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njemtbvol

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I ride on a volunteer squad 1-2 nights a week. Last week we get a call for a difficulty breathing at a private. Myself and my partner (both orthodox Jews wearing skullcaps) responded as usual. When we got to the house a young man (mid20's) called us frantically into the living room where his elderly grandmother was. The women, who was "lls" took one look at us and with what little breath she had started yelling how she wouldn't want to be touched by "dirty" Jews. Her grandson on the other hand was telling us not to listen to her and assist her.
She wasn't AMS, so we couldn't touch her, she allowed us to show her grandson how to put her on oxygen at which point she magically got better and quickly kicked us out.
(My guess is her family took her to the hospital the second we were out.)
My question is:
Should we have called for another unit?
 
Have her sign a refusal, call in to a recorded dispatch line stating what happened (preferably in a way that the patient could be heard saying she doesn't want you touching her), leave, and hope your AED has a charged battery.
 
did you treat her any differently because you were jewish?

were you trained to properly care for her?

and she did not want to be assisted by two trained professionals?

have her sign an RMA, or have her family sign for her that she doesn't want you to touch her. She has the right to refuse. and when she dies, and the family call you back, treat her like you would treat any other cardiac arrest.
 
A competent patient always has the right to refuse medical care, even if its potentially fatal for them to do so.

Don't worry about it.
 
We did have her sign an RMA, and no I didn't treat her any differently. My question was whether we should have called for another unit.
She would have received better care, but should we change protocols because the patient is for lack of a better term a racist.
 
njemtbvol said:
We did have her sign an RMA, and no I didn't treat her any differently. My question was whether we should have called for another unit.
She would have received better care, but should we change protocols because the patient is for lack of a better term a racist.
Click to expand...

No, no and no.

Assuming yourself and crew partner are two qualified Ambulance Officers then its really TS for her, if she doesnt want your help and declines treatment again its TS for her.
 
Brown is right, if she's mentally competent there is nothing you can do. Just explain the consequences refusing treatment, advise her to call back if things get worse, and document the hell out of it. In your pcr I would stick to the facts and leave out any mention of her being racist.
 
Exactly as Brown says.

I have walked into houses before and had folks decide they don't like me for some reason and tell me "NO".

If they are medically competent, they can sign an RMA and I let dispatch know over the recorded dispatch frequency. I then ask them to attach a writeup to the call.

Clear and back in service.

Remember, CYA.

WM
 
njemtbvol said:
volunteer squad
difficulty breathing
orthodox Jews wearing skullcaps
young man called us frantically
elderly grandmother
with what little breath she had
yelling how she wouldn't want to be touched by "dirty" Jews.
she allowed us to show her grandson how to put her on oxygen
she magically got better and quickly kicked us out.
Should we have called for another unit?
Click to expand...

You got insulted. What does that have to do with you making appropriate choices for your patient's welfare?

Even if you got a document releasing you that shouldn't cloud your judgment regarding her actual need to be seen. If you think she needs to go in, do what you can to make that happen. As best you can, make sure there's continuity of care; either make sure she gets a relative to take her in or another yarmulke-less ambulance gets there. You can do that without having any contact with her.

Technically though, I'd advise your dispatch of the situation and let THEM make the decision to call another agency or not. Then, do the usual CYA documentation. In this case, I'd say err on the side of fulfilling your moral obligation first.

If, in your assessment there's really nothing amiss, you've got an interesting story!
 
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It's your own judgment call, unfortunately. If she chose not to receive care from you, document it and leave.

If you felt passionate about her getting a ride in with an ambulance, call a second unit.

Both are defensible positions, IMO. One is working a little harder for the patient, but she could one day claim that her hypoxia was clouding her judgment...even though I don't typically practice litigious-sensitive EMS.

I've been in that situation because I was white and the patients were not, and we just got a refusal and left. The complaint was total BS though. I'm not sure if I'd clear up and walk away from a bigot who was actually sick without making sure they received adequate medical attention because my typical stance in life is to do the whole "kill them with kindness" routine.
 
This is a high risk refusal. I'd call for a district chief and they will either advise for a second unit, or come on scene and try to convince the pt to let us transport. If they still refuse, not my problem.
 
jjesusfreak01 said:
This is a high risk refusal. I'd call for a district chief and they will either advise for a second unit, or come on scene and try to convince the pt to let us transport. If they still refuse, not my problem.
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If the patient does not want to hear nor see Ambulance, a second crew is not going to do any good.

Try to involve the family by all means, but at the end of the day a competent patient has the right to refuse treatment including life saving treatment.
 
In my system there were no shortage of units, so I'd most likely call for another unit as I began the refusal process. Our system required online medical control for a refusal, so that took time. If another unit wasn't readily available, I'd have no problem signing a refusal.

Ultimately, as much it may frustrate us as providers, a competent patient has the right to refuse medical treatment.
 
If she was in a well enough state to sign off, Id have her sign and probably have all of her family sign as witnesses.

If she is too racist to accept help then let her deal with her decisions.
 
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Let me tell a small story about a partner of mine. I run with a volunteer agency and one of my frequent partners is an 18 year old girl, looks even younger. We were dispatched to a pedestrian struck on a major road where a 10 year old had bilateral femur fractures.

Upon arrival, patients mother starts screaming and tells my partner she is to touch her son because she was only a child herself. We informed her that my partner was very well educated and actually had more experience than myself having been certified at 16 running as a third EMT. She did not accept that and demanded a sup, our sup came out and told the mother its her or noone. His exact words were, "I refuse to have an additional ambulance dispatched because some bimbo will not let a well trained and experienced medical professional touch their kid because of age prejudice." Needless to say, a mom is a mom and gave in.

In the end, she sincerely apologized and admitted wrong.
 
MrBrown said:
If the patient does not want to hear nor see Ambulance, a second crew is not going to do any good.

Try to involve the family by all means, but at the end of the day a competent patient has the right to refuse treatment including life saving treatment.
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I'm of the opinion that if the patient has a real medical emergency (ie, something we would WANT to transport), and there is a way to get them to a hospital, then do it. If you have a second unit with a non-Jewish crew, then send them in, they take over the call, and that's that. If she still refuses, she refuses. If a patient expresses a hate for all ambulance personnel and doesn't want to go, that's different. I might try to reason with them, but won't be asking for a second unit. Its not that i'm worried about getting sued (once I have a signed refusal that's out of my mind), but a lot of the patients I see have subpar medical care, or haven't been to the doc in years, and if they are in any sort of emergent situation, going to the hospital for a full workup and a chat with the doc will do them good.
 
I have kind of the opposite problem. An alarming number of middle-to-old aged female pts seem to... take to me. The best was the 40-something streetwalker tripping out of her mind on PCP.

Still haven't run that magical call for a low-speed bus crash full of Swedish models. Maybe this week.
 
dixie_flatline said:
Still haven't run that magical call for a low-speed bus crash full of Swedish models. Maybe this week.
Click to expand...

I plan on making some business cards to carry around, in case this situation arises. They will read something like:

Brad XXXXX
Professional Life Saver
919-XXX-XXXX


And their might be a picture of a lifesaver candy, or me and a kitten, or me cradling an infant.
 
She's legally able to refuse (unless there are other facts at play you didn't share). It's her choice. If it happened to me, the refusal would be documented on a recorded medical command phone call, to cover my you-know-what.

OP - I'm sorry you had to deal with this... it is truly a shame that there is such prejudice in this world. Shalom
 
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