Were they justified?

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Sasha

Sasha

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I would just like some fellow EMS provider input on this.

I got sent home today from work. Let me tell you the story.

I was working a 2-10 shift. Our first and only call was an LBS patient who was 400 pounds. They knew when they dispatched this call to us that this was a heavy patient because we had to retrieve the LBS stretcher and we don't use that for anything less than 350.

So we got on scene, saw patient, decided we couldn't safely lift him. He was 400 pounds and sitting in a dialysis recliner without removable side arms. We called for a lift assist, and got denied. Mind you, we are both small women. We voiced our concern about not being able to safely lift the patient. Asked the RNs and techs for help, said they weren't allowed, was going to call the fire department to come out non emergency and assist us, told we couldn't do that.

So my partner and I took a seat, and waited. About an hour after that we get the "Unit 109, what is your status?" "Waiting for the patient to magically float to the stretcher".

We got our lift assist, got called back to the station, and sent home.

Was it justifiable to send us home?
 
Sasha said:
I would just like some fellow EMS provider input on this.

I got sent home today from work. Let me tell you the story.

I was working a 2-10 shift. Our first and only call was an LBS patient who was 400 pounds. They knew when they dispatched this call to us that this was a heavy patient because we had to retrieve the LBS stretcher and we don't use that for anything less than 350.

So we got on scene, saw patient, decided we couldn't safely lift him. He was 400 pounds and sitting in a dialysis recliner without removable side arms. We called for a lift assist, and got denied. Mind you, we are both small women. We voiced our concern about not being able to safely lift the patient. Asked the RNs and techs for help, said they weren't allowed, was going to call the fire department to come out non emergency and assist us, told we couldn't do that.

So my partner and I took a seat, and waited. About an hour after that we get the "Unit 109, what is your status?" "Waiting for the patient to magically float to the stretcher".

We got our lift assist, got called back to the station, and sent home.

Was it justifiable to send us home?
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Yes.

But they also made it extremely difficult for you.
 
Given the report on the radio, it could be justified, however, it is probably a bit too much. I once got sent home for calling a 'sanity check' out of boredom on the radio!

OH&S is very important. Here in Australia, we are not permitted to lift bariatric patients without lifting equipment (slings, etc) and all lifts are at least 2 people.

It is a wonder that the facility did not have patient lifters for a start, and I have used rescue staff for a lift when the patient is a little to heavy. We also have specialist ambulances over here now for the husky patients as normal vehicles are not actually weight rated for some of the patients these days.

I hope you enjoyed the afternoon off!
 
Run, don't walk, away from that company. You've got one back and it's not worth what ever they're paying you.
 
if thats actually what you said back, then yes they were perfectly justified in sending you home.

you need to be professionally ascertive in this type of situation. i would have told the supervisor on duty that the patient exceeds the maximum two person lift weight and that we required a lift assist. i would also have mentioned that the facility staff was unable/willing to help and that that is irrelevant becuase they certainly wouldnt be able to help us lift into the truck and out at the destination etc. inform the super that you will gladly wait until a lift assist is available but that you wont risk your health or the health of your patient to keep a schedule(my biggest greivance with the private ambulance industry). conduct yourself professionally when standing your ground against the company. anything else gives them grounds to give you the boot. i have gone toe to toe with the company more than once. two rules. be right and be professional.
 
Kev's right. In order to protect you and your partner, you reserve the right to refuse anything dangerous. That's precisely what you can tell your company.

That you're not refusing to transport that pt. But you are exercising your right to refuse to transport that pt without proper lifting assistance.

Stating it with any other tone of voice can give them justifiable cause to send you home, I'm afraid.
 
What I am about to say is not an attack of you, but an analysis of the facts you gave. I am sorry it it comes off that way.

I agree with all of the above statements. I also believe that if you had made that response over a "land line" as opposed to an open radio channel, you would have been fine.

You were clearly justified in waiting to lift the patient until you had proper manpower and or equipment. I dont think you were justified in just sitting there. Why didnt you continue to problem-solve? Call dispatch, ask them how long until they have a clear truck for the lift assist. How did the patient get to dialysis?

However justified you were, your mistake was making that comment over the air. You might have been frustrated about the situation, but that isnt an excuse to make a comment like that over an open, publicly accessible radio channel. When dispatch called asking your status, they were more than likely just doing a welfare check-- but curious how you made out with that patient.

If, at that time, they didn't have a truck available for a life assist, that's okay, they should have told you they would send the next clear truck in the area. There was no way you should have taken that patient yourselves, both for your own, and for your patient's safety. Perhaps the company should consider making a lift assist standard when using the bariatric stretcher, as other companies have done. Perhaps, if this is an dialysis patient, who your company transports often, in your dispatch it should go out as a double-male crew. Or maybe the the dialysis clinic should consider investing in a hoyer lift just for this patient. Possibly this patient should be dialyzed in a hospital bed, so you can do a sheet carry as opposed to having to pick them up over the arm rests, then lift the stretcher. What I am meaning to say is that there were ways to prevent this, and other options.

