Sometimes I wish the hospital would not sedate my psych patients before

[Sasha]

Emtgirl21,

I work for a fully funded government run service. My qualifications are between your EMT-I & EMT-P. We do not have private transport companies. WE R NOT PART OF A FIRE BRIGADE!!!!!!!

Now that is out of the way. If you have read my posts, i agree that there are many transfers that are done that are not requiring ambulance resources. What I am challenging here is the notion that

1. as was staed earlier, all psych patients are drug addicts,

2. Even though they may have no physical injuries, a psych patient is indeed a medical emergency because they have an illness of the mind, &

3. That the attitudes that we, as so called prfessional are bordering on the ignorant by believing otherwise.

I have been assaulted by a psych pt in the past, so don't preach to me about that crap. EMS covers a vast array of illnesses, I am sick to death of hearing most people brag about the trauma the do, the cardiac, the off beat jobs, well psych is as off beat as they get, but no one wants to brag about them.

The attitude in the broader communities will never change if the attitudes within the medical community doesnt change. Mental Illness, according to the World Health Organisation will be, by 2020, second only to trauma as a killer. Like it or not, we will be dealing with it more & more over the next few years.

The challenge is to treat psych pateints with the dignity & respect they DESERVE. Sedation is an option, but should always be a final option.

Emtgirl21, try reading all of my posts again & this time read them properly, i am challenging everyone who reads this thread to open their minds, not just label all psych patients. Oh, yeah, & when we do a psych transfer it is in excess of 2 hours & the receiving hospital will not accept them sedated.

probably the best post on this thread.

 

[downunderwunda]

probably the best post on this thread.

Thank you.

 

[ffemt8978]

Oh, yeah, & when we do a psych transfer it is in excess of 2 hours & the receiving hospital will not accept them sedated.

Interesting concept there...
Longer transport time, longer time patient confined to ambulance, farther distance you travel, farther from immediate assistance you are, and you can't use sedation?

So if patient becomes violent during transport, and you sedate them for safety reasons, what are you supposed to do once you get to the receiving hospital? Drive around the block until the sedation wears off?

 

[downunderwunda]

Interesting concept there...
Longer transport time, longer time patient confined to ambulance, farther distance you travel, farther from immediate assistance you are, and you can't use sedation?

So if patient becomes violent during transport, and you sedate them for safety reasons, what are you supposed to do once you get to the receiving hospital? Drive around the block until the sedation wears off?

For all of the psych transfers I have done, i have found that by talking to the patient, negotiating with them, showing empaty to them, I have never even seen a need to chemically retrain. I have on occasion used a mechanical restraint, but that is representative of less than 0.5% of all transfers.

EMS is about knowing how to deal with people, how to talk to them & how to show respect. Drugs should alsways be a last resort in these cases, not a front line option.

 

[ffemt8978]

For all of the psych transfers I have done, i have found that by talking to the patient, negotiating with them, showing empaty to them, I have never even seen a need to chemically retrain. I have on occasion used a mechanical restraint, but that is representative of less than 0.5% of all transfers.

EMS is about knowing how to deal with people, how to talk to them & how to show respect. Drugs should alsways be a last resort in these cases, not a front line option.

I agree 100%, but I was wondering what would happen if you had to use that last option, since the hospital won't take them then.

 

[downunderwunda]

The psych hospital is currently seperate from the main hospital, they go to an ED restraine with mechanical restraints until they r lucid enough for further transfer on to the mental institution.

 

[Jon]

Does this mean we dont transfer obsterics cases because we are not appropriatley trained & there may be 'more appropriate transport' that should be made available.

We need clarity in definition here, mentally ill people are sick people. While I agree that ambulatory resources are misused with a lot, these people have an illness. Like it or not. Until there is better systems put inplace, it is more appropriate to transport in an ambulance than a police car, unless they are seriously violent.

I understand what you are saying... but they are also legally committed for a short-term (or longer term) hold... kinda like being arrested. They might need to be restrained. A separate system for transporting these patients makes sense.

 

[downunderwunda]

I understand what you are saying... but they are also legally committed for a short-term (or longer term) hold... kinda like being arrested. They might need to be restrained. A separate system for transporting these patients makes sense.

The simple fact is that this is still a MENTAL ILLNESS. That is, in reality medical. Not legal. They have a legal constraint to protect themselves & others just in case. The simple reality is that the vast majority are not violent, do not have & will never have violent tendencies & police/law enforcment is more inappropriate than an ambulance.

I always thought EMS was a caring profession, but obviously i must be mistaken, we only want to deal with the glory stuff so we can attempt to show how good we are.

Take the good with the bad. Psych patients deserve as good if not better treatment than most because we can make a real difference in their lives. If we treat them right today & look after them, they will remember it & each time you will make it easier for yourself. Too many in EMS are full of their own self importance & want to look down on our Psych patients.

Remember this though PTSD is a MENTAL ILLNESS. How many in EMS will suffer from this in varying degrees?

 

[Lone Star]

Hockey9019:

I have to agree with the posts I’ve read about your lack of empathy, compassion and professionalism. First off, not taking the appropriate steps to secure your belongings is your own fault. I don’t understand why you felt the need to bring an Xbox to work.

To refer to a psych patient as a “low life” is highly unprofessional! I’m willing to bet that when you do geriatric transfers, you refer to them as ‘gomer slings’, ‘raisin runs’ or other ‘derogatory terms’. These PEOPLE are our PATIENTS, and to diminish that shows that maybe you should consider a different line of work! I’m sure that this mentality wouldn’t even be tolerated at the local McDonalds!

As I stated earlier, these patients are human beings, and they deserve at least that much respect!



Buzz,

I too have done some really LONG distance transfers, (Detroit VA to Saginaw VA).

Yes, it was an ‘uneventful’ transfer, but with monitoring vitals, establishing history, meds, etc; it helped pass the time.