# Medic dumps patient off gurney on purpose



## waaaemt (Jun 13, 2015)

I'm sure we've all fantasized about it but what was going on in this dude's life to make him actually snap and do it? 

http://m.clickorlando.com/news/brev...disabled-patient-has-charges-reduced/33554616


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## chaz90 (Jun 13, 2015)

Uhh...I've had plenty of difficult patients, but I can't say I've ever been tempted to intentionally flip one off my stretcher. 

No idea what was going on with this guy, but that kind of temper and loss of self control is inexcusable. I don't like to judge, but it seems termination and criminal charges were appropriate here.


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## Underoath87 (Jun 13, 2015)

That pt must be a real joy to deal with...


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## JPINFV (Jun 13, 2015)

Underoath87 said:


> That pt must be a real joy to deal with...


The paramedic too...


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## joshrunkle35 (Jun 13, 2015)

The medic should be charged with battery


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## Uclabruin103 (Jun 15, 2015)

Oh the stretcher was hardly high at all.  People need to be responsible for their actions.  The medic is losing his job, and the patient probably was being an ***.


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## cprted (Jun 15, 2015)

Uclabruin103 said:


> Oh the stretcher was hardly high at all.  People need to be responsible for their actions.  The medic is losing his job, and the patient probably was being an ***.


That is absolutely no excuse for the Paramedic's action.


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## SeeNoMore (Jun 16, 2015)

Uclabruin103 said:


> Oh the stretcher was hardly high at all.  People need to be responsible for their actions.  The medic is losing his job, and the patient probably was being an ***.



What a sad opinion.


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## joshrunkle35 (Jun 16, 2015)

Uclabruin103 said:


> Oh the stretcher was hardly high at all.  People need to be responsible for their actions.  The medic is losing his job, and the patient probably was being an ***.



I agree that people need to be responsible for their actions. The guy who said something stupid should be responsible for what he said, however, we in EMS are not the hand of Karma or Justice. We aren't the ones to hold people responsible. We are patient advocates, and you seem to have forgotten that.


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## SeeNoMore (Jun 16, 2015)

joshrunkle35 said:


> I agree that people need to be responsible for their actions. The guy who said something stupid should be responsible for what he said, however, we in EMS are not the hand of Karma or Justice. We aren't the ones to hold people responsible. We are patient advocates, and you seem to have forgotten that.


 
Exactly. This isn't Bringing out the Dead. Settle down Heroes!


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## Angel (Jun 17, 2015)

SeeNoMore said:


> What a sad opinion.



why?


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## Tigger (Jun 17, 2015)

Does it matter how the patient acted? At what point would it ever be ok to toss a patient the floor in this scenario.

There are few times for the word never, this may be one of them.


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## SeeNoMore (Jun 17, 2015)

Angel said:


> why?


 
Responding to a Paramedic flipping a patient off of a stretcher with the sentiment "Oh the stretcher was hardly high at all" and suggesting that the patient was in some way getting what they deserved is absurd. It's immature and pathetic.

It's troubling that you would have to ask.


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## Handsome Robb (Jun 17, 2015)

Tigger said:


> Does it matter how the patient acted? At what point would it ever be ok to toss a patient the floor in this scenario.
> 
> There are few times for the word never, this may be one of them.



If they were trying to cause harm to me or my partner it's perfectly appropriate. Outside of that never.


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## Angel (Jun 17, 2015)

the stretcher wasnt high...and he said people are responsible for their actions. not sure what else you want?


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## SeeNoMore (Jun 17, 2015)

Angel said:


> the stretcher wasnt high...and he said people are responsible for their actions. not sure what else you want?


 
I don't want anything. I said the post was sad.


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## SandpitMedic (Jun 17, 2015)

That's crazy. He was fired as he should have been. I think this displays a deep lack of professionalism and a total loss of self control; completely shameful action here. That medic has no place in this business, I don't care if you're on for one year or twenty years - it is never okay to act like that. I have difficult patients all the damn time - suck it up. And if you're too burnt then move on.


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## OnceAnEMT (Jun 17, 2015)

Handsome Robb said:


> If they were trying to cause harm to me or my partner it's perfectly appropriate. Outside of that never.



Stretcher fire?

It's things like this that'll kill the decent light shed on EMS/Fire.


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## mgr22 (Jun 17, 2015)

Handsome Robb said:


> If they were trying to cause harm to me or my partner it's perfectly appropriate. Outside of that never.


So...say you've got this patient on your stretcher. What would be an example of how the patient might be trying to cause you or your partner harm that would cause you to dump him off the stretcher?


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## PotatoMedic (Jun 17, 2015)

mgr22 said:


> So...say you've got this patient on your stretcher. What would be an example of how the patient might be trying to cause you or your partner harm that would cause you to dump him off the stretcher?


He pulls a gun.

Note I am not condoning any action made and admit my reason is extreme.


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## gotbeerz001 (Jun 17, 2015)

The medic is wrong. Period.


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## Angel (Jun 17, 2015)

Meh


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## Tigger (Jun 17, 2015)

If he pulls a gun or tries to harm me from the cot I'm just going to leave. Not get closer and tip the cot over. 

But yea. "The cot wasn't high."

And that matters how?


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## SeeNoMore (Jun 17, 2015)

It matters because some EMTs feel that a few months/years of rudimentary education and driving the truck really fast entitles them to act like judge and jury. So in their minds the patient was "acting like an *******" and "the cot wasn't even that high" so they would be justified in acting in any manner they chose. We all know people like this with stupid war stories about how they have treated patients and other caregivers awfully. We are supposed to be professionals. That should mean something.


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## joshrunkle35 (Jun 17, 2015)

Tigger said:


> If he pulls a gun or tries to harm me from the cot I'm just going to leave. Not get closer and tip the cot over.



