First Ride Along w/ Funny Story

[akflightmedic]

i'm not in this argument, i've just been observing, but i have a quick question for not just akflightmedic but for everyone.

Are you strictly against using some sort of placebo effect? Maybe you won't use them if lying about drugs, but for more simple things maybe you will? Or do you see them as flat out bad, and never use any sort of placebo? Is there a time for them to be used and a time not to be used?

an example i can think of is when i was working with junior lifeguards, one of them got a little jellyfish sting(around here they just come in the form of little red rashes). usual treatment is to spray with vinegar, but we were out, so i filled the bottle with water, sprayed it on, and told her it was vinegar. she didn't know the difference, and after spraying she let out a sigh like "ahhh, thats better," and went on with her day.

ok for small things, or wrong whenever?

When I respond as a medical professional in a box with blinkie things and whoo whoos...I do not have to resort to placebos. There just has not been a need for it when you are educated, professional and have all the tools you need at your disposal.

Will certain treatments possibly make them feel better with no studies to justify it...sure (your example was one, except you lied to her). I simply would have said water has a cooling effect and I will apply it now. No lie, no deception.

Had your treatment not worked, what would you have said? "Oh the vinegar must be expired", or would you then have to tell the truth and go get the right treatment. Will this junior lifeguard respect you now for lying to her, will she lose respect for others in your similar position since she equates an authority figure with more knowledge than her to a liar?

See where this goes?

 

[Epi-do]

I just hate it when people angrily jump to unreasonable conclusions without considering that there might be another side to the story.

First of all, I wasn't "angry" when making my comments. Shocked that someone could be such a horse's butt, yes, but not angry. Secondly, please share a circumstance where taping an aspirin to a patient's forehead is ever acceptable behavior. If there is one single, legitimate circumstance then I will be more than happy to give them the benefit of the doubt for their actions. (And, things such as trying to "show off" for the ride-along is not an acceptable reason. I am looking for a circumstance that would make this a medically acceptable action for the medic to take.)

 

[triemal04]

If they are having an anxiety attack (by this I am thinking you mean hyperventiliating as that what is keeps getting implied) and you have ruled out every other treatable medical condition which may cause hyperventilation (see previous threads on this topic and Vents wonderful replies) and you are unable to talk them down...guess what? The patient will pass out and resume normal breathing, they will also be calmer.

If they are truly in a panic attack with hyperventilation and I am unable to professionally, ethically and intelligently calm them down through the use of several "talking down" techniques, they will pass out and then it becomes a little easier.

Actually, I didn't mean someone who was hyperventilating; not every panic attack includes hyperventilation, and many only have a moderately elevated respiratory rate, if that. So waiting for them to pass out...not always going to happen. As is assuming that if they do, when they wake up everything will be hunkey-dory; what if the problem has continued? If the hyperventilation was secondary to an anxiety attack and they are still worked up, what do you think happens next? Now it's a nice cycle of pass out-wake up-pass out wake up and so on...sound like a good thing? And you should document all your treatments, as I've said, including this if it was used; no reason not to.

Like I said, will everyone need to do this? Nope. But, does everyone have the ability to chemically treat that type of problem? Nope. Does everyone have the ability to talk to every individual person in a way that will calm them during that type of situation? Nope. So what do you do?

Sasha-you can use whatever reason suits you...if it's not been needed in your experience then it hasn't been needed...as I said, not everyone will need to. Especially with a short transport. With longer though, the need to treat your pt will increase, and with limited options...what do you do? But do you know where you'll be working in the future? Do you know if you'll have the ability to use meds? It's better to have thought about a problem and found a solution before it happens.

 

[Sasha]

Where will I be working? In a hospital as a nurse, this is just a pas time gig til I start nursing school. Twist it however you want I won't lie to pts.

 

[exodus]

Where will I be working? In a hospital as a nurse, this is just a pas time gig til I start nursing school. Twist it however you want I won't lie to pts.

Okay Nurse Jackie! ;] Edit( This is a joke and I am not implying that you will be practicing anything she does, it is a joke... Btw, she doesn't lie to pt's!)

My first ride a long we Tx'd a women with an exacerbated (I can't spell that! Where it comes out...) bowel...

 

[triemal04]

Where will I be working? In a hospital as a nurse, this is just a pas time gig til I start nursing school. Twist it however you want I won't lie to pts.

I haven't twisted anything you've said, sorry. Try again. Or don't, either way.

 

[HotelCo]

Where will I be working? In a hospital as a nurse, this is just a pas time gig til I start nursing school. Twist it however you want I won't lie to pts.

