# Omg dont touch me!



## MissTrishEMTB08 (Sep 25, 2008)

Yesterday we had this female patient that was very very touchy. It got to the point where I was ready to take her hand off my freaking knee! 

It started out as me taking her BP en route, I always support their arm with my knee while I take it. Well, after I moved her arm back to her, she ended up putting her hand on my knee and rubbing it and everything. I would stand up to throw my gloves away, or turn away to move my knees, but she always put her hand on my knee. I dont think she meant anything by it, she said I reminded her of her favorite granddaughter and she was going to hospice, so Im sure she was scared, so I didnt want to embarrass her by asking her not to touch me, but jeez! I wouldnt mind holding her hand if it would make her feel better because it must be terrifying, but touching my leg is kind of off limits

In the end I asked her if she was cold and went to go fiddle with the controls by the captains chair.

So have any of you run into a situation where you had to tactfully ask a patient to take their hands off you? How do you do it?

And yes! THis one made it all the way to hospice alive! (Though the same hospice case worker was kinda p!ssy when I asked, privately and away from all family and the patient, if she was really ok to transport and wasnt going to conk out half way.)


----------



## emt19723 (Sep 25, 2008)

hmmmm.....dont know about this situation....but myself personally...not a whole lot bothers me. if she just wanted to rest her hand on my knee, or rub it, or whatever.....as long as it keeps her calm and makes her a better pt, go for it. granted, there are limits to that. as long as you have good judgement on where those lines may be, you should be all right. something as harmless as what youre describing wouldnt alarm me though.


----------



## Flight-LP (Sep 25, 2008)

Just wait until you get the happy drunk patient. Touching your leg will be the least of your concerns................................

BTW - Ummmm, hospice pts. typically go to hospice for one reason and one reason only; to die. With this knowledge in mind, why would one even ask the case worker if the pt. could possibly "conk". Of course she could, will that change you transporting, not in the least bit. I would probably be a little annoyed too if I were the case worker.......................


----------



## BossyCow (Sep 25, 2008)

A little old lady reaching out for some human contact in a scary situation creeped you out? Our work involves touching people, sometimes they touch back. I've done a lot of hugging and comforting of the smelly, old and odd. But then I'm not too bothered by the touchy feeley stuff.

There is a difference between that and the more sexual contact that some of our more chemically enhanced pts want to engage in. I have looked some of these directly in the eye and told them in no uncertain terms that I was going to pull the rig over, put them in restraints and get a LEO to ride with us the rest of the way if they didn't knock it off immediately. 

Its all about boundaries. Know where yours are and enforce them firmly.


----------



## Ridryder911 (Sep 25, 2008)

Okay newbie.. *New flash*! Your the one that has the problem, not the patient. Personally if you asked me in those terms or words_.."if she was really ok to transport and wasnt going to conk out half way".. _ I would be more than irritated. I would contact your Supervisor and ask for some form of actions be taken or I would assure there would be another transport for our patients. You know what occurs then?....  

Alike Bossy described, .. she is going to die and your worried about your feelings and uncomfortableness.. shame on her, how dare she reach out as a human! 

My opinion is to think about things.. maybe a change in career or how you perceive patients. Personally, we have enough ambulance drivers, time we get some empathetic professional medics. Remember, it's easy to be replaced.


----------



## JPINFV (Sep 25, 2008)

MissTrishEMTB08 said:


> It started out as me taking her BP en route, I always support their arm with my knee while I take it. Well, after I moved her arm back to her, she ended up putting her hand on my knee and rubbing it and everything. I would stand up to throw my gloves away, or turn away to move my knees, but she always put her hand on my knee. I dont think she meant anything by it, she said I reminded her of her favorite granddaughter and she was going to hospice, so Im sure she was scared, so I didnt want to embarrass her by asking her not to touch me, but jeez! I wouldnt mind holding her hand if it would make her feel better because it must be terrifying, but touching my leg is kind of off limits



Well, you could have just, you know, held her hand. It gives the patient the contact that she was looking for and you the personal space that you're looking for. Win win situation.


----------



## MissTrishEMTB08 (Sep 25, 2008)

The whole asking if she was going to conk out thing was because the last hospice patient I transported died in the middle of transport, cleared by the same case worker. Wasnt a long transport, 10-15 minutes. I KNOW what hospice patients do, but they shouldnt be doing it on the 10-15 minute ride to the hospice. 

I know you touch the patients, but the thing is the patient was touching me in a manner that I found uncomfortable. I stated clearly in my post that I wouldnt have minded holding her hand but I find touching my leg to be inappropriate. Just because Im an EMT does not mean I should be subjected to touching which makes me feel uncomfortable.


----------



## Ridryder911 (Sep 25, 2008)

MissTrishEMTB08 said:


> I know you touch the patients, but the thing is the patient was touching me in a manner that I found uncomfortable. I stated clearly in my post that I wouldnt have minded holding her hand but I find touching my leg to be inappropriate. Just because Im an EMT does not mean I should be subjected to touching which makes me feel uncomfortable.



You know, I would think that the call should had been about the patient not you...

Would you object from a hug from a patient? .. Even you described you knew it was non-sexual, so again .. Who has the problem? 

Sorry, somewhere in the EMT program they should had informed you this was a caring, profession and yes... patients need to be touched and in return they may touch you back.  How much is excessive? Move or as others described, hold her hand. Deal with it appropriately. 

Yes, I don't care to be touched all over (by patients) especially with those with feces or bodily fluids. So I deal with it by clasping their hands, talking to them. Still giving them the care and empathy they need and *deserve*. 

Things will be much more than this.... and yes, I am serious of reconsidering professions. 

R/r 911


----------



## MissTrishEMTB08 (Sep 25, 2008)

Ridryder911 said:


> You know, I would think that the call should had been about the patient not you...
> 
> Would you object from a hug from a patient? .. Even you described you knew it was non-sexual, so again .. Who has the problem?
> 
> ...



I did move, quite a few times, yet her hand always found a place back on my leg.

Jesus christ, calm down. I didnt say anything to her about it, I just stated, on this board, not to her, that I was uncomfortable with it, youre acting as if I screamed in horror and started to scrub at my knee feverishly with the foam antiseptic.

The call was about her, I got her to her hospice comfortably, adjusted her 02 when she said it was drying out her nose, fixed her cannual with some 2x2s because her ears were irritated by it and so on and so forth, she got there smoothly. I made sure she was comfortable, I didnt embarrass her or anything by telling her that the hand on my knee makes me uncomfortable, didnt make her feel icky or gross or burdenful, nor even wince away when she sneezed in my face, she actually told me she had been transported hospital to hospital by many different people and I was the nicest to her.

Yeah, but Im a horrible EMT because I dont like to have my legs touched, I should quit right now, while Im halfway through medic school.


----------



## JPINFV (Sep 25, 2008)

MissTrishEMTB08 said:


> Jesus christ, calm down. I didnt say anything to her about it, I just stated, on this board, not to her, that I was uncomfortable with it, youre acting as if I screamed in horror and started to scrub at my knee feverishly with the foam antiseptic.



Full disclosure time:

While I didn't scream, I did scrub my cheek once with antiseptic after having a patient plant a kiss on my cheek when I was dropping her off (long story). Sneaky cougars.


----------



## BossyCow (Sep 25, 2008)

The point is that a patient, touching you in a non-sexual way during a time of physical crisis, made you uncomfortable. Uncomfortable enough for you to come in here and post with the title.. OMG don't touch me.. 

While you may have been able to cover your discomfort in front of the pt.. (bully for you) you are still missing the point of Rid's and my comments..... this will happen again, often. I find it interesting that you commented about being okay with touching pts but uncomfortable with them touching you. Hmm so who has the control in the situation where you are comfortable? you stated 


> It got to the point where I was ready to take her hand off my freaking knee!



That's not something you say about something that is a mild annoyance. It sounds like you have issues with being touched without your permission which is simply a matter of personal preferences and the boundaries of your personal space. While it is certainly your right and privledge to set those boundaries wherever you please, the placement of yours will be in conflict with the line of work you have chosen. 

So, we are not going to pat you on the head and sympathize with you over the handsy little old lady that made you uncomfortable. In my opinion, she was not out of line and you will either have to loosen up your boundaries or face continual discomfort.


----------



## mikie (Sep 25, 2008)

ok, I too would feel a little weird about someone rubbing my knee.  I'd survive though


----------



## Ridryder911 (Sep 25, 2008)

I'll take a rub on a a knee than being urinated, defecated or even vomited upon any day.


----------



## reaper (Sep 25, 2008)

I actually like the knee rubbing!!!!


----------



## VentMedic (Sep 25, 2008)

Get a little closer Rid.  You too reaper.  I can't reach you guys way over there.


----------



## Ridryder911 (Sep 25, 2008)

LOL... You can tell us that have been in EMS for a while. We consider a rub on the knee as a company benefit rather than an annoyance.


----------



## daedalus (Sep 25, 2008)

I think ill go on the dissent here, and agree with the OP. I was taught on no uncertain terms by my CCT RN that patients, other than comforting hand holding (with gloves), should not touch you other than that. There is a huge difference in us touching them, its professional and serves a work related purpose. Touching someone else for other reasons can be an invasion of someone's personal space. Remember, we all have our own comfort levels. Besides, no one wants hands that have been covered in urine/feces/mucous/sweat/etc toughing them. Thats dangerous and carries its own hazards. 

Its perfectly okay to be not okay with someone touching you. Period.


----------



## daedalus (Sep 25, 2008)

BossyCow said:


> In my opinion, she was not out of line and you will either have to loosen up your boundaries or face continual discomfort.



I believe she was out of line. Touching someone without permission is not okay, regardless of your age. If it made the OP uncomfortable, that makes it wrong.


----------



## VentMedic (Sep 25, 2008)

And that is why they made recipe books for EMTs and Paramedics. 

If you can not use your own judgement or don't have the clinical skills to know when a patient is frightened or has just spent the last several months inside a hospital and is now on their way to hospice to die, then find a career with cadavers. At least they won't reach out and touch you or express some form of human emotion.


----------



## rmellish (Sep 25, 2008)

VentMedic said:


> And that is why they made recipe books for EMTs and Paramedics.
> 
> If you can not use your own judgement or don't have the clinical skills to know when a patient is frightened or has just spent the last several months inside a hospital and is now on their way to hospice to die, then find a career with cadavers. At least they won't reach out and touch you or express some form of human emotion.



