# Partners who think they are the hospital.



## NYMedic828 (Apr 18, 2012)

Does anyone work with people like this frequently?

One of my partners thinks he is the greatest medic of all time.

Today for example we get called by BLS for an AMS possibly hypoglycemic.

Turns out she was sick for 3 days with vomitting, severely hypotensive at like 60/40 heartrate 100+. Hot to touch. Ruling out possible sepsis.

He does a quick 3/12 lead while I stick an IV in her arm. He gets the bag hooked up and I say "lets get going." (We are still upstairs in the apartment)

He decides, no, we are gonna stay here and let 500ccs of the bag go through to "stabilize" her. He also said he didn't want to move her just yet because with such hypotension if we move her too quickly she could get an arrhythmia. I have never heard that one before.

I told him I felt we should go to the hospital, we can just as easily give fluid while we move and get her to a place that can correct the sepsis. He disagreed with me and I left it at that as to not start a scene in front of the family.

The same thing happened a couple weeks back with an obvious GI bleed. Severe hypotension, he wants to stay on scene because he thinks he can stabilize the patient with his magical bag of normal saline. I just don't get it.


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## bstone (Apr 18, 2012)

NS is a powerful tool, but not nearly as much as BS.


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## abckidsmom (Apr 18, 2012)

bstone said:


> NS is a powerful tool, but not nearly as much as BS.



This is an excellent quote.


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## bstone (Apr 18, 2012)

abckidsmom said:


> This is an excellent quote.



Why thank you, Dana! Want to put it as your signature and quote me? Then two people would have done that!


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## firecoins (Apr 18, 2012)

NYMedic828 said:


> He decides, no, we are gonna stay here and let 500ccs of the bag go through to "stabilize" her. He also said he didn't want to move her just yet because with such hypotension if we move her too quickly she could get an arrhythmia. I have never heard that one before.
> 
> I told him I felt we should go to the hospital, we can just as easily give fluid while we move and get her to a place that can correct the sepsis. He disagreed with me and I left it at that as to not start a scene in front of the family..



I don't like being a protocol pus but NYC remac makes it clear to not delay transport in these kinds of situations.


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## RocketMedic (Apr 19, 2012)

More than that, delaying transport for something like that puts you out of service for even longer _and_ it does the patient no good. 500mL of NS won't stabilize someone any more than a chicken dance will.


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## Handsome Robb (Apr 19, 2012)

Rocketmedic40 said:


> 500mL of NS won't stabilize someone any more than a chicken dance will.



I don't know...I do a pretty mean chicken dance. h34r:

I must be spoiled but all my partners and I have gotten along just fine and I'm like a medic jumper, being per diem but working full time hours in the past and near full time hours now I end up working with a lot of different medics although I tend to have a set partner that I work most of my hours with. Never really had issues like this.


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## STXmedic (Apr 19, 2012)

I could understand if it was to start a more aggressive treatment, such as a levophed drip. But to hang around just to watch 500mLs infuse is fairly retarded. Especially since a half a liter bolus is likely to not do a damn thing.


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## Handsome Robb (Apr 19, 2012)

PoeticInjustice said:


> I could understand if it was to start a more aggressive treatment, such as a levophed drip. But to hang around just to watch 500mLs infuse is fairly retarded. Especially since a half a liter bolus is likely to not do a damn thing.



Especially since you only retain 1/3 of that volume in your vascular space over an hour if I'm not mistaken.  165 mLs roughly... Not going to do a whole lot of anything.


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## bstone (Apr 19, 2012)

NVRob said:


> Especially since you only retain 1/3 of that volume in your vascular space over an hour if I'm not mistaken.  165 mLs roughly... Not going to do a whole lot of anything.



All depends on how dehydrated you are, the tonicity of the solution, and how your lymphatic system is feeling at the moment.


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## NYMedic828 (Apr 19, 2012)

PoeticInjustice said:


> I could understand if it was to start a more aggressive treatment, such as a levophed drip. But to hang around just to watch 500mLs infuse is fairly retarded. Especially since a half a liter bolus is likely to not do a damn thing.



