Guest guest Posted April 26, 2010 Report Share Posted April 26, 2010 I have a sincere request for the list. Please let me know your honest opinion about the following: Three shifts ago, I was dispatched via 911 for an elderly man with difficulty breathing. I and my partner arrive to find a 50+ male complaining of shortness of breath after just having woken up. Patients states he needs oxygen. On assessment, patient is hypoxic, SpO2 of 88%, BP 136/80, P 84, R 16, breath sounds dimminished lower lobes. I requested my partner to apply oxygen at 15 L/m via NRB and continue to assess the patient. He is a hemodialysis patient that is schedualed to get his treatment the next day. I explain to the patient that he is possibly suffering from fluid overload and needs to get dialysis. Patient agrees, and confirms that he has had more fluid then he is supposed to. I advise patient to let us take him to the local ER and be evaluated. Patient states that he now feels much better and does not wish to be transported. I explain that his condition, while right now seems better, could worsen and he should be seen by a doctor for evaluation. Patient refuses transport again and states if he feels bad later he will call 911 later. Patient signs refusal of transport form and we return to base. Forward to two shifts ago and my direct supervisor pulls me aside and tells me that he does not believe that I should have allowed that patient to refuse transport and that this call and PCR will be reviewed. Today, I am told that I am being given both a verbal and written reprimand for that call. I am told that the patient was contacted and he both validated that the events of the call went as I stated on his PCR and that he refused transport of his own free will. I am being reprimanded for both allowing this patient to refuse transport and for performing a treatment, I.e. Oxygen, before transporting this patient. I am told I should have advised the patient that it is officially against company policy to allow refusal of transport if patient calls 911, and that I should have with held the oxygen until the patient was on my stretcher in the back of my unit enroute to the ER. I refused to sign this written repremand and was immediatly suspended without pay, pending further review of this call and my actions. What did I do wrong? What could I have done different? What can I do now? I am standing firm that what I did was correct patient care, and that I cannot coerce or force a patient to be transported against their will. McGee, EMT-P Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2010 Report Share Posted April 26, 2010 Is the statement that " it is officially against company policy to allow refusal of transport if patient calls 911, and that I should have with held the oxygen until the patient was on my stretcher in the back of my unit enroute to the ER. " In writing? If so I'd hang on to that. Since they are saying you don't accept refusals from persons who call 9-1-1 are they advocating violating a Patients right to refuse? As for witholding O2 from a Patient in extemis I'd call that criminal and I've fired BLS folks for not giving O2 in a timely manner. Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Typed by my fingers on my iPhone. Please excuse any typos. (Cell) LNMolino@... > I am told I should have advised the patient that it is officially > against company policy to allow refusal of transport if patient > calls 911, and that I should have with held the oxygen until the > patient was on my stretcher in the back of my unit enroute to the ER. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2010 Report Share Posted April 26, 2010 Is the statement that " it is officially against company policy to allow refusal of transport if patient calls 911, and that I should have with held the oxygen until the patient was on my stretcher in the back of my unit enroute to the ER. " In writing? If so I'd hang on to that. Since they are saying you don't accept refusals from persons who call 9-1-1 are they advocating violating a Patients right to refuse? As for witholding O2 from a Patient in extemis I'd call that criminal and I've fired BLS folks for not giving O2 in a timely manner. Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Typed by my fingers on my iPhone. Please excuse any typos. (Cell) LNMolino@... > I am told I should have advised the patient that it is officially > against company policy to allow refusal of transport if patient > calls 911, and that I should have with held the oxygen until the > patient was on my stretcher in the back of my unit enroute to the ER. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2010 Report Share Posted April 26, 2010 Is the statement that " it is officially against company policy to allow refusal of transport if patient calls 911, and that I should have with held the oxygen until the patient was on my stretcher in the back of my unit enroute to the ER. " In writing? If so I'd hang on to that. Since they are saying you don't accept refusals from persons who call 9-1-1 are they advocating violating a Patients right to refuse? As for witholding O2 from a Patient in extemis I'd call that criminal and I've fired BLS folks for not giving O2 in a timely manner. Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Typed by my fingers on my iPhone. Please excuse any typos. (Cell) LNMolino@... > I am told I should have advised the patient that it is officially > against company policy to allow refusal of transport if patient > calls 911, and that I should have with held the oxygen until the > patient was on my stretcher in the back of my unit enroute to the ER. