Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 Who is your medical director was he present for the reprimand? Sorry if this has already been asked just looked at this thread this morning and haven't had a chance to read them all! -Chris Sorry for the spelling and punctuation this was typed on the tiny keyboard on my iPhone > 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 > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 Who is your medical director was he present for the reprimand? Sorry if this has already been asked just looked at this thread this morning and haven't had a chance to read them all! -Chris Sorry for the spelling and punctuation this was typed on the tiny keyboard on my iPhone > 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 > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 Who is your medical director was he present for the reprimand? Sorry if this has already been asked just looked at this thread this morning and haven't had a chance to read them all! -Chris Sorry for the spelling and punctuation this was typed on the tiny keyboard on my iPhone > 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 > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 Just thinking, if this was my case, you might not want this whole thing floating around the internet before it's finally resolved, whether it's lawsuit, HR grievance, DSHS complaint, etc. -Wes (not your lawyer) 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 > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 Just thinking, if this was my case, you might not want this whole thing floating around the internet before it's finally resolved, whether it's lawsuit, HR grievance, DSHS complaint, etc. -Wes (not your lawyer) 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 > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 Wes and Bob (as well as others) make good points. First how this went from not allowing an oriented patient to refuse, to claiming Medicare fraud is amazing. Unless there is M'care fraud, then leave that discussion to another thread. Second, as Wes points out, I would probably take this to private emails until you have it resolved. No employer can set a policy in place that orders you to violate a criminal law. That in itself is insane. Hatfield " The main part of intellectual education is not the acquisition of facts but learning how to make facts live. " - Oliver Wendell Holmes > > > From: > Subject: Raw deal or not > To: texasems-l@yahoogro ups.com > 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 > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 Wes and Bob (as well as others) make good points. First how this went from not allowing an oriented patient to refuse, to claiming Medicare fraud is amazing. Unless there is M'care fraud, then leave that discussion to another thread. Second, as Wes points out, I would probably take this to private emails until you have it resolved. No employer can set a policy in place that orders you to violate a criminal law. That in itself is insane. Hatfield " The main part of intellectual education is not the acquisition of facts but learning how to make facts live. " - Oliver Wendell Holmes > > > From: > Subject: Raw deal or not > To: texasems-l@yahoogro ups.com > 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 > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 Wes and Bob (as well as others) make good points. First how this went from not allowing an oriented patient to refuse, to claiming Medicare fraud is amazing. Unless there is M'care fraud, then leave that discussion to another thread. Second, as Wes points out, I would probably take this to private emails until you have it resolved. No employer can set a policy in place that orders you to violate a criminal law. That in itself is insane. Hatfield " The main part of intellectual education is not the acquisition of facts but learning how to make facts live. " - Oliver Wendell Holmes > > > From: > Subject: Raw deal or not > To: texasems-l@yahoogro ups.com > 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 > > > > > > > > > > > > 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.