X2
I guess I'm not really understanding the issue the OP is having. It's a shame that we as ems professionals, and I use that term loosely at times, could be expected to not only do paperwork and transport a dying patient across town, but to care just a little bit as well? 

Based on the description given by the OP and the tone of the post I'm agreeing with Rid and Vent on this one.


----------



## MedicPrincess (Sep 25, 2008)

MissTrishEMTB08 said:


> I wouldnt mind holding her hand if it would make her feel better because it must be terrifying, but touching my leg is kind of off limits
> 
> In the end I asked her if she was cold and went to go fiddle with the controls by the captains chair.





> The call was about her, I got her to her hospice comfortably, adjusted her 02 when she said it was drying out her nose, fixed her cannual with some 2x2s because her ears were irritated by it and so on and so forth, she got there smoothly. I made sure she was comfortable, I didnt embarrass her or anything by telling her that the hand on my knee makes me uncomfortable, didnt make her feel icky or gross or burdenful, nor even wince away when she sneezed in my face, she actually told me she had been transported hospital to hospital by many different people and I was the nicest to her.


 
So if you would not have minded holding her hand, and she was obviously scared and near the end, why would not take her hand in yours and hold it.  Its obvious she was in desperate need of some physical comfort, instead you hid behind her and pretended not be be aware of her needs. 

Sure you did all these "Nice" clinical things for her and took care of her immediate clinical needs, but what about her even deeper emotional needs?  You would be surprised how much that simple hand holding would have meant to her.



> Wasnt a long transport, 10-15 minutes. I KNOW what hospice patients do, but they shouldnt be doing it on the 10-15 minute ride to the hospice.


 
I happens.  I have transferred hospice patients where the reports included the phrases "probably won't make it to the destination" and the like, but we were taking them home so they could be with their family when they died.  If you are doing hospice transfers, get used to it.  People die.  How would you feel if the person died in the back of your truck while you were hiding behind them fiddling with controls when all they wanted was to have some simple human kindness prior to dieing.


----------



## Ridryder911 (Sep 25, 2008)

daedalus said:


> I think ill go on the dissent here, and agree with the OP. I was taught on no uncertain terms by my CCT RN that patients, other than comforting hand holding (with gloves), should not touch you other than that.
> Its perfectly okay to be not okay with someone touching you. Period.



She better be damned glad she is NOT one of my nurses or any of the hospitals I have worked in. Nursing as well as all of medicine is a compassion business. Science is ONLY one part of it. If you can't handle the "humanistic part" then you need to get the heck out! We have enough cold, insensitive persons .. (hence usually physicians) and that is why they have very little trust from patients. Maybe, that is why we are getting the same reputation? 

Wow! I would be insulted that a patient would have to ask to touch me? My space? WTF? .... Get over yourself QUICKLY! The business is a people and caring business. Those patients are clients and those clients are our patients and those patients are humans! If you can't deal with that; it's time for a career change. Really the business is NOT ABOUT THE PROVIDER IT IS ABOUT THE PATIENT!. This is not to say we should allow inappropriate contact nor abuse, but for the patient not to express appreciation or have personal contact because.... the medics personal space? Ludicurous!  

If you need "your space" I believe they have some openings in the Parks and Recreation or some "factory" .. where one can be in touch with themselves and do us (the profession) and the patients a favor...get the hel* out!


----------



## traumateam1 (Sep 25, 2008)

Flight-LP said:
			
		

> Just wait until you get the happy drunk patient. Touching your leg will be the least of your concerns................................


Haha reminds me of a call recently. 30ish y/o F ETOH+++ and something else on board. Was doing vitals (resps, pulse, BP, etc etc) and while I was doing that she was resting her head on my arm, and running her hand up my short sleeve to my shoulder and then it got to the point where she was kissing my arm! She also was asking if I would take her home to bed and take care of her.
I'm still getting bugged about it today, and was the fist time a woman went that far on me while on duty .

To the OP's concern/question I really don't mind p/t's having physical contact with me, especially if they are going to hospice. I know they are scared to death (no pun intended) and want as much comfort as they can get, and being a health care professional I know they want contact with us.. must be our caring demeanor. If they want to rub my knee (has happened), hold my hand (of course that's happened), asked for a hug (I think everyone gets asked that) or just want to touch you in some appropriate way I personally do not mind. 
I'm not to sure how long you've been an EMT but you will get this a lot, and I'm sure it will get easier and easier.. hopefully.


----------



## traumateam1 (Sep 25, 2008)

Ridryder911 said:
			
		

> She better be damned glad she is NOT one of my nurses or any of the hospitals I have worked in. Nursing as well as all of medicine is a compassion business. Science is ONLY one part of it. If you can't handle the "humanistic part" then you need to get the heck out! We have enough cold, insensitive persons .. (hence usually physicians) and that is why they have very little trust from patients. Maybe, that is why we are getting the same reputation?
> 
> Wow! I would be insulted that a patient would have to ask to touch me? My space? WTF? .... Get over yourself QUICKLY! The business is a people and caring business. Those patients are clients and those clients are our patients and those patients are humans! If you can't deal with that; it's time for a career change. Really the business is NOT ABOUT THE PROVIDER IT IS ABOUT THE PATIENT!. This is not to say we should allow inappropriate contact nor abuse, but for the patient not to express appreciation or have personal contact because.... the medics personal space? Ludicurous!
> 
> If you need "your space" I believe they have some openings in the Parks and Recreation or some "factory" .. where one can be in touch with themselves and do us (the profession) and the patients a favor...get the hel* out!



Couldn't agree more!


> I was taught on no uncertain terms by my CCT RN that patients, other than comforting hand holding (with gloves), should not touch you other than that.
> Its perfectly okay to be not okay with someone touching you. Period.



I cannot believe that you were taught this, and even more practice that! People in times of crisis and uncertainty NEED physical contact WITHOUT glove. They need hugs and hand holding! If you need that much "personal space" the health care profession *is not for you!*


----------



## MissTrishEMTB08 (Sep 25, 2008)

You guys are unbelievable. God forbid I not want some lady touching my knee, that makes me completely compassionless and a bad EMT.

Yeah right. I have a lot of compassion for people but I have certain boundaries I dont like breached, touching my leg is off limits and there are very very very very personal reasons as to why I do not like to have my legs touched, period. I dont see how that makes me compassionless. God forbid.

And you all make it sound like she was starved for human contact, she was not. She was in the hospital for 4 days, and according to the nurse she had family there the entire time. Her daughter was there when we got there, along with her brother, hugged her goodbye. They met us at the hospice when we got there. She was not starved for human touch. I understand she is scared, that does not make violating my personal space ok.


----------



## traumateam1 (Sep 25, 2008)

Miss, that wasn't directed towards you.. you are willing to have more contact than gloved hand holding.

If you don't want any p/ts touching your knees than fine.. who are we to tell you what to do or how to treat your p/ts. No one thats who. All I am saying is if *my* patient wants to touch me (appropriately of course) than I don't mind. I'm not guessing or judging your patient care. However if you believe and only follow gloved hand holding, that is something of its own and is not needed. Why not hold a hand? Are they all disease ridden and suppose to be in quarantine?

Again, I am not telling you how to do your job, or judging your p/t care Miss.


----------



## rhan101277 (Sep 25, 2008)

I haven't had any experience with this yet.  I would have to say I don't think I would mind, especially being that this pt. is hospice.  They are afraid and trying to reach out.  Some people have boundaries though I guess.  Was she moving her hand up your thigh or something?  Or just your knee.

I think it all depends on things that have happened to an individual as well.  I had some hard times growing up.


----------



## Flight-LP (Sep 26, 2008)

MissTrishEMTB08 said:


> The whole asking if she was going to conk out thing was because the last hospice patient I transported died in the middle of transport, cleared by the same case worker. Wasnt a long transport, 10-15 minutes. I KNOW what hospice patients do, but they shouldnt be doing it on the 10-15 minute ride to the hospice.



What part of this are you having difficulty comprehending? HOSPICE PTS. DIE! They can do so at any time, not a damn thing you can do about it. If they do, you simply follow your SOP's for a deceased pt. It's not your decision, you cannot decide how you will and won't transport, and you certainly have no right to question someone who knows a whole heck of a lot more about this pt. than you do.

As for the touchy feely issue you have, again what are you going to do when someone grabs more than your knee? Are you going to deck them? I have had people grab, touch, spank, pinch, and caress probably every inch of my body. It happens! The unpredictable nature of this business makes this a more than rare occurance. I am not saying that people have the right to violate you, but sometimes people do peverse things. Sometimes its not even intended. Case in point..............You are sitting on the bench seat attempting to start an IV in your pts. A/C. Their arm is hanging off of the side of the stretcher between your legs. Your pt. accidently brushes their hand against your inner thigh. What now? Are you going to freak out on them? Sometimes we need to put our personal insecurities aside and see things for what they really are. As previously pointed out, this industry is not about you. You are a servant to the patient. Looking at it in any other fashion is self serving and really inapporpriate. 

Honestly, either get over it or revisit yourself and your future in EMS.....................


----------



## mycrofft (Sep 26, 2008)

*OK OK break it up.    (>>>*

If you're not touchy-feely, that's your business, but don't be surprised when everyone here comes at you when you ventilate all- "John Wayne" with "OMG". I think  a reassuring touch is a tool, and the more sincere you are with touch, the better it works. Sometimes it's OK to fake sincere if it will help the pt, just do it well.

On the other hand, when I was wearing a real tie and not a jazzbow during the first week working my first civilian ambulance, a nice little old lady reached up to pat my face, tried to climb my tie and slapped me. (No, my hand wasn't on her knee!). Judgement always.  I think that if someone else has less comfort in being touched than I do, that's their business, not mine.

 If you are uncomfortable with patients touching your legs etc (I would be, especially where I work!! :unsure, substitute your hand.  Then YOU are touching THEM, you have control.

Beware...some pts don't want to be touched either.

PS: Sounds nice, but we are never literally the servant of the patient. We must seamlessly disregard any hangups we have which may sacrifice their care, but we are never their servant.


----------



## traumateam1 (Sep 26, 2008)

mycrofft said:
			
		

> If you are uncomfortable with patients touching your legs etc (I would be, especially where I work!! )


Don't drop the soap big guy  Don't you work in a jail mister? Haha... I think I'd be very uncomfortable!