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2010 Report Share Posted April 26, 2010 , I am so confused. You are a provider in a Emergency response organization. The fact that the public depends on you to do your job had no meaning on the fact that someone is looking for money. We are trained to do our jobs quickly and efficiently to benefit the patient. Your agency is taking a step that seems to be unstable to say the least. If your write up says those things make that copy and hold dearly. They are asking you to withhold treatment and force payment. Even a diabetic that is out and is revived with dextrose has the right to say NO. There is not a policy out there that will stop that ever. So I am truly perplexed to hear them choosing to do discipline over this call. ________________________________ To: texasems-l Sent: Mon, April 26, 2010 10:04:50 PM Subject: Raw deal or not I have a sincere request for the list. Please let me know your honest opinion about the following: Three shifts ago, I was dispatched via 911 for an elderly man with difficulty breathing. I and my partner arrive to find a 50+ male complaining of shortness of breath after just having woken up. Patients states he needs oxygen. On assessment, patient is hypoxic, SpO2 of 88%, BP 136/80, P 84, R 16, breath sounds dimminished lower lobes. I requested my partner to apply oxygen at 15 L/m via NRB and continue to assess the patient. He is a hemodialysis patient that is schedualed to get his treatment the next day. I explain to the patient that he is possibly suffering from fluid overload and needs to get dialysis. Patient agrees, and confirms that he has had more fluid then he is supposed to. I advise patient to let us take him to the local ER and be evaluated. Patient states that he now feels much better and does not wish to be transported. I explain that his condition, while right now seems better, could worsen and he should be seen by a doctor for evaluation. Patient refuses transport again and states if he feels bad later he will call 911 later. Patient signs refusal of transport form and we return to base. Forward to two shifts ago and my direct supervisor pulls me aside and tells me that he does not believe that I should have allowed that patient to refuse transport and that this call and PCR will be reviewed. Today, I am told that I am being given both a verbal and written reprimand for that call. I am told that the patient was contacted and he both validated that the events of the call went as I stated on his PCR and that he refused transport of his own free will. I am being reprimanded for both allowing this patient to refuse transport and for performing a treatment, I.e. Oxygen, before transporting this patient. I am told I should have advised the patient that it is officially against company policy to allow refusal of transport if patient calls 911, and that I should have with held the oxygen until the patient was on my stretcher in the back of my unit enroute to the ER. I refused to sign this written repremand and was immediatly suspended without pay, pending further review of this call and my actions. What did I do wrong? What could I have done different? What can I do now? I am standing firm that what I did was correct patient care, and that I cannot coerce or force a patient to be transported against their will. McGee, EMT-P Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2010 Report Share Posted April 26, 2010 , I am so confused. You are a provider in a Emergency response organization. The fact that the public depends on you to do your job had no meaning on the fact that someone is looking for money. We are trained to do our jobs quickly and efficiently to benefit the patient. Your agency is taking a step that seems to be unstable to say the least. If your write up says those things make that copy and hold dearly. They are asking you to withhold treatment and force payment. Even a diabetic that is out and is revived with dextrose has the right to say NO. There is not a policy out there that will stop that ever. So I am truly perplexed to hear them choosing to do discipline over this call. ________________________________ To: texasems-l Sent: Mon, April 26, 2010 10:04:50 PM Subject: Raw deal or not I have a sincere request for the list. Please let me know your honest opinion about the following: Three shifts ago, I was dispatched via 911 for an elderly man with difficulty breathing. I and my partner arrive to find a 50+ male complaining of shortness of breath after just having woken up. Patients states he needs oxygen. On assessment, patient is hypoxic, SpO2 of 88%, BP 136/80, P 84, R 16, breath sounds dimminished lower lobes. I requested my partner to apply oxygen at 15 L/m via NRB and continue to assess the patient. He is a hemodialysis patient that is schedualed to get his treatment the next day. I explain to the patient that he is possibly suffering from fluid overload and needs to get dialysis. Patient agrees, and confirms that he has had more fluid then he is supposed to. I advise patient to let us take him to the local ER and be evaluated. Patient states that he now feels much better and does not wish to be transported. I explain that his condition, while right now seems better, could worsen and he should be seen by a doctor for evaluation. Patient refuses transport again and states if he feels bad later he will call 911 later. Patient signs refusal of transport form and we return to base. Forward to two shifts ago and my direct supervisor pulls me aside and tells me that he does not believe that I should have allowed that patient to refuse transport and that this call and PCR will be reviewed. Today, I am told that I am being given both a verbal and written reprimand for that call. I am told that the patient was contacted and he both validated that the events of the call went as I stated on his PCR and that he refused transport of his own free will. I am being reprimanded for both allowing this patient to refuse transport and for performing