Fired from patient complaint

[DrParasite]

Yeah it’s a huge problem in our system, and I guess what can u do , hop on for the ride we going to the ER

I'm curious: where is your system?

Because for a an experienced veteran, you seem very naive about how EMS works, particularly in the urban cities (meaning, it's not just YOUR system).

You can "educate" the population on misuse of EMS, risk a complaint being filed, and possibly end up terminated, or you can smile, be polite, and do what the patient and your management are asking you to do, and give them a nice comfy ride to the ER. I know what used to do when I was on the ambulance.....

 

[medichopeful]

"hey, you might not want to mix insecticide and industrial adhesives into your synthetic marijuana, and you should probably take your insulin at least somewhat regularly"

Killjoy.

 

[photog]

Someone please explain me this: why on earth would you give a ride to someone who doesn't require pre-hospital care and / or transportation with an ambulance? In my system (and pretty much in the whole country) we tell people that they are still free to take a taxi / bus / car / whatever to the E.R. if they feel the need to. We only transport patients if there is a (medically) valid reason for ambulance transport. Otherwise it would be a taxi service, not a pre-hospital emergency medical service. (I work in an ALS / critical care unit in a rather busy city.)

 

[rescue1]

In most places in the US it's not an option, thanks to (real or imagined) fear of litigation from management or the medical director.

There are a few places that let paramedics refuse transport in the States, but they're a minority.

 

[mgr22]

Someone please explain me this: why on earth would you give a ride to someone who doesn't require pre-hospital care and / or transportation with an ambulance? In my system (and pretty much in the whole country) we tell people that they are still free to take a taxi / bus / car / whatever to the E.R. if they feel the need to. We only transport patients if there is a (medically) valid reason for ambulance transport. Otherwise it would be a taxi service, not a pre-hospital emergency medical service. (I work in an ALS / critical care unit in a rather busy city.)

How did you conclude that the way your system redirects patients to alternative transportation is the way that's done "pretty much in the whole country"? I'm pretty sure you're in the minority, not the majority.

 

[mgr22]

Oh, you're from Finland. Never mind.

 

[photog]

In most places in the US it's not an option, thanks to (real or imagined) fear of litigation from management or the medical director.

There are a few places that let paramedics refuse transport in the States, but they're a minority.

Yes, I was thinking about something like that. It's a sad world where actions are guided by the fear of complaints or getting sued and not logical sense. Ambulances are not available for real emergencies when doing "taxi service". Yes, sometimes (less than 1 in 100 000 ambulance calls) misjudgements happen and people die (whether or not it had anything to do with them not getting an ambulance ride), but a significant number of lives are saved because of shorter response times to real emergencies.

Professionals working in the EMS should have enough suitable education and equipment to be able to do clinical decisions in the field. That also applies to dispatch center employees. That, and guidelines. In my country the national emergency response centre received a total of 2,65 million calls in 2017. Of those calls, only 1,35 million actually activated an emergency service response (EMS, fire, police). Also, around 40% of calls we responded with ALS / BLS ambulances ended up not transporting the patient.

Sorry, got a bit sidetracked from the original subject...

 

[photog]

Oh, you're from Finland. Never mind.

Yes. Sorry. Should have mentioned that. We also have basically free tax-funded health care system. EMS services (including ambulance rides) only cost around 24 EUR for the patient. Rest of the treatment is paid by the government.

 

[rescue1]

Yeah it's sad. It's not limited to EMS--it raises healthcare costs because physicians order tests or perform procedures just to cover their butts too.

What can I say, America is a great place to be a lawyer.

 

[mgr22]

Yes. Sorry. Should have mentioned that. We also have basically free tax-funded health care system. EMS services (including ambulance rides) only cost around 24 EUR for the patient. Rest of the treatment is paid by the government.

No problem, I shouldn't have assumed you were from the US. It's good to hear how EMS is handled elsewhere.

 

[Colt45]

Yeah it's sad. It's not limited to EMS--it raises healthcare costs because physicians order tests or perform procedures just to cover their butts too.

What can I say, America is a great place to be a lawyer.

Love this comment.

 

[FiremanMike]

Well a EMT was giving examples of how certian people abuse the ambulance knowing they aren’t going to pay for it and the tax payers will and the Emt gave options to a paitent to get to the ER because it a non emergency call but EMS was still happy to give them a ride to the ER for med refill

Do yourself a favor and commit the following to memory, it will save you countless hours of being pissed off at the people who called 911.