Which it didn't.

Her pressure was unchanged by time of arrival at the ER. He does this all the time.


Is there any validity whatsoever behind his statement of We cant move her too quickly with her pressure, she could develop an arrhythmia.

 I have never heard that one before but im sure I could be wrong.


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## Veneficus (Apr 19, 2012)

NYMedic828 said:


> One of my partners thinks he is the greatest medic of all time..



I think everyone thinks this way sooner or later, it just manifests in different ways, the medic who thinks they are the greatest because of something they thinnk or do or the medic who thinks they are the best because of everything they don't do or think about in the name of humility.

The balance of confidence and arrogance is tough to master and most people including me, slip back and forth from time to time.

It is a constant struggle.

Today for example we get called by BLS for an AMS possibly hypoglycemic.



NYMedic828 said:


> Turns out she was sick for 3 days with vomitting, severely hypotensive at like 60/40 heartrate 100+. Hot to touch. Ruling out possible sepsis...



You mean "suggesting possible sepsis"?

He does a quick 3/12 lead while I stick an IV in her arm. He gets the bag hooked up and I say "lets get going." (We are still upstairs in the apartment)



NYMedic828 said:


> He decides, no, we are gonna stay here and let 500ccs of the bag go through to "stabilize" her. He also said he didn't want to move her just yet because with such hypotension if we move her too quickly she could get an arrhythmia. I have never heard that one before..



500cc isn't much, probably won't even increase intravascular volume any. 

This is the first I have heard of causing an arrrhythmia in this way also. 

I would suggest if moving was going to cause it though, 500cc of saline wasn't going to prevent it unless you were planning to have her walk to the truck. 



NYMedic828 said:


> I told him I felt we should go to the hospital, we can just as easily give fluid while we move and get her to a place that can correct the sepsis. He disagreed with me and I left it at that as to not start a scene in front of the family...



Well since sepsis has a 30-50% mortality rate, maybe he was giving her a few more minutes to say "goodbye" to her home incase she didn't make it back?:wacko:

The treat on scene vs. transport to the hospital, is a fundamental argument of medical philosophy. Not just with medics. But since the US system is largely set up based on transport, he probably won't win many arguments about it there. If he thinks 500cc of saline is the solution to a possible sepsis, he probably doesn't know enough to successfully or even intelligently argue the matter either.



NYMedic828 said:


> The same thing happened a couple weeks back with an obvious GI bleed. Severe hypotension, he wants to stay on scene because he thinks he can stabilize the patient with his magical bag of normal saline. I just don't get it.



Seen ED docs do the same thing actually. 

This crazy idea you can "stablize" somebody requiring surgery before surgical correction of the underlying surgical pathology.

One of the most respected emergency physicians in the US (an EM specialist) I have ever met once told me: "The only purpose of an emergency physician in severe trauma or any other surgical emergency is to wave "goodbye" to the patient on their way to surgery."

He even went on to tell me in his opinion ED docs shouldn't even waste time evaluating such patients. 

I think the theory of restoring homeostasis (resuscitation) prior to surgical intervention is flawed logic based on outdated information. 

If you look at the guidlines for control of ruptured aneurysm and the obviously indusputable scientific evidence that has come from military conflicts dating back to WWI, in patients requiring surgery, presurgical resuscitation attempts represent a severe breakdown in critical thinking.

But you see it in emergency departments all over the world.


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## CCNRMedic1982 (Apr 19, 2012)

I can see starting tx in the house especially for someone that hypotensive but not waiting for 500cc of fluid to finish. The is a little validity to his arrhythmia statement like maybe a sinus arrest or she could go into a v-tach or have a few PVCs. I would wanna know her hx and I believe you said she was altered. If this wasn't normal for her. Acute alteration in mental status is a life threat to me. Also, not sure how long your transports are but if she didn't improve her pressure with fluid resuscitation then I would've thought about giving a vasopressor. What was her me ration, sugar, hx. Just curious sounds like there might have been more to it.