a treatment, I.e. Oxygen, before transporting this patient. I am told I should have advised the patient that it is officially against company policy to allow refusal of transport if patient calls 911, and that I should have with held the oxygen until the patient was on my stretcher in the back of my unit enroute to the ER. I refused to sign this written repremand and was immediatly suspended without pay, pending further review of this call and my actions. What did I do wrong? What could I have done different? What can I do now? I am standing firm that what I did was correct patient care, and that I cannot coerce or force a patient to be transported against their will. McGee, EMT-P Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2010 Report Share Posted April 26, 2010 " I am told I should have advised the patient that it is officially against company policy to allow refusal of transport if patient calls 911 " ?? What last I checked that referred to as kidnapping. ANY patient with decision making capability can refuse treatment and/or transport. Your company might want to check the enforceability of there so called policies. Jim< Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2010 Report Share Posted April 26, 2010 " I am told I should have advised the patient that it is officially against company policy to allow refusal of transport if patient calls 911 " ?? What last I checked that referred to as kidnapping. ANY patient with decision making capability can refuse treatment and/or transport. Your company might want to check the enforceability of there so called policies. Jim< Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2010 Report Share Posted April 26, 2010 Company policy vs. Standard of Care. This does not sound good for the company. I smell a lawyer in your future. Jodi CEP From: texasems-l [mailto:texasems-l ] On Behalf Of Sent: Monday, April 26, 2010 8:05 PM To: texasems-l Subject: Raw deal or not I have a sincere request for the list. Please let me know your honest opinion about the following: Three shifts ago, I was dispatched via 911 for an elderly man with difficulty breathing. I and my partner arrive to find a 50+ male complaining of shortness of breath after just having woken up. Patients states he needs oxygen. On assessment, patient is hypoxic, SpO2 of 88%, BP 136/80, P 84, R 16, breath sounds dimminished lower lobes. I requested my partner to apply oxygen at 15 L/m via NRB and continue to assess the patient. He is a hemodialysis patient that is schedualed to get his treatment the next day. I explain to the patient that he is possibly suffering from fluid overload and needs to get dialysis. Patient agrees, and confirms that he has had more fluid then he is supposed to. I advise patient to let us take him to the local ER and be evaluated. Patient states that he now feels much better and does not wish to be transported. I explain that his condition, while right now seems better, could worsen and he should be seen by a doctor for evaluation. Patient refuses transport again and states if he feels bad later he will call 911 later. Patient signs refusal of transport form and we return to base. Forward to two shifts ago and my direct supervisor pulls me aside and tells me that he does not believe that I should have allowed that patient to refuse transport and that this call and PCR will be reviewed. Today, I am told that I am being given both a verbal and written reprimand for that call. I am told that the patient was contacted and he both validated that the events of the call went as I stated on his PCR and that he refused transport of his own free will. I am being reprimanded for both allowing this patient to refuse transport and for performing a treatment, I.e. Oxygen, before transporting this patient. I am told I should have advised the patient that it is officially against company policy to allow refusal of transport if patient calls 911, and that I should have with held the oxygen until the patient was on my stretcher in the back of my unit enroute to the ER. I refused to sign this written repremand and was immediatly suspended without pay, pending further review of this call and my actions. What did I do wrong? What could I have done different? What can I do now? I am standing firm that what I did was correct patient care, and that I cannot coerce or force a patient to be transported against their will. McGee, EMT-P Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2010 Report Share Posted April 26, 2010 , Your company's policy violates the law.  An adult patient who has the present mental capacity to make an informed refusal, has the right to do so, and your company cannot force him to consent.  Sounds like you're company is trolling for billable fares. Technically, forcing a patient into the ambulance is kidnapping and assault. Further, your company's directive to withhold oxygen until the patient is in the truck violates every tenet of emergency care. Find a new job. GG Subject: Raw deal or not Date: April 26, 2010 8:04:50 PM MST To: texasems-l I have a sincere request for the list. Please let me know your honest opinion about the following: Three shifts ago, I was dispatched via 911 for an elderly man with difficulty breathing. I and my partner arrive to find a 50+ male complaining of shortness of breath after just having woken up. Patients states he needs oxygen. On assessment, patient is hypoxic, SpO2 of 88%, BP 136/80, P 84, R 16, breath sounds dimminished lower lobes. I requested my partner to apply oxygen at 15 L/m via NRB and continue to assess the patient. He is a hemodialysis patient that is schedualed to get his treatment the next day. I explain to the patient that he is possibly suffering from fluid overload and needs to get dialysis. Patient agrees, and confirms that he has had more fluid then he is