Cardiac patient walked down stairs, medics don't document it

[Mountain Res-Q]

I have on more than one occasion document that a patient was "assisted to gurney by EMTs" and if asked about it, I will state that I had them stand up, with help, pivot, and sit back down on the gurney.

I would argue that it should have read in that case, "EMT's assited pt. in stnading and pivoting onto gurney." If that is what happened then document it that way. If you write "Assisted to gurney by EMT's" how are you gonna remember the details 6 months latter when you get asked by an investigator. I am by no means being a smart a** here or being rude. Documentation is a sore point with me for that reason. I was investigated on some BS deal and it was my paperwork that saved my but, because I had documented it just as it happened and was able to reference it and recall teh exact event in question (tansient looking for a fix 6 months ago and now looking for a settlement). But I know (hope) that no matter what you wrote, even if vague) it would not be an outright lie to CYA. If you provide quality medical care then you have no reason to lie.

 

[JPINFV]

Your post reads like it's a simple hatchet job that takes the day to day operations out of context for no more reason than to lynch a pair of EMTs. I don't think the factors matter much once the providers lied, twice. If the story was "We walked him because the situation was such that we couldn't use a stair chair (patient weight, tight quarters, etc)" then I could agree that the story is very one sided. A classic "They didn't follow the rules even though the situation made it so the rules couldn't be followed." Once they lie, though, the story has much more force behind it.

 

[Mountain Res-Q]

Your post reads like it's a simple hatchet job that takes the day to day operations out of context for no more reason than to lynch a pair of EMTs. I don't think the factors matter much once the providers lied, twice. If the story was "We walked him because the situation was such that we couldn't use a stair chair (patient weight, tight quarters, etc)" then I could agree that the story is very one sided. A classic "They didn't follow the rules even though the situation made it so the rules couldn't be followed." Once they lie, though, the story has much more force behind it.

Exactely, they lose all credability once they lied, and lied to cover a lie, and lied some more becasue they didn't know what else to say... hard to side with them even if the walk was justified.

 

[daedalus]

Your post reads like it's a simple hatchet job that takes the day to day operations out of context for no more reason than to lynch a pair of EMTs. I don't think the factors matter much once the providers lied, twice. If the story was "We walked him because the situation was such that we couldn't use a stair chair (patient weight, tight quarters, etc)" then I could agree that the story is very one sided. A classic "They didn't follow the rules even though the situation made it so the rules couldn't be followed." Once they lie, though, the story has much more force behind it.

I choose to defer judgement, because I no nothing more than the headline and a paragraph or two into the story. They very well could be deserving of whatever is coming to them, whatever that might be. I have no idea, and care very little. All I know is that this strengthens the case for me to cover my ***. I simply do not get paid enough for risking law suits. I do not lie in my documentation, even if I am breaking company policy to be accommodating. So far, I have explained the circumstances and have never had a problem. My post should have read "Lie, and pay the consequences".

 

[Sasha]

I am very convincing.
They called me because they felt that they needed help and if I don't do the best I can to provide the BEST CARE then I might as well have become a LEO. I am going to pull a VentMedic line of thought here and scream out the importance of COMMUNICATION. It is one of those things that seperates a good EMSers from a great one and you obviously think I am great "since you've got all the answer". (Ya know, if I could find a woman that said that to my face without the sarcasm, I might consider getting married one day.) I can communicate and convince my pateint that I am here to help and would do nothing to endanger him... including walking him. I am an advocate for my patient and their health.

However, your argument here is based on a belief that this man refused to be carried. No information exists in this article to support this. I doubt that a patient in that much pain and suffering would protest a quick, safe carry to the hospital, or couldn;t be convinced by a quality EMT with a basic grasp of the Ameriglish Language.. But, let's take it one step further... what if your patient was deathly affraid of vehicles and refused transport my ambulance or other vehicle, but wanted to go to the hospital... you gonna walk the MI patient to the hospital? However, all ridiculous hypotheticles aside, would you have walked this patient... not some hypothetic patients? And then would you lie about it, a sure sign that you feel guilty for providing a lower standard of care than you ought?

For someone who claims to be so good in communication you're missing a big part of it, listening and comprehending what the other person is saying.

I NEVER advocated forcing a patient to walk down the stairs, I never advocated lying in your paperwork.

Have you worked in the field? Even in my short field experience I have run into the stubborn old goats who, no matter what you say, want to do what THEY want. It is within their right to refuse any part of treatment, which includes being walked down the stairs.

I am not saying that is what happened, I'm presenting it as another possible side to the story. You're right, there isn't anywhere in the article that hints at it, but there is no where in the article that hints that he was forced to walk down or not given an option, it doesn't give you enough information on what had happened. It's up to interpertation.

What daedalus, boingo and I are trying to say is it's VERY possible that the patient refused. it's also possible that the patient wasn't given an option, it's not clear in the article.

Again, instead of going on a rant about the paramedics why don't you take the moral of the story? Document document document, and document CORRECTLY.

 

[daedalus]

I think Sasha and I were misunderstood. I will not risk my health or life unnecessarily when something can reasonably done to prevent it. Falsifying a report is illegal and unethical.

 

[ffemt8978]

We don't know enough about what happened on scene to make any judgments about the care they provided or did not provide....and it doesn't matter at this point. Their lack of documentation, followed by their alleged lying, will be their downfall. Regardless of what happened on scene, once you lie about it in your documentation, you can't win because everything you say or do after that becomes suspect.