1. Everyone is going to the hospital, just offer them a ride and as long as the hospital they want to go to is a reasonable distance, oblige them.
2. You are not better than ANYONE who has called 911.
3. You will not fix the problems of abuse of healthcare. For every person that you think you "educated" as to the proper usage of 911, there are 10 more behind them ready to call 911 for the sniffles.
4. Make peace with the fact that you'll transport people for nonsense, no sense in being mad or arrogant about it, just accept it.
5. Your truck is not an irreplaceable resource. Move away from the mentality that someone actually sick might die while we're dealing with this stubbed toe and we could have been better used elsewhere. Take each run as they come in, the other runs will get handled, I promise.

If you can commit these things to your psyche, the job becomes SIGNIFICANTLY less stressful.

 

[VentMonkey]

Having found myself guilty of one, if not all five of the list @FiremanMike posted at some point in my career, I can tell you firsthand OP, A) that’s the best post in this thread, and B) he is absolutely right.

I know it’s frustrating, we all do. But, the layperson really does not know what they do not know; much like we don’t.

I get it’s only further compounded by co-workers who endlessly spout pointless war stories, and use terms like “patient advocacy” with absolutely zero comprehension of how to define this term (hint: their completely self-centered version is a far cry from what it means).

The reality is, is that I was fortunate enough to have been able to educate myself to the point of reasonable sanity, and learn how to practice a multitude of practical approaches to prehospital medicine. That could be anyone’s reality should they so choose to quit their griping, “water cooler” talk, SM bragging and just focus on the god damn job.

The former half of the previous sentence dictates ego, the latter half dictates self improvement. Which one seems much more like a sane persons quest to give it a go at an actual career to you?

And FWIW, even if paramedic isn’t the end-goal, the healthcare and public service fields have countless parallels.

 

[Peak]

@FiremanMike has great advice, I'm going to give you a slightly more jaded version.

You don't have to like your patients or their families, but being rude to them doesn't get you anything but trouble. Studies show that one of the largest predictors of having litigation against you is your patients perceptions of how much you care, not the quality of your care. Same translates to having complaints against you with the state or management.

It is easier to deal with happy patients than angry patients. This doesn't mean you need to provide treatment that you wouldn't otherwise give or withhold treatment they should have had. It does mean you should be polite in tone, syntax, content, and non-verbal communication. I'm still going to call CPS, but I'm going to tell you that it is because I'm concerned for the safety of you child and my legal obligation as a nurse and not as a judgment against you; and that my hope is that they can help you with resources so that you can have a great outcome with your child.

The patients that call 911 for primary care problems are well aware that they could have gone to the pharmacy and picked up ibuprofen, they chose not to. It might be that calling 911 was cheaper, it might be that they think calling 911 will be faster, it might be that they couldn't get a PCP appointment for two weeks. Regardless of the reason they called 911 and in the vast majority of the US that means that you are obligated to drive them in. The 911 system is rife with abuse; be it law enforcement, EMS, or fire.

The 911 system and ED will always have non-sick patients, this is part of your job. If you want to exclusively have sicker patients then you need to work where they are at, be it critical care transport or an ICU. Mind you that their families are still around and the patients are often still not particularly pleasant.

If you cannot deal with this (and mind you it takes practice and time), then EMS might not be the right spot for you. Between the pay, scope of practice, and political nonsense I got tired of it and left the 911 system.

 

[Carlos Danger]

The last three posters have all given excellent advice. 911 is hard to do and a lot of people can't do it forever. I'm one who couldn't. I worked in a busy urban system for a couple years and even though I kind of liked it, I found it very stressful and likely wouldn't have lasted a lot longer in EMS if I hadn't gotten into a different environment (HEMS). If I had been given and followed the advice above, I may have been much happier with my 911 role.

The bottom line - as the other guys said - is that you HAVE to just accept the job for what it is. And the reality is that 911 abuse is a big part of what it is. You learn to do that, and you might love the job. You don't do that, and you WILL probably hate it before too long.

Also, keep in mind that just because someone isn't suffering a life-threatening crisis doesn't mean that you aren't helping them in some way.

 

[joshrunkle35]

Well a EMT was giving examples of how certian people abuse the ambulance knowing they aren’t going to pay for it and the tax payers will and the Emt gave options to a paitent to get to the ER because it a non emergency call but EMS was still happy to give them a ride to the ER for med refill

It’s your job to be your patient’s advocate, not your state’s advocate or your job’s advocate.