DrParasite
The fire extinguisher is not just for show
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hmmm, I always thought that a DNR was a legal document written and signed by the patient and their doctor, enforceable by the courts. It took a 2nd year med student to tell me that they were just a request and didn't need to be followed because no one is physically going to stop you.Hell, a DNR is just a request, why not just ignore every DNR that meets criteria because, hey, it's just a request no one is going to physically stop you.
yes, I did, because it is only a request. We try to accommodate the hospital's request, but if we can't, oh well, not going to lose sleep over it, nor will I lose any sleep because the ER staff is unhappy that we brought a patient to them while on divert. And just so you are happy, nor will my supervisors, upper management, or local EMS regulatory agency.Didn't you just say it's just a request? Why even have reasons to begin with. If it's just a request, couldn't you just say, "We came here because we wanted to. You know... save the company gas money and put less miles on the ambulance."
BTW, when a hospital goes on divert, do they close their walk in entrance? no, they keep accepting patients, they just all need to wait a little longer. That's why a divert is a request and a courtesy, they can't actively refuse to accept a patient (something about EMTALA and dumping patients if I remember correctly).
well, I could always say "STOP!!!! do not touch MY patient!!!" would be extremely over dramatic, and not all that productive, but I COULD do it. Not that I would, especially for a simple, quick life saving intervention.What are you going to do to stop the hospital from treating someone on your gurney anyways?
But if the hospital wants to put the patient on a 12 lead monitor, starts 2 IVs and start pushing medications, maybe even putting in an advanced airway, I'm gonna say "hold it, lets put him on one of your beds, then you can do whatever you want, and we can get out of your way." and most of the time, it will get done. and if it doesn't, that's when you get your supervisors to call their supervisors and document everything to follow up to prevent it from happening again.
I guess it's a differences in the importance your hospitals view EMS. In NJ anyway, might not be the same out west.Why draw the line there? So they don't have a bed ready now, everything else gets delayed instead of getting imaging studies and labs cooking?
Also, if you permit all the work to be done with the patient on your cot, it means that your time and your equipment is not as valuable as theirs. meaning, why should they even try to get a bed for you when they can just have you babysit the patient until they get around to it? yes the work needs to be done, but it needs to tie up a hospital resource, not an EMS resource.
it has nothing to do with EMT, paramedic, IFT, 911, uneducated EMS or EMS that requires a Masters degree. it has to do with the fact that the ambulance does not belong in the ER in a holding pattern with no end in sight. 911 trucks need to be available to answer 911 calls, IFT trucks need to be available to answer IFT calls.
But if you accept the fact that you can be put in the holding pattern, than that means you have a very low opinion of yourself/your job and your role in the over all system, and you have accept that the ER's time and resources are more valuable than your own.
I might not be very educated when compared to some of the doctors, but at least I got enough self worth to know that my time isn't there just to be wasted by others. shame others in the profession don't have that same amount of self worth.