Maybe, maybe not. Tipping over the cot of a person who suddenly has a gun and intends to use it on you might disrupt their OODA loop and buy you time to escape, rather than them just shooting you in the back as you run away. 

My point being: I agree with both of you. The idea is to get away from dangerous people. We're not the cops. Most EMS in most states are not armed or trained to deal with an armed person. The safest action is to leave. However, occasionally, the correct action to take in order to escape as quickly and safely as possible can sometimes be distracting someone as you safely run away, or momentarily engaging them in order to buy you or your partner the ability to get away safely. 

Essentially: Harm no patient unless failing to do so would present a risk to your own life. I agree with both of you.


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## joshrunkle35 (Jun 17, 2015)

SeeNoMore said:


> We are supposed to be professionals. That should mean something.



I totally agree...sorry to sound like a broken record (from other threads), but seriously, the thing that will help take EMS personnel into the area of actually being "professionals", is a standard of education that requires a college degree. 

It's not true 100% of the time, but my subjective experience in EMS has been that typically the people that seem to have very strong ethics and personal codes within EMS have some sort of degree, or an extreme amount of significantly unusual training/experience (FP-C for 20 years, etc). Or, people who watch another person on their department get "railroaded" for something they thought was no big deal...so they slowly change their tune and seek out new training and new standards as a result. 

The ones who are super casual about their patient contacts typically seem to have less training/learning/schooling. 

I think it comes about from some sort of Dunning-Kruger effect, but obviously (thank God!) I am not a psychologist. 

Obviously this is not always true, just my own personal, subjective experience, and my own cognitive biases.


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## mgr22 (Jun 17, 2015)

FireWA1 said:


> He pulls a gun.
> 
> Note I am not condoning any action made and admit my reason is extreme.



Well...thanks, I did ask  I'm just trying to wrap my head around dump-the-patient-off-the-stretcher as a defensive maneuver.


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## Uclabruin103 (Jun 17, 2015)

You all are so easy to get a rise out of.  His actions were totally inexcusable.


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## SeeNoMore (Jun 17, 2015)

You're incredibly funny. Thanks


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## Angel (Jun 17, 2015)

Um fire is seen as professional. This guy works / worked for a fire dept. So what does any of this have to EMS and professionalism?


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## SeeNoMore (Jun 17, 2015)

I am not quite sure what you are asking. Surely you see the connection between this incident and professionalism in EMS.


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## Tigger (Jun 17, 2015)

Angel said:


> Um fire is seen as professional. This guy works / worked for a fire dept. So what does any of this have to EMS and professionalism?


A firefighter operating an ambulance dumps a patient to floor and that doesn't make EMS look bad how?

Fire is not magical.


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## SeeNoMore (Jun 17, 2015)

Angel, you seem ambivelent about the criticism this Paramedic has recieved. Why is that? I am honestly curious, no sarcasm or offense implied.


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## FiremanMike (Jun 18, 2015)

Has anyone stopped for a minute and consider that this medic is at the end of his rope, burnt out, and possibly working in a malignant department with no support system?

Anyone who's worked in an urban environment can understand how a situation like this can brew over the course of several years of dealing with difficult patients.  Dumping the patient was wrong, but I'm not immediately in the camp of "screw this guy, fire him, charge him, flog him, etc".  I'd at least like to get to the cause and see if this guy is salvageable.

Now, does being an urban medic make you superman?  No, of course not.  I know morons, *******s, and just generally terrible medics who remain terrible despite taking 20 calls per day.  I've also met truly brilliant providers who are so burnt out from abuse that they could find them self in this guys shoes, should their "give a damn" ever finally break.


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## BOS 101 (Jun 18, 2015)

Normally I like to give the benefit of the doubt and all that but no I really can't find a reason to excuse it here.
I do think he should be fired and all that because when you go into ems you are there to help, not hurt.  And you get an idea of how difficult patients can be before you ever get there so theres no surprise of anything.  Burnt or not theres no excuse, I mean pushing the gurney over is a really obvious line, hard action to make accidentally without intent you know? I know some patients deserve it, but that doesnt mean I get to do it to them.  How can you be a medical professional and be responsible for people when you're willing to toss them on the ground?  It's just not right.
I would not imagine he is salveable, and regardless of if he is normally a good guy or whatever, no one would ever or should ever trust him with patient care again.  It's his reality now, due to his actions.
I also agree with the whole gun thing above, thats your only excuse, self defense in a dire scenario.


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## Tigger (Jun 18, 2015)

Being burned out and working for a crappy employer is not a good place to be. 

Still doesn't justify assaulting the patient. At the end of the day you are accountable for your own actions no matter how terrible your environment is.


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## BOS 101 (Jun 18, 2015)

Tigger said:


> Being burned out and working for a crappy employer is not a good place to be.
> 
> Still doesn't justify assaulting the patient. At the end of the day you are accountable for your own actions no matter how terrible your environment is.


 Yup, cant really shake the blame for pushing someone on the ground
It is battery after all, and being a medic doesnt allow you to do that


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## FiremanMike (Jun 18, 2015)

Please re-read my post.  I'm not saying he's justified, just offering an explanation.

And what if this is his first screw up?  "Never trust him again" seems a bit far based on a short video clip on the Internet with 0 context..


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## Tigger (Jun 18, 2015)

FiremanMike said:


> Please re-read my post.  I'm not saying he's justified, just offering an explanation.
> 
> And what if this is his first screw up?  "Never trust him again" seems a bit far based on a short video clip on the Internet with 0 context..


I think your explanation is perfect viable and close to the truth. 

But at a certain point does it matter? Individual accountability before all else.


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## SeeNoMore (Jun 18, 2015)

It could be that he snapped from the stress of the job. If so I am sorry. That is rough. It also could be that he honestly felt that the patient deserved what he go for daring to question him. I think a holier than though attitude is too common in EMS. Either way, if you tip a patient off of a stretcher you are done.