supposed to. I advise patient to let us take him to the local ER and be evaluated. Patient states that he now feels much better and does not wish to be transported. I explain that his condition, while right now seems better, could worsen and he should be seen by a doctor for evaluation. Patient refuses transport again and states if he feels bad later he will call 911 later. Patient signs refusal of transport form and we return to base. Forward to two shifts ago and my direct supervisor pulls me aside and tells me that he does not believe that I should have allowed that patient to refuse transport and that this call and PCR will be reviewed. Today, I am told that I am being given both a verbal and written reprimand for that call. I am told that the patient was contacted and he both validated that the events of the call went as I stated on his PCR and that he refused transport of his own free will. I am being reprimanded for both allowing this patient to refuse transport and for performing a treatment, I.e. Oxygen, before transporting this patient. I am told I should have advised the patient that it is officially against company policy to allow refusal of transport if patient calls 911, and that I should have with held the oxygen until the patient was on my stretcher in the back of my unit enroute to the ER. I refused to sign this written repremand and was immediatly suspended without pay, pending further review of this call and my actions. What did I do wrong? What could I have done different? What can I do now? I am standing firm that what I did was correct patient care, and that I cannot coerce or force a patient to be transported against their will. McGee, EMT-P T Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2010 Report Share Posted April 26, 2010 , Your company's policy violates the law.  An adult patient who has the present mental capacity to make an informed refusal, has the right to do so, and your company cannot force him to consent.  Sounds like you're company is trolling for billable fares. Technically, forcing a patient into the ambulance is kidnapping and assault. Further, your company's directive to withhold oxygen until the patient is in the truck violates every tenet of emergency care. Find a new job. GG Subject: Raw deal or not Date: April 26, 2010 8:04:50 PM MST To: texasems-l I have a sincere request for the list. Please let me know your honest opinion about the following: Three shifts ago, I was dispatched via 911 for an elderly man with difficulty breathing. I and my partner arrive to find a 50+ male complaining of shortness of breath after just having woken up. Patients states he needs oxygen. On assessment, patient is hypoxic, SpO2 of 88%, BP 136/80, P 84, R 16, breath sounds dimminished lower lobes. I requested my partner to apply oxygen at 15 L/m via NRB and continue to assess the patient. He is a hemodialysis patient that is schedualed to get his treatment the next day. I explain to the patient that he is possibly suffering from fluid overload and needs to get dialysis. Patient agrees, and confirms that he has had more fluid then he is supposed to. I advise patient to let us take him to the local ER and be evaluated. Patient states that he now feels much better and does not wish to be transported. I explain that his condition, while right now seems better, could worsen and he should be seen by a doctor for evaluation. Patient refuses transport again and states if he feels bad later he will call 911 later. Patient signs refusal of transport form and we return to base. Forward to two shifts ago and my direct supervisor pulls me aside and tells me that he does not believe that I should have allowed that patient to refuse transport and that this call and PCR will be reviewed. Today, I am told that I am being given both a verbal and written reprimand for that call. I am told that the patient was contacted and he both validated that the events of the call went as I stated on his PCR and that he refused transport of his own free will. I am being reprimanded for both allowing this patient to refuse transport and for performing a treatment, I.e. Oxygen, before transporting this patient. I am told I should have advised the patient that it is officially against company policy to allow refusal of transport if patient calls 911, and that I should have with held the oxygen until the patient was on my stretcher in the back of my unit enroute to the ER. I refused to sign this written repremand and was immediatly suspended without pay, pending further review of this call and my actions. What did I do wrong? What could I have done different? What can I do now? I am standing firm that what I did was correct patient care, and that I cannot coerce or force a patient to be transported against their will. McGee, EMT-P T Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2010 Report Share Posted April 26, 2010 , Your company's policy violates the law.  An adult patient who has the present mental capacity to make an informed refusal, has the right to do so, and your company cannot force him to consent.  