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## NYMedic828 (Apr 19, 2012)

Sorry Ven, I was trying to word it the best I could without saying "I'm diagnosing sepsis without labs or anything."

We have to write a presumptive diagnosis on our
Pcr.


Our transport time is 10 minutes to 3 different facilities around us.

The full story is

60 year old female
Sick supposedly 3 days to a week.
Vomiting x 2 days. No blood or anything in vomitus.
No GI conplaints. No pain complaints.
History HTN/diabetes.

Initial vitals
BP 60/39 via monitor.
HR 110 sinus tach on the 3 lead. No ectopy.
RR 20
SPo2 100%
BGL 335 (she didnt take her insulin that morning)
Hot to touch. Normal skin otherwise.
12 lead unremarkable.

By arrival at ER BP unchanged we gave 1250cc while she was with us. 
ED told us her core temp was 101.5*
Last I knew when we left 20 min later ED had her on another 2 liters via 2 IVs and were giving levophed.

I don't see any validity behind causing an arrhythmia with movement due to hypotension. I can understand as a result of such poor perfusion the heart becomes irritable, but I don't understand how movement would add to that. And I don't think the heart which recieves the most immediate supply of oxygenated blood is going to be your first concern in that regard.

In NYC out main goal with such close transport times is supposed to be keeping the patient alive to make it to the ER not staying onscene trying to play doctor with limited resources.


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## Veneficus (Apr 19, 2012)

NYMedic828 said:


> Sorry Ven, I was trying to word it the best I could without saying "I'm diagnosing sepsis without labs or anything."
> 
> We have to write a presumptive diagnosis on our
> Pcr..



I thought you were trying to say sepsis was your presumptive dx, but typed you ruled it out.

Thinking one thing and typing another is something I am guilty of regularly, especially when multitasking beyond my capability to do so.


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## NYMedic828 (Apr 19, 2012)

Veneficus said:


> I thought you were trying to say sepsis was your presumptive dx, but typed you ruled it out.
> 
> Thinking one thing and typing another is something I am guilty of regularly, especially when multitasking beyond my capability to do so.



Well I did say "possible sepsis" as a means of saying "suggesting" it.


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## CCNRMedic1982 (Apr 19, 2012)

You don't understand how movement would effect cardiac irritability? Yes the heart will always get its blood first but if the amount of oxygenated blood being delivered to the heart is decreased then having the pt. move will increase myocardial oxygen demand increasing workload on the heart to some extent. Heart becomes irritable arrhythmias are possible. But I do agree that the pt. should have been moved and transported. The need for transport did not outweigh the risk of a possible arrhythmia. ( which I feel like we are pretty good at correcting).


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## Veneficus (Apr 19, 2012)

CCNRMedic1982 said:


> You don't understand how movement would effect cardiac irritability? Yes the heart will always get its blood first but if the amount of oxygenated blood being delivered to the heart is decreased then having the pt. move will increase myocardial oxygen demand increasing workload on the heart to some extent. Heart becomes irritable arrhythmias are possible. But I do agree that the pt. should have been moved and transported. The need for transport did not outweigh the risk of a possible arrhythmia. ( which I feel like we are pretty good at correcting).



I am thinking if the stress of being lifted onto a cot and moved was enough to throw this patient into a lethal rhtym, that patient needs to get to the hospital more than she needs treatment of 500cc of NS.


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## NYMedic828 (Apr 19, 2012)

CCNRMedic1982 said:


> You don't understand how movement would effect cardiac irritability? Yes the heart will always get its blood first but if the amount of oxygenated blood being delivered to the heart is decreased then having the pt. move will increase myocardial oxygen demand increasing workload on the heart to some extent. Heart becomes irritable arrhythmias are possible. But I do agree that the pt. should have been moved and transported. The need for transport did not outweigh the risk of a possible arrhythmia. ( which I feel like we are pretty good at correcting).



I was not referring to the patient moving themself.

I was referring to us moving the patient onto a scoop stretcher and onto the cot. 

No one is going to argue that the patient exerting their own effort will cause stress.


