Attitudes torwards patients

[Aidey]

I know this is kind of similar to some other threads that have been around, but I wanted to start a fresh discussion.


How do you guys feel about transporting psych patients, drug users, alcohol abusers etc? What about people who insist they need an ambulance, when you absolutely think they dont?

I've noticed a prevailing attitude with people that feel these calls are a waste of time, resources and money. I've worked with several medics who have openly told drunk patients this, or mocked them, or whatever.

My FTO and his partner actually told me I needed to get more jaded, because unless I was jaded I would never have the confidence to be a good medic (I'm not sure they understand what jaded actually means but anyway).

Do you guys see a problem with being "nice" to the aforementioned types of patients. I might not necessarily be their best friend, but I've never felt the need to say "Oh, so we are transporting you because you can't hold your liquor" to a patient either.

 

[emtfarva]

I may not be their best friends, but I would still treat them. I may not like it, I may not agree what they have done. I will treat them appropriately. I can tell you that the nurse will be told what kind of person they are, and when back at in the truck my partner will hear about it.

 

[Ridryder911]

How do you guys feel about transporting psych patients, drug users, alcohol abusers etc? What about people who insist they need an ambulance, when you absolutely think they dont?

Is there is any other type of patients?

R/r 911

 

[Sasha]

It's part of the job. Plain in simple. It's an emergency to them in some way or another, and that's all that matters.

Granted, I have little experience, and I see people who have been at it for years and years and years who are bitter old men and women and worry if I'll end up becoming so bitter and mean with a lack of general faith in people.. but now, I'm nice to all my patients. Drug addicts, alcoholics, toe pain x10 days, etc. and treat them with respect that I feel all humans deserve.

 

[VentMedic]

When one becomes so jaded they no longer see the medical concerns of these patients or provide care with professionalism, it is time for a different line of work that does not involve patients. Other healthcare providers also get their views skewed by some of the patients but they must still continue to provide professional care for many hours and maybe several days to multiple patients. When the attitudes of other healthcare providers become so jaded that it involves open mockery and poor care, they may be removed from patient care regardless of title. That includes doctors and nurses even though both professions are in high demand. It is not encouraged or looked highly upon as a good characteristic to have as it is in some EMS agencies. It is also these attitudes that prompt those in EMS who are serious about providing good medical care to move on to other agencies or professions that share a similar interest in medicine and patient care. It is not just because of the long hours and low pay. No amount of money is worth staying on a truck with someone who believes some patients are not worthy of care and openly mocks them.

 

[Epi-do]

The ones that irk me the most are the ones that have straight up told me they called 911 for an ambulance so they would be seen faster when getting to the ER for the hangnail they have had for 2 weeks. I used to just grin and bear it, but now I make sure they understand that when going to the ER the sickest patients are seen first, and it doesn't matter if they walk in to the front doors of the ER or come in the back by ambulance. When they look shocked that they are going out to the waiting room to be triaged, I can't help but smile after walking away.

As for the drunks, psych patients, frequent fliers, etc. - it is just part of the job. I give them all an appropriate evaluation and treatment (as needed). I may not be as chatty/friendly, especially at 3 in the morning, but I am not rude and treat them fairly. You can either let them get under your skin, or choose to not let them get to you.

 

[Aidey]

How do you guys work with people who have attitudes like this? I'm riding as a 3rd because I'm waiting for my state license, and the paramedic and EMT I'm working with now have pretty poor attitudes towards these patients, although the MICP is a lot worse. When he was being an arse to a drunk patient who had been on a bender he kept saying things like "So you called an ambulance because you can't hold your liquor" and I finally was like "Dude, enough" and he told me he was being nicer than he usually was.

After that call I got the "I've been doing this for 15 years and I'm a good medic" speech, to which I kind of felt like saying "So what? That means nothing to me if you're going to be an ***" but I would rather not get pulled into the Supervisors office so I kept my mouth shut.

 

[medic417]

I treat all callers with respect. If they do not need an ambulance, which is determined by exam, I tell them they are not eligible for transport. I will assist them to locate other transport or other services for their problem but I will not transport them. I do this respectfully. I have no tolerance for EMT's and Paramedics that are rude to callers, even if they call and admit they just want a ride to get some booze.

 

[2630]

minus the folks that just want a ride to the hospital...
alot of folks that i see are older and live alone. i have found that most of the time they just need someone to reassure them of what is going on or they are just lonely. no matter what they may be complaining of, i still show up and still have a smile on my face. even for the old lady who refuses to take her meds and still calls at least once a week. if i can't do that anymore then i think it is time to take a break!

2630

 

[JROD]

I believe this type of dilemma is actually a National Registry question, isn't it? The truth is that most of the "experienced" medics have developed this lack of empathy because they have become burnt out and have forgotten that these patients call 911 because THEY are experiencing an emergency. You can always be honest with the patient but you should never be disrespectful or "an ***" as it was so eloquently put

 

[firecoins]

How do you guys feel about transporting psych patients, drug users, alcohol abusers etc? What about people who insist they need an ambulance, when you absolutely think they dont?

Its better than sitting around doing nothing all day.

I've worked with several medics who have openly told drunk patients this, or mocked them, or whatever.

