contempt along with out compassion shall we?

after all, they are two sides of the same human coin, and i'm not afraid to express either vs. being a cold dry participant in ems

it's been said that the majority of our calls are no more than taxi rides, and we all know that a certain % have no chief complaint, other than wishing to get checked out for insurance reasons, evading the cops,etc

so why can't we call them on it? heck, most mothers (especially those who've raised multiple boys) would downplay , if not ridicule such behavior wouldn't they?

Too bad telling a patient to 'go to your room' could be construed as malfecant, that's what my brothers and i usually recieved short of an arterial bleed or exposed bone....

~S~

 

[ffemt8978]

so why can't we call them on it? heck, most mothers (especially those who've raised multiple boys) would downplay , if not ridicule such behavior wouldn't they?
~S~

We kind of do this. We have what's called a "Medical Necessity" form that we can use if we feel there is no valid reason for the patient to go by ambulance. It basically says since we can't determine that you have a valid need for transport by ambulance, your insurance will not pay for the ride meaning you get stuck for the whole bill. In addition, we will send you to collections if you fail to pay it.

It's not perfect, and we don't get all of our money back but about half the time, the patient reads that form and decides that yeah, they can go by POV.

 

[Stevo]

We have what's called a "Medical Necessity" form

i would like to learn more about this FF, seems we could use this (listen to me wishing for more paperwork, gawd...)


~S~

 

[Guardian]

good, then lets have at it Guardian , i so love people with a firey tude like mine...

so let's say that we apply being real, and doling out our contempt along with out compassion shall we?

after all, they are two sides of the same human coin, and i'm not afraid to express either vs. being a cold dry participant in ems

it's been said that the majority of our calls are no more than taxi rides, and we all know that a certain % have no chief complaint, other than wishing to get checked out for insurance reasons, evading the cops,etc

so why can't we call them on it? heck, most mothers (especially those who've raised multiple boys) would downplay , if not ridicule such behavior wouldn't they?

Too bad telling a patient to 'go to your room' could be construed as malfecant, that's what my brothers and i usually recieved short of an arterial bleed or exposed bone....

~S~

So you're all for letting lawyers decide how you should provide care?

It won't be easy but we have to do something. The system here is broken.

I'm asking that we be truthful with pts. If someone comes up and spits into your face, you don't smile and say thank you. That would be a dishonest reaction. An honest reaction would be to voice your concerns. If they spit into your face again, you take them out DT4EMS style. These people are spitting in our face every time they take advantage of us.

The most we are looking at is nonfeasance, not malfeasance.

I personally don't like the idea of taxi vouchers because I think people should pay their own way if they can and I don't want to pay (taxes) for these slugs.

Medical Necessity forms may work for your system ffemt8978, but it wouldn't work for ours. The people we pick up would gladly sign the form. Then when we tried to bill them, they wouldn't pay. It's as simple as that. They know we can't touch their medicaid or welfare checks. They know we can't kick them out of public housing. If we took them to court, we wouldn't get anything because they don't have anything of major value so it would be a waste of time and money for EMS agencies. And, in our state, they wouldn't even think of putting these deadbeats in prison.

Keep the ideas coming. We need to figure out something and fast. We are no longer an EMS service but instead a cabulance service that is forced to transport deadbeats. In my opinion, tolerating these people and allowing them to tie up our resources because we are afraid of being sued is misfeasance against the people who really need our care.

 

[fm_emt]

SIn my opinion, tolerating these people and allowing them to tie up our resources because we are afraid of being sued is misfeasance against the people who really need our care.

We need more lawyers on our side, eh?

 

[ffmedic]

edited post

 

[ffmedic]

Gosh! I guess systems are really different all over. I have for the last 25 years been able to decide if someone even gets in my rig. Originally we contacted Med Control and they OK'ed it As recently as 7 years ago the Doc's just got tired of hearing from us. They told us to stop calling. Only call if its a "value added" question. So, if I decide you don't get a ride, you don't get a ride. It would be difficult to do it any other way now for me.

Lucky I guess to have grown up with a really great system. Seriously though, it doesn't come up that often. Most just take the suggestion to POV. A very few are told "sorry, it aint happening". That's not to say losers don't get transported, just losers with a better story.

 

[Guardian]

Gosh! I guess systems are really different all over. I have for the last 25 years been able to decide if someone even gets in my rig. Originally we contacted Med Control and they OK'ed it As recently as 7 years ago the Doc's just got tired of hearing from us. They told us to stop calling. Only call if its a "value added" question. So, if I decide you don't get a ride, you don't get a ride. It would be difficult to do it any other way now for me.