----------



## mycrofft (Sep 26, 2008)

*It took me a while, we were taught never to let the inmates touch us.*

For jail newbies that's a good start; rarely, it is appropriate, and then the pt is bad off enough we know there are no games going on. I do not allow them to touch me, except, rarely, to shake hands. Then I disinfect; thier environment is dirty, not their fault.

Newsflash: for a sociopath or a bully, touching _you_ is a dominance display and allowing their touch is in their eyes an invitation to be used. But, for a little old lady on the way to hospice, (or the big burly tatted biker meth cook, who think's he's dying, with Menier's syndrome), it can be a comfort and a reassurance to them to be touched, and either can alleviate distress and promote a better outcome.

I don't shower with them.


----------



## LucidResq (Sep 26, 2008)

As health care providers sometimes we need to to put up with a little bit of discomfort for the sake of our patients. 

Whether it's listening to a horribly boring and long story, answering painfully awkward questions, helping a nurse shove a bed pan under a 300 lb + woman's bum so she can go pee, being swung at by drunk woman, being hit on by a man old enough to be your grandpa, listening to the relentless screeching wails of a sick baby, smelling the most horrid things smell-able on Earth or having some old woman put her hand on your leg for a little... it's kinda part of the job, and as others have said, having an old lady touch you in a kind, non-sexual way is pretty low on the list of "discomforting things that patients do to EMS providers" for most people.

Did she injure you, put you at increased risk for infectious disease or sexually harass you? No, so my advice would be to deal with it. I would be touched if I reminded a dying woman of one of her loved ones.


----------



## MissTrishEMTB08 (Sep 26, 2008)

Flight-LP said:


> What part of this are you having difficulty comprehending? HOSPICE PTS. DIE! They can do so at any time, not a damn thing you can do about it. If they do, you simply follow your SOP's for a deceased pt. It's not your decision, you cannot decide how you will and won't transport, and you certainly have no right to question someone who knows a whole heck of a lot more about this pt. than you do.
> 
> As for the touchy feely issue you have, again what are you going to do when someone grabs more than your knee? Are you going to deck them? I have had people grab, touch, spank, pinch, and caress probably every inch of my body. It happens! The unpredictable nature of this business makes this a more than rare occurance. I am not saying that people have the right to violate you, but sometimes people do peverse things. Sometimes its not even intended. Case in point..............You are sitting on the bench seat attempting to start an IV in your pts. A/C. Their arm is hanging off of the side of the stretcher between your legs. Your pt. accidently brushes their hand against your inner thigh. What now? Are you going to freak out on them? Sometimes we need to put our personal insecurities aside and see things for what they really are. As previously pointed out, this industry is not about you. You are a servant to the patient. Looking at it in any other fashion is self serving and really inapporpriate.
> 
> Honestly, either get over it or revisit yourself and your future in EMS.....................



Yes, they die but if they are that close to death they should not be being transported by ambulance, they should die where they are.

Think about your patient, would you rather die in some noisy bumpy rig or in the warm comfort of a hospital bed?

Did I hit the lady? No. Did I tell her to get the :censored::censored::censored::censored: off me? No. Did I tell her she was weird and creepy for touching me? No. Did I scream and scrub with antispetic? No. 

So what is the problem with me stating I was uncomfortable with it, not even to her, but to a message board? Her care did not suffer in the least, she was pleased with the ride to the hospice, said I was the nicest one to transport her. I didnt treat her like she was plauged or diseased, I laughed and joked with her, made sure she was comfortable.

I would also like to add this woman was NOT aware that it made me uncomfortable. I didnt make it painfully obvious that her rubbing all up on my knee was making me uncomfortable, all movements away were natural, reaching for something I would use, adjust the air and lighting in the ambulance, turn to shout up something to my partner. She didnt suffer at all, wasnt made to feel uncomfortable.

I am within my right to feel uncomfortable about a situation. Being uncomfortable with something does not make compassionless or a bad EMT.


----------



## reaper (Sep 26, 2008)

No one is saying you did wrong in the way you treated the pt. They are trying to tell you the same thing over and over.

If you are freaked out from a little old lady touching your knee, what are you going to do when the drunk grabs something a lot more personal? Or when the psych pt attacks you in the back and is grabbing everything?

They are trying to tell you that this is something you will deal with weekly. If it is that bad, then you might want to decide that now, before you are in to deep.


----------



## MissTrishEMTB08 (Sep 26, 2008)

..........................


----------



## MissTrishEMTB08 (Sep 26, 2008)

reaper said:


> No one is saying you did wrong in the way you treated the pt. They are trying to tell you the same thing over and over.
> 
> If you are freaked out from a little old lady touching your knee, what are you going to do when the drunk grabs something a lot more personal? Or when the psych pt attacks you in the back and is grabbing everything?
> 
> They are trying to tell you that this is something you will deal with weekly. If it is that bad, then you might want to decide that now, before you are in to deep.



I dont mind being touched, but I have a hang up about people rubbing my legs/knees that stems from the way a person who did very bad things would touch me when I was younger. I am certainly entitled to feel uncomfortable about not having my knees and legs rubbed on and felt up.

But from the posts garnered here, being uncomfortable makes me compassionless, go figure.


----------



## reaper (Sep 26, 2008)

OK, since you don't want to listen to anyone, your on your own.

I am sorry for what you went through when you were younger. What we are trying to say is simple. If it is to much for you to be rubbed on or felt up, then this may not be the job for you. It will happen. Yes, it is wrong, but it will happen.

If this is something you will always be stressing over, then you need to think about your future, or you will be stressing this the rest of your life.


----------



## MedicPrincess (Sep 26, 2008)

MissTrishEMTB08 said:


> Yes, they die but if they are that close to death they should not be being transported by ambulance, they should die where they are.
> 
> Think about your patient, would you rather die in some noisy bumpy rig or in the warm comfort of a hospital bed?


 
I would rather make the attempt to get that hospice patient to their home to be surrounded by loved ones in an eviroment they loved.  I have transported patients with respirations of 4-6..... one very memorable man who died as soon as we put him in his bed at home.....  people who were not expected to make to our destination.... All so they could be anywhere BUT a cold unfamiliar hospital bed that was not "home" for them.  It humbles you.

As far as the right to be uncomfortable.... You absolutely have the right to feel uncomfortable.  The point everyone here is trying to make to you is touching happens.  If you are so distraught and upset about a scared old lady thats FTD seeking comfort during her end, then perhaps you shoudl rethink what your doing.  You are going to be touched a lot more ways.  Pretty much everything from your feet to your hair will be touched by a patient at some point.  Your legs will be rubbed, arms stroked, breasts grabbed, butt massaged.  Some intentional, some "accidental."  

If you are this creeped out about a desperate old lady, you are going to have serious issues, very quickly.  Some of my worst "offenders" are little old dementia men.  I have been felt up more by those guys than the drunk homeless ones.  Its all a matter of accepting it, redirecting their hands (usually to mine, and I HOLD THEIR HAND!), or depending on what they are touching just letting them.


----------



## Flight-LP (Sep 26, 2008)

MissTrishEMTB08 said:


> Yes, they die but if they are that close to death they should not be being transported by ambulance, they should die where they are.
> 
> Think about your patient, would you rather die in some noisy bumpy rig or in the warm comfort of a hospital bed?




Actually if I was offered hospice care as my final level of comfort, I would want to go to hospice. The choice isn't yours, the family, the pt. (if able), and the entire collaborative health care team is aware that the pt. may expire prior to arrival at hospice. It happens. But your opinion or assumption of what the pt. and or family wants is irrelevent. Your job is to give that person a ride there, plain and simple.........................

As far as the touchy feely issue goes, as I and others have said already, you either need to find better coping mechanisms (i.e. dealing with it) or re-evaluate your future in this industry. Bottom line, one of these days, someones going to feel you up, all peversities intended. If you cannot effectively deal with it, you may find yourself becoming unprofessional at an unopportune time and damaging your personal reputation, the organization's reputation, and the industry as a whole. You really need to think this over and determine if these personal issues will become professional ones. It sounds as though it already has........................


----------



## Ridryder911 (Sep 26, 2008)

I think your missing our entire point. I never believed you did poor care or maybe even acted rude to the patient. The point is that within your own feelings. 

I had wrote a lengthy response but read from one of your responses..."_I have a hang up about people rubbing my legs/knees that stems from the way a person who did very bad things would touch me when I was younger"_... 

This is very understandable, you have your own demons to deal with. Yet, this is not the patients. Sorry this occurred, but you need to be aware the requirements of this job demand interpersonal communications and touching. This is nothing against you, but you chose to be in this career and you are attempting to make it fit you and not you fit in it. One can either be able to handle such daily occurrences or possibly choose another career. I would give the same information for those that work with the elderly, or with handicap (Downs Syndrome) patients to expect to be touched without warning, it is just part of the job and in-fact one of the ways patients express appreciation. Again, no one is saying inappropriate touch. 

I would really recommend to do some interpersonal thinking. It apparently bothers you a lot. Again, can you deal with this on a daily basis for years? It is not going to get better or go away. I do hope you really consider all the options before getting into this profession more in depth and that it requires an area you are very uncomfortable in. Time to explore many options .. good luck.


----------



## VentMedic (Sep 26, 2008)

This is a great example of why the EMT-B program needs to be at least 1 year with no less then 200 hours of clinicals with direct patient contact and not 8 hours at an ambulance station having coffee. 

During that time any personal issues like this can be identified and dealt with.  That may also mean that you would find out early that healthcare is not for you.   

It would be a benefit to the patients who would not have a provider with issues.   It would also prevent a person from continuing in a profession that they are not suited for.


