Medic dumps patient off gurney on purpose

[Uclabruin103]

Where did that 1.5% come from?

Do you not think the vast majority of these incidents go unreported, or do get reported but never go anywhere?

http://bfy.tw/RqS

 

[SandpitMedic]

Interesting protocol.

I was thinking the exact same thing. Taking lip service is part of the gig. You can't just knock everyone out.

 

[SandpitMedic]

We aren't debating the use of force by police.

Start a new topic if you have a grievance or inquiry.

 

[hogwiley]

That (former)Paramedic got what he deserved, I don't feel the least bit sorry for him. What a moronic hot head.

 

[waaaemt]

Wow, never thought a thread started by me would stir up so much controversy

As far as A hole patients, in my experience I have found that being obnoxiously nice to them, asking them to talk to you etc will make them settle down. Which EMS, fire and police should all be doing anyway..

 

[SandpitMedic]

Sentenced to one year of probation.

 

[akflightmedic]

How did I miss this thread? LOL

This particular incident hit very close to home, literally. I also know the guy and the behavior is not typical. I read every post in this thread and I see a few creeping towards alternative explanations but no justifications (I am unsure if there are any) however I can empathize with him.

A few facts I have not seen anyone address:

First, the patient was holding the stretcher hostage. The patient is a terminal cancer, AIDS and HEP C patient. The patient is a frequent caller of 911. He is dying, he is angry. (We could side bar here about inadequate end of life care, counseling and medical care as cause of patients attitude and abuse).

The patient is disgruntled and verbally abusive. Brevard County is a fairly busy service and some areas it is homeless call after homeless call.

After the patient was transported to the facility, the medics were instructed to bring the guy to triage. The patient went full on rant as he was under the impression that yet again he would get the immediate bed in back since he came by rescue. The video being showed everywhere is not the full video obviously as that does not get ratings. The patient refused to get off the stretched once brought to triage. The medics took the guy in back and tried to offload him there again, no could do. They brought the stretcher back to triage and tried to get the patient in a wheelchair. The patient refused to cooperate while at the same time berating everyone.

The ordeal went on for well over a half hour. He simply refused to get off the stretcher. Now while this event is gong on, there are other calls going out. Units are out of area, responses are being delayed and one contributor to this is a patient who will not get off the stretcher cause he is out front instead of in the back.

I can empathize with the medic...constant abuse, frustration over prolonged period of time, stress from patient, the subtle stress of other calls pending, the stress of 20 year career. It all has an effect whether the majority acknowledge or not, it exists (apparently it seems many of us are super human or simply have never worked in other systems for true comparison).

So there are so many overlapping contributing factors to this stretcher flipping from both the patient, the medic and the system...I simply cannot point the finger at the medic and say "bad, bad, bad". Could I possibly flip a stretcher one day? I do not think I would but I do think I could given the right circumstances. I simply would not know until in a similar situation and I have learned to never rule out anything.

Anyways, he did not get "only 1 year of probation"....he lost his career. He "surrendered" his paramedic license. His life is forever changed for the worse (right now) and the patient continues to call 911 however he now has his settlement check from the County to enjoy until his death...drink it up buddy!

 

[akflightmedic]

Just to further elaborate and frame this in a context where those who are mortified at the medic's behavior and are ready to persecute him...we are medical care givers. This means we very rarely treat a complicated patient on one issue alone. We have to recognize and identify many issues overlapping which all need some attention in order to "fix" the problem we were called for.

This situation and any situation actually is not that different...there are many "comorbidities" which brought the situation to what it is, what you are seeing. This is where human empathy and logic come into play. The system has failed its people in many different areas until they all overlapped, reacted, interacted and festered to an incident such as this.

At the end of the day all we are left with is two very hurt people, a lot of drama on the news so everyone else can ignore their own issues and a lot of righteous people finger pointing. None of this solved or helped the two people hurt the most...

 

[mgr22]

Just to further elaborate and frame this in a context where those who are mortified at the medic's behavior and are ready to persecute him...we are medical care givers. This means we very rarely treat a complicated patient on one issue alone. We have to recognize and identify many issues overlapping which all need some attention in order to "fix" the problem we were called for.

This situation and any situation actually is not that different...there are many "comorbidities" which brought the situation to what it is, what you are seeing. This is where human empathy and logic come into play. The system has failed its people in many different areas until they all overlapped, reacted, interacted and festered to an incident such as this.

At the end of the day all we are left with is two very hurt people, a lot of drama on the news so everyone else can ignore their own issues and a lot of righteous people finger pointing. None of this solved or helped the two people hurt the most...