Lucky I guess to have grown up with a really great system.

Cool. Do you work for public or private company. Affiliated with a fire dept?

Here, if people request to be transported, we take them. I would be really nervous refusing to take someone. Ex. pt complains of N/V since yesterday. I say, no sir, you can't ride to the hospital with us because this isn't an emergency. You just have a stomach virus. With my luck, the SOB would die because of massive GI bleed. I would rather find a way to discourage the people from calling in the first place. I want them to drive to a primary care doc like everyone else.

 

[Guardian]

Also, what are the demographics. Do you see a lot of poor inner city pts, lower middle class, middle class, or rich?

 

[FF894]

For example, some people want me to hold their hand while my partner starts an IV. You wouldn't see this being done at the hospital would you?

haha, yeah I have seen it and been asked to do it in the ED before....

 

[FF894]

I also think we should stop encouraging this behavior which is what we do every time we gratuitously hold their hands.

Sorry to go back to this one, but heres what I dont understand about this, and I teach this to veterans all time. You say this as if all of your patients have a forum like this that they can talk about how they are treated. Your patients dont talk to each other. They have no idea what you did for the last guy. You need to single out every single call as if it was your only call of the day. If you go into a call thinking its just the next call then thats exactly the kind of treatment you will provide. Sure, there are frequent flyers that have been in the ambulance who knows how many times, but for most people going in the ambulance is A BAD DAY for them. Who wants to call 911 for an ambulance ride to the hospital? Some people are really scared of just the site of the ambulance let alone riding in one, not to mention whatever is going on with them. You have seen so many sick people, you become numb to the fact that if someone can't breath or they feel like they have an elephant on their chest, they need you for help. Its up to you to control the situation. And if a simple hand holding is part of what makes them feel better, than give them your damn hand. They didnt know the last guy wanted to, too. They just want you to look at them, hold their hand, and let them know that you are there now, and you are goign to help them.

 

[joemt]

I could not have said it better...good job ff894!

 

[ffemt8978]

You need to single out every single call as if it was your only call of the day.

I think this point bears repeating.

 

[Guardian]

haha, yeah I have seen it and been asked to do it in the ED before....

haha, yeah, sometimes I have to go back and spell it out for people. I write in general and not in absolutes. Of course there have been times throughout recorded history that people have asked someone in the ED to hold their hand but IN GENERAL this doesn't happen

 

[Guardian]

Sorry to go back to this one, but heres what I dont understand about this, and I teach this to veterans all time. You say this as if all of your patients have a forum like this that they can talk about how they are treated. Your patients dont talk to each other. They have no idea what you did for the last guy. You need to single out every single call as if it was your only call of the day. If you go into a call thinking its just the next call then thats exactly the kind of treatment you will provide. Sure, there are frequent flyers that have been in the ambulance who knows how many times, but for most people going in the ambulance is A BAD DAY for them. Who wants to call 911 for an ambulance ride to the hospital? Some people are really scared of just the site of the ambulance let alone riding in one, not to mention whatever is going on with them. You have seen so many sick people, you become numb to the fact that if someone can't breath or they feel like they have an elephant on their chest, they need you for help. Its up to you to control the situation. And if a simple hand holding is part of what makes them feel better, than give them your damn hand. They didnt know the last guy wanted to, too. They just want you to look at them, hold their hand, and let them know that you are there now, and you are goign to help them.

You are underestimating people. People do come to expect certain things and there is a word for this, it's called culture. People see things on TV. People talk to aunt sally about her experience riding in the ambulance. People talk to each other. When we go and pick someone up, you can bet the family will be talking about and picking apart our visit for days to come.

I strive for perfection on every call even though I never achieve it.

Who wants to call 911 for a ride to the hospital? (BS) About 60,000 people a year where I work.

Here is the problem with your attitude. You are encouraging the misuse of EMS. You are catching little Johny with his hand in the cookie jar and you are saying thats OK, what you did was fine and here are some pointers on how not to get caught next time. I am starting to think some of you think EMS is a routine house call with a nice ride to the hospital. EMS is for EMERGENCIES ONLY! hence the name EMERGENCY medical service. I wish someone told me the truth early on, I wish someone said "being a paramedic is taking care of minor medical problems 99% of the time because people are to lazy and inconsiderate to take care of themselves."