It seems there was a breakdown in a few places in this transport. From the companies policies related to bariatric patients, to the availability of units to assist you with a patient, to radio procedure, everyone could learn something from this call.
 
The patient got to dialysis earlier in the day by one of our trucks, but the truck was staffed with the two strongest people in our company who were able to safely lift him.

I informed them several times on the phone that I could not, and would not, safely lift the patient. I told them doing so put myself, my partner and the patient in danger of injury. We were either going to hurt ourselves or drop the patient. or both. We were told that they were too busy, couldn't get a lift assist out and to do our best. I asked if they wanted us to go take someone else's call and someone more able to safely lift the patient come here. Nope. Just get the patient on the stretcher. I also told them even if we could get the patient on the stretcher, we couldn't load him into the truck because we would need to two point him and have someone lift the carriage, which would require three people.
Problem solve? How do you expect us to get someone to heavy for us to lift up, over an arm rest, and onto a stretcher? When NO ONE would help us? The RNs and techs were all very adament that they weren't allowed to even support his legs. There was nothing that we could do. They had no bariatric lifts, no slide boards (though how you're going to use a slideboard to get a patient up and over an arm rest is beyond me.)

We asked nurses and techs to help. Nope.

Asked the patient if there's any way he could help at all, if he could stand or scoot. Nope.

Said we'd call the FD out for a lift assist, which has been done by our company before. Nope.

Perhaps I was too mouthy over the radio, but we had told them, more than once, that we needed help, that we weren't being lazy, we just could not do it. We were both frustrated.

Sure did get a lift assist out there quickly when an hour later, we still hadn't been able to get the patient on the stretcher.
 
emt-student said:
If, at that time, they didn't have a truck available for a life assist, that's okay, they should have told you they would send the next clear truck in the area. There was no way you should have taken that patient yourselves, both for your own, and for your patient's safety.
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That's half the reason we were annoyed. There were people getting cleared from the hospital right down the road and being sent on another call right away. When we got to the nursing home, there was another truck from our company picking up a patient. Sending us a lift assist would NOT have been difficult. It would have taken ten minutes from each truck. And no, these were all IFT trucks getting cleared, not 911 trucks. They were so concerned about getting everyone wherever they could be as quick as they could that they wanted us to lift a patient too heavy for us when freaking trucks are right down the road.
 
I mostly disagree with everyone.. I really don't think they were justified in sending you home. I'm not sure where you were when you said that over the radio, like in the hall or what not.. if they sent you home because you sarcastically snapped at dispatch around the patient, and made the company look incompotent (even though it sounds like they are), they might be justified in doing so.. but if you weren't by the pt or around many people, I don't see what the hell the problem is.

Besides the dignity and God complex of whoever sent you home, what is wrong with a sarcastic comment after an hour of legitmately doing your job and being criticized for it? Because someone may be able to eavesdrop on your radio channel and hear it? BFD. Some of the stuff said on our channels, I wouldn't dream of saying. To anyone. You didn't do anything "wrong" as far as EMTs are concerned..you did everything in your power to be an advocate for your patient: stood behind your instincts that the job in question was not safely possible, and tried to convince them.

Do you know the exact reason of why you were sent home? Was it because of the comment, or was it because of not trying to lift the 400lb patient? If it IS because of the comment, why was your partner sent home? If you genuinely told them you two can't lift 400lbs, especially in the pt's weird position and no equipment being available..and they sent you home because of it, ..screw that.
 
I agree with what Kev said except sending you home. I think if thats what you really said on the radio then a quick talk would suffice, sending you home is kind of harsh.
 
When dispatch called asking your status, they were more than likely just doing a welfare check-- but curious how you made out with that patient.
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By the way, we don't do IFT well fare checks unless it's to a private residence in the ghetto :P They wanted to know why we were taking so long.
 
Sasha, I don't believe I have ever posted in response to you but I feel that this is a wonderful opportunity for you to grow in your profession. You strike me as a pretty sharp cookie, and I believe you are in the profession for the right reasons. You have a personal style that some of us oldsters can sometimes find irritating. This is true for all of us. EMS attracts strong personalities and who of us haven't irritated someone at some point.

I can sometimes come across as a flake. I have a light hearted approach to things and habitually "throw myself under a bus". These things can hurt me professionally. I was in medic school when my mentor told me that I had to become aware of how I appeared to others. I have had to modify my style, especially when dealing with professional issues.