Thanks for the PM Ven. Always a good read.


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## CCNRMedic1982 (Apr 19, 2012)

Right, I understood and agree just using  "movement" as a general term. No argument just responding to the original question in your post as to why movement could possibly cause an arrhythmia. With pt moving themselves or otherwise.


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## CCNRMedic1982 (Apr 19, 2012)

Sorry meant to say example not term.


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## Farmer2DO (Apr 19, 2012)

NYMedic828 said:


> He decides, no, we are gonna stay here and let 500ccs of the bag go through to "stabilize" her. He also said he didn't want to move her just yet because with such hypotension if we move her too quickly she could get an arrhythmia. I have never heard that one before.



He's blowing smoke up your backside to try and make himself look like the smart one.  Ask him for evidence for this from the literature.



> I told him I felt we should go to the hospital, we can just as easily give fluid while we move and get her to a place that can correct the sepsis. He disagreed with me and I left it at that as to not start a scene in front of the family.



He wasn't doing the patient any favors.  I would suggest that calling his bluff on scene, even if it is in front of family, is indicated here.



> The same thing happened a couple weeks back with an obvious GI bleed. Severe hypotension, he wants to stay on scene because he thinks he can stabilize the patient with his magical bag of normal saline. I just don't get it.



By that logic, he should be doing the same things with trauma patients.  Tell him then, the next gunshot to the chest or belly you get needs to wait on scene while you get a fluid bolus in.  Who needs a surgeon?



CCNRMedic1982 said:


> The is a little validity to his arrhythmia statement



Do you have evidence to back that up?  Which journal article can I go to to read that?



> Acute alteration in mental status is a life threat to me.



That's going to be fixed by staying in the house and watching the fluid drip in?



> but if she didn't improve her pressure with fluid resuscitation then I would've thought about giving a vasopressor.



You would have started a pressor after 500 ml?  I don't even usually consider a pressor until I'm 2 L in.  You need to fill the tank before you start squeezing it.  And dopamine is far from my favorite pressor.  I prefer levo, vaso, and neo; all 4 of which should go through a central line and should have an art line for titration.



CCNRMedic1982 said:


> You don't understand how movement would effect cardiac irritability? Yes the heart will always get its blood first but if the amount of oxygenated blood being delivered to the heart is decreased then having the pt. move will increase myocardial oxygen demand increasing workload on the heart to some extent. Heart becomes irritable arrhythmias are possible.



Which textbook did you get this from?  This is pulled from some accepted medical source, right?

This guy is a cowboy and a danger to his patients.  He thinks he can play God and that he is as good as any hospital.  I can guarantee you, in regards to septic shock and surgical emergencies, he most certainly is not.  You should take this up the ladder through QA before he causes harm to someone and drags you into it.


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## the_negro_puppy (Apr 19, 2012)

Any chance of DKA or the like with this pt? brought on by an infection?

U have had a similar presenting pt hypotenisve tachy at 140 with ECG showing nearly global s-t depression. BSL high type one diabetic, Decreased blood ph at hospital dx metabolic acidosis.


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## medic417 (Apr 19, 2012)

Hard to condemn a person when all we have is the statements of a person that obviously has their panties in a wad.


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## Farmer2DO (Apr 19, 2012)

medic417 said:


> Hard to condemn a person when all we have is the statements of a person that obviously has their panties in a wad.



So you're saying his statement isn't credible?  I actually don't think it sounds like his "panties are all in a wad".  I think he sounds pretty reasonable.


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## medic417 (Apr 19, 2012)

Farmer2DO said:


> So you're saying his statement isn't credible?  I actually don't think it sounds like his "panties are all in a wad".  I think he sounds pretty reasonable.



When one believes one side w/o hearing the other side one shows lack of wisdom.  Remember there are at least 2 sides to this event.  

The OP made statements that sound like a child pouting when they got caught with their hand in the cookie jar.


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## Farmer2DO (Apr 19, 2012)

medic417 said:


> When one believes one side w/o hearing the other side one shows lack of wisdom.  Remember there are at least 2 sides to this event.
> 
> The OP made statements that sound like a child pouting when they got caught with their hand in the cookie jar.



