Raw deal or not

[Guest guest]

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

[Guest guest]

,

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

[Guest guest]

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

[Guest guest]

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

[Guest guest]

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

[Guest guest]

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

[Guest guest]

yes, I among others raised the questions, but at least in my case, it was

more in order to point out that this was going on, it was dumb on the part

of the company, given the recent cases in Texas.

I also recommended consultation with an attorney who specialized in

wage/hour (labor) law.

ck

In a message dated 4/27/2010 08:51:42 Central Daylight Time,

kellow.bob@... writes:

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?

[Guest guest]

yes, I among others raised the questions, but at least in my case, it was

more in order to point out that this was going on, it was dumb on the part

of the company, given the recent cases in Texas.

I also recommended consultation with an attorney who specialized in

wage/hour (labor) law.

ck

In a message dated 4/27/2010 08:51:42 Central Daylight Time,

kellow.bob@... writes:

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?

[Guest guest]

yes, I among others raised the questions, but at least in my case, it was

more in order to point out that this was going on, it was dumb on the part

of the company, given the recent cases in Texas.

I also recommended consultation with an attorney who specialized in

wage/hour (labor) law.

ck

In a message dated 4/27/2010 08:51:42 Central Daylight Time,

kellow.bob@... writes:

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?

[Guest guest]

,

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

------------------------------------

[Guest guest]

,

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

------------------------------------

[Guest guest]

,

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

------------------------------------

[Guest guest]

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

>

> ------------------------------------

>

>

[Guest guest]

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

>

> ------------------------------------

>

>

[Guest guest]

,

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

>

[Guest guest]

,

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

>

[Guest guest]

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 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

------------------------------------

[Guest guest]

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 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

------------------------------------

[Guest guest]

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 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

------------------------------------

[Guest guest]

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

------------------------------------

[Guest guest]

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

------------------------------------

[Guest guest]

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

------------------------------------

[Guest guest]

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

------------------------------------

[Guest guest]

First, hire a good lawyer and fight them tooth and nail.  That being said, I

thought that it was illegal to force a pt that is of sound mind on to a

stretcher and tell them that they have no choice because they called 911 that

they have to go to the ER.  Any one of sound mind and is A&O x3 or 4 has the

right to refuse transport.  How many times have we placed a pt on 02 and they

feel better and then refuse to go to the ER? 

 

Kind of goes back to the unresponsive diabetic that you run on all the time with

a D-stick of 20. You know that when you give them D-50 they will not want to go

to the ER, so you put them in the ambulance and start transport then give the

D-50 so they have to go because they are already in the ambulance.

 

I would have refused to sign that also.  Especially, when the pt backs your

story up 100%.  He told them that he refused transport, even though you told

him that he should go and that his condition could change or worse. 

 

Reminds me of a call I had once, where I had a diabetic pt that had a BG of over

600, as the monitor read HI, so it was somewhere over 600.  She had no veins

and because of this, her doc had placed med port under the skin in the right

upper chest area.  These ports are not made for just any type of needle, this

one you used a Huber needle, which an ambulance does not carry.  So, no way to

give fluids.  The boss thought that I should have just put a regular needle in

there...yea right and risk messing up the port....I don't think so.  That being

said, they did not like the way that call was run.  Because of that and another

situation that was in the best interest of the pt, I left because she didn't

like the pt care. 

I was not going to stick a pt that tells me, I have no veins....that is why I

have this port.  I did look at her hands and arms, and yea she had no veins. 

You don't stick a pt just to stick them.

 

I would talk with the medical director since this call is " under review " and see

what they tell me.

 

Stand your ground, because I think that you were right.  We can't force anyone

to with use, but we can highly recommend that they do, and explain why.  But we

can't throw them on the cot, hog tie them down and make them go, unless

something has changed in EMS and no one bothered to tell us...right?

 

Wayne

Subject: Raw deal or not

To: texasems-l

Date: Monday, April 26, 2010, 10:04 PM

 

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

[Guest guest]

First, hire a good lawyer and fight them tooth and nail.  That being said, I

thought that it was illegal to force a pt that is of sound mind on to a

stretcher and tell them that they have no choice because they called 911 that

they have to go to the ER.  Any one of sound mind and is A&O x3 or 4 has the

right to refuse transport.  How many times have we placed a pt on 02 and they

feel better and then refuse to go to the ER? 

 

Kind of goes back to the unresponsive diabetic that you run on all the time with

a D-stick of 20. You know that when you give them D-50 they will not want to go

to the ER, so you put them in the ambulance and start transport then give the

D-50 so they have to go because they are already in the ambulance.

 

I would have refused to sign that also.  Especially, when the pt backs your

story up 100%.  He told them that he refused transport, even though you told

him that he should go and that his condition could change or worse. 

 

Reminds me of a call I had once, where I had a diabetic pt that had a BG of over

600, as the monitor read HI, so it was somewhere over 600.  She had no veins

and because of this, her doc had placed med port under the skin in the right

upper chest area.  These ports are not made for just any type of needle, this

one you used a Huber needle, which an ambulance does not carry.  So, no way to

give fluids.  The boss thought that I should have just put a regular needle in

there...yea right and risk messing up the port....I don't think so.  That being

said, they did not like the way that call was run.  Because of that and another

situation that was in the best interest of the pt, I left because she didn't

like the pt care. 

I was not going to stick a pt that tells me, I have no veins....that is why I

have this port.  I did look at her hands and arms, and yea she had no veins. 

You don't stick a pt just to stick them.

 

I would talk with the medical director since this call is " under review " and see

what they tell me.

 

Stand your ground, because I think that you were right.  We can't force anyone

to with use, but we can highly recommend that they do, and explain why.  But we

can't throw them on the cot, hog tie them down and make them go, unless

something has changed in EMS and no one bothered to tell us...right?

 

Wayne

Subject: Raw deal or not

To: texasems-l

Date: Monday, April 26, 2010, 10:04 PM

 

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