Bystander MD and RN

ffemt8978

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Most of us have been on a call where somebody stated that they were a doctor or a nurse. I've had four of them, but I was wondering how you handle these people.

I will say that our protocols actually have a procedure for us to deal with this situation, and it's not too bad to work with.
 

rescuecpt

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In my area, we have medical control, medical control designated field physicians, and non-designated physicians. Medical control and MC designated field physicians can give order based on the protocols and do not have to be present in the ambulance to do so.

Non-designated physicians may give orders IF they accept responsibility for the patient and accompany us to the hospital in the ambulance. Also, we may only perform skills that are within our protocols and that we have been trained to do.

Nurses have no authority, unless they are a nurse practicioner working in their own environment, but to maintain authority they must ride to the hospital in the ambulance. PA's are the same way.
 

SafetyPro2

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I think the best way is to flat-out tell them that if they want to assume treatment, they can, but that they'll be riding the ambulance into the ER and staying with the patient until the ER staff takes over. Most of the time, that'll shut them up.

We did have a call a few weeks ago where an elderly male with Parkinson's had fallen on a residential street. One of the residents was an MD, and she stood at the scene (well out of the way) during the treatment and offered a couple of suggestions, but didn't try to take control and was very complimentary of our treatment.
 
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ffemt8978

ffemt8978

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Good points, but you're missing the obvious. ONE of the four calls I referred to involved a nurse that had LOST their license for some reason.

My question should have been, "How would you handle someone that claims to be a MD or RN on the scene of a call?" It is very difficult to verify credentials in the field.

Our protocols state that we only have to take orders from medical control. This means that if a doctor is on scene and telling us to do something that we shouldn't, we don't have to. We are to call medical control and let the two of them sling it out. We've had to do this a couple of times with a local clinic, who wanted to send trauma patients to their affiliated hospital (level 5 trauma center) instead of a designated trauma center as state law and our protocols require. We put the two doctors on the phone, and began transport to the appropriate trauma center while they were still talking.
 

rescuecpt

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We are told, in our protocols, that we need to see ID such as a State Medical Board License, Medical Association License, or an MD shield or license plate. The County designated field physicians have cards that identify them as such.

On July 4th one of our FF's got hurt at the house. He had a pretty good gash in his ankle from some sort of freak accident with the dolly we were using to shift kegs around. While we were cutting his sock off, a man came up and told us to just tear the sock off. We pointed out that it would be more traumatic to do it that way, and cutting was working just fine. He then stated that he was an orthopedic surgeon.

I said "Great! You're welcome to take over care here, but I need you to come to the hospital with us and sign our paperwork acknowledging that you are the responsible party." I looked down to grab a piece of gauze, and when I looked up, he was gone. Was it something I said? ;)
 
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ffemt8978

ffemt8978

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Originally posted by rescuelt@Jul 18 2004, 02:19 PM
I said "Great! You're welcome to take over care here, but I need you to come to the hospital with us and sign our paperwork acknowledging that you are the responsible party." I looked down to grab a piece of gauze, and when I looked up, he was gone. Was it something I said? ;)
My guess is that he had a tee time coming up. :D
 

MMiz

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I'm going to have to stick with ffemt8978 on this one, let them duke it out with online medical control.

I have yet to have a person approach me and offer assistance, but I'm sure it will ultimately happen.
 

Firechic

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I love our protocols in this situation - we do not recognize any Dr or RN - it is our patient and we treat them accordingly. Pretty straight forward there! B)
 

emeraldjay

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I love our protocols in this situation - we do not recognize any Dr or RN - it is our patient and we treat them accordingly. Pretty straight forward there!
Our protocols are real similar to yours. The MD is handed a little card that says something to the effect that once EMS is on scene, medical control is lord king and master. If the doc wants to help then he has to contact medical control to get permission. RN's get no recognition beyond a "yup that's nice" as near as I can tell from our book of protocols. To the best of my knowledge, an RN only gets a say when one is required during transport between facilities.

Personally, in an emergency, you won't find me standing around waiting to check credentials.
 

ma2va92

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it seems pretty simple here.... {but have yet to come across the problem} protocol states... call medical control with there ID number ... if it is approved they may help out and then as some have already said they must ride... it ID # is denied.. they there are told to back off .... medical control will also contact pd.. the the number is bad.. for what ever reason.... but we must have there ID to give to MC.....

easyer said that done.. I let you know as soon as i run up on this problem... and if they are a real jerk.. i'll let you know after i get bailed out
 

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