I'm not really sure where your comments are coming from.  Panties in a wad and child pouting?  I didn't get that at all from the OP.  Apparently you have something against him.  Fine.  Go ahead and be judgmental.

People post scenarios, situations and disagreements on here all the time, without their credibility being attacked.  I'm not sure why, all of a sudden, the OP's comments aren't credible.  Are you the paramedic that thinks that he can cure septic shock with 500 ml NS?


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## medic417 (Apr 19, 2012)

Farmer2DO said:


> I'm not really sure where your comments are coming from.  Panties in a wad and child pouting?  I didn't get that at all from the OP.  Apparently you have something against him.  Fine.  Go ahead and be judgmental.
> 
> People post scenarios, situations and disagreements on here all the time, without their credibility being attacked.  I'm not sure why, all of a sudden, the OP's comments aren't credible.  Are you the paramedic that thinks that he can cure septic shock with 500 ml NS?



I have nothing against the OP just stating how the post sounds.  

Everyone else is judging w/o facts or the other side of the story so guess that makes me making judgments OK as well.  

This was not a scenario this was an attack on a person not here to provide a defense, to provide the other side of the story.


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## Doczilla (Apr 19, 2012)

Got a quick question--- what do your SOP's say about fluid challenges in general? Are they 500ml boluses repeated after serial assessments? If not, forget I asked. 

Anyhoo, people in sepsis require MASSIVE amounts of fluids, as much as 8 liters in the first day alone. And that's assuming there's no DIC, ARDS, or anything else nasty that rolls downhill with sepsis. If the're creeping up on endstage, [a few days in might do it] you might actually make them WORSE with crystalloids [read: without pressors, PRBC's,FFP,cryoprecipitate, steroids, antibiotics] by causing dilutional coagulopathy. 

As far as the arrythmia --- yeah it can happen, and guess what: there's bigger fish to fry. The only concept behind that [as mentioned before] is the irritable heart from global ischemia. With control measures in place, it's reasonable to say that you'll most likely see some PVC's. 

Best medicine for that is diesel--- especially in an urban system where transport times are minimal. But that's the thing, you see alot of that mentaility in urban/metro systems because people KNOW that once you get enroute, there's not much time to do anything. So if you're a "stay and play" medic, the only way to feel like more than a glorified taxi is to mess around on scene. 

But I see it this way: I.V fluids don't save lives--- SURGERY saves lives. Definitive care saves lives. Fluids are a stop-gap to buy more time.


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## RocketMedic (Apr 20, 2012)

If you see a change in your patient's condition after 500mL of NS, that change is a sign your patient is probably a little more serious than you think...


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## Doczilla (Apr 20, 2012)

Oh one more thing- I meant the arrythmias (read : PVC's that you would just look at and not treat) would happen if they were gonna happen, not be caused by getting sheeted to a scoop stretcher.


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## NYMedic828 (Apr 20, 2012)

Ok so here's a scenario that occurred yesterday.

Late 30s male came in as unconscious at the pharmacy.

Arrive onscene patient severely lethargic and AMS but verbally responsive.

Pharmacist said he was waiting on his insulin script, sat down in chair and went out. She said something sounded wrong when he was talkin to her.

BP 85/60 sitting in the chair
HR 130 sinus tach no ectopy 
RR 20 regular
SPo2 98%
12 lead unremarkable
BGL 435 + ketone warning.

Our assumption is possibly DKA on the basis of he probably hasnt had his insulin for a few days now since he's picking up a new batch.

We call for a BLS backup my partner goes out to get the stretcher. The guy had horrible veins but I made an attempt at finding an AC while waiting on my partner. No luck.

My partner is now dead set on getting this IV, again 10 min from the hospital. He attempts twice more on the same arm I just made one attempt on. Then in the bus he fails again on the other arm. Then he fails The left EJ. We pull into the ER bay, and he starts an attempt at the right EJ. Mind you we are at the hospital... And he failed again of course.