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## DrParasite (Jun 19, 2015)

Sorry, but I don't care what the his reasoning was.... there is absolutely no reason to EVER flip the patient off the stretcher.  You can make excuses all you want, but in the end, the paramedic deserves to lose his job, and deserves to lose his career.  

Not sure if he should be in jail, but I wouldn't object to him having a criminal record after this.  After all, his actions were criminal.

I don't care how much of an *** the patient is (and I have dealt with more than my share) the medics actions are completely uncalled for.

The other question is, how often do events like this occur, only nothing ever happens, because they aren't captured on video?


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## Angel (Jun 19, 2015)

Probably about as much as police killing unarmed civilians and saying it was self defense -.-


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## FiremanMike (Jun 19, 2015)

Oh, didn't realize that this one was one of those forums.. 

I'm out.



Angel said:


> Probably about as much as police killing unarmed civilians and saying it was self defense -.-


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## Angel (Jun 19, 2015)

Bye? Why the melodramatic post...


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## joshrunkle35 (Jun 19, 2015)

Angel said:


> Probably about as much as police killing unarmed civilians and saying it was self defense -.-



WTF?!?


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## Handsome Robb (Jun 20, 2015)

mgr22 said:


> So...say you've got this patient on your stretcher. What would be an example of how the patient might be trying to cause you or your partner harm that would cause you to dump him off the stretcher?



Pulls a knife or a gun. Just because they're on the stretcher doesn't magically make them cooperative and unable to cause harm to those around them. 

The ideal situation is to leave as quickly as possible but if it comes down to it and something needs to be done I wouldn't lose sleep over it. As someone else said sometimes escape involves disruption/distraction as well. Running away from every situation isn't always the answer. By no means am I advocating staying and fighting with someone but in some situations actions like what this medic did can provide you and your partner/co-responders the valuable few extra seconds to allow you to actually escape rather than be injured or killed a few steps closer to the door than you were originally. The OODA loop! 

As I said before the actions in this video are absolutely unacceptable. Was this medic probably burnt out and at the end of his rope? More than likely. Was this patient being an ***? Maybe, maybe not however judging by the actions of the medic I'm pretty confident that he probably was. Does it justify the medics actions at all? Not one bit. We need more accountability in EMS. I don't want anyone trying to say I'm condoning the actions of this guy.

I'm with FiremanMike though, I'm not gonna hang around a thread where anti-police crap is going to start coming up when it has absolutely no relation to the topic at hand.


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## SandpitMedic (Jun 20, 2015)

I don't think it was anti-cop.

Most of us are pro police- we know the way it goes out there. 

However, you can't deny that such issues have been top news. We can't ignore it. Ferguson= hype. South Carolina = murder (caught on tape).

We serve and live amongst many different people. I'm not for or against any of them. I am for equal justice. 

I believe her comment lacked a bit more descriptive verbiage, and it was not intended to be an all encompassing anti-cop post.


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## SandpitMedic (Jun 20, 2015)

In other words:

Calm down.


No one has yet to justify this guy tossing the gurney... (No matter what kind of garbage is on it)


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## Carlos Danger (Jun 20, 2015)

It should go without saying (though sadly, it obviously does not) that no one condones violence against patients. We should be able to discuss this without having to make that disclaimer constantly.

A fair amount of discussion goes on on this forum about mental health in EMS - we frequently acknowledge the manifestations of high levels of chronic stress and its negative affects on our well being, which as we all know can include lack of self-discipline and impulsive decision-making. With that in mind, it seems a bit contradictory to me that we show limitless compassion and understanding for those whose mental health imbalance results in self-harm, but nothing but vitriol for those whose imbalance results in decision-making that harms others. Are these not potentially just different symptoms of the same disease? Can someone who makes a mistake not deserve both discipline and compassion at the same time?

My take on Angel's post about the cops was the double standard where police routinely use excessive force and are still highly respected in public safety circles, yet when someone in EMS snaps and makes a bad decision - even if only once - we all want to burn him at the stake and worry about how it makes EMS look. Another glaring contradiction, if you ask me.


P.S. It isn't "anti-cop" to recognize and call out police abuse any more than it is "anti-paramedic" to recognize and call out paramedics who abuse.


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## joshrunkle35 (Jun 20, 2015)

Remi said:


> ...police routinely use excessive force...



You think this is what angel is saying, and it is what you are saying.

This is the part that I strongly disagree with.


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## Angel (Jun 20, 2015)

Remi and chewy said it a lot better, and less hostile than I would've.


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## Carlos Danger (Jun 20, 2015)

joshrunkle35 said:


> You think this is what angel is saying, and it is what you are saying.
> 
> This is the part that I strongly disagree with.



Well that isn't the point of this thread, so I'm not going to argue it here. But if you don't think that's the case you are ignoring many, many, many examples.

And again, acknowledging a problem is not "bashing" anything or anyone.


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## SeeNoMore (Jun 20, 2015)

I agree that in many cases agressive behavior by EMS workers can be tied to the stresses of the job and should be treated with sympathy regardless of the need for corrective action , termination etc.

I also feel that some EMS workers think they are cops or vigilantes and that people must listen to them or face abuse (verbal or physical) for their lack of compliance. Obviously no one is perfect and like most I have lost my temper. However, I think we all need to combat the belief that driving an ambulance around gives you the right to act unprofessionally (swearing, openly making crude sexist/racist/homophobic jokes, calling pt's liars, physical violence etc).


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## Uclabruin103 (Jun 21, 2015)

If any patient gives me lip they get a versed benadryl cocktail so I don't have to hear their complaining. Shaken, not stirred. 

In my eyes police have the hardest job. We give them so much latitude to protect us and themselves from increasingly violent criminals. Yet any mistake they make and they're crucified. At this rate we won't have any police around cause no one will want to be one. 