----------



## MissTrishEMTB08 (Sep 26, 2008)

MedicPrincess said:


> I would rather make the attempt to get that hospice patient to their home to be surrounded by loved ones in an eviroment they loved.  I have transported patients with respirations of 4-6..... one very memorable man who died as soon as we put him in his bed at home.....  people who were not expected to make to our destination.... All so they could be anywhere BUT a cold unfamiliar hospital bed that was not "home" for them.  It humbles you.
> 
> As far as the right to be uncomfortable.... You absolutely have the right to feel uncomfortable.  The point everyone here is trying to make to you is touching happens.  If you are so distraught and upset about a scared old lady thats FTD seeking comfort during her end, then perhaps you shoudl rethink what your doing.  You are going to be touched a lot more ways.  Pretty much everything from your feet to your hair will be touched by a patient at some point.  Your legs will be rubbed, arms stroked, breasts grabbed, butt massaged.  Some intentional, some "accidental."
> 
> If you are this creeped out about a desperate old lady, you are going to have serious issues, very quickly.  Some of my worst "offenders" are little old dementia men.  I have been felt up more by those guys than the drunk homeless ones.  Its all a matter of accepting it, redirecting their hands (usually to mine, and I HOLD THEIR HAND!), or depending on what they are touching just letting them.



the patient who died was not going home, she was leaving home to go to the Hospice House. Had we not transported her, she would have died at home.  McFeely wasn't going home either, she was leaving the hospital to go to the ame hospice(coincidentally in the same room that we dropped the dead one off in.). 99 percent of our hospice transfers are going to the same hospice house and leaving nurses qho had cared for them weeks or family at home and going to a  place they have never been before. if they are circling the drain I would think they would want to stay where they are familiar.


----------



## Tiberius (Sep 26, 2008)

I'd rather not have hands on my knees either....but, while on the truck I put these issues on the back burner. Also it's easy to "take command" of the situation. I would just hold her hand, talk to her about whatever she wanted and continue to provide reassurances in that manner; I'd never say anything like "get out of my personal space", etc. In this industry, compassion is a big part of the game. It's best to sit beside the pt in these situations rather than behind them, especially if you sense that (or if they tell you) they're scared.


----------



## BossyCow (Sep 26, 2008)

Trish, you need to sit back, put your defensiveness on hold for enough time to actually read what is being posted here. That includes the posts you are making. When you first started this thread, you were using exclamation points, phrases like OMG and asking the forum what they thought, and how they handled similar situations. 

When you were given very honest responses to that post you immediately became defensive about your right to set your own personal boundaries and the inappropriateness of the pts behavior, the inappropriateness of the facility for putting these types of pts in your rig, the unfairness of us responding and a reiteration of the righteousness of your position. 

In some ways you are correct. You have every right (I said so in an earlier post) to determine your own personal boundaries. You absolutely have the right to refuse to be touched. No one is arguing with that! 

Where we disagree is the expectation that the injured and dying will have the ability to operate within those parameters. Your expectation that you must be respected and treated in accordance with your own personal rules is an unreasonable expectation given your chosen line of work. 

People will die on their own timetable, not at your convenience or when and how you think they should. Families will make determinations for the care and transport of their loved ones based on their own personal needs, desires and motivations, not yours. Facilities will decide who goes where, when and how as is appropriate in their eyes only.  

These are facts. They may be unfair, inconsiderate, inappropriate, not what you deem correct, uncomfortable to endure, but they are still the working conditions of EMS. We have all been where you are. We have all had to reconcile our personal histories with the day to day operation of our duties in EMS. What pretty much everyone here has been telling you is that this is going to happen again and again and again. It doesn't matter how justified your feelings are, because they truly do not matter to your pts. 

So, the real issue here is, do you want to continually subject yourself to something that is so uncomfortable? Are you going to be able to overcome your issues with touching? Because if you can't, no matter how unfair that seems, EMS is not for you.


----------



## Jon (Sep 26, 2008)

I think Bossy said it best.

Trish... I don't like to be touched either... but, as others have said, my threshold is a little different between the 3am drunk and a 90-year-old woman who is on the way to hospice and looks like she's going to kick the bucket any minute.

When I take a blood pressure on many patients, I rest the patient's arm on my leg... it reduces some of the motion noise. I usually put the arm back on their lap... but I've had some patients... like yours, or older patients with dementia, or other major life changes... and they just want some human contact and comfort.

I've held hands... I've had patients hold onto my knee. If they are scared... and it makes them a little more comfortable... I'm not going to be a ****.


Jon


----------



## SmokeyBear (Sep 26, 2008)

I've had this happen many, many times. Most of the time its because of the height of the stretcher relative to where you are sitting in the ambulance--especially when taking vitals like BP in which the patient will often stretch their arm out towards ones knee. I have also found the LARGER patients are the more often they tend to try to "rest" their arms on your legs or what ever is parallel to the stretcher, this seems especially the case with obese patients (at least in my experience). The fact that they are "touchy-feely" isnt unusual either. They generally mean nothing by it and if the patient feels scared or anxious they may ESPECIALLY want to hold your hand or grasp on to your shirt side. When a patient is in trouble and if it helps them, they can reach for my hand, grab my knee, as much as they wish as long as it doesnt effect my ability to provide proper care.* This is a touchy type job*.  But if it bothers you that much sit at the head of the stretcher and stand when working the patient.


----------



## MissTrishEMTB08 (Sep 26, 2008)

BossyCow said:


> Trish, you need to sit back, put your defensiveness on hold for enough time to actually read what is being posted here. That includes the posts you are making. When you first started this thread, you were using exclamation points, phrases like OMG and asking the forum what they thought, and how they handled similar situations.
> 
> When you were given very honest responses to that post you immediately became defensive about your right to set your own personal boundaries and the inappropriateness of the pts behavior, the inappropriateness of the facility for putting these types of pts in your rig, the unfairness of us responding and a reiteration of the righteousness of your position.
> 
> ...




I have overcome a tremendous amount to stay in the EMS program. I used to be painfully shy and quiet to the point you would forget I was in the room, my school is murderously expensive because its an AS degree at a private college and I am young, single with no children but no parental help. I have over come a deathly fear of needles. I -hated- needles. I bawled my eyes out the first time someone stuck me (but I cried harder when I stuck them because I wasnt ready to try on a real person yet, and my instructor was forcing me too, and I really really didnt want to hurt them and had no earthly clue what I was doing.). Ive grown a thicker skin to the taunting and teasing of my classmates (They call me the blood god now! I tend to forget to pop the tourniquet and tamponade which creates a fountain of blood.) and I have been working for a very long time on my own mental issues and have began to overcome them and its not a dislike to being touched, its a dislike to having specifically ONE area of my body touched, which are my knee/upper leg. I dont mind hugs, they can touch my face (if they arent too infectious or fluidy), waist, shoulders, stomach, hand, arm, anywhere else. 

EMS *IS* for me. I love every single minute of it, I think its fascinating and love taking care of patients, its also my stepping stone into nursing school and eventually med school. Im not interested in it because its a cool or respected job, and certainly not in it for the money. I know I can be a great medic and I know right now Im a fantastic EMT. This is a little road bump, it really didnt bug me that much, I just kinda vented after a rough day and I guess I picked the wrong patient to vent over.

I started getting defensive when people told me to reconsider career paths, it sounded so condescending and it ticked me off more than it should because I worked so hard to stay here and Im not going to give up and throw in the towel now.

You can say im in it for the wrong reasons if youd like, or that I shouldnt be in EMS and reconsider my career path, but it really doesnt matter because Im in it to stay. 

Regarding the woman who died in transport, considering the thread I had posted about it and how people were saying refuse transport and all of that, plus the staff at the hospice house even said that the woman should NOT have been transported, I dont think Im unfair in saying that people minutes from death shouldnt be transported, at least not on a BLS truck.


----------



## rmellish (Sep 26, 2008)

MissTrishEMTB08 said:


> Regarding the woman who died in transport, considering the thread I had posted about it and how people were saying refuse transport and all of that, plus the staff at the hospice house even said that the woman should NOT have been transported, I dont think Im unfair in saying that people minutes from death shouldnt be transported, at least not on a BLS truck.



Why not a BLS truck? I'm assuming pt was DNR. Even with comfort measures, pt can be dosed prior to ems transport. Why take a paramedic out of service to transport a pt which ALS cannot do much for from a legal and ethical standpoint?


----------



## daedalus (Sep 26, 2008)

Ridryder911 said:


> She better be damned glad she is NOT one of my nurses or any of the hospitals I have worked in. Nursing as well as all of medicine is a compassion business. Science is ONLY one part of it. If you can't handle the "humanistic part" then you need to get the heck out! We have enough cold, insensitive persons .. (hence usually physicians) and that is why they have very little trust from patients. Maybe, that is why we are getting the same reputation?
> 
> Wow! I would be insulted that a patient would have to ask to touch me? My space? WTF? .... Get over yourself QUICKLY! The business is a people and caring business. Those patients are clients and those clients are our patients and those patients are humans! If you can't deal with that; it's time for a career change. Really the business is NOT ABOUT THE PROVIDER IT IS ABOUT THE PATIENT!. This is not to say we should allow inappropriate contact nor abuse, but for the patient not to express appreciation or have personal contact because.... the medics personal space? Ludicurous!
> 
> If you need "your space" I believe they have some openings in the Parks and Recreation or some "factory" .. where one can be in touch with themselves and do us (the profession) and the patients a favor...get the hel* out!



Remember, we are in the business of caring for humans, and I agree with that. Humans, by virtue of being human, vary! Some are uncomfortable being touched on the leg, and are otherwise wonderful compassion filled providers!

I know that, getting into EMS, most have the best of intentions. And if your not a whacker, etc, but a true EMS provider with a passion for medicine, you care about your patients and your responsibility to them. Medicine is as much about curing the body as it is caring for the person. I still think there can be boundaries.


----------



## BossyCow (Sep 26, 2008)

MissTrishEMTB08 said:


> I have overcome a tremendous amount to stay in the EMS program.



Again Trish, how much you have overcome is not the issue. *It's not about you!* How often you cried during class is not the issue, what personal demons you overcame is not the issue. The issue is that EMS is tough, hard, annoying, life or death stuff and you still seem invested in getting people to appreciate what this all means to you. 

In the back of the rig, the only one who's history matters is the patient. And I still stick by my initial assumption that you need to get clear on your role in the back of the rig. Please stop attempting to show us how tough this has been for you. You are not the one on your way to hospice. You are not the one getting CPR. Quit whining "oh poor me" and move on.


----------



## MissTrishEMTB08 (Sep 26, 2008)

rmellish said:


> Why not a BLS truck? I'm assuming pt was DNR. Even with comfort measures, pt can be dosed prior to ems transport. Why take a paramedic out of service to transport a pt which ALS cannot do much for from a legal and ethical standpoint?



Because the patient technically didnt have a valid DNR. The family couldnt locate it, so when she died she should have been worked but instead my partner illegally chose to let her die and got a copy of the DNR that was signed after she was already dead.

Edited to clarify, after she was already dead for a couple of minutes and before anyone knew she was dead except the RN at the hospice house is when hospices DNR got signed. We waited around in her room with the nurse, and the door closed for about 20 minutes and then OOPS LOOK SHE DIED to cover his butt.