Sounds like you're company is trolling for billable fares. Technically, forcing a patient into the ambulance is kidnapping and assault. Further, your company's directive to withhold oxygen until the patient is in the truck violates every tenet of emergency care. Find a new job. GG Subject: Raw deal or not Date: April 26, 2010 8:04:50 PM MST To: texasems-l I have a sincere request for the list. Please let me know your honest opinion about the following: Three shifts ago, I was dispatched via 911 for an elderly man with difficulty breathing. I and my partner arrive to find a 50+ male complaining of shortness of breath after just having woken up. Patients states he needs oxygen. On assessment, patient is hypoxic, SpO2 of 88%, BP 136/80, P 84, R 16, breath sounds dimminished lower lobes. I requested my partner to apply oxygen at 15 L/m via NRB and continue to assess the patient. He is a hemodialysis patient that is schedualed to get his treatment the next day. I explain to the patient that he is possibly suffering from fluid overload and needs to get dialysis. Patient agrees, and confirms that he has had more fluid then he is supposed to. I advise patient to let us take him to the local ER and be evaluated. Patient states that he now feels much better and does not wish to be transported. I explain that his condition, while right now seems better, could worsen and he should be seen by a doctor for evaluation. Patient refuses transport again and states if he feels bad later he will call 911 later. Patient signs refusal of transport form and we return to base. Forward to two shifts ago and my direct supervisor pulls me aside and tells me that he does not believe that I should have allowed that patient to refuse transport and that this call and PCR will be reviewed. Today, I am told that I am being given both a verbal and written reprimand for that call. I am told that the patient was contacted and he both validated that the events of the call went as I stated on his PCR and that he refused transport of his own free will. I am being reprimanded for both allowing this patient to refuse transport and for performing a treatment, I.e. Oxygen, before transporting this patient. I am told I should have advised the patient that it is officially against company policy to allow refusal of transport if patient calls 911, and that I should have with held the oxygen until the patient was on my stretcher in the back of my unit enroute to the ER. I refused to sign this written repremand and was immediatly suspended without pay, pending further review of this call and my actions. What did I do wrong? What could I have done different? What can I do now? I am standing firm that what I did was correct patient care, and that I cannot coerce or force a patient to be transported against their will. McGee, EMT-P T Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2010 Report Share Posted April 26, 2010 Tom, I hope you are able to resolve this amicably with your employer, but if not, here are some things you might think about.  Lodging a complaint with DSHS about the company; filing a lawsuit. Does your company do dialysis transports or any others that are within the spectrum of Medicare fraud?  Have you ever been told to write PCRs in a certain way in order to justify ambulance transport when none was needed?  Have you observed other instances of " patient entrapment " so as to create a bill? Keep your eyes and ears open.  You may find that there are some things they're doing that are illegal.  A call to CMS OCR or the FBI or the Texas Attorney General might be in order if you have something solid. Subject: Raw deal or not Date: April 26, 2010 8:04:50 PM MST To: texasems-l I have a sincere request for the list. Please let me know your honest opinion about the following: Three shifts ago, I was dispatched via 911 for an elderly man with difficulty breathing. I and my partner arrive to find a 50+ male complaining of shortness of breath after just having woken up. Patients states he needs oxygen. On assessment, patient is hypoxic, SpO2 of 88%, BP 136/80, P 84, R 16, breath sounds dimminished lower lobes. I requested my partner to apply oxygen at 15 L/m via NRB and continue to assess the patient. He is a hemodialysis patient that is schedualed to get his treatment the next day. I explain to the patient that he is possibly suffering from fluid overload and needs to get dialysis. Patient agrees, and confirms that he has had more fluid then he is supposed to. I advise patient to let us take him to the local ER and be evaluated. Patient states that he now feels much better and does not wish to be transported. I explain that his condition, while right now seems better, could worsen and he should be seen by a doctor for evaluation. Patient refuses transport again and states if he feels bad later he will call 911 later. Patient signs refusal of transport form and we return to base. Forward to two shifts ago and my direct supervisor pulls me aside and tells me that he does not believe that I should have allowed that patient to refuse transport and that this call and PCR will be reviewed. Today, I am told that I am being given both a verbal and written reprimand for that call. I am told that the patient was contacted and he both validated that the events of the call went as I stated on his PCR and that he refused transport of his own free will. I am being reprimanded for both allowing this patient to refuse transport and for performing a treatment, I.e. Oxygen, before transporting this patient. I am told I should have advised the patient that it is officially against company policy to allow refusal of transport if patient calls 911, and that I should have with held the oxygen until the patient was on my stretcher in the back of my unit enroute to the ER. I refused to sign this written repremand and was immediatly suspended without pay, pending further review of this call and my actions. What did I do wrong? What could I have done different? What can I do now? I am standing firm that what I did was correct patient care, and that I cannot coerce or force a patient to be transported against their will. McGee, EMT-P Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 So many attorneys and so little factual evidence. Claims of Medicare fraud, institutionalized kidnapping and encouraging civil lawsuits - all in the conspicuous absence of factual discovery. What's wrong with this picture? It's interesting that no one has yet asked for the company to present its side of the story. What is the exact language of the policy that forbids that