I blame the media. In late 2000s excessive force incidents were around 1.5% of arrests. I want to see if this rate has increased or stayed constant.  I'm sure it's stayed the same but couldn't find it after ten seconds of googling and sleep is too enticing. 

We need to protect our police force. It's what they do for us. If they make a mistake, hold them accountable; be it termination or criminal charges, but get the media out of the picture. The media no longer reports, they put their own judgement on things and the public is too stupid to think for themselves. STOP!  

No more pointless riots.


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## Angel (Jun 21, 2015)

This thread is taking an entire new direction.


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## SandpitMedic (Jun 21, 2015)

Don't flip people off of your gurney... ever.

(There you go Angel.)


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## Carlos Danger (Jun 21, 2015)

Uclabruin103 said:


> I blame the media. In late 2000s excessive force incidents were around 1.5% of arrests. I want to see if this rate has increased or stayed constant.



Where did that 1.5% come from?

Do you not think the vast majority of these incidents go unreported, or do get reported but never go anywhere?


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## mgr22 (Jun 21, 2015)

Uclabruin103 said:


> If any patient gives me lip they get a versed benadryl cocktail so I don't have to hear their complaining. Shaken, not stirred.



Interesting protocol.


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## NomadicMedic (Jun 21, 2015)

Uclabruin103 said:


> If any patient gives me lip they get a versed benadryl cocktail so I don't have to hear their complaining. Shaken, not stirred.


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## Tigger (Jun 21, 2015)

This is the part where we stay on topic.


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## Uclabruin103 (Jun 21, 2015)

Remi said:


> Where did that 1.5% come from?
> 
> Do you not think the vast majority of these incidents go unreported, or do get reported but never go anywhere?



http://bfy.tw/RqS


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## SandpitMedic (Jun 21, 2015)

mgr22 said:


> Interesting protocol.


I was thinking the exact same thing. Taking lip service is part of the gig. You can't just knock everyone out.


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## SandpitMedic (Jun 21, 2015)

We aren't debating the use of force by police.

Start a new topic if you have a grievance or inquiry.


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## hogwiley (Jun 22, 2015)

That (former)Paramedic got what he deserved, I don't feel the least bit sorry for him. What a moronic hot head.


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## waaaemt (Jun 24, 2015)

Wow,  never thought a thread started by me  would stir up so much controversy   

As far as A hole patients, in my experience I have found that being obnoxiously nice to them, asking them to talk to you etc will make them settle down. Which EMS,  fire and police should all be doing anyway..


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## SandpitMedic (Jun 27, 2015)

Sentenced to one year of probation.


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## akflightmedic (Jul 5, 2015)

How did I miss this thread? LOL

This particular incident hit very close to home, literally. I also know the guy and the behavior is not typical. I read every post in this thread and I see a few creeping towards alternative explanations but no justifications (I am unsure if there are any) however I can empathize with him.

A few facts I have not seen anyone address:

First, the patient was holding the stretcher hostage. The patient is a terminal cancer, AIDS and HEP C patient. The patient is a frequent caller of 911. He is dying, he is angry. (We could side bar here about inadequate end of life care, counseling  and medical care as cause of patients attitude and abuse).

The patient is disgruntled and verbally abusive. Brevard County is a fairly busy service and some areas it is homeless call after homeless call. 

After the patient was transported to the facility, the medics were instructed to bring the guy to triage. The patient went full on rant as he was under the impression that yet again he would get the immediate bed in back since he came by rescue. The video being showed everywhere is not the full video obviously as that does not get ratings. The patient refused to get off the stretched once brought to triage. The medics took the guy in back and tried to offload him there again, no could do. They brought the stretcher back to triage and tried to get the patient in a wheelchair. The patient refused to cooperate while at the same time berating everyone.

The ordeal went on for well over a half hour. He simply refused to get off the stretcher. Now while this event is gong on, there are other calls going out. Units are out of area, responses are being delayed and one contributor to this is a patient who will not get off the stretcher cause he is out front instead of in the back.

I can empathize with the medic...constant abuse, frustration over prolonged period of time, stress from patient, the subtle stress of other calls pending, the stress of 20 year career. It all has an effect whether the majority acknowledge or not, it exists (apparently it seems many of us are super human or simply have never worked in other systems for true comparison).

So there are so many overlapping contributing factors to this stretcher flipping from both the patient, the medic and the system...I simply cannot point the finger at the medic and say "bad, bad, bad". Could I possibly flip a stretcher one day? I do not think I would but I do think I could given the right circumstances. I simply would not know until in a similar situation and I have learned to never rule out anything.

Anyways, he did not get "only 1 year of probation"....he lost his career. He "surrendered" his paramedic license. His life is forever changed for the worse (right now) and the patient continues to call 911 however he now has his settlement check from the County to enjoy until his death...drink it up buddy!


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## akflightmedic (Jul 5, 2015)

Just to further elaborate and frame this in a context where those who are mortified at the medic's behavior and are ready to persecute him...we are medical care givers. This means we very rarely treat a complicated patient on one issue alone. We have to recognize and identify many issues overlapping which all need some attention in order to "fix" the problem we were called for.

This situation and any situation actually is not that different...there are many "comorbidities" which brought the situation to what it is, what you are seeing. This is where human empathy and logic come into play. The system has failed its people in many different areas until they all overlapped, reacted, interacted and festered to an incident such as this. 

At the end of the day all we are left with is two very hurt people, a lot of drama on the news so everyone else can ignore their own issues and a lot of righteous people finger pointing. None of this solved or helped the two people hurt the most...


