adamjh3
Forum Culinary Powerhouse
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I ran a call that really chapped my a:censored::censored: last week, and I want to get your folks input on it.
AOS to a (really bad, dark, dirty... all the nurses just came on 5 minutes ago and the time is 1346) Board and Care facility, PD is on scene. Pt. is a 275lb pound (muscular) male in his mid fifties. According to one of the officers on scene, they were called out because the Pt was being aggressive towards the staff and punched several holes in the wall along the hallway.
Pt has a Hx of Schizophrenia, psychosis, OCD, and hypertension. Pt is on a conservatorship. Facility wants Pt transported to hospital for Psych eval.
Pt is found sitting upright in a relaxed position on a chair outside the board and care facility chatting pleasantly to one of the PD officers about the super bowl.
Ax shows the Pt has several superficial lacerations on his R hand which PD wrapped with a towel from the facility. Pt is A&Ox2, he thinks it's 1986, but answers most questions appropriately while often going off on separate tangents after answering questions. VS are stable and within the Pt's normal limits (according to Hx on paper-work received from facility) Pt denies N/V, states R hand pain due to lacerations. Pt is dirty, as though he hasn't showered in several weeks, and his clothes are unwashed.
As far as Rx, we irrigated the wounds on his hands with sterile water, wrapped his hand with gauze. Tx in POC, ASPT.
Here's where my questions come up.
We arrive to the hospital, offload the Pt and get into the ER. We're informed by the charge nurse that there will be an offload delay. That's fine, we're paid by the hour.
Pt becomes very vocal, making passes at women that walk by, and speaking nonsense at a very high volume. After a minute of that I told him to quiet down. Pt states that he's been to this facility before and does not like the staff. I run my "Hey, I've been cool with you, right? I played your favorite radio station on the way down here. You don't want to get ME in trouble, right? So just quiet down until you get a bed and I'll make sure they treat you right"
Pt quiets down, for about 5 minutes, but makes a remark when a security guard passes by. One of the staff pops their head out of a room a few feet away and says "Hey, shut your mouth, this isn't the streets!"
Patient becomes vocal again, tells this person he doesn't give a :censored: etc. Staff person marches up to the gurney asks the Pt if he wants a glove in his mouth (yeah, those words). Staff person continues yelling at the patient, taunting him to get off of my gurney and swing at him. The pt starts removing his seat belts, so I jump in and put my hand on the staff persons chest and gently push him back saying "Hey, man, don't provoke him, you're being childish," And proceed to talk the patient down. Staff person looks at me and my partner and walks back to his little room.
I then find out that the staff person is one of the ER docs. Not an ER tech like I originally thought.
Not my concern, I'm there to do what's best for the patient, and having him jump off of my gurney and start swinging at a doctor is not what's best for him.
I feel I was in the right with what I did in diffusing the situation; However, my partner has a different viewpoint.
He brought up several counter arguments for what I did to include "Hey, the doctor could have destroyed your career for interfering with him" "What if the doctor was testing the patient's threshold for something?" and "Hey, if he jumps off our gurney, he's in the hospital and not our problem anymore."
What do you guys think? Did I make the right call? Should I have handled the situation differently?
AOS to a (really bad, dark, dirty... all the nurses just came on 5 minutes ago and the time is 1346) Board and Care facility, PD is on scene. Pt. is a 275lb pound (muscular) male in his mid fifties. According to one of the officers on scene, they were called out because the Pt was being aggressive towards the staff and punched several holes in the wall along the hallway.
Pt has a Hx of Schizophrenia, psychosis, OCD, and hypertension. Pt is on a conservatorship. Facility wants Pt transported to hospital for Psych eval.
Pt is found sitting upright in a relaxed position on a chair outside the board and care facility chatting pleasantly to one of the PD officers about the super bowl.
Ax shows the Pt has several superficial lacerations on his R hand which PD wrapped with a towel from the facility. Pt is A&Ox2, he thinks it's 1986, but answers most questions appropriately while often going off on separate tangents after answering questions. VS are stable and within the Pt's normal limits (according to Hx on paper-work received from facility) Pt denies N/V, states R hand pain due to lacerations. Pt is dirty, as though he hasn't showered in several weeks, and his clothes are unwashed.
As far as Rx, we irrigated the wounds on his hands with sterile water, wrapped his hand with gauze. Tx in POC, ASPT.
Here's where my questions come up.
We arrive to the hospital, offload the Pt and get into the ER. We're informed by the charge nurse that there will be an offload delay. That's fine, we're paid by the hour.
Pt becomes very vocal, making passes at women that walk by, and speaking nonsense at a very high volume. After a minute of that I told him to quiet down. Pt states that he's been to this facility before and does not like the staff. I run my "Hey, I've been cool with you, right? I played your favorite radio station on the way down here. You don't want to get ME in trouble, right? So just quiet down until you get a bed and I'll make sure they treat you right"
Pt quiets down, for about 5 minutes, but makes a remark when a security guard passes by. One of the staff pops their head out of a room a few feet away and says "Hey, shut your mouth, this isn't the streets!"
Patient becomes vocal again, tells this person he doesn't give a :censored: etc. Staff person marches up to the gurney asks the Pt if he wants a glove in his mouth (yeah, those words). Staff person continues yelling at the patient, taunting him to get off of my gurney and swing at him. The pt starts removing his seat belts, so I jump in and put my hand on the staff persons chest and gently push him back saying "Hey, man, don't provoke him, you're being childish," And proceed to talk the patient down. Staff person looks at me and my partner and walks back to his little room.
I then find out that the staff person is one of the ER docs. Not an ER tech like I originally thought.
Not my concern, I'm there to do what's best for the patient, and having him jump off of my gurney and start swinging at a doctor is not what's best for him.
I feel I was in the right with what I did in diffusing the situation; However, my partner has a different viewpoint.
He brought up several counter arguments for what I did to include "Hey, the doctor could have destroyed your career for interfering with him" "What if the doctor was testing the patient's threshold for something?" and "Hey, if he jumps off our gurney, he's in the hospital and not our problem anymore."
What do you guys think? Did I make the right call? Should I have handled the situation differently?