He was frantically going about the whole time like the patient was deteriorating when in reality he was in the same condition as when we first made contact. Vitals unchanged.

The ER doc agreed probable DKA and she acquired a left EJ with ease.

Unfortunately there's nothing I can do about it. He has almost 20 years with the agency as BLS and a couple as ALS. My few years doesn't get my voice heard too well.


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## Veneficus (Apr 20, 2012)

NYMedic828 said:


> Ok so here's a scenario that occurred yesterday.
> 
> Late 30s male came in as unconscious at the pharmacy.
> 
> ...



That is what medical directors are for. Start there.


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## abckidsmom (Apr 20, 2012)

NYMedic828 said:


> Ok so here's a scenario that occurred yesterday.
> 
> Late 30s male came in as unconscious at the pharmacy.
> 
> ...



I have a form rule for myself. Two sticks and I'm out. Max of three total for the patient. No more than that, ever. If they need it that bad, they can have an IO. 

Nothing good comes of multiple sticks by the same, over pressured provider.


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## medic417 (Apr 20, 2012)

Invite your partner to join here so we can hear both sides.  Perhaps then we can help both of you improve patient care.


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## NYMedic828 (Apr 20, 2012)

medic417 said:


> Invite your partner to join here so we can hear both sides.  Perhaps then we can help both of you improve patient care.



Yea that will go over well I'm sure. He wouldn't know a place that could possibly teach him something more even existed.

You haven't been useful for anything in this thread other than making assumptions that for whatever reason i came on this forum to lie about something to make myself feel better. with all due respect, :censored::censored::censored::censored: off.


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## medic417 (Apr 20, 2012)

NYMedic828 said:


> Yea that will go over well I'm sure. He wouldn't know a place that could possibly teach him something more even existed.
> 
> You haven't been useful for anything in this thread other than making assumptions that for whatever reason i came on this forum to lie about something to make myself feel better. with all due respect, :censored::censored::censored::censored: off.



I have done nothing but help you and everyone else to remember that there is more than just your side of the story.  No need for the rude response.  If you are telling the truth you should have no reason not to allow us to hear the other side.


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## NYMedic828 (Apr 20, 2012)

medic417 said:


> I have done nothing but help you and everyone else to remember that there is more than just your side of the story.  No need for the rude response.  If you are telling the truth you should have no reason not to allow us to hear the other side.



Actually Your only posts in this thread have been to question the validity of my story.

Do you really think it an exceptional idea to tell the person I am forced to sit next to for 30 hours a week that I utterly dispise him and everything he does and want to take it up with him on a public forum?

Thats the last of my quarrel with you. I have no reason to fight with someone behind a keyboard.


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## medic417 (Apr 20, 2012)

NYMedic828 said:


> Actually Your only posts in this thread have been to question the validity of my story.
> 
> Do you really think it an exceptional idea to tell the person I am forced to sit next to for 30 hours a week that I utterly dispise him and everything he does and want to take it up with him on a public forum?
> 
> Thats the last of my quarrel with you. I have no reason to fight with someone behind a keyboard.



Then choose not to fight as I have not fought, just pointed out we have only one side of the story.  In your mind you have presented the facts.  If your partner gave their side we would see they are biased towards them being right just as you are biased that you are right.  Then those of us on the outside would be able to see that the truth lies somewhere in the middle.  That or your partner would come on here hoping to prove to us they are the greatest of all time and we would then agree with you.  

No need to get excited just understand we should never pass judgement w/o the facts.  Though as those initially grabbing the pitch forks and torches on here proved many are more than willing to join a mob w/o all the evidence.  Heck we see it in the media even in todays news.


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## abckidsmom (Apr 20, 2012)

medic417 said:


> Then choose not to fight as I have not fought, just pointed out we have only one side of the story.  In your mind you have presented the facts.  If your partner gave their side we would see they are biased towards them being right just as you are biased that you are right.  Then those of us on the outside would be able to see that the truth lies somewhere in the middle.  That or your partner would come on here hoping to prove to us they are the greatest of all time and we would then agree with you.
> 
> No need to get excited just understand we should never pass judgement w/o the facts.  Though as those initially grabbing the pitch forks and torches on here proved many are more than willing to join a mob w/o all the evidence.  Heck we see it in the media even in todays news.