I understand where they are coming from. I don't agree but I understand.

My FTO and his partner actually told me I needed to get more jaded, because unless I was jaded I would never have the confidence to be a good medic (I'm not sure they understand what jaded actually means but anyway).

One has nothing to do with the other.

 

[Aidey]

I treat all callers with respect. If they do not need an ambulance, which is determined by exam, I tell them they are not eligible for transport. I will assist them to locate other transport or other services for their problem but I will not transport them. I do this respectfully. I have no tolerance for EMT's and Paramedics that are rude to callers, even if they call and admit they just want a ride to get some booze.

We aren't allowed to tell patients they don't need an ambulance. One of the joys of working for a private company. We can only discuss it with them if they bring it up first.

One has nothing to do with the other.

Like I said, I don't think they truly understand what jaded really means.

 

[reaper]

Vent hit it on the head. They are burnt out medics. There is no reason to treat anyone that way. If they are, then they need to step out of the field and take a break.

In 20 years, I have never been rude to any pt, no matter why they called. The BS calls are job security. If they stop calling tomorrow, you calls would be cut in half. Then they would only need half the amount of staff!

If anyone ever gives you the "I been doing this for 15 years" line as a reason to be rude. Then they have been doing this job 15 years to long!

 

[Aidey]

I think the "I've been doing this for 15 years" speech was his way of telling me not to tell him what to do.

It's actually been pretty annoying working with him. I've been in EMS for 5 years and a MICP for 2 1/2 of that and he's treating me like I've never treated a patient before. I'm not very familiar with this particular system yet, but I do know how to take care of a patient.

 

[reaper]

Decide if this is a fight you want to fight.

Remember, not all FTO's are meant to be FTO's. Most services give it to people because of experience. Not because they are good medics or know how to teach!

If it keeps up, request a new FTO. Not all people get along and it will hurt you in the long run.

 

[Aidey]

I'm only going to have him for 3 more shifts I think. Because our service hosts students and has a new hire class coming up we are short on FTOs/preceptors. I'm a low priority for being assigned to someone since I'm already a medic and i'm just waiting for a license.

 

[RielHalfbreed]

As for the drunks, psych patients, frequent fliers, etc. - it is just part of the job. I give them all an appropriate evaluation and treatment (as needed). I may not be as chatty/friendly, especially at 3 in the morning, but I am not rude and treat them fairly.

The thing we have to remember is our frequent callers/situations are the ones that ultimately pay the bills. My medics get paid because we get paid and we get paid by the people who call us (or their insurance companies). So next time a patient that you think is non critical is getting to you, remember it's people like that who feed bought your house or feed your family or support your habits.

 

[medic417]

The thing we have to remember is our frequent callers/situations are the ones that ultimately pay the bills. My medics get paid because we get paid and we get paid by the people who call us (or their insurance companies). So next time a patient that you think is non critical is getting to you, remember it's people like that who feed bought your house or feed your family or support your habits.

Actually no. In 911 the frequent fliers are often the ones that do not pay. And the trip does not qualify for medicaid/medicare because unless you commit fraud that needless transport is not getting paid. So you just spent money and got no return. So guess what they do not feed my family in fact they are also part of the reason we have low pay in EMS.

 

[PapaBear434]

I got into this job simply because I was in the police department first. I like this better, as there is no moral ambiguity. I don't care if this person is a psych patient, a rapist, a crack addicted mother of six, or even a Republican (kidding!), my job is to fix them and help them in any way I can.

I don't have to worry about what they might have done or what trouble they may be in with the law. I don't need to concern myself with the fact that this person may or may not be a hypercondreact that is draining money or resources, that's for the budget keepers up top to worry about. My job is to comfort this guy as well as I can and figure out if he actually has a legit problem I can help him with.

Granted, I'm relatively new and haven't developed my healthy hatred of people yet, though lonely old people at 0300 ARE getting to be kind of annoying (again, kidding.) And yes, I do have my moments where I place my own moral judgments on a patient or two, as I am human and apt to do so in certain situations. But they are my patient regardless, and I'm going to do what I can, and I hope I don't get to the point where I am jaded enough to tell someone to screw off or that they are wasting my time to their face.

That said, I am fond of saying "This job would be so much better if it wasn't for all those damn patients."

 

[Foxbat]

The thing we have to remember is our frequent callers/situations are the ones that ultimately pay the bills.

I guess it depends on the area.
First of all, in many places, no transport = no charge and many frequnet fliers' calls end with no transport.
Second, many non-profit EMS services do not charge their area's residents at all or only charge their insurance providers (which basically means no co-pay). It corrupts some people who think they can now call 911 for everything - after all, they won't have to pay.
So these calls from frequent fliers put wear and tear on your ambulance, and make EMS service spend money on fuel, often without giving anyting in return.
Third (this one is not about money), if a call from an old lady with AMI comes when you are treating that guy who wants to go to the hospital for a stubbed toe, well... I guess old lady will have to wait for your mutual aid ambulance.
Fourth, EMS abuse by frequent fliers frustrates and burns out providers, which ultimately may impact legitimate pts. Yes, dealing with frequent fliers is not an excuse for poor attitude, but this is what happens.