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## mgr22 (Jul 5, 2015)

akflightmedic said:


> Just to further elaborate and frame this in a context where those who are mortified at the medic's behavior and are ready to persecute him...we are medical care givers. This means we very rarely treat a complicated patient on one issue alone. We have to recognize and identify many issues overlapping which all need some attention in order to "fix" the problem we were called for.
> 
> This situation and any situation actually is not that different...there are many "comorbidities" which brought the situation to what it is, what you are seeing. This is where human empathy and logic come into play. The system has failed its people in many different areas until they all overlapped, reacted, interacted and festered to an incident such as this.
> 
> At the end of the day all we are left with is two very hurt people, a lot of drama on the news so everyone else can ignore their own issues and a lot of righteous people finger pointing. None of this solved or helped the two people hurt the most...



Yes, two hurt people and all that, but I still think it's okay to say that specific behavior -- in this case, dumping a patient off a stretcher -- even out of context, even without having been there to witness it, is bad. I mean, can you imagine a curriculum anywhere in EMS that would include "dumping a patient off a stretcher" as a possible solution to any problem -- even one involving the safety of the providers? I'm trying to picture a practical exercise that begins, "Say your patient is on your stretcher in an ED, won't get off, and has a gun/knife/RPG. What would you do?" Is there a course or an algorithm anywhere that's going to include, even as a third-line option of undetermined value, "Consider dumping the patient off the stretcher?" Seriously, can't we just say that's a dumb thing to do?


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## akflightmedic (Jul 5, 2015)

Until I am in that situation with the same issues I cannot definitively say I would or would not do something. It it seemingly a dumb thing? Sure it is. Is it justifiable? Maybe, who knows. However, the extreme comments and persecution displayed in this thread and in others I have seen are keeping it too simple, black and white...when if you actually pause and think, and consider all the factors at play and employ some human empathy...it might not have been all that irrational.

The entire weapon tangent is superfluous to this incident. When weapons enter the equation, all bets are off and anything/everything now becomes possible including "dumping the patient" which would actually be on my list of actions of defense.


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## RedAirplane (Jul 5, 2015)

mgr22 said:


> Yes, two hurt people and all that, but I still think it's okay to say that specific behavior -- in this case, dumping a patient off a stretcher -- even out of context, even without having been there to witness it, is bad. I mean, can you imagine a curriculum anywhere in EMS that would include "dumping a patient off a stretcher" as a possible solution to any problem -- even one involving the safety of the providers? I'm trying to picture a practical exercise that begins, "Say your patient is on your stretcher in an ED, won't get off, and has a gun/knife/RPG. What would you do?" Is there a course or an algorithm anywhere that's going to include, even as a third-line option of undetermined value, "Consider dumping the patient off the stretcher?" Seriously, can't we just say that's a dumb thing to do?



Hahaha gotta love textbook/protocol language

1. Take appropriate body substance isolation (BSI) precautions.

2. Reassess the patient's airway, breathing, and circulation (ABC). 

3. Obtain On-line Medical Control (OLMC) orders as required by your local protocol.

4. Advise your patient of the procedure you are about to perform and its purpose in a calm and professional manner. 

5. If possible, one EMT should look directly at the patient and reassure him while a second EMT performs the procedure. EMT #2 should lift the gurney with the knees, not the back (Fig. 2.3) and rotate it 180 degrees (Fig 2.4(a)-(d)) allowing the patient to gradually fall rapidly towards the ground.

6. Rotate the gurney 180 degrees once again and return the gurney to the ground.

7. Repeat steps 5-6 as necessary for overly adhesive patients.

8. Recheck distal circulation, sensation, and motor function (CSM).


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## mgr22 (Jul 5, 2015)

akflightmedic said:


> The entire weapon tangent is superfluous to this incident. When weapons enter the equation, all bets are off and anything/everything now becomes possible including "dumping the patient" which would actually be on my list of actions of defense.



I agree about weapons being tangential to the topic. I only mentioned them because others did. I think we're really straining to find a justification for stretcher dumping when we have to start treating it as if it were a martial-arts maneuver.

RedAirplane, I like it. You've shown the way. I feel much shame


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## SeeNoMore (Jul 5, 2015)

I didn't think self defense was really the issue in this case? I am all about helping emts who are struggling with stress and anger. But you can't flip stretchers.


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## Ewok Jerky (Jul 5, 2015)

I sympathize with this guy, I probably have been in situations where I wanted to tip a Pt on the floor...but I never did. And if I was at the point I thought it was OK to do so, I would be on the phone to a supervisor or my PCP asking for some mental help. As remi pointed out, its a sign of bad things to come either for me or my patients. So I do sympathize with the medic.
...however...
He should have gotten help when he started burning out. Too late now. That level of anger and impulsivity is too much to ignore. 

At the end if the day, who cares if the Pt won't get off the stretcher? Is it really that big of a deal? Call security, call PD, call dispatch and let them know you are delayed. Other calls are going out? so what, there are other ambulances, there is no need to resort to violence.

I empathize and feel sorry for him, but he should not be in EMS. Maybe he is a nice guy who lost his cool, I don't know. If so then he doesn't deserve jail time or maybe a criminal record.


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## DesertMedic66 (Jul 5, 2015)

Ewok Jerky said:


> At the end if the day, who cares if the Pt won't get off the stretcher? Is it really that big of a deal? Call security, call PD, call dispatch and let them know you are delayed. Other calls are going out? so what, there are other ambulances, there is no need to resort to violence.



This. He doesn't want to get off my gurney in the lobby? Cool. I'll lower the gurney to the ground, I'll call security/pd, dispatch, and my supervisor to just let them know. Then I'll grab a chair and sit. I'll finish my paperwork and then I'll start watching some TV until the patient is removed from the gurney by PD. 

Maybe I haven't been doing this job long enough but never once have I thought about flipping over the gurney with a patient on it.


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## akflightmedic (Jul 6, 2015)

Ewok Jerky said:


> I sympathize with this guy, I probably have been in situations where I wanted to tip a Pt on the floor...but I never did. And if I was at the point I thought it was OK to do so, I would be on the phone to a supervisor or my PCP asking for some mental help.
> He should have gotten help when he started burning out. Too late now. That level of anger and impulsivity is too much to ignore.



