If you were granted one day to say what you want…

[EFDUnit823]

If you were granted to say anything you wanted to patients without any form of consequences, what would it be?

For me;

To the frequent flyer non-insurance having seekers

“Look, we are not a taxi and I am over picking you up 2/3/4 times a month so you can try to get high. Every time you are in the back of my ambulance, you are tying up a resource that maybe used for a REAL emergency!”

 

[Joe]

Ha 3 times a month??? More like 2-3 times a shift some days. Guy is a total seeker for sure. Or the people that call for complete horse crap when there is multiple working vehicles in the driveway and the for bls to the hospital and complain about the bumps and lack of morphine

 

[Aprz]

AAAAAAAAAAAAaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaahhhhhhhhhhhhhhhhhhhhhhhh!!!!

 

[SoCal911]

The bs calls I'd explain that any pain thats lasted "a couple days" can be driven to the hospital. And tell them bs calls are bs calls.

 

[Steveb]

'You see that phone use it to call a taxi'

 

[Tigger]

I would not say a word, I would just force altoids on every patient. There are few patients I dislike, patients with bad breath that overwhelms the exhaust fan make that list. Seriously I've been called every name in the book but I can brush that off. I cannot unsmell two weeks of failing to brush teeth.

 

[abckidsmom]

I always say what I want to. Sometimes I spin a little more PC than others but for the most part I just say what's on my mind.

Now if I could say whatever I wanted and they would listen to me and do what I say? That would be a good day.

 

[Shishkabob]

I always say what I want to. Sometimes I spin a little more PC than others but for the most part I just say what's on my mind.

Now if I could say whatever I wanted and they would listen to me and do what I say? That would be a good day.

I try to spin in my way while trying to not come off in a way that will gets complaints filed due to idiocy. Sucks. Still doesn't work.



IE, if someone says they've had leg pain for 5 days, one of my first questions is "Why did you wait 5 days to get it taken care of?" What I WANT to say is "So instead of calling 5 days ago, or driving yourself to the hospital for the past 4 days, you think calling 911 is the best way to be taken care of?"




But as I said, it doesn't always keep me from getting bad looks. I once had an abd pain patient, and I learned that they had been to the hospital 12 hours earlier for the same complaint, got pain and nausea medications and sent home. They have no taken any of the medications, nothing changed, and wanted to go back. My first question? "Why haven't you taken the medications that were prescribed to you this morning for this exact complaint?"

A legit medical question that will be asked by the RN and doctor on arrival to the hospital. A volly FF on scene complained to my station captain stating "It makes the patient feel like their call wasn't legit". I then proceeded to have a nearly 2 hours debate with my station captain about his "You call, we hall" mentality and my "How about we educate patients on when the proper time to call is?" mentality. I didn't get in trouble because there was nothing to get in trouble for, but still. This was at my old agency, and not my knew one which prides itself on trying to reduce abuse.




This is why I envy police officers. They can say it how it is without getting in trouble. Too many people in EMS think 911 is customer service to the general public, but it's not. There is no reason why we shouldn't be able to question the public's use of the system to their face... as, even though most will continue to misuse or abuse the system, if we never attempt, we'll never teach, and even attempting makes me feel better knowing I did what I could.

 

[abckidsmom]

I try to spin in my way while trying to not come off in a way that will gets complaints filed due to idiocy. Sucks. Still doesn't work.



IE, if someone says they've had leg pain for 5 days, one of my first questions is "Why did you wait 5 days to get it taken care of?" What I WANT to say is "So instead of calling 5 days ago, or driving yourself to the hospital for the past 4 days, you think calling 911 is the best way to be taken care of?"




But as I said, it doesn't always keep me from getting bad looks. I once had an abd pain patient, and I learned that they had been to the hospital 12 hours earlier for the same complaint, got pain and nausea medications and sent home. They have no taken any of the medications, nothing changed, and wanted to go back. My first question? "Why haven't you taken the medications that were prescribed to you this morning for this exact complaint?"

A legit medical question that will be asked by the RN and doctor on arrival to the hospital. A volly FF on scene complained to my station captain stating "It makes the patient feel like their call wasn't legit". I then proceeded to have a nearly 2 hours debate with my station captain about his "You call, we hall" mentality and my "How about we educate patients on when the proper time to call is?" mentality. I didn't get in trouble because there was nothing to get in trouble for, but still. This was at my old agency, and not my knew one which prides itself on trying to reduce abuse.




This is why I envy police officers. They can say it how it is without getting in trouble. Too many people in EMS think 911 is customer service to the general public, but it's not. There is no reason why we shouldn't be able to question the public's use of the system to their face... as, even though most will continue to misuse or abuse the system, if we never attempt, we'll never teach, and even attempting makes me feel better knowing I did what I could.

I love it when the cops step in and throw the BS card in strong language. It's fantastic.

 

[medickat]

This is why I envy police officers. They can say it how it is without getting in trouble. Too many people in EMS think 911 is customer service to the general public, but it's not. There is no reason why we shouldn't be able to question the public's use of the system to their face... as, even though most will continue to misuse or abuse the system, if we never attempt, we'll never teach, and even attempting makes me feel better knowing I did what I could.