Or we could assume for the sake of discussion, which is all this is, that what he said was true, fully detailed, and completely accurate. Having assumed all of that, we could then discuss THAT situation, without relevance to the actual situation, I we choose to believe that there is anything wrong with discussing a one-sided scenario. 

And in the future, we could choose to contribute our opinion or knowledge on the topic at hand and maybe not question the veracity of posters.


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## medic417 (Apr 20, 2012)

abckidsmom said:


> Or we could assume for the sake of discussion, which is all this is, that what he said was true, fully detailed, and completely accurate. Having assumed all of that, we could then discuss THAT situation, without relevance to the actual situation, I we choose to believe that there is anything wrong with discussing a one-sided scenario.
> 
> And in the future, we could choose to contribute our opinion or knowledge on the topic at hand and maybe not question the veracity of posters.



Had he posted it as a scenario I would agree fully.  OP made blatant attack though of his partner w/o allowing a defense.  Big difference there.  Had it been posed as hypothetical event w/o attacking an individual then yes I agree lets presume the one side presented is 100% accurate but in this case the OP came to us asking us to bash his partner w/o all the facts being presented.  

All I have done is try to get all those that attacked the partner to recall that they have not been given enough evidence to do so.


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## Remeber343 (Apr 20, 2012)

NYMedic828, Don't mind Medic417, hes kind of an :censored::censored::censored: He likes to sound holier then thou and make smart 	:censored:	:censored:	:censored: remarks to get a reaction and start arguments.  Sounds like your "partner" needs a wake up call.  He sounds like a poor patient advocate and should probably be talked to by someone...  Sure we only hear your side of the story, but from the facts you are giving, sounds kind of like he is full of himself.  Good luck with dealing with him, every agency has people like that, makes it rough for the rest of us.


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## medic417 (Apr 20, 2012)

Remeber343 said:


> NYMedic828, Don't mind Medic417, hes kind of an :censored::censored::censored: He likes to sound holier then thou and make smart 	:censored:	:censored:	:censored: remarks to get a reaction and start arguments.  Sounds like your "partner" needs a wake up call.  He sounds like a poor patient advocate and should probably be talked to by someone...  Sure we only hear your side of the story, but from the facts you are giving, sounds kind of like he is full of himself.  Good luck with dealing with him, every agency has people like that, makes it rough for the rest of us.



Well thanks for the compliment.


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## Remeber343 (Apr 20, 2012)

medic417 said:


> Had he posted it as a scenario I would agree fully.  OP made blatant attack though of his partner w/o allowing a defense.  Big difference there.  Had it been posed as hypothetical event w/o attacking an individual then yes I agree lets presume the one side presented is 100% accurate but in this case the OP came to us asking us to bash his partner w/o all the facts being presented.
> 
> All I have done is try to get all those that attacked the partner to recall that they have not been given enough evidence to do so.



But by that statement you are saying there is enough evidence.  You just said so yourself, if he would have posted it as a scenario, you would have fully agreed.  Now you say since he added the bit about the partner, it makes your first thought of agreeing null?  That makes no sense.

Also, I would not say this is bashing, I would say he is just venting.  He isn't asking us to bash either.  Just wanted input.


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## medic417 (Apr 20, 2012)

Remeber343 said:


> But by that statement you are saying there is enough evidence.  You just said so yourself, if he would have posted it as a scenario, you would have fully agreed.  Now you say since he added the bit about the partner, it makes your first thought of agreeing null?  That makes no sense.



Nope an accusation is not a scenario.  Big difference that any intelligent person can easily see.


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## usalsfyre (Apr 20, 2012)

medic417 said:


> Big difference that any intelligent person can easily see.


Kinda like being able to see strawman arguments?


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## ffemt8978 (Apr 20, 2012)

That's enough of this one.


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