I snipped your quote, but this is exactly what I was saying only you did not seem to fully accept there was more involved than personal accountability.

My replies to this were multi-purpose:
1. To try and show others to not react and vilify so fast without at least giving consideration to other possible factors.
2. To highlight system failures.

Ewok, you make the assumption that the guy planed his course of action or even recognized it. Maybe it is also implied that someone else recognized it and ignored it? Either way it is sounding as if the guy planned his action instead of possibly considering that his reaction was in the heat of the moment and this WAS his breaking point. Maybe there were no signs leading up to this.

Did he himself recognize he had been harboring these feelings up to the point of snapitude? 

I am beyond the guy doing something which I agreed was a very bad ideal. Root cause analysis here...we have issues on both sides (patient and paramedic)...what have we done about it? Step one is discussing it, bringing the issue forward and then exploring solutions. Next phase is actually implementing them. Where are we at with this? How can we prevent this going forward?

Or, is it just easy to point finger, crucify, say "I would never" and "how could he" and then we all go along our way until the next incident and repeat the cycle?


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## akflightmedic (Jul 6, 2015)

DesertMedic66 said:


> This. He doesn't want to get off my gurney in the lobby? Cool. I'll lower the gurney to the ground, I'll call security/pd, dispatch, and my supervisor to just let them know. Then I'll grab a chair and sit. I'll finish my paperwork and then I'll start watching some TV until the patient is removed from the gurney by PD.
> 
> Maybe I haven't been doing this job long enough but never once have I thought about flipping over the gurney with a patient on it.



We all say/think this...that is until we are in the same situation. And that is the irony of Monday morning quarterbacking...none of us will ever be in that exact same situation. Similar yes, but never the same...so how can we say we would or would not?

I get your point, you offer very reasonable/sane solutions, but those simply do not apply sometimes.

I am not justifying his action, just want to clarify that before anyone misses it from earlier and goes off, but I absolutely empathize and am willing to explore outside contributors. 

My solution would have been to keep the paramedic on the department and send him though a variety of medical and psych exam sessions and see if there was some help with counseling. Some benefit from this. His job would have been held until he could return and then he would be back in a probationary position assigned to a station with senior officers present. 

As for the patient, the County could issue a formal apology and see about getting him some appropriate services as well. Find out why he is calling 911 repeatedly and abusing the system. He does not have long left to live so this would be a short term commitment, but it just might open their eyes to something they could change, something simple. Or not...but we do not know until we try something different.


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## Ewok Jerky (Jul 6, 2015)

There are ways to deal with stress. Not recognizing it and letting it bottle up until you explode is not a good quality for EMS personelle.

Maybe he deserves a second chance, I don't know him and I don't know the specifics of the scenario that led to him intentionally flip a patient onto the floor.


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## akflightmedic (Jul 6, 2015)

Yes, there are ways to deal with it and we all talk about it...for about 5 minutes and 2 pages in EMT school with a refresher of same length later on in Paramedic school.

Do "we" as a culture make it ok, do we recognize it, do we talk about it or do we deem those who do as being incapable and no longer worthy of being in the system?

Another friend of mine returned to work after almost 8 months of counseling. He finally opened up (ok, slight breakdown at work) and sought the help needed. He now has coping mechanisms in place. He is back at work and functioning...but at what cost? During his absence, he was accused of milking/abusing the medical policies in place, getting a paid vacation, called crazy, made fun of, called weak...people even said maybe he is not fit to work. They were all making decisions for him instead of standing him up and supporting him.

This is what boggles my mind. Someone does exactly what they should do to be healthy and we destroy them. Just because we personally do not or have not yet felt that way, we lack comprehension of it and refuse to have empathy. 

We in EMS do not make it acceptable for our fellow workers to get the healthcare they need. We turn our backs on them.


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## joshrunkle35 (Jul 6, 2015)

Yes, I agree, however, you are focusing on the harm done to the practitioner, and others (like myself) are focused on the harm to society/future patients. 

What would need to occur would be that the practitioner would probably have to move to a different state, so that there was no loss of public trust. As we don't have a national licensing system that would allow this to work, we look at whether society or the practitioner should suffer when it appears to be a "zero-sum" scenario, and we choose to apply the "cost" to the individual, rather than society.

Obviously, you are seeing a "whole sum" scenario, where harm to the practitioner and society can be prevented. Unfortunately, most agencies are not set up to rehabilitate practitioners who commit criminal actions at this moment.


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## mgr22 (Jul 6, 2015)

I agree we should discuss stress more in medic school, but still...

Can't it be okay to set boundaries on behavior, without necessarily knowing all the reasons for that behavior?

In my most recent EMS job in the entertainment industry, if I had cursed at a customer/patient for whatever reason, I probably would have been fired. Maybe I would have been having a bad day, maybe I'd never done it before and would never do it again, but I still would have crossed the boundary of acceptable behavior in that job. If there were a video showing me doing that, instead of just gossip and suspicion about what I'd done, that would have made the decision pretty easy for my employers. I would have broken the "don't mistreat the customers" rule -- hardly a controversial policy or one that would not be a component of common sense in that environment.

It is true that people who are given second chances after acting aberrantly sometimes do better and might never commit the same offense again, but why should a company have to take that risk and incur those expenses when there's a video showing what happened? Not showing _why_, just showing _what_. We're not speculating about the what and we can't fix all the whys.

I think a reasonable course of action is for the stretcher-dumper to accept responsibility, take whatever punishment is handed out, and seek help privately if he feels he needs to do better. The chances are remarkably good that he will be able to continue in EMS if he wants to.