Yes, two hurt people and all that, but I still think it's okay to say that specific behavior -- in this case, dumping a patient off a stretcher -- even out of context, even without having been there to witness it, is bad. I mean, can you imagine a curriculum anywhere in EMS that would include "dumping a patient off a stretcher" as a possible solution to any problem -- even one involving the safety of the providers? I'm trying to picture a practical exercise that begins, "Say your patient is on your stretcher in an ED, won't get off, and has a gun/knife/RPG. What would you do?" Is there a course or an algorithm anywhere that's going to include, even as a third-line option of undetermined value, "Consider dumping the patient off the stretcher?" Seriously, can't we just say that's a dumb thing to do?

 

[akflightmedic]

Until I am in that situation with the same issues I cannot definitively say I would or would not do something. It it seemingly a dumb thing? Sure it is. Is it justifiable? Maybe, who knows. However, the extreme comments and persecution displayed in this thread and in others I have seen are keeping it too simple, black and white...when if you actually pause and think, and consider all the factors at play and employ some human empathy...it might not have been all that irrational.

The entire weapon tangent is superfluous to this incident. When weapons enter the equation, all bets are off and anything/everything now becomes possible including "dumping the patient" which would actually be on my list of actions of defense.

 

[RedAirplane]

Yes, two hurt people and all that, but I still think it's okay to say that specific behavior -- in this case, dumping a patient off a stretcher -- even out of context, even without having been there to witness it, is bad. I mean, can you imagine a curriculum anywhere in EMS that would include "dumping a patient off a stretcher" as a possible solution to any problem -- even one involving the safety of the providers? I'm trying to picture a practical exercise that begins, "Say your patient is on your stretcher in an ED, won't get off, and has a gun/knife/RPG. What would you do?" Is there a course or an algorithm anywhere that's going to include, even as a third-line option of undetermined value, "Consider dumping the patient off the stretcher?" Seriously, can't we just say that's a dumb thing to do?

Hahaha gotta love textbook/protocol language

1. Take appropriate body substance isolation (BSI) precautions.

2. Reassess the patient's airway, breathing, and circulation (ABC).

3. Obtain On-line Medical Control (OLMC) orders as required by your local protocol.

4. Advise your patient of the procedure you are about to perform and its purpose in a calm and professional manner.

5. If possible, one EMT should look directly at the patient and reassure him while a second EMT performs the procedure. EMT #2 should lift the gurney with the knees, not the back (Fig. 2.3) and rotate it 180 degrees (Fig 2.4(a)-(d)) allowing the patient to gradually fall rapidly towards the ground.

6. Rotate the gurney 180 degrees once again and return the gurney to the ground.

7. Repeat steps 5-6 as necessary for overly adhesive patients.

8. Recheck distal circulation, sensation, and motor function (CSM).

 

[mgr22]

The entire weapon tangent is superfluous to this incident. When weapons enter the equation, all bets are off and anything/everything now becomes possible including "dumping the patient" which would actually be on my list of actions of defense.

I agree about weapons being tangential to the topic. I only mentioned them because others did. I think we're really straining to find a justification for stretcher dumping when we have to start treating it as if it were a martial-arts maneuver.

RedAirplane, I like it. You've shown the way. I feel much shame

 

[SeeNoMore]

I didn't think self defense was really the issue in this case? I am all about helping emts who are struggling with stress and anger. But you can't flip stretchers.

 

[Ewok Jerky]

I sympathize with this guy, I probably have been in situations where I wanted to tip a Pt on the floor...but I never did. And if I was at the point I thought it was OK to do so, I would be on the phone to a supervisor or my PCP asking for some mental help. As remi pointed out, its a sign of bad things to come either for me or my patients. So I do sympathize with the medic.
...however...
He should have gotten help when he started burning out. Too late now. That level of anger and impulsivity is too much to ignore.

At the end if the day, who cares if the Pt won't get off the stretcher? Is it really that big of a deal? Call security, call PD, call dispatch and let them know you are delayed. Other calls are going out? so what, there are other ambulances, there is no need to resort to violence.

I empathize and feel sorry for him, but he should not be in EMS. Maybe he is a nice guy who lost his cool, I don't know. If so then he doesn't deserve jail time or maybe a criminal record.

 

[DesertMedic66]

At the end if the day, who cares if the Pt won't get off the stretcher? Is it really that big of a deal? Call security, call PD, call dispatch and let them know you are delayed. Other calls are going out? so what, there are other ambulances, there is no need to resort to violence.

This. He doesn't want to get off my gurney in the lobby? Cool. I'll lower the gurney to the ground, I'll call security/pd, dispatch, and my supervisor to just let them know. Then I'll grab a chair and sit. I'll finish my paperwork and then I'll start watching some TV until the patient is removed from the gurney by PD.