Hah, this reminds me of a BS psych I did a few months ago.

Lobby of a mental health facility, 19 yo female patient, obvious drug seeker looking to go to the hospital for some Fentanyl for "hand pain." Freaking out and threatening everyone on scene.

One police officer offered a few expletives at her as a reflection of her character and then went over to a corner, got on his cell phone and ordered a tunafish sub from the local deli in front of her face.

She was hilariously not pleased.

 

[NomadicMedic]

I don't understand why you're not allowed to say that to a patient. If I have a patient that was seen at the hospital eight hours ago for nausea and vomiting, was prescribed meds and then went home… Then called 911 again, you can be sure that I'm going to ask that patient what they expect me to do for them and what they expect when they get to the hospital. And then I'm going to call the doc and get a BLS release, because there's no need for me to waste an ALS resource on a patient that does not need to be seen.

I've never gotten in trouble for calling BS on any patient. One of my favorites is, "who owns all these cars in the driveway?" the patient will usually point out brother, mother, sister, boyfriend, spouse, roommate… then I ask, "so which one of these fine folks are going to drive you to the hospital?"

Some of the things we get called to are simply ridiculous. And until somebody stands up and says "this is ridiculous" things will never change.

I clearly remember, while working a 72 hour shift in Washington, going to the same house three times in a row for a seeker. The third time I was there, I knew I wasn't going to take the patient but he was going to continue to complain and call 911. I finally called law enforcement and it turned out he had a warrant. Problem solved.

Document every call clearly. If you have the opportunity to get a refusal or a BLS release, use it. Don't tie up valuable resources for people that don't need this service.

 

[Shishkabob]

The thing is, I try to call it out in ways that won't lead to a complaint, as, even in a progressive system where provider refusals exists, I'm not too keen on getting a complaint with the person saying I talked them out of going, then my job gets in jeopardy for a stupid person calling for a stupid reason. Though, several of the medics I talk to at the agency, including our advanced providers, state they call out the BS patients fairly often.

Civilians complain for a lot less then being called out for stupidity (Like ambulances who "just turn on the lights to get through a red" even when they obviously don't know the call was cancelled)... I try to limit the things they can lie on to feel happy.




At my last agency, we had a patient a block from our station on a trach, and her husband would call weekly, if not more, for transport to the hospital. Complaint was always things such as fever. It got to the point where one of the hopsitals outright refused to accept the patient. After one week where a unit was sent nearly daily, I got fed up and pulled the husband aside.

I explained to him that what he kept calling for were not life threatening emergencies and therefor were not appropriate use of 911. He countered "But the doctors office said to" to which I further explained that's what they ALWAYS say. I told him I was not willing to run lights and sirens to their house and put innocent peoples lives in danger for something that was not an emergency. I asked him how he'd feel if some kid was run over on his street responding to his wife for a fever. I told him next time he needed her taken to the hospital, to call the non emergency number and set up transport that way.

For the next several weeks, whenever we got a call out there, it was non-lights and sirens. Lasted for a bit, but he reverted back to 911. Oh well, idiots never change.

 

[NomadicMedic]

Sure, we've all had people that abuse the system and we've all been suckered into taking patients with no complaint or problem to the ER. Specifically, I'm talking about the 22-year-old who's complaining of a "migraine" and when you arrive on scene is watching TV and playing with her cell phone. The house has 4 or 5 other people in it, everybody's smoking cigarettes, you have to walk around four cars in the driveway… You get the picture?

Those people will not go to the hospital with me, ALS. I've become very good at "painting a clinical picture" on the radio so the doc gets the full story and has no problem with what I'm doing. All of our radio traffic is recorded, and if anyone ever questions my actions, I've got the recording of the radio call and all of my documentation to back up my decision.

I'm sorry, but I am not about to waste a paramedic unit for these kind of calls. And if your service doesn't trust the judgment of the paramedics on scene, there's an issue there. All of our refusals and BLS releases go through a rigorous QI process, and if it turns out we're abusing the system, then that medic will have a problem. But for the most part, our medics are very good at clearing scenes where we're not needed.

Now having said that, all of my calls tomorrow will be pure BLS and I will wind up transporting every single one of them.

 

[Shishkabob]

Except for the difference between our agency types, n7. You do ALS fly cars. We have Paramedics on every truck. Your BLS can still transport when you decide it's not ALS worthy. We will still have the Paramedic on the truck even if it becomes a BLS transport.



But, better then my last agency, where the Paramedic had to run EVERY call, no matter how B(l)S.

 

[Bullets]

Simply, "No"

Drive yourself, you are fine

And to the intrusive family members who answer over the patient

"Are you injured? Are you looking to go to the hospital? Then go sit over there and shut up, unless you are going to drive"

And this is why i only do EMS for fun, and have switched to Law Enforcement for Profit. When i wear the black i can say this kind of stuff, when im wearing navy i get yelled at

 

[ffemt8978]

I would say nothing. Remember, when it comes to supervisors and customers, if it felt good saying it, it was the wrong thing to say.