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## MonkeyArrow (Jul 6, 2015)

Honestly, the world does come down to your actions. The circumstances can matter, to an extent. If we look at a more extreme example, for the sake of argument, homicide. Let's say a guy (1) kept on getting his house burglarized by the same person over and over. Guy 1 carries a gun for self defense. One day, he is walking down the road when he sees the burglar also just walking down the street and decides to confront him. Guy 2 flips him off and tries to continue on his way. Guy 1 gets angry and pulls out his gun and shoots him.

When it comes to trial, the guy burglarizing my house is not a valid defense to shooting him when he was not actively in the act of stealing from you. You're still going to be guilty of some sort of murder. Sure, there are degrees of murder, and mitigating and aggregating factors during sentencing, but it is without question that guy 1 is guilty of homicide. 

At a point, there has to be a line where we draw the line for making excuses and looking at circumstances and just accept what happened and say it shouldn't have. Guy 1 shouldn't of shot guy 2, even though guy 1 has been victimized by guy 2 in the past. The medic in question should not of flipped the patient off of the gurney. Unfortunately, I think it is as simple as this. It shouldn't have happened. Under the circumstances presented to us, there was no justification to flip the gurney and be in the right. Similarly, there is no justification for shooting guy 2 unless he is trying to break into your home, while you're in it, and you must shoot him in self defense. It's just that simple.


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## akflightmedic (Jul 6, 2015)

Thanks for the post but I disagree...I too am focused on harm to society and future patients. What happened has happened, now I am discussing prevention, prevention of harm to your two concerns and my three concerns. 

Glad you acknowledge there is an issue...now how do we fix it?


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## Carlos Danger (Jul 6, 2015)

MonkeyArrow said:


> At a point, there has to be a line where we draw the line for making excuses and looking at circumstances and just accept what happened and say it shouldn't have. Guy 1 shouldn't of shot guy 2, even though guy 1 has been victimized by guy 2 in the past. The medic in question should not of flipped the patient off of the gurney. Unfortunately, I think it is as simple as this. It shouldn't have happened. Under the circumstances presented to us, there was no justification to flip the gurney and be in the right. Similarly, there is no justification for shooting guy 2 unless he is trying to break into your home, while you're in it, and you must shoot him in self defense. It's just that simple.



Again, no one is saying that guy one would be _justified_ in shooting guy 2, or that this medic was _justified_ in tossing this guy off the stretcher.

You can't deny that circumstances play a big role in these situations. What if guy 2 terrorized and threatened guy 1 to the point that guy 1 was convinced that guy 2 was going to kill him next time he came to his house? What if guy 1 had done everything right to that point - gone to the cops multiple times, talked to lawyers, etc, and guy 2 was still burglarizing his house and threatening him? Would that make a difference? Yeah, I think it might, or at least it should. It doesn't necessarily justify shooting him unarmed in the street, but it changes the storyline quite a bit. 

Of course this is hypothetical, but those are exactly the kinds of important details that you often don't get from a news article, and exactly why jumping to conclusions and just assuming someone is a complete dirtbag when you don't know anything about what went on is a bad thing.


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## DrParasite (Jul 6, 2015)

akflightmedic said:


> This is what boggles my mind. Someone does exactly what they should do to be healthy and we destroy them. Just because we personally do not or have not yet felt that way, we lack comprehension of it and refuse to have empathy.
> 
> We in EMS do not make it acceptable for our fellow workers to get the healthcare they need. We turn our backs on them.


What exactly are you saying?  We, as a profession, should accept this behavior because he was under so much mental anguish?    I'm pretty sure you aren't, but I'm not entirely sure right now....

If your buddy (or anyone actually) were to get help, i would support him 100%.  Would I ***** about him taking several months off?  absolutely, because I (and the rest of my coworkers) need to work more to pick up his slack.  But as long as he or she comes back better, more power to him.  But that has to be before an incident.

Think of it this way: would you support your coworker who had a drug/alcohol problem?  if he wanted to get help for their problem?  I would imagine you would, as would we all.  Now, what about when he comes to work drunk or under the influence, and gets behind the wheel of the ambulance?  would you support his termination or want to support him getting help and returning to work?  There needs to be a consequence to his actions, regardless of the underlying cause.

I support his termination, and I support him surrendering his license.  He probably doesn't deserve to be in jail, but if he never steps foot on an ambulance again, I won't shed a tear.  It sucks that it happened, and I'm hoping he gets the help he needs.

I agree with what others have said about the situation.  He doesn't want to get off my gurney in the lobby? Cool. I'll lower the gurney to the ground, I'll call security/pd, dispatch, and my supervisor to just let them know. Then I'll grab a chair and sit. I'll finish my paperwork and then I'll start watching some TV until the patient is removed from the gurney by PD or security.  I get paid by the hour, no matter how many calls I go on.  And if I need to write an incident report explaining my actions, well, it's better than flipping the patient off the cot.


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## mgr22 (Jul 6, 2015)

Ok, I'm imagining I'm Guy 1 and I'm convinced Guy 2 is going to kill me; I throw him off the stretcher? I just can't imagine that being the reaction of most EMS providers. I've considered hitting patients and cursing at patients and running away from patients, but never throwing them off the stretcher. During five years of supervising a regulatory EMS agency in a large system, with about 600,000 calls in that stretch, I never heard of that happening.

Isn't part of the problem here that these what-if scenarios are getting a bit contrived? I can understand considering contributing factors to a point, but wouldn't you agree that the chances of the patient having robbed and threatened the medic are so slim that they shouldn't really be part of the analysis? Do we have to consider every conceivable explanation for aberrant behavior before taking action? I mean, if a teacher is caught on tape pulling the chair out from under my six-year-old, must I allow for the possibility that my kid reminded the teacher of a childhood bully, or that the teacher had been mugged by another six-year-old on the way to school that morning, or...

What are the chances? Must there be an imperative to consider every possible explanation before making a decision?