Maybe I haven't been doing this job long enough but never once have I thought about flipping over the gurney with a patient on it.

 

[akflightmedic]

I sympathize with this guy, I probably have been in situations where I wanted to tip a Pt on the floor...but I never did. And if I was at the point I thought it was OK to do so, I would be on the phone to a supervisor or my PCP asking for some mental help.
He should have gotten help when he started burning out. Too late now. That level of anger and impulsivity is too much to ignore.

I snipped your quote, but this is exactly what I was saying only you did not seem to fully accept there was more involved than personal accountability.

My replies to this were multi-purpose:
1. To try and show others to not react and vilify so fast without at least giving consideration to other possible factors.
2. To highlight system failures.

Ewok, you make the assumption that the guy planed his course of action or even recognized it. Maybe it is also implied that someone else recognized it and ignored it? Either way it is sounding as if the guy planned his action instead of possibly considering that his reaction was in the heat of the moment and this WAS his breaking point. Maybe there were no signs leading up to this.

Did he himself recognize he had been harboring these feelings up to the point of snapitude?

I am beyond the guy doing something which I agreed was a very bad ideal. Root cause analysis here...we have issues on both sides (patient and paramedic)...what have we done about it? Step one is discussing it, bringing the issue forward and then exploring solutions. Next phase is actually implementing them. Where are we at with this? How can we prevent this going forward?

Or, is it just easy to point finger, crucify, say "I would never" and "how could he" and then we all go along our way until the next incident and repeat the cycle?

 

[akflightmedic]

This. He doesn't want to get off my gurney in the lobby? Cool. I'll lower the gurney to the ground, I'll call security/pd, dispatch, and my supervisor to just let them know. Then I'll grab a chair and sit. I'll finish my paperwork and then I'll start watching some TV until the patient is removed from the gurney by PD.

Maybe I haven't been doing this job long enough but never once have I thought about flipping over the gurney with a patient on it.

We all say/think this...that is until we are in the same situation. And that is the irony of Monday morning quarterbacking...none of us will ever be in that exact same situation. Similar yes, but never the same...so how can we say we would or would not?

I get your point, you offer very reasonable/sane solutions, but those simply do not apply sometimes.

I am not justifying his action, just want to clarify that before anyone misses it from earlier and goes off, but I absolutely empathize and am willing to explore outside contributors.

My solution would have been to keep the paramedic on the department and send him though a variety of medical and psych exam sessions and see if there was some help with counseling. Some benefit from this. His job would have been held until he could return and then he would be back in a probationary position assigned to a station with senior officers present.

As for the patient, the County could issue a formal apology and see about getting him some appropriate services as well. Find out why he is calling 911 repeatedly and abusing the system. He does not have long left to live so this would be a short term commitment, but it just might open their eyes to something they could change, something simple. Or not...but we do not know until we try something different.

 

[Ewok Jerky]

There are ways to deal with stress. Not recognizing it and letting it bottle up until you explode is not a good quality for EMS personelle.

Maybe he deserves a second chance, I don't know him and I don't know the specifics of the scenario that led to him intentionally flip a patient onto the floor.

 

[akflightmedic]

Yes, there are ways to deal with it and we all talk about it...for about 5 minutes and 2 pages in EMT school with a refresher of same length later on in Paramedic school.

Do "we" as a culture make it ok, do we recognize it, do we talk about it or do we deem those who do as being incapable and no longer worthy of being in the system?

Another friend of mine returned to work after almost 8 months of counseling. He finally opened up (ok, slight breakdown at work) and sought the help needed. He now has coping mechanisms in place. He is back at work and functioning...but at what cost? During his absence, he was accused of milking/abusing the medical policies in place, getting a paid vacation, called crazy, made fun of, called weak...people even said maybe he is not fit to work. They were all making decisions for him instead of standing him up and supporting him.

This is what boggles my mind. Someone does exactly what they should do to be healthy and we destroy them. Just because we personally do not or have not yet felt that way, we lack comprehension of it and refuse to have empathy.

We in EMS do not make it acceptable for our fellow workers to get the healthcare they need. We turn our backs on them.

 

[joshrunkle35]

Yes, I agree, however, you are focusing on the harm done to the practitioner, and others (like myself) are focused on the harm to society/future patients.

What would need to occur would be that the practitioner would probably have to move to a different state, so that there was no loss of public trust. As we don't have a national licensing system that would allow this to work, we look at whether society or the practitioner should suffer when it appears to be a "zero-sum" scenario, and we choose to apply the "cost" to the individual, rather than society.

Obviously, you are seeing a "whole sum" scenario, where harm to the practitioner and society can be prevented. Unfortunately, most agencies are not set up to rehabilitate practitioners who commit criminal actions at this moment.