acceptance of patient refusals? Where is the transcript of the disciplinary action? Is there any other condition that could have caused the patient's symptoms? If so, wouldn't that render the " diagnosis " of needing to be dialyzed - supposition? From what I've heard, there's not enough factual information to render an opinion one way or another. That we continue to try these types of things in the court of public (read: listserve) opinion is disturbing. If someone feels that they've been wronged, there are remedies available to them that have a more meaningful effect than collecting unfounded opinions on this listserve. I can only trust that our court system guarantees greater accountability and due process. Bob > > > , > > Two things > > 1. your are right and did the right thing > > 2. you are up a creek without a paddle. Try not to piss anybody off while > you find other employment. Research the next firm a little better. You can > hire a lawyer but you will still be the biggest looser in the end even if > you win. Consider this a live learning experience and move. Don't dog the > company at your next interview, just simply state you are looking for a more > professional company where you have the possibility of advancement. > > Medicare will get them if they are doning wrong. By that time you will be > long gone and feeling better. > > Henry > Raw deal or not > > I have a sincere request for the list. Please let me know your honest > opinion about the following: > > Three shifts ago, I was dispatched via 911 for an elderly man with > difficulty breathing. I and my partner arrive to find a 50+ male complaining > of shortness of breath after just having woken up. Patients states he needs > oxygen. On assessment, patient is hypoxic, SpO2 of 88%, BP 136/80, P 84, R > 16, breath sounds dimminished lower lobes. > I requested my partner to apply oxygen at 15 L/m > via NRB and continue to assess the patient. > He is a hemodialysis patient that is schedualed to get his treatment the > next day. I explain to the patient that he is possibly suffering from fluid > overload and needs to get dialysis. Patient agrees, and confirms that he has > had more fluid then he is supposed to. I advise patient to let us take him > to the local ER and be evaluated. Patient states that he now feels much > better and does not wish to be transported. I explain that his condition, > while right now seems better, could worsen and he should be seen by a doctor > for evaluation. Patient refuses transport again and states if he feels bad > later he will call 911 later. Patient signs refusal of transport form and we > return to base. > > Forward to two shifts ago and my direct supervisor pulls me aside and tells > me that he does not believe that I should have allowed that patient to > refuse transport and that this call and PCR will be reviewed. > > Today, I am told that I am being given both a verbal and written reprimand > for that call. I am told that the patient was contacted and he both > validated that the events of the call went as I stated on his PCR and that > he refused transport of his own free will. > > I am being reprimanded for both allowing this patient to refuse transport > and for performing a treatment, I.e. Oxygen, before transporting this > patient. I am told I should have advised the patient that it is officially > against company policy to allow refusal of transport if patient calls 911, > and that I should have with held the oxygen until the patient was on my > stretcher in the back of my unit enroute to the ER. > > I refused to sign this written repremand and was immediatly suspended > without pay, pending further review of this call and my actions. > > What did I do wrong? What could I have done different? What can I do now? > > I am standing firm that what I did was correct patient care, and that I > cannot coerce or force a patient to be transported against their will. > > McGee, EMT-P > > ------------------------------------ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 , Henry is on the right track. You certainly did your job and provided proper patient care. You need to find another company. I'm guessing that your current employer will not be around too long given their approach to patient care. The only thing I might add is that you provide a full account of the incident to DSHS for their review. Trying to take action against the company is too much aggravation for very little reward. Dick > > , > > Two things > > 1. your are right and did the right thing > > 2. you are up a creek without a paddle. Try not to piss anybody off > while you find other employment. Research the next firm a little > better. You can hire a lawyer but you will still be the biggest looser > in the end even if you win. Consider this a live learning experience > and move. Don't dog the company at your next interview, just simply > state you are looking for a more professional company where you have > the possibility of advancement. > > Medicare will get them if they are doning wrong. By that time you will > be long gone and feeling better. > > Henry > Raw deal or not > > I have a sincere request for the list. Please let me know your honest > opinion about the following: > > Three shifts ago, I was dispatched via 911 for an elderly man with > difficulty breathing. I and my partner arrive to find a 50+ male > complaining of shortness of breath after just having woken up. > Patients states he needs oxygen. On assessment, patient is hypoxic, > SpO2 of 88%, BP 136/80, P 84, R 16, breath sounds dimminished lower > lobes. > I requested my partner to apply oxygen at 15 L/m > via NRB and continue to assess the patient. > He is a hemodialysis patient that is schedualed to get his treatment > the next day. I explain to the patient that he is possibly suffering > from fluid overload and