Isn't it much more likely (not certain -- just much more likely) that the medic in the video screwed up without extenuating circumstances that would justify such behavior? (Perhaps those circumstances would help explain the behavior, but not justify it.) If so, isn't it okay, even for those of us who weren't there, to say, based on the video, it was bad behavior?


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## akflightmedic (Jul 6, 2015)

I have made myself clear on what I find concerning and what I do and do not agree with.

Spinning this into an addiction issue obfuscates the point I am making and the awareness I am trying to evoke.

Mgr22 you posted while I was replying. I do not disagree with your last paragraph, however no consideration was given to the entire situation and what potentially caused it. It was Hang 'em high noon at the OK Corral as far as majority were concerned. This to me is concerning of our profession and I think it should be explored more.


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## mgr22 (Jul 6, 2015)

akflightmedic said:


> I have made myself clear on what I find concerning and what I do and do not agree with.
> 
> Spinning this into an addiction issue obfuscates the point I am making and the awareness I am trying to evoke.
> 
> Mgr22 you posted while I was replying. I do not disagree with your last paragraph, however no consideration was given to the entire situation and what potentially caused it. It was Hang 'em high noon at the OK Corral as far as majority were concerned. This to me is concerning of our profession and I think it should be explored more.



Ok, good discussion, nice to have a forum for that.


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## DrParasite (Jul 6, 2015)

There is no addition issue to obfuscate the point.... it's the underlying cause that you are discussing, and whether it be an addiction, long term stress, or poor upbringing, it doesn't excuse the actions that occurred.  And actions have consequences.



akflightmedic said:


> however no consideration was given to the entire situation and what potentially caused it. It was Hang 'em high noon at the OK Corral as far as majority were concerned. This to me is concerning of our profession and I think it should be explored more.


the entire situation?  he acted inappropriately.  He handled the situation very poorly.  It was completely uncalled for.  It doesn't matter if the guy wouldn't get off the cot, or was verbally abusive, or they had been waiting 30 minutes..... His actions were inexcusable, and because of his actions, he found himself in the situation.  I've considered the entire situation, and what potentially caused it, and it doesn't change my thoughts regarding what happened.

Your friend deserves to be fired.  He deserves to lose his medic cert.  His actions were inexcusable.  Maybe now he will get some help, and find a new career.  Shame he didn't get help beforehand, but his actions have consequences


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## akflightmedic (Jul 6, 2015)

And then we have that....and the cycle never ends..ba dump dump dump.

Cheers.


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## Angel (Jul 6, 2015)

i think maybe some people are missing AK's point. Is the knee jerk reaction a lot of you seem to have, almost like you are better than someone else who is struggling and can therefore pass judgement.


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## mgr22 (Jul 6, 2015)

Angel said:


> i think maybe some people are missing AK's point. Is the knee jerk reaction a lot of you seem to have, almost like you are better than someone else who is struggling and can therefore pass judgement.



"Just when I thought I was out, they pull me back in." I've always wanted to use that line -- thanks. 

Angel, when I think of a "knee-jerk reaction," I think of an action or reply that has little or no thought behind it. I feel a lot of thought is being given to this debate by almost everyone who's participated.

Also, I know it's unpopular to acknowledge, but we judge each other all the time. It's human nature. It doesn't have to be coupled to a sense of superiority. Perhaps the issue is Judgment with a capital J -- on what some would consider a Biblical level -- versus everyday judgment involving opinions like "I think he's right/wrong." Is there a problem with the latter? You're employing that sort of judgment, too, aren't you? I think that's healthy.


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## Carlos Danger (Jul 6, 2015)

mgr22 said:


> "Just when I thought I was out, they pull me back in." I've always wanted to use that line -- thanks.
> 
> Angel, when I think of a "knee-jerk reaction," I think of an action or reply that has little or no thought behind it. I feel a lot of thought is being given to this debate by almost everyone who's participated.
> 
> Also, I know it's unpopular to acknowledge, but we judge each other all the time. It's human nature. It doesn't have to be coupled to a sense of superiority. Perhaps the issue is Judgment with a capital J -- on what some would consider a Biblical level -- versus everyday judgment involving opinions like "I think he's right/wrong." Is there a problem with the latter? You're employing that sort of judgment, too, aren't you? I think that's healthy.


Makes me think of that term "low-information voter".


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## Jim37F (Jul 6, 2015)

AK, while I can certainly sympathize with the reasons that caused the buildup of stress to the snapping point in this particular medic, the fact remains that once he assaulted the patient, he crossed a line that cannot be uncrossed. Imagine if that was your father on the gurney, what would your reaction be to him suffering physical harm at the hands of the paramedic you entrust to take care of him, and prevent further harm?


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## triemal04 (Jul 6, 2015)

Angel said:


> i think maybe some people are missing AK's point. Is the knee jerk reaction a lot of you seem to have, almost like you are better than someone else who is struggling and can therefore pass judgement.


It's not a knee-jerk reaction, at least for me, though I think you are accurate in using that term.

The guy did what he did.  There very well may be some very extenuating circumstances that we aren't privy to (in fact even before AK spoke up I figured that was a certainty) but it doesn't change what happened.  And I agree that it is very possible that he was having issues due to his job that may have been the root cause  of this; that's a very realistic problem that everyone should be aware of and be ready to face if it comes to that.

But it doesn't excuse what he did.  It may help to explain what happened, but it's not a justification.  It also brings up the problem of, if this was due to a build up of stress, work related or not, doesn't the individual bear some responsibility for realizing there is a problem and trying to fix it (which may not be possible)?  I say yes.  Maybe this was the final straw...but I don't know if I believe it.  And even if it was, while it explains the situation, and the guy should get as much help and support as he needs to get through this...he did what he did.  There will be consequences.  There are things that people do, that no matter the reason, you don't just get to shrug your shoulders and say "no big deal."  Depending on the true circumstances of what happened the consequences here may have been overboard, and may make a bad situation worse, but that doesn't mean some type of punishment isn't right.


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