Edited again to add, Im sure the husband probably already knew she was dead, but still.


----------



## John E (Sep 26, 2008)

*Please just stop now...*

there's an old saying about being in a hole and realising that the first thing to do is to stop digging.

Stop slandering people on a public forum. Stating that your "partner" illegally allowed a patient to die is a legally actionable offense. You're clearly not qualified to be making those kinds of comments.

Stop thinking that your ability to overcome psychological issues is a valid reason to remain working in EMS.

Get some counseling, please.

John E.


----------



## imurphy (Sep 26, 2008)

VentMedic said:


> And that is why they made recipe books for EMTs and Paramedics.
> 
> If you can not use your own judgement or don't have the clinical skills to know when a patient is frightened or has just spent the last several months inside a hospital and is now on their way to hospice to die, then find a career with cadavers. At least they won't reach out and touch you or express some form of human emotion.



VentMedic. You haven't been working around corpses enough! They sometimes touch you! Now THAT's bad touch! 

To the OP: I have to tell you that I have done my fair share of hospise runs in my years. And after pretty much any of those patients have hugged me, held my hand or anything, I felt disgusted after. 

Disgusted at myself that I couldn't do anything more to help these poor people. Remember, with any patient ever, even Jane Doe with the cold, you could be the last person they see. 

Whenever I did Inter-facilities, I always looked at these people AS people. Not patients. People, with families. And would you not like your Mom or Dad looked after in the same way? Or would you rather the last people they see be uncomfortable with them being people?


----------



## Ridryder911 (Sep 26, 2008)

imurphy said:


> VentMedic. You haven't been working around corpses enough! They sometimes touch you! Now THAT's bad touch!



If they reached out and touched you... they were not dead. Dead people do not reach out...

R/r 911


----------



## MissTrishEMTB08 (Sep 26, 2008)

John E said:


> there's an old saying about being in a hole and realising that the first thing to do is to stop digging.
> 
> Stop slandering people on a public forum. Stating that your "partner" illegally allowed a patient to die is a legally actionable offense. You're clearly not qualified to be making those kinds of comments.
> 
> ...



Sorry, I thought everyone knew not working a patient in arrest with out a DNR IN HAND, signed and on its colored paper, was bad mojo, at least in my protocols.


----------



## JPINFV (Sep 26, 2008)

MissTrishEMTB08 said:


> Sorry, I thought everyone knew not working a patient in arrest with out a DNR IN HAND, signed and on its colored paper, was bad mojo, *at least in my protocols.*



Bolded the important part because that patient would have been considered to have a legal DNR (family request to withhold resuscitation) where I worked. 



Ridryder911 said:


> If they reached out and touched you... they were not dead. Dead people do not reach out...
> 
> R/r 911



"I don't want to go on the cart."


----------



## MissTrishEMTB08 (Sep 26, 2008)

JPINFV said:


> Bolded the important part because that patient would have been considered to have a legal DNR (family request to withhold resuscitation) where I worked.
> 
> 
> 
> "I don't want to go on the cart."



Thats kinda scary, like what if the family is waiting to move in on Grandmas savings accounts and now that shes in arrest ask you not to do it? Or people changing their mind later saying NOOOO I WANTED HER WORKED.

In Florida you HAVE to have the DNR, on its colored paper, signed. If you dont have it, you have to work it unless there are obvious signs of death like a missing head, dependant lividity, or rigor. Even then, only certain protocols allow the paramedics to call it. And in return, if they have a valid one the family cant suddeny decide, no, I want you to save her. Well if you wanted that then why did you show the DNR??


----------



## JPINFV (Sep 26, 2008)

MissTrishEMTB08 said:


> Thats kinda scary, like what if the family is waiting to move in on Grandmas savings accounts and now that shes in arrest ask you not to do it? Or people changing their mind later saying NOOOO I WANTED HER WORKED.



Any disagreement or concern over the wishes of the family means that the decision on DNR gets kicked up to medical control and the patient worked pending the outcome. Of course if the family is trying to get Grannie's savings accounts, then why call EMS to begin with? As far as people changing their minds, the first thing that goes in my narrative is "Pt DNR per _____, patient's [relationship]" followed by the relative's signature AND that relative gets to sign the runsheet at the bottom as well. It's great for hospice discharges.


----------



## Flight-LP (Sep 26, 2008)

MissTrishEMTB08 said:


> Because the patient technically didnt have a valid DNR. The family couldnt locate it, so when she died she should have been worked but instead my partner illegally chose to let her die and got a copy of the DNR that was signed after she was already dead.
> 
> Edited to clarify, after she was already dead for a couple of minutes and before anyone knew she was dead except the RN at the hospice house is when hospices DNR got signed. We waited around in her room with the nurse, and the door closed for about 20 minutes and then OOPS LOOK SHE DIED to cover his butt.
> 
> Edited again to add, Im sure the husband probably already knew she was dead, but still.



Yea it would have been nice to have the papers, but what your partner did (more specifically didn't do), was exactly as the pt. wished. THE PT. WAS A HOSPICE PT! They do not go to hospice as a full code. They do not want to be worked. There is advanced directive paperwork, durable power of attorney's, and DNR's stating that very thing. The cookbook attitude of "if I don't have the papers I have to work him/her" is total b.s. Ask the family their wishes, contact the physician, contact the hospice, they will have the precious piece of $.05 paper that you see as the ultimate decision whether or not to resuscitate a person that does not wish to live. 

Even outside of the whole "my issues" drama that you are having difficulties with, you seem to be clueless to a large aspect of your job. If the hospice pt's. are a large percentage of your population, then maybe you need to research a little into their operation; how they work and what they are about. The hospice folks know what they are doing; they look at all aspects from family to quality of life. It is not your place to worry about who gets access to grandma's money and your opinion on the matter is again irrelevent. Focus on what needs to be done, i.e. learn your job without all these personal opinions, feelings, and emotions. Listen to what others have to say. You may not like it, it may not be correct, but at least listen to it. Otherwise, your EMS career will be short lived. That my dear, is a guarrantee......


----------



## Hastings (Sep 26, 2008)

Flight-LP said:


> Yea it would have been nice to have the papers, but what your partner did (more specifically didn't do), was exactly as the pt. wished. THE PT. WAS A HOSPICE PT! They do not go to hospice as a full code. They do not want to be worked. There is advanced directive paperwork, durable power of attorney's, and DNR's stating that very thing. The cookbook attitude of "if I don't have the papers I have to work him/her" is total b.s. Ask the family their wishes, contact the physician, contact the hospice, they will have the precious piece of $.05 paper that you see as the ultimate decision whether or not to resuscitate a person that does not wish to live.



Wanted to add that from a legal perspective, you can be in as much trouble for working someone without a written DNR in situations similar to this one. Use common sense. I know of one instance where a medic was sued by a family for successfully working a hospice patient that died en route. Seriously. Even though there was no paper, the family argued that it had been implied under the circumstances and expressed by those involved. I can't say how it turned out, but just know that it's not always so by-the-paper. I think it this specific case, your partner did the right thing, though it's not the textbook answer from EMT/Medic school.


----------



## daimere (Sep 26, 2008)

In the state of Kentucky, you have to have an EMS DNR which also has a slip of paper you can put in a plastic bracelet.  If you don't have the DNR or right DNR, the EMS will have to do it.


----------



## reaper (Sep 27, 2008)

MissTrishEMTB08 said:


> In Florida you HAVE to have the DNR, on its colored paper, signed. If you dont have it, you have to work it unless there are obvious signs of death like a missing head, dependant lividity, or rigor. Even then, only certain protocols allow the paramedics to call it. And in return, if they have a valid one the family cant suddeny decide, no, I want you to save her. Well if you wanted that then why did you show the DNR??




Hate to tell you, but in FL the direct family can and does over turn a DNR. It does not matter if you have the original in hand. If the husband would have stated that he wanted her worked, then you have to work them. Most "good" systems in FL, also have protocals for hospice pt's. They are in hospice to end life peacefully. If the family or staff state that there is a DNR present on a hospice pt, but cannot find the original, a lot of systems are setup to honor that verbal DNR. 

The pt you had was unable to make medical decisions at that time. I would have asked the husband what he wanted and honored that request. Your partner did the right thing!


----------



## Sasha (Sep 27, 2008)

Flight-LP said:


> Yea it would have been nice to have the papers, but what your partner did (more specifically didn't do), was exactly as the pt. wished. THE PT. WAS A HOSPICE PT! They do not go to hospice as a full code. They do not want to be worked. There is advanced directive paperwork, durable power of attorney's, and DNR's stating that very thing. The cookbook attitude of "if I don't have the papers I have to work him/her" is total b.s. Ask the family their wishes, contact the physician, contact the hospice, they will have the precious piece of $.05 paper that you see as the ultimate decision whether or not to resuscitate a person that does not wish to live.
> 
> Even outside of the whole "my issues" drama that you are having difficulties with, you seem to be clueless to a large aspect of your job. If the hospice pt's. are a large percentage of your population, then maybe you need to research a little into their operation; how they work and what they are about. The hospice folks know what they are doing; they look at all aspects from family to quality of life. It is not your place to worry about who gets access to grandma's money and your opinion on the matter is again irrelevent. Focus on what needs to be done, i.e. learn your job without all these personal opinions, feelings, and emotions. Listen to what others have to say. You may not like it, it may not be correct, but at least listen to it. Otherwise, your EMS career will be short lived. That my dear, is a guarrantee......



Ok I was gonna stay out of this because when I was in school, I was actually classmates with MissTrish, she introduced me to EMT life amd we talk almost daily.

Not working a patient with out a valid DNR in hand is not a personal opinion, according to our text books and Florida state law you HAVE to work them, no ifs ands or buts. Seriously, if that husband wanted to come back and sue the pants off of her company and the EMT himself then yeah, he would totally have grounds too. Why? Because they had no DNR in hand. In Florida, it doesnt matter if they cant find it, then as far as the EMS provider is concerned they do not have one. Period. End of story. If you do not work a cardiac arrest with out a DNR you can and probably will lose your license if it ever gets brought up.

At that point, with no DNR, it doesnt matter what the family wants, that patient is getting worked all the way to the nearest hospital.


----------



## reaper (Sep 27, 2008)

Read above posts!


----------



## Ridryder911 (Sep 27, 2008)

Amazing those that have very little to no experience and education attempting to describe what to do versus those with experience and higher education and license. 