needs to get dialysis. Patient agrees, and > confirms that he has had more fluid then he is supposed to. I advise > patient to let us take him to the local ER and be evaluated. Patient > states that he now feels much better and does not wish to be > transported. I explain that his condition, while right now seems > better, could worsen and he should be seen by a doctor for evaluation. > Patient refuses transport again and states if he feels bad later he > will call 911 later. Patient signs refusal of transport form and we > return to base. > > Forward to two shifts ago and my direct supervisor pulls me aside and > tells me that he does not believe that I should have allowed that > patient to refuse transport and that this call and PCR will be reviewed. > > Today, I am told that I am being given both a verbal and written > reprimand for that call. I am told that the patient was contacted and > he both validated that the events of the call went as I stated on his > PCR and that he refused transport of his own free will. > > I am being reprimanded for both allowing this patient to refuse > transport and for performing a treatment, I.e. Oxygen, before > transporting this patient. I am told I should have advised the patient > that it is officially against company policy to allow refusal of > transport if patient calls 911, and that I should have with held the > oxygen until the patient was on my stretcher in the back of my unit > enroute to the ER. > > I refused to sign this written repremand and was immediatly suspended > without pay, pending further review of this call and my actions. > > What did I do wrong? What could I have done different? What can I do now? > > I am standing firm that what I did was correct patient care, and that > I cannot coerce or force a patient to be transported against their will. > > McGee, EMT-P > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 Bob, How dare you inject sanity into a hue and cry to burn the witch at the stake! -Wes Ogilvie Re: Raw deal or not So many attorneys and so little factual evidence. Claims of Medicare fraud, institutionalized kidnapping and encouraging civil awsuits - all in the conspicuous absence of factual discovery. What's wrong ith this picture? It's interesting that no one has yet asked for the company to present its ide of the story. What is the exact language of the policy that forbids hat acceptance of patient refusals? Where is the transcript of the isciplinary action? Is there any other condition that could have caused the atient's symptoms? If so, wouldn't that render the " diagnosis " of needing o be dialyzed - supposition? From what I've heard, there's not enough factual information to render an pinion one way or another. That we continue to try these types of things in he court of public (read: listserve) opinion is disturbing. If someone eels that they've been wronged, there are remedies available to them that ave a more meaningful effect than collecting unfounded opinions on this istserve. I can only trust that our court system guarantees greater ccountability and due process. Bob > , Two things 1. your are right and did the right thing 2. you are up a creek without a paddle. Try not to piss anybody off while you find other employment. Research the next firm a little better. You can hire a lawyer but you will still be the biggest looser in the end even if you win. Consider this a live learning experience and move. Don't dog the company at your next interview, just simply state you are looking for a more professional company where you have the possibility of advancement. Medicare will get them if they are doning wrong. By that time you will be long gone and feeling better. Henry Raw deal or not I have a sincere request for the list. Please let me know your honest opinion about the following: Three shifts ago, I was dispatched via 911 for an elderly man with difficulty breathing. I and my partner arrive to find a 50+ male complaining of shortness of breath after just having woken up. Patients states he needs oxygen. On assessment, patient is hypoxic, SpO2 of 88%, BP 136/80, P 84, R 16, breath sounds dimminished lower lobes. I requested my partner to apply oxygen at 15 L/m via NRB and continue to assess the patient. He is a hemodialysis patient that is schedualed to get his treatment the next day. I explain to the patient that he is possibly suffering from fluid overload and needs to get dialysis. Patient agrees, and confirms that he has had more fluid then he is supposed to. I advise patient to let us take him to the local ER and be evaluated. Patient states that he now feels much better and does not wish to be transported. I explain that his condition, while right now seems better, could worsen and he should be seen by a doctor for evaluation. Patient refuses transport again and states if he feels bad later he will call 911 later. Patient signs refusal of transport form and we return to base. Forward to two shifts ago and my direct supervisor pulls me aside and tells me that he does not believe that I should have allowed that patient to refuse transport and that this call and PCR will be reviewed. Today, I am told that I am being given both a verbal and written reprimand for that call. I am told that the patient was contacted and he both validated that the events of the call went as I stated on his PCR and that he refused transport of his own free will. I am being reprimanded for both allowing this patient to refuse transport and for performing a treatment, I.e. Oxygen, before transporting this patient. I am told I should have advised the patient that it is officially against company policy to allow refusal of transport if patient calls 911, and that I should have with held the oxygen until the patient was on my stretcher in the back of my unit enroute to the ER. I refused to sign