Sasha, you're single-handedly destroying EMS. ^_^

 

[Melclin]

First of all, I wasn't "angry" when making my comments. Shocked that someone could be such a horse's butt, yes, but not angry. Secondly, please share a circumstance where taping an aspirin to a patient's forehead is ever acceptable behavior. If there is one single, legitimate circumstance then I will be more than happy to give them the benefit of the doubt for their actions. (And, things such as trying to "show off" for the ride-along is not an acceptable reason. I am looking for a circumstance that would make this a medically acceptable action for the medic to take.)

Angry, shocked. You know what I mean.

I already mentioned an example... if you replace thought protecting mask with thought protecting asprin. I can think of many examples. Most of which, I'm sure you can think of and disagree with, so there's not much point really.

I suspect that they genuinely felt it would help him but they didn't particularly care that the side affect was mild humiliation because he was a drug user. I don't have a problem with that. Everyone gets treated differently based on the kind of person they are, or appear to be. I don't mean medically, everyone gets equitable medical treatment. But would I make a cup of tea for an nice old lady who called me out in the middle of the night for a CC of 'bad dream', yes. Would I for a criminal who hurt himself while trying to rob said old lady, no, he'd get the least care I could medically afford to give him, get shoved into the back of the ambulance, told to shut up, and ignored, failing a life threatening change.

Aside from whether or not they were actually trying to humiliate him (maybe there's a bit of a cultural difference here) health care pros taking the piss out of addicts/users, even to their face, doesn't bother me. I've seen and heard of it happening plenty. If you choose that lifestyle as far as I'm concerned, you'll just have to put up with a little ridicule. As long as you aren't really sacrificing their actual medical care, I don't give a stuff if they feel a bit embarrassed. There are degrees of humiliation that I would probably find to be unacceptable, but taping an asprin to their forehead, especially seeing as though its actually helping them, doesn't qualify as over the top in my view. We'll just have to agree to disagree I suppose.

 

[Sasha]

Sasha, you're single-handedly destroying EMS. ^_^

I know, how horrible! I should be ashamed! How dare I actually want to further my education and go on to an actual profession and not stay in what is widely considered a hobby!

So, I contradict myself. I lied to a patient today. She spoke Spanish. I speak English. Despite telling her multiple times that I don't understand, she talked the entire transport. I smiled, nodded and tried to give her an impression that I was paying attention, even though I had noclue what she was saying.

According to a Spanish speaking nurse, I was smiling and nodding when she asked if we were going to puerto rico. We in fact were going to Orlando.

Angry, shocked. You know what I mean.

I already mentioned an example... if you replace thought protecting mask with thought protecting asprin. I can think of many examples. Most of which, I'm sure you can think of and disagree with, so there's not much point really.

I suspect that they genuinely felt it would help him but they didn't particularly care that the side affect was mild humiliation because he was a drug user. I don't have a problem with that. Everyone gets treated differently based on the kind of person they are, or appear to be. I don't mean medically, everyone gets equitable medical treatment. But would I make a cup of tea for an nice old lady who called me out in the middle of the night for a CC of 'bad dream', yes. Would I for a criminal who hurt himself while trying to rob said old lady, no, he'd get the least care I could medically afford to give him, get shoved into the back of the ambulance, told to shut up, and ignored, failing a life threatening change.

Aside from whether or not they were actually trying to humiliate him (maybe there's a bit of a cultural difference here) health care pros taking the piss out of addicts/users, even to their face, doesn't bother me. I've seen and heard of it happening plenty. If you choose that lifestyle as far as I'm concerned, you'll just have to put up with a little ridicule. As long as you aren't really sacrificing their actual medical care, I don't give a stuff if they feel a bit embarrassed. There are degrees of humiliation that I would probably find to be unacceptable, but taping an asprin to their forehead, especially seeing as though its actually helping them, doesn't qualify as over the top in my view. We'll just have to agree to disagree I suppose.

My heart goes out to your patients if you really think humiliating them is okay. We are patient advocates, not advocates only to the patients we like or agree with.

If they were really trying to just calm him down and weren't trying to humiliate him, there are less conspicuous places to tape an asprin. Inside of the wrist, maybe?

 

[Shishkabob]

What, you mean you didn't become fluent in Spanish so that you can better help your patients, like you claimed all people should?


^_^

 

[Sasha]

What, you mean you didn't become fluent in Spanish so that you can better help your patients, like you claimed all people should?


^_^

Becoming fluent in a language takes time, and I am working on learning Spanish. However my limited vocabulary goes out the window when the patient is speaking far too fast and is confused.

And I never said fluent, I said enough to communicate effectively with patients during an assesment. I can ask the patient if they are in pain, on a scale of 1-10, point to the pain, do you feel short of breathe? and tell them I am going to put them on oxygen in Spanish. Oh and I have the phrase "Hello my name is Sasha, I know very little Spanish" down perfectly. And "Adios!"