Anyone can sue for anything. Heck, they can sue for the remark that was made to the nurse. 

R/r 911


----------



## Sasha (Sep 27, 2008)

Ridryder911 said:


> Amazing those that have very little to no experience and education attempting to describe what to do versus those with experience and higher education and license.
> 
> Anyone can sue for anything. Heck, they can sue for the remark that was made to the nurse.
> 
> R/r 911



So experience gives you the right to ignore laws?


----------



## reaper (Sep 27, 2008)

Again, read posts and understand the laws!


----------



## Sasha (Sep 27, 2008)

reaper said:


> Again, read posts and understand the laws!



I do understand the laws, exactly as our text book states them and exactly what I was told by the state medical director when I asked a question during our practical exams.

No DNR? Work them. Plain and simple.


----------



## MedicPrincess (Sep 27, 2008)

MissTrishEMTB08 said:


> In Florida you HAVE to have the DNR, on its colored paper, signed.


 
No so fast ma'am. That is the textbook/correct answer for the state test. If you are transferring a patient from one medical facility to another you can get by with a white copy/or no copy. Thats what protocols and medical control are for.




> And in return, *if they have a valid one the family cant suddeny decide, no, I want you to save her.* *Well if you wanted that then why did you show the DNR*??


 
I once had a daughter tackle me to the ground as I went to get up from my knees, after the mans wife had presented the DNR. She was screaming thats not what he actually wanted. After having my new found "friend" pulled off me, a very short discussion ensued with her and the wife, and long story short.... we worked the heck out of him.

Why'd they show the DNR? Who knows? But the point is, The DNR is not neccessarily the be all/end all in some terrible heartbreaking cases.


MissTrish- in one of your posts you mentioned being a medic student? How long did you WORK as an EMT before starting medic school? I specifically say WORK, because working as an EMT and just having your card but doing something else is different.

I think, especially since your on a BLS truck now, once you finish Paramedic school and get out on the road you will have the same OMG moment a lot of new (and even old ones still can have) Paramedics have had. OMG this isn't what they taught us to do in school! OMG this is a crappy decision I have to make, and nobody will be happy with it! OMG I have to decide whether or not to work this fairly young person who is clearly dead but the people around are begging me to do something. OMG why is everyone looking at me.... OMG OMG OMG I AM the ONLY paramedic on this scene and my EMT is even newer at this than I am and all I have with me are volunteers that aren't even first responders yet!!!! 

You going to have repeated OMG Moments. The key is to being able to remained focused on whats best for your patient and their health.


----------



## Flight-LP (Sep 27, 2008)

Sasha said:


> So experience gives you the right to ignore laws?



Not in any sense, but it does provide for one thing you young and extremely impressionable EMT's do not have. Its called the ability to use common sense, critical thinking, and combine both into a collaborative level of care.

You, my dear, are wrong in your ascertation that every pt. in cardiac arrest and not in possession of a DNR has to be resuscitated. Two prime examples:

1. Trauma arrests and 2. Pts. with a presentation incompatable with life. 

Neither pt. is an appropriate candidate for CPR and the professional organziations know it; they are the ones who advise the individual medical directors and assist in the development of protocols. They are one's who utilize evidence based research to make the determination of what is best for the overall population of patients. That is a representative example of medicine.

Get rid of the darn textbook. It is generic and does not meet the above criteria. I don't give a rat's a$$ what the textbook says, I want a medic who can explain the rationale and why's of pt. care. Not someone who can read left to right and realize that words make a sentence and that sentences make a paragraph!

If you want to be successful as a medic, you need to know the hows and whys, not just the whats...........................................

Besides, even if they did drop right in front of you, all you would have to do is pick up the phone, call medical control, and explain that a hospice pt. has passed. No MD in his or her right mind is going to overrule an advanced directive, durable POA, or hospice order. I haven't seen one in 17 years, I'd be interested to hear other views (Vent - calling you specifically as you would really be able to provide some professional insight and experience in this matter)


----------



## Ridryder911 (Sep 27, 2008)

As one that provides and writes & reviews for many of those textbooks, I ask this; Do you have a specific textbook ..just for Florida? Then you need to review and read again. 

No experience, does not make me right. Knowing the general law and having multiple degrees and experience in this speciality does. Especially in regards to a student and over those that lack clinical and expertise in this matter. 

Did somewhere in your training, they failed to teach the ability to use critical thinking skills, that everything is not black & white? That there is "_undue influence"_that can occur. That the Paramedic can be held as responsible for resuscitating the patient as much as NOT resuscitating the patient. That the Paramedic held undue considerations of the patients wishes and wants, even after being informed from the family and knowingly that the patient had a terminal illness or disease process? 

That the EMS service can be held liable for going against the wishes of the deceased for causing undue monetary and emotional stress on the family? Did all measures performed, did so to ensure that the wishes of the patient were carried out? 

The same if he/she had not resuscitated the patient. 

Again, the law and alike life is not black and white. You can't always have it your way. You can be damned from either side. Dependent on the view, if you will get screwed or not. Sure we teach to favor on the side of the patient. That is the best CYA. 

In real clinical practice, one does what is best for the patient and at the current time. Again, a Paramedic should have access to a licensed physician. Obtain a verbal order. It's not hard to do, I do it daily. 

As well, as not resuscitating someone (unless it is special circumstances) that has been down > 15 minutes. No, I never hook up an ECG to determine death either. Why? If I need that to determine their dead, I should be working them. 

*Textbooks are suggested guidelines and standards*. They are a reference point, not the end all and exact. Again, a beginning not the end. 

Listen to those that have progressed passed the naivete's of a student. We are attempting to teach you. 

R/r911


----------



## Foxbat (Sep 27, 2008)

LucidResq said:


> Whether it's listening to a horribly boring and long story, answering painfully awkward questions, helping a nurse shove a bed pan under a 300 lb + woman's bum so she can go pee, *being swung at by drunk woman*, being hit on by a man old enough to be your grandpa, listening to the relentless screeching wails of a sick baby, smelling the most horrid things smell-able on Earth or having some old woman put her hand on your leg for a little... it's kinda part of the job, and as others have said, having an old lady touch you in a kind, non-sexual way is pretty low on the list of "discomforting things that patients do to EMS providers" for most people.



I agree with you - except that one phrase.
I think there is a huge difference between a patient being combative due to his/her illness and a drunk S. o. B. who takes a swing at you because he/she can. The latter should be prosecuted so next time he or those like him will think twice before attempting something like that.
Risk of being attacked/abused is an inherent risk in EMS, as the risk of being injured is in the fire service. This does not mean that arsonists should not be punished or that attacking EMS provider should be tolerated because it is "part of the job".


----------



## reaper (Sep 27, 2008)

I agree, but you will hardly ever get a conviction on the charge. A "drunk" is under the influence of a mind altering substance. Any Good attorney can argue that the Pt did not know what they were doing.

If the drunk Pt is to combative, then let LEO handle it. If they are calm or just Aholes, then don't antagonize them. A lot of people in EMS push these people to being combative. They like to "mess" with the drunks and end up pissing them off.


----------



## Hastings (Sep 27, 2008)

Ridryder911 said:


> As well, as not resuscitating someone (unless it is special circumstances) that has been down > 15 minutes. No, I never hook up an ECG to determine death either. Why? If I need that to determine their dead, I should be working them.



I agree with most of what was said except for this section. My advice, though coming from someone much less experienced than others, is ALWAYS to obtain an EKG strip from a patient no matter how dead they appear or what the circumstances are. There is no downside. It is vital in covering your ***. Always confirm death with the EKG and always have the proof. Make a habit of hooking the EKG up to every patient, even if you've already made the decision not to work them.


----------



## Epi-do (Sep 27, 2008)

Hastings said:


> I agree with most of what was said except for this section. My advice, though coming from someone much less experienced than others, is ALWAYS to obtain an EKG strip from a patient no matter how dead they appear or what the circumstances are. There is no downside. It is vital in covering your ***. Always confirm death with the EKG and always have the proof. Make a habit of hooking the EKG up to every patient, even if you've already made the decision not to work them.



"Always," just like "never," is an absolute and we all know there are no absolutes in EMS (or life, for that matter).  What is the point of putting the monitor on a patient that is rigored or has lividity present?  What about the trauma patient that has obvious injuries incompatible with life?  Certain patients are so blatently beyond any hope of even thinking about working them that applying the monitor really serves no purpose.  Sorry, but I have to agree with Rid on this one.  Using the monitor to confirm death just doesn't make alot of sense.


----------



## Hastings (Sep 27, 2008)

Epi-do said:


> "Always," just like "never," is an absolute and we all know there are no absolutes in EMS (or life, for that matter).  What is the point of putting the monitor on a patient that is rigored or has lividity present?  What about the trauma patient that has obvious injuries incompatible with life?  Certain patients are so blatently beyond any hope of even thinking about working them that applying the monitor really serves no purpose.  Sorry, but I have to agree with Rid on this one.  Using the monitor to confirm death just doesn't make alot of sense.



I absolutely EKG patients in Rigor or with other obvious signs of death, even though I know I will not be working them. Why? There is no reason not to. It is proof of death. Sure, you know they're dead. But now you can prove it to someone else. It's lazy not to do it, and reckless in this profession.

Hook up every patient to confirm death. EVERY. ALWAYS. I have no fear in using those terms in this case. The reason is that even though YOU don't need the confirmation, others may. Better to have it.

Except decapitation.


----------



## Epi-do (Sep 27, 2008)

While I can understand what you are saying, I guess we are just going to disagree on this one.  I just really feel that if there are obvious signs of death, a well written narrative documenting what was found upon arriving at the patient's side is all that is needed.


----------



## Hastings (Sep 28, 2008)

Epi-do said:


> While I can understand what you are saying, I guess we are just going to disagree on this one.  I just really feel that if there are obvious signs of death, a well written narrative documenting what was found upon arriving at the patient's side is all that is needed.



I'm somewhere between the two extremes expressed in this thread. I recognize the importance of critical thinking and common sense and realize that each situation needs to be taken as an individual case, but I also have the medic school philosophy of do absolutely everything you can to cover your *** no matter how unnecessary it seems. And obvious DOAs fall under that catagory. I know they're dead. I can justify why I didn't work them to my boss, my co-workers, or a review board. However, I want that extra bit of physical proof to be able to prove it to someone without any type of medical knowledge. I'm usually not a fan of "because we can" thinking, but in this case, it's foolish and lazy not to do it. It's fast, it's easy, and it has the potential (though 99% of the time, there wont be problems) to save your *** if you're forced into a position of explaining your inaction.