this written repremand and was immediatly suspended without pay, pending further review of this call and my actions. What did I do wrong? What could I have done different? What can I do now? I am standing firm that what I did was correct patient care, and that I cannot coerce or force a patient to be transported against their will. McGee, EMT-P ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 Bob, Thank you for your attempt to reverse the entropy. If I was a smarter man, I would invest in pitchforks and torches. Kenny Navarro Dallas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 Bob, Thank you for your attempt to reverse the entropy. If I was a smarter man, I would invest in pitchforks and torches. Kenny Navarro Dallas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 Bob, Thank you for your attempt to reverse the entropy. If I was a smarter man, I would invest in pitchforks and torches. Kenny Navarro Dallas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 Bob, First let me thank you for at least taking time out of your busy schedual to answer my humble post. Second, yes I do have hard, concrete documentation of my companies policies and my written repremand. And last but not least, if you noticed from my post, I am not trying to try or convict my company for having done or trying to do anything. I am just asking for advice and seeking to explore what options that I now have. If you, or anyone else would like to see the " factual evidence " , just let me know. I have nothing to hide, and probably don't have a job now either. Sent from my iPhone, McGee, EMT-P, EMT-T So many attorneys and so little factual evidence. Claims of Medicare fraud, institutionalized kidnapping and encouraging civil lawsuits - all in the conspicuous absence of factual discovery. What's wrong with this picture? It's interesting that no one has yet asked for the company to present its side of the story. What is the exact language of the policy that forbids that acceptance of patient refusals? Where is the transcript of the disciplinary action? Is there any other condition that could have caused the patient's symptoms? If so, wouldn't that render the " diagnosis " of needing to be dialyzed - supposition? From what I've heard, there's not enough factual information to render an opinion one way or another. That we continue to try these types of things in the court of public (read: listserve) opinion is disturbing. If someone feels that they've been wronged, there are remedies available to them that have a more meaningful effect than collecting unfounded opinions on this listserve. I can only trust that our court system guarantees greater accountability and due process. Bob , Two things 1. your are right and did the right thing 2. you are up a creek without a paddle. Try not to piss anybody off while you find other employment. Research the next firm a little better. You can hire a lawyer but you will still be the biggest looser in the end even if you win. Consider this a live learning experience and move. Don't dog the company at your next interview, just simply state you are looking for a more professional company where you have the possibility of advancement. Medicare will get them if they are doning wrong. By that time you will be long gone and feeling better. Henry Raw deal or not I have a sincere request for the list. Please let me know your honest opinion about the following: Three shifts ago, I was dispatched via 911 for an elderly man with difficulty breathing. I and my partner arrive to find a 50+ male complaining of shortness of breath after just having woken up. Patients states he needs oxygen. On assessment, patient is hypoxic, SpO2 of 88%, BP 136/80, P 84, R 16, breath sounds dimminished lower lobes. I requested my partner to apply oxygen at 15 L/m via NRB and continue to assess the patient. He is a hemodialysis patient that is schedualed to get his treatment the next day. I explain to the patient that he is possibly suffering from fluid overload and needs to get dialysis. Patient agrees, and confirms that he has had more fluid then he is supposed to. I advise patient to let us take him to the local ER and be evaluated. Patient states that he now feels much better and does not wish to be transported. I explain that his condition, while right now seems better, could worsen and he should be seen by a doctor for evaluation. Patient refuses transport again and states if he feels bad later he will call 911 later. Patient signs refusal of transport form and we return to base. Forward to two shifts ago and my direct supervisor pulls me aside and tells me that he does not believe that I should have allowed that patient to refuse transport and that this call and PCR will be reviewed. Today, I am told that I am being given both a verbal and written reprimand for that call. I am told that the patient was contacted and he both validated that the events of the call went as I stated on his PCR and that he refused transport of his own free will. I am being reprimanded for both allowing this patient to refuse transport and for performing a treatment, I.e. Oxygen, before transporting this patient. I am told I should have advised the patient that it is officially against company policy to allow refusal of transport if patient calls 911, and that I should have with held the oxygen until the patient was on my stretcher in the back of my unit enroute to the ER. I refused to sign this written repremand and was immediatly suspended without pay, pending further review of this call and my actions. What did I do wrong? What could I have done different? What can I do now? I am standing firm that what I did was correct patient care, and that I cannot coerce or force a patient to be transported against their will. McGee, EMT-P ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.