 

[Melclin]

My heart goes out to your patients if you really think humiliating them is okay. We are patient advocates, not advocates only to the patients we like or agree with.

If they were really trying to just calm him down and weren't trying to humiliate him, there are less conspicuous places to tape an asprin. Inside of the wrist, maybe?

Well that's good, I was afraid I was going to become a good paramedic, I'm glad I have you here to inform me otherwise. After reading your brief patronizing remarks, I realized how wrong I was and will endeavor to follow in your example of argumentative piety, sweeping generalizations and false dichotomies.

Mostly friendly sarcasm aside, on the topic of the asa on the head, that's probably true. But maybe they didn't think it out and discuss the matter on a forum before hand and they just happened upon an idea to calm a pt down, gave it a shot and maybe some of their frustration manifested itself with that, who knows. I did say I thought it was likely they were trying to make fun of him. I just thought it was unfair to write them off on an anecdote.

Anyway, I think I've made my point, and we know know you're a pillar of ethical practice, I've read plenty of your holier-than-thou posts before, and if you read mine you might notice that I like to play devils advocate for the sake of a fair argument. There's not much point in continuing the conversation, unless we both like whipping a dead horse.

 

[CAOX3]

Let me get this right people are trying to justify what these two dingbats did? A placebo effect. Right.

Fired.

 

[Epi-do]

Angry, shocked. You know what I mean.

I already mentioned an example... if you replace thought protecting mask with thought protecting asprin. I can think of many examples. Most of which, I'm sure you can think of and disagree with, so there's not much point really.

I suspect that they genuinely felt it would help him but they didn't particularly care that the side affect was mild humiliation because he was a drug user. I don't have a problem with that. Everyone gets treated differently based on the kind of person they are, or appear to be. I don't mean medically, everyone gets equitable medical treatment. But would I make a cup of tea for an nice old lady who called me out in the middle of the night for a CC of 'bad dream', yes. Would I for a criminal who hurt himself while trying to rob said old lady, no, he'd get the least care I could medically afford to give him, get shoved into the back of the ambulance, told to shut up, and ignored, failing a life threatening change.

Aside from whether or not they were actually trying to humiliate him (maybe there's a bit of a cultural difference here) health care pros taking the piss out of addicts/users, even to their face, doesn't bother me. I've seen and heard of it happening plenty. If you choose that lifestyle as far as I'm concerned, you'll just have to put up with a little ridicule. As long as you aren't really sacrificing their actual medical care, I don't give a stuff if they feel a bit embarrassed. There are degrees of humiliation that I would probably find to be unacceptable, but taping an asprin to their forehead, especially seeing as though its actually helping them, doesn't qualify as over the top in my view. We'll just have to agree to disagree I suppose.

Like Sasha mentioned, taping an asa to the wrist, arm, ankle, etc - ok. To the FOREHEAD - no, there is no other reason to do that than to humiliate/make fun of your patient.

How sad for your patients that you think it is ok to consciously choose to treat some patients better than others, based upon your preconceived notions of their situation. (And how is that any different than my feelings about how these medics treated this particular patient?) I am not going to say that I have always treated all of my patients to the best of my ability. I am willing to bet all of us have given less than our best on occasion. However, I have never consciously chosen to treat one patient better or worse than another based upon my opinions about their chosen lifestyle or actions leading up to their encounter with EMS.

Since neither one of us are going to change the others mind, I guess you are right and we will just have to agree to disagree on this one.

 

[SeeNoMore]

This is not aimed at anyone, but I also think its worth remembering that wholly worthy people can get themsevles in screwed up situations/periods of their lives. This does not take away personal responsibility, but we should never make fun of, or treat less seriously, a patient because they are in a bad way. Perhaps your professional conduct and care will be the impetus for a new start? You never know. I was a social worker for a time and believe very strongly that acts of respect and kindness that can seem small can have a huge effect.

Just food for thought.

 

[Sasha]

I guess in all that education required in austraila they didn't include an ethics class.

 

[WuLabsWuTecH]

I guess in all that education required in austraila they didn't include an ethics class.

Not that we have one here either?

 

[ffemt8978]

Do I really need to post my favorite smilie in this thread?

 

[medichopeful]

I guess in all that education required in austraila they didn't include an ethics class.

That seems a little low.

 

[Sasha]

That seems a little low.

So is humiliating patients because you don't agree with their lifestyle.

And no, we don't, we should, but we don't. However you can become an EMT in as little as two weeks here, and Austraila boasts higher educational standards.