You had a problem on the scene. As a woman, there are always people that will judge on your ability to lift. You can be whip smart and wonderful with people, know your medicine and still it comes down to many people as "can she lift".

What I am trying to say is that you need to make an extra special effort to stay very professional whenever you are resolving problems, especially when it is a hot button topic like lifting.

Bottom line - you were correct about not putting yourself and your partner in danger. You were out of line not with what you were communicating but how you communicated it.
 
I stand corrected by you Sasha, with the details it makes more sense, and you are further justified. If you feel that what you did was right, you need to make sure you document it well. Document this on the PCR, write an incident report with the facts, do whatever you need to. Does dispatch record all telephone and radio conversations? Good. They can only support you.

Did they punish you with anything else? Suspension? Ask your supervisor for a reason for it. Appeal the decision, cite the evidence. The big thing, is just document it well.
 
Probably should have rephrased your response over the radio.

"109, what's your status?"
"Unable to safely lift PT. Your orders?"

Throw it back at them.

But that said... I'd be bugging out of there if that's how they play.


Later!

--Coop
 
First,what was you sent home for?Get back to me and let me know.I will then tell you your next step.Also find out what your policy and procedures are for filing a grievance
 
Should you have been sent home?

It depends why. If it was for refusing to lift a heavy pt. Absolutly not. You have to know your limits. Here we have the right to refuse dangerous work. A 400lb pt that will hurt you if you try to lift is dangerous work. I believe you did the right thing by refusing to lift without the proper assistance.

However. Your tone (I'm guessing), and words on the radio were not the best choice possible. Here you would have got at least a letter of reprimand for it. If this is why you were sent home you probably have to suck it up. That's your companys way of diciplining you. You deserve to know why you were sent home and should have a letter to that effect.

Sometimes we really want to say what is on our mind but have to bite our lip and say something more diplomatic. I know. I've gotten a letter for it.
 
Sasha said:
I would just like some fellow EMS provider input on this.

I got sent home today from work. Let me tell you the story.

I was working a 2-10 shift. Our first and only call was an LBS patient who was 400 pounds. They knew when they dispatched this call to us that this was a heavy patient because we had to retrieve the LBS stretcher and we don't use that for anything less than 350.

So we got on scene, saw patient, decided we couldn't safely lift him. He was 400 pounds and sitting in a dialysis recliner without removable side arms. We called for a lift assist, and got denied. Mind you, we are both small women. We voiced our concern about not being able to safely lift the patient. Asked the RNs and techs for help, said they weren't allowed, was going to call the fire department to come out non emergency and assist us, told we couldn't do that.

So my partner and I took a seat, and waited. About an hour after that we get the "Unit 109, what is your status?" "Waiting for the patient to magically float to the stretcher".

We got our lift assist, got called back to the station, and sent home.

Was it justifiable to send us home?
Click to expand...

First a few questions.

1. who did you call for lift assist?

2. who denied fire dept help?

Although it was impossible for you to move the pt, and just waiting was fine, the reply on the radio is probably what did it. Maybe someting like "We cannot safely lift the pt and have been denied lift assist 3 times so we are still on scene."

Is there another company you can work for?:unsure:
 
aidan said:
what is wrong with a sarcastic comment after an hour of legitmately doing your job and being criticized for it? Because someone may be able to eavesdrop on your radio channel and hear it? BFD.
Click to expand...

I believe it is a big deal. If we want to be taken seriously as a profession then we have to be professional. Scanner land is alive and well. People hear things and right or wrong make judgements. They then pass that judgement along to their friends and community. That then becomes one more thing we have to overcome. I don't believe smart *** comments belong in the public domain. They are best kept amongst ourselves in private.

Just my opinion.
 
Outbac1 said:
I believe it is a big deal. If we want to be taken seriously as a profession then we have to be professional. Scanner land is alive and well......(and) I don't believe smart *** comments belong in the public domain. They are best kept amongst ourselves in private.
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I absolutely agree. Think about what you are putting out there for the world to see, hear and ultimately judge you by. This sounds like a combination of frustration and immaturity. Whether we are paid or volunteer, we each carry a responsibility to conduct ourselves in a respectable manner that lends credibility to our profession and agencies.

I mean no disrespect to you when I say the over-the-air comment about a pt floating to the stretcher is right up there with the "EMS Eye Candy" line in your sig file. It‘s haughty, arrogant, inappropriate and has no place in the professional world of EMS, IMO. You probably do not intend to be perceived that way, but clearly you are. That said, you should look at this situation as more of an overall learning experience, take what is said in the manner in which it’s intended and apply it in everything you do EMS related.

Side note: When you need lift assist, you need lift assist period. You are on scene, you are the eyes and ears for dispatch. When you need help, they should take your request seriously and get it out to you immediately. To do any less is simply poor patient care.
 
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