 

[Mountain Res-Q]

I understand that everyone wants to find a "possible other side to the story" to defned them. And I agree that there are cases where it may not be possible to do what is in the best interest of your patient. But if you must choose the lesser of 2 evils then back up your desision. People who lie are guilty of something. There is no reason to lie if you are inocent. You all want to come up with defences for theses Medics actions (not their lies), but there lies are a manifestation of their guilt for not providing teh best care they could have... not neccisarily should have if they couldn't convince the man to be lifted. Obvioulsy we have a very one sided story, but the lies solidify the story for me. Once a public servent lies about someones health and safety (and death) then they lose are credability and should not be defended in anyones hypothericals. That is my point. They obviously knew that they were providing a lesser form of care than was expected. If the man refused to be carried down after they tried to convince him than document it, just as we all would. But that is obvioulsy not the case as they were caught in a lie and continued to lie.

There was no misunderstadning on my part. I understood your attempts to find explainations for why these guys screwed up. Sasha, even in your "short field experience" (dirrect quote) you know not to lie about patient care, especially when you are forced to diviate from stadard protocol and common sence. Why didn't they? My 8 years experience (short compared to many), my foot-stool status as an EMT, and my experience dealing with California's sue-happy patients has taught me that A. you don't lie, B. If you lie you are probably guilty, and C. NO ONE should defend a smear on the face of EMS.

 

[Sasha]

I understand that everyone wants to find a "possible other side to the story" to defned them. And I agree that there are cases where it may not be possible to do what is in the best interest of your patient. But if you must choose the lesser of 2 evils then back up your desision. People who lie are guilty of something. There is no reason to lie if you are inocent. You all want to come up with defences for theses Medics actions (not their lies), but there lies are a manifestation of their guilt for not providing teh best care they could have... not neccisarily should have if they couldn't convince the man to be lifted. Obvioulsy we have a very one sided story, but the lies solidify the story for me. Once a public servent lies about someones health and safety (and death) then they lose are credability and should not be defended in anyones hypothericals. That is my point. They obviously knew that they were providing a lesser form of care than was expected. If the man refused to be carried down after they tried to convince him than document it, just as we all would. But that is obvioulsy not the case as they were caught in a lie and continued to lie.

There was no misunderstadning on my part. I understood your attempts to find explainations for why these guys screwed up. Sasha, even in your "short field experience" (dirrect quote) you know not to lie about patient care, especially when you are forced to diviate from stadard protocol and common sence. Why didn't they? My 8 years experience (short compared to many), my foot-stool status as an EMT, and my experience dealing with California's sue-happy patients has taught me that A. you don't lie, B. If you lie you are probably guilty, and C. NO ONE should defend a smear on the face of EMS.

I can't explain why they lied. I don't know why the lied in their documentation. Do I believe that he could have written it automatically? Yes. I used to all the time on my IFT patients. Some days at the end of a long hard shift there was more crossing out and initialing than there was actual written text. Do I believe that absolves them from guilt? No. That's why they should go back and read their paperwork before turning it in.

Do I believe they could have forced the patient to walk? Certainly. Do I believe that a middle aged man could have insisted on walking? Again, certainly.

You speak lesser of two evils. Which evil is less, leaving them on scene because they refuse to get on a stair chair, or assisting them in walking down the stairs? Or even sitting their, burning valuable cardiac tissue while you try and talk them into getting on a stair chair???

You're not listening. I'm not defending them, just stating that I'm not so quick to be outraged at their deviation from standard of care.

 

[Mountain Res-Q]

I'm not defending them.

If you say so... -_-

 

[Sasha]

If you say so... -_-

You can see a possible other side of the story without absolving someone from guilt, dear.

 

[daedalus]

If you say so... -_-

Why would she lie? Better, why do you persist with this? Take what she said for what she said, and move on.

 

[Mountain Res-Q]

You can see a possible other side of the story without absolving someone from guilt, dear.

Why would she lie? Better, why do you persist with this? Take what she said for what she said, and move on.

Okay... -_-

 

[ffemt8978]

Do I really need to remind everyone?

 

[Sasha]

Do I really need to remind everyone?

I love the gun totin' star!!

 

[AJ Hidell]

FAIL!

That's all there is to say.

 

[CAOX3]

1. They lied about the fire department being there.

2. They lied about him walking on they're paperwork.

3. Then they lied about it when they were questioned.

They were terminated, why would this be if it was all a big misunderstanding?

They also lost a extended procedure(RSI) from their medical directors.

The manager who didnt follow up with the family's complaint, he gets the axe too.

If any of my patients refuse any treatment, being carried, immobilization, o2 or anything they sign a refusal stating such, and it gets stapled to my run form.

Get out your check book, its going to be costly.

We all face these situations daily, we dont walk people with chest pain down three flights of stairs, its simple.

This is one of the easy ones.

 

[boingo]

I don't know how much they can expect, it would be awfully hard to prove that the patient walking down 3 flights of stairs was the final nail in his coffin. Bad judgement, less than standard of care? Maybe, but actually causing his death? A bit of a stretch.

 

[CAOX3]

I don't know how much they can expect, it would be awfully hard to prove that the patient walking down 3 flights of stairs was the final nail in his coffin. Bad judgement, less than standard of care? Maybe, but actually causing his death? A bit of a stretch.

I dont believe this will ever see the nside of a courtroom.

Settlement.

 

[bmennig]

I love how everyone argues over the dumbest crap on this forum, there is hardly ever a cival thread on here. I've had cardiac pt's that insist on walking, I usually make them refuse moving equipment with a signature. It is up to them. It should also be documented in the narrative what took place. You then have 2 items that back your arse up in court. I understand what these medics did, they just did a horrible job with documentation which, if your a Medic, EMT, or FR, you best know all about. Falsification of what was done was not appropriate either....

and oh my god, a PAID PROFESSIONAL did this, not a volunteer, what next?