Refusing to provide service

[ThirdCareerMedic]

In my opinion refusing to care for a patient with a communicable disease, with appropriate PPE available, is unacceptable. What did you expect when you went into the medical field? Now I am not saying go into a TB patients room with no mask but it refuse to care but refusing to take a patient with AIDS is just blatantly ignorant.


We had a scenario in my ethics class about a hypoglycemic elderly patient who was combative and assaulted the tech who was trying to get out of bed. Out of my class (40ish) only 3 people said they would treat the patient, everyone else said they would refuse to enter the room or that they would wait for security. My favorite comment was "Assign a male nurse to the patient ".

Wow! Did your classmates come to understand their professional ethical obligations by the end of the course? (Hope springs eternal! :lol

 

[Veneficus]

We had a scenario in my ethics class about a hypoglycemic elderly patient who was combative and assaulted the tech who was trying to get out of bed. Out of my class (40ish) only 3 people said they would treat the patient, everyone else said they would refuse to enter the room or that they would wait for security. My favorite comment was "Assign a male nurse to the patient ".

I am not sure there is a problem here, if it was unsafe for a provider to enter and treat, waiting for security or refusing to put themselves in a dangerous situation seems perfectly acceptable to me.

There is not some fantastic martyrdom oaths that healthcare workers take.

When rushing in to help, if you get hurt and miss work who is paying for that?

If you are disabled, how does that affect your employability and quality of life.

Lose an eye to treat a hypoglycemic? Not a good trade in my book.

What is safe for some may not be safe for others, but I think the idea of self sacrifice in order to provide medical care is more than a little extreme.

 

[VFlutter]

What is safe for some may not be safe for others, but I think the idea of self sacrifice in order to provide medical care is more than a little extreme.

Very true, I am not advocating taking huge risks but at least to me personally potentially taking a punch from a confused patient would not stop me from providing care.

 

[Veneficus]

Very true, I am not advocating taking huge risks but at least to me personally potentially taking a punch from a confused patient would not stop me from providing care.

Make sure you don't take a head shot doing that or a floating rib

 

[ThirdCareerMedic]

Very true, I am not advocating taking huge risks but at least to me personally potentially taking a punch from a confused patient would not stop me from providing care.

I have had to work with confused (Alzheimer's) elderly patients who were being aggressive AND needed care. My first concern is always my and my partner's safety but when we are called out we have the duty to act and so attempt everything we could to gain the patient's cooperation. Distraction works well in some cases and calling a trusted caregiver to calm them works in others. It is important to get the proper training to be able to better interact with such patients AND knowing when it is futile and calling for back up.

In terms of the hypoglycemia patient, we know that the patient needs care immediately. We know that we can provide it but that to do so, we need to be sure we can do so without undue risk to ourselves. There are two of us and in an institutional setting, we should be able to quickly get staff to help us humanely restrain the patient. That may or may not be the case depending on the institution....

I work rural where we have little back up from fire, police or anyone else. The nature of our environment makes it imperative for us to learn how to deal with aggressive/confused patients and deescalate situations as quickly and safely as possible. In some ways, we may take more risks than urban medics. However, they are (hopefully) calculated risks based on what we know about the community and our desire to serve it....

Any thoughts?

 

[Veneficus]

In some ways, we may take more risks than urban medics. However, they are (hopefully) calculated risks based on what we know about the community and our desire to serve it....

Any thoughts?

I submit you have never worked in the inner city US...

The same can be said and is true.

There are many things that would be considered "extremely risky" to people who do not work and understand their environment.

I have knocked on doors so people can disarm their booby trap, walk past a table full of drugs and guns to attend to the matriarch of the family whos social security cheque was supporting 3 generations in the house. Never once did we call the cops or for back-up.

An experienced provider who understands, can work with, and manipulate their environment, while seemingly so, does not take much risk at all.

But it is impossible with the varied provider experience and environments to make blaket statements on what is risky or not.

What I do advocate is if you are unsure, untrained, outclassed, you play it safe.

If that means a patient suffers or dies, then they do. But providers come home in the same condition they left it in.

That is not negotiable. There are no "acceptable losses."

 

[ThirdCareerMedic]

I submit you have never worked in the inner city US...

What I do advocate is if you are unsure, untrained, outclassed, you play it safe.

If that means a patient suffers or dies, then they do. But providers come home in the same condition they left it in.

That is not negotiable. There are no "acceptable losses."

I am in full agreement with you there!