----------



## Ridryder911 (Sep 28, 2008)

My medical director is the one enforcing do NOT hook up to the monitor. (Ever see a pacer fire and the family thinks they have activity?) The theory is if you need a monitor to determine death, you should be working them. An ECG is not going to save your arse if you declare death and they were really alive. No one will get in trouble but the reason being, you bring in a monitor then you should work them. A decision of not working them should be made by obvious reasons.. time of death, obvious signs (levidity), rigor mortis or signs of incapability of life (decapitatation). All conclusive signs of death, without use of an ECG. 

If one needs an ECG on a obviously rigored patient, we have a problem. 

I listen for apical heart beat as well as my partner, two set of ears are better than two and document such. We also have a doppler unit, if we want to verify. I have never seen it used.


----------



## piranah (Sep 28, 2008)

*interesting*

not to judge by any means.....I like to be very straight forward and honest and guess what.....there is a mental portion of pt care just as much as physical....i have let old ladies hold my pant leg or talk to me about what they're last words are to their family.....there is a bond between the pt and yourself that is unmatchable.....i find it a honor to be the last person they see before passing...it is a job like none i've ever done....and i love it.....i've spoken to pts about extremely personal things.....ive hugged husbands and been a shoulder for wives.....its part of the job....but just as so you should be empathetic.. hold yourself to be the one who makes them feel secure..............you probably work in the private setting...which is good exp. but you need to get used to comforting ppl...even the family......because the first time you have a child pass with the mother there.........its rough....they are going to need you...and THAT IS YOUR JOB...not only for the child but for the parent/sibling/boyfriend/girlfirend/husband or wife....it is taught in all the BLS,ALS whatever txts.......be ready because its not easy....but be sure to stay professional and upright.....


----------



## Onceamedic (Sep 28, 2008)

MissTrishEMTB08 said:


> McFeely wasn't going home either, she was leaving the hospital to go to the ame hospice(coincidentally in the same room that we dropped the dead one off in.).



Do you read anything that people have tried to say to you?  You're exterior shell is getting thicker and thicker.  I know that there is a caring compassionate person inside you somewhere and I am not sure if it is your youth or your relative lack of experience that makes you come across so callous.  I have a feeling that your experiences in youth have cause you do develop a facade for coping with the world.  Girl - you have a long way to go and this field is going to bring you to a place I'm not sure you want to go.  Take this as the best advice I can give - from someone who is decades down the road ahead of you.


----------



## MedicAngel (Sep 28, 2008)

I have been loathe to respond to this post because of the OP's lack of any compassion and how she phrases things leave much to be desired. Where you drop off the dead ones off?? If you worked on my floor at the hospital we would of already chewed you up and spit you out for how rude you have been! 

While I am still fairly "new" in the EMT world with only 4 years under my belt, I would NEVER be as cold and callous as you have been nor have said what you have said in your posts. If that is what you feel about someone who is in the end stages of their life, perhaps it is better for you to find another area to work in as compassion isn't your forte is it? When I was 20 I started in hospice care as a private CNA and let me tell you, I learned a lot and am very enriched in my life for it. I prefer hospice care over everything else I have done, save being an EMT, and if we would only learn to be tolerant and listen instead of flapping our mouth, we may learn something from that person you seem so loath to let touch you. It was an elderly woman, get over yourself ! 

I can only hope that when it is your turn to die, you get stuck with some lass with your hang ups who treats you like crap and won't take the time to touch your hand or place her hand on yours, look in your eyes, offer up a smile and let them know that they are there for them. Something so simple means so much.  Maybe when your confused and know your dying and no one is there for you, you may get a clue but by then, it will be too late. And stop using your personal problems to justify your ignorance in your job.


----------



## imurphy (Sep 28, 2008)

And really, calling your patient McFeely REALLY stinks of immaturity. Surely too immature to be in charge of peoples lives. 

Honestly Trish, another career may be the best for you and dare I say it, better for your service...


----------



## JPINFV (Sep 28, 2008)

imurphy said:


> And really, calling your patient McFeely REALLY stinks of immaturity.



To be fair, Have you seen the patient's cousin?


----------



## gillysaurus (Sep 28, 2008)

^ Hehehe. I was totally thinking that when I read "McFeely", too!

I actually prefer it when patients place their hands/forearms on my knee. Like when I'm taking a blood pressure, it just seems more comfortable and kind for them to let them know they can rest their hands on my knee and relax while I tell them what I'm going to do. The last thing I want is for a patient to have a bad EMS experience that would have been solely prevented by a little compassion from me. Afterall, when a patient is in the ambulance it is probably one of the worst days they've had in a LONG time.

One of the best calls I've had so far was a transport of an elderly woman with dementia who would not let go of my hand, and even gripped my knee and my cargo pockets. I was in the back with another basic who took vitals while I talked to the woman and let her grip my fingers. Even though she didn't have the foggiest idea what was going on, you could tell she was frightened and really sought comfort in the compassion of one of her caregivers. If I hadn't opened myself up to such a "feely" woman, I would have never had that experience of connecting with a patient and feeling like I made their EMS experience a little more positive, regardless of whether or not she will remember it. And isn't that a lot of what this job is about? Trying to make the best of someone else's terrible situation?

If anything, I sometimes worry that my hand-on-shoulder, reassuring the patient methods are a little too touchy-feely. I try to keep my distance, but sometimes they really do look so scared.

MissTrish, I wish you luck. You've gotten a lot of really harsh comments here but also a lot of really good advice. I hope you take it to heart!


----------



## emtgirl515 (Sep 28, 2008)

I still agree with & think Rid and BossyCow said it best. I am truly sorry for what happened when you were a child. Now, I know I'm just a new EMT w/o much experience I completely admit, so I'm just throwing my newbie 2 cents in. 
Even first going into this field, while I was in school, I was aware *it's about the patients* & pretty much constant contact with them so even by my clinicals I was ready for that....and I think what helped me adjust so quick besides just being a people person is I helped teach preschool before doing this so I was use to people grabbing, peeing, pulling, drooling, taking my hand, awkwardly touching my legs--(think of the height of a 3 y/o), etc. all the time & not necessarily w/ my permission...lol. Yeah, and in my opinion uhh no one is ever really comfortable with the dirty old man who "accidentally" pinches your butt when your detangling O2 tubing, but hey it's part of the package whether you're outgoing or shy. I'd take that or a knee rub anyday over someone: threatening to kick my A**, a drunk, or being combative with feces all over them. Especially when they're alert & know/sense the end is near I would not only allow appropriate physical contact; I consider it part of my job and try to be sincere no matter what is going through my head b/c even an elderly person with dementia can read body language & emotion. Everybody does and should have boundaries especially those that work in this field, but unfortunately not everyone we encounter on a daily basis in it has them (if they ever did). You just have to prepare yourself for that. I think whatever reasons anyone in or considering being in the healthcare field has with physical contact need to be resolved if you are going to stay in it, b/c the majority of patients are going to have hands ^_^


----------



## Sasha (Sep 28, 2008)

MedicAngel said:


> I have been loathe to respond to this post because of the OP's lack of any compassion and how she phrases things leave much to be desired. Where you drop off the dead ones off?? If you worked on my floor at the hospital we would of already chewed you up and spit you out for how rude you have been!
> 
> While I am still fairly "new" in the EMT world with only 4 years under my belt, I would NEVER be as cold and callous as you have been nor have said what you have said in your posts. If that is what you feel about someone who is in the end stages of their life, perhaps it is better for you to find another area to work in as compassion isn't your forte is it? When I was 20 I started in hospice care as a private CNA and let me tell you, I learned a lot and am very enriched in my life for it. I prefer hospice care over everything else I have done, save being an EMT, and if we would only learn to be tolerant and listen instead of flapping our mouth, we may learn something from that person you seem so loath to let touch you. It was an elderly woman, get over yourself !
> 
> I can only hope that when it is your turn to die, you get stuck with some lass with your hang ups who treats you like crap and won't take the time to touch your hand or place her hand on yours, look in your eyes, offer up a smile and let them know that they are there for them. Something so simple means so much.  Maybe when your confused and know your dying and no one is there for you, you may get a clue but by then, it will be too late. And stop using your personal problems to justify your ignorance in your job.



Whoooooa doggy. There seems to be a lot of assumption in this post (Actually, on the entire thread.) 

The OP clearly stated that the woman's patient care didn't suffer and that the patient had liked being transported by her. She stated she wouldn't have minded holding hands. Where did it state anywhere that she didn't maintain eye contact or smile at them? Actually, in later posts the OP states she laughed and joked with her. I've never seen someone who can laugh with out smiling.

Maybe I'm just retarded, but I can't fathom how anyone can equate someone not wanting their legged touched to not having compassion.


----------



## Sasha (Sep 28, 2008)

imurphy said:


> And really, calling your patient McFeely REALLY stinks of immaturity. Surely too immature to be in charge of peoples lives.
> 
> Honestly Trish, another career may be the best for you and dare I say it, better for your service...



Would you have rather her used the patient's real name? Violation of the privacy act, isn't it?


----------



## Sasha (Sep 28, 2008)

Kaisu said:


> Do you read anything that people have tried to say to you?  You're exterior shell is getting thicker and thicker.  I know that there is a caring compassionate person inside you somewhere and I am not sure if it is your youth or your relative lack of experience that makes you come across so callous.  I have a feeling that your experiences in youth have cause you do develop a facade for coping with the world.  Girl - you have a long way to go and this field is going to bring you to a place I'm not sure you want to go.  Take this as the best advice I can give - from someone who is decades down the road ahead of you.



Jesus H. Home girl can't catch a break, can she? What would you have rather her posted? "Layed the dead woman to rest in"? I'm almost certain that's not what happened. I've always heard people say they "dropped their patients off".


----------



## Onceamedic (Sep 28, 2008)

Sasha said:


> Jesus H. Home girl can't catch a break, can she? What would you have rather her posted? "Layed the dead woman to rest in"? I'm almost certain that's not what happened. I've always heard people say they "dropped their patients off".



What are you talking about?  I don't understand your response to a statement I never made.   Please clarify.


----------



## Hastings (Sep 28, 2008)

Ok, to expand on what Sasha said...

There's a bit of an overreaction here. And personally, I'm sick of people posting comments about this not being the proper profession for her. That is completely unnecessary. That might even be true. However, what was posted is NOTHING NEAR the level to which members of this forum should be acting so aggressively towards her. I'd like to consider this as a friendly forum, but there was NOTHING diplomatic or helpful about the responses to someone who is 1. new 2. seeking advice. I know some of you are frustrated with the current state of EMS. I understand that there are people out there that are in the profession for the wrong reasons or have unreasonable expectations. However, the OP is not one of those people. This is not someone who doesn't have compassion. This is someone that is NEW. This is someone that is learning. Instead of suggesting she look into something else, give advice, diplomatically inform her that it's part of the job.

Personally, I'm glad I didn't join this forum while I was still in school. This is not a very friendly forum at times. I know a lot of the older members believe in tough love and all that bit, but there needs to be some diplomacy. I sometimes wonder why many members post once and then disappear, but then I remember just how intimidating it can be at times. Sure, some people need a reality check. But can we try not to completely demolish their spirits while doing so? Again, there is nothing she said that suggests to me that she's in the wrong profession. It suggests to me that she has some learning yet to do, and members of this forum could help if in a slightly more respectful manner.


----------



## reaper (Sep 28, 2008)

That was done, numerous times! It just didn't sink in.


----------



## ffemt8978 (Sep 28, 2008)

Hastings said:


> Ok, to expand on what Sasha said...
> 
> There's a bit of an overreaction here. And personally, I'm sick of people posting comments about this not being the proper profession for her. That is completely unnecessary. That might even be true. However, what was posted is NOTHING NEAR the level to which members of this forum should be acting so aggressively towards her. I'd like to consider this as a friendly forum, but there was NOTHING diplomatic or helpful about the responses to someone who is 1. new 2. seeking advice. I know some of you are frustrated with the current state of EMS. I understand that there are people out there that are in the profession for the wrong reasons or have unreasonable expectations. However, the OP is not one of those people. This is not someone who doesn't have compassion. This is someone that is NEW. This is someone that is learning. Instead of suggesting she look into something else, give advice, diplomatically inform her that it's part of the job.
> 
> Personally, I'm glad I didn't join this forum while I was still in school. This is not a very friendly forum at times. I know a lot of the older members believe in tough love and all that bit, but there needs to be some diplomacy. I sometimes wonder why many members post once and then disappear, but then I remember just how intimidating it can be at times. Sure, some people need a reality check. But can we try not to completely demolish their spirits while doing so? Again, there is nothing she said that suggests to me that she's in the wrong profession. It suggests to me that she has some learning yet to do, and members of this forum could help if in a slightly more respectful manner.



There was a reason I haven't responded to this thread yet but I've been following it closely hoping that it would get back on track.

Yes, some of the posts/comments were very close to crossing the line but none actually did (IMHO).  However, I do believe it's time to give this thread a 24 hour time out to allow everyone a chance to reassess things and cool off a bit.







 for 24 hours.


----------



## Jon (Sep 29, 2008)

I've re-opened the thread.

Remember:


----------



## Ridryder911 (Sep 29, 2008)

Hastings said:


> Ok, to expand on what Sasha said...
> 
> There's a bit of an overreaction here. And personally, I'm sick of people posting comments about this not being the proper profession for her. That is completely unnecessary. That might even be true. However, what was posted is NOTHING NEAR the level to which members of this forum should be acting so aggressively towards her. I'd like to consider this as a friendly forum, but there was NOTHING diplomatic or helpful about the responses to someone who is 1. new 2. seeking advice. I know some of you are frustrated with the current state of EMS. I understand that there are people out there that are in the profession for the wrong reasons or have unreasonable expectations. However, the OP is not one of those people. This is not someone who doesn't have compassion. This is someone that is NEW. This is someone that is learning. Instead of suggesting she look into something else, give advice, diplomatically inform her that it's part of the job.
> 
> Personally, I'm glad I didn't join this forum while I was still in school. This is not a very friendly forum at times. I know a lot of the older members believe in tough love and all that bit, but there needs to be some diplomacy. I sometimes wonder why many members post once and then disappear, but then I remember just how intimidating it can be at times. Sure, some people need a reality check. But can we try not to completely demolish their spirits while doing so? Again, there is nothing she said that suggests to me that she's in the wrong profession. It suggests to me that she has some learning yet to do, and members of this forum could help if in a slightly more respectful manner.




If I came across rough.. so be it. We have to much "touchy, feely, sensitive" feelings to those that plan to enter the profession and workplace. When did it change that this profession was for everyone? 

Sorry, I personally would advise any student to seriously consider entering a profession when this is part of and demand of the job. By not informing would be injustice not just to her but the profession and future patients. 

If this was posted by a CNA in a nursing home, I am sure that the replies would be more brutal. can one imagine reading a statement of "OMG, my patient touched me!" Then to continue informing on how they have personal issues in regards to being touched. Nothing wrong with that, but being in the people and touchy business, one has to expect being touched and touching back. Again, as repeatedly posted, its part of the job. 

I much rather blast someone on the forum and inform them, and hope that they will re-consider their actions and future than to enter only to drop out because they could not handle it. Yes, its that serious especially with other actions and discussion. It is the reason that all students should be informed of the job demands as well as be properly screened. 
Would it cause an increase in shortage.. so what? I much rather have those that are suited for the job, than those that will only take up space and attempt at the job. 

Somewhere we lost the ability to be honest with each other. Not everyone is cut out for this job, as other professions have demands that not everyone can perform also. It is NOT being rude, or mean just another form of us caring enough, we want the best for everyone. 

R/r911


----------



## Guardian (Sep 30, 2008)

touchy touchy, its not about you, its about the pt, get out of our profession you heartless....check

more education and critical thinking skills.....check

textbook and protocols vs guidelines.....check

don't run ekg on DOA.....check

local dnr clarifications......check

finale: rid gives us some straight talk so we can do some soul searching and we’re all a little better off for it……check




She has now run her predictable course, lock this baby down for good jon.


----------



## SmokeyBear (Sep 30, 2008)

IMHO this is a good time to educate. Granted *submitter* came across in an unusual way but, the "OMG's" and the "!!!!" may be just a generational way of talking. Seriously. One of my old partners made a habit of "O-M-G'ding" everything from taking out the stretcher to traffic. But, she was a hell of a paramedic. 

As I stated in a previous post there are many reasons a patient may grab someones knee: a need for comfort, fear, anxiety or simply because of your position relative to the stretcher. People do have their boundaries and although I _don't_ agree with *submitter*, she (or he) does have options. Here are a few:
1) Sit at the head of the stretcher 
2) give the patient a "bunkie" (or blanket) to hang on to 
3)  if the patient grabs your knee hold their hand instead 
4)  if you don't want to hold their hand pat their arm...

if none of these options appeal to *submitter* than he (or she) may wish to *reevaluate *their reasons for being in the profession or seek advice from their supervisor.


----------



## LAnel1 (Sep 30, 2008)

Flight-LP said:


> Just wait until you get the happy drunk patient. Touching your leg will be the least of your concerns................................
> 
> BTW - Ummmm, hospice pts. typically go to hospice for one reason and one reason only; to die. With this knowledge in mind, why would one even ask the case worker if the pt. could possibly "conk". Of course she could, will that change you transporting, not in the least bit. I would probably be a little annoyed too if I were the case worker.......................



Haha... i'll have to agree with that. I've had wayyy too many of those "happy" drunks, lol. "Are you in any pain tonight?" "No, but I'm horny." ... cute, huh? I love when I'm working w/ a guy and they'll make up a lie, like, they're my fiance, or b/f... like it'll actually make the drunk keep his mouth shut and his hands to himself. Honestly, I'm just used to it now. I don't think I'd mind an old woman putting her hand on my knee... maybe next time, it would be better to just actually hold her hand if she just needed comfort. 

And yes... I def. agree w/ the second part of what this quote says. They've already thought about all that... they don't care... they just need this woman transported. My philosophy: I get paid by the hour... I do what they say, when they say it, and that's that.


----------



## Claren (Sep 30, 2008)

This reminds me of a Facebook group I saw the other day. It was titled "I tried to make out with the EMT when I was taken to the ER for alcohol poisoning".

There was a thread on the group forum, started by the girl whose antics had resulted in the creation of the group. She had posted: "Ahem... I did not try to make out with the EMT, I -Did- make out with him, activated charcoal mustache and all."

It got a good laugh out of me.


----------



## cricketfire46 (Sep 30, 2008)

your job when transporting the pt is to keep them comfortable. if they are a hospice pt then this is especially important. if they want to keep their hand on your knee and it keeps them comfortable then let it happen. it doesnt hurt you in any way so why let it bother you


----------



## imurphy (Oct 1, 2008)

I think this thread has run it's course IMHO. Now it's just.....







Think it should be locked......


----------



## Onceamedic (Oct 1, 2008)

Its one thing to beat a dead horse..  around here we like to kick the farts out of it.....


----------



## Sasha (Oct 1, 2008)

imurphy said:


> I think this thread has run it's course IMHO. Now it's just.....
> 
> 
> 
> ...



Then why did you bring it back to the top of this list?


----------



## Robby1974 (Oct 4, 2008)

Flight-LP said:


> What part of this are you having difficulty comprehending? HOSPICE PTS. DIE! They can do so at any time, not a damn thing you can do about it. If they do, you simply follow your SOP's for a deceased pt. It's not your decision, you cannot decide how you will and won't transport, and you certainly have no right to question someone who knows a whole heck of a lot more about this pt. than you do.
> 
> Sometimes we need to put our personal insecurities aside and see things for what they really are. As previously pointed out, this industry is not about you. You are a servant to the patient. Looking at it in any other fashion is self serving and really inapporpriate.
> 
> Honestly, either get over it or revisit yourself and your future in EMS.....................



Well put! I have to say I agree. If you have (and I quote) "very very very very personal issues with your legs being touched"
Then perhaps being an EMT on an ambulance or transport rig is not for you. There are certainly other jobs available to EMT's outside ambulance or transport. Just my little ole opinion though not saying that you're a bad EMT or did anything wrong.


----------



## Robby1974 (Oct 4, 2008)

OK so I was in the middle of reading replys on this thread and thought I would post. Now however it looks like it has been discussed PLENTY  sorry about the beating of the equestrine animal while it was already well into rigor.


----------

