btkspot89
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I work for a Transport company and one of our contracts is Hospice provider. We were dispatched for a pick up coming from a residence going to a Inpatient Hospice center. Patient is an 80 yr old male who is in the care of hospice for stage 4 cancer. Simple enough for my partner and I because generally they are routine and close enough to the hospice center. We arrive and greet the friendly pt who is fully alert and oriented. After stair-chairing him to our stretcher outside we make sure that we get a valid DNR (in this case MSNJ DNR) Simple load and go after. About 2 minutes in transit my EMT who was doing patient care told me the pt went unresponsive and had very shallow breathing. For hospice this was normal and we continued to transport to the hospice center (3 county's and several miles away) Shortly after my partner advised me that the patient had stopped breathing and had no pulse. He being a rather new member of the company was not sure about the protocol for a DNR hospice patient who had already been in transit to the hospice center.
Needless to say this very rarely happens when a patient codes in the back of an ambulance has a DNR and is going for inpatient Hospice care. I did what I thought was right and contacted the dispatcher to call ALS. The dispatcher confirms that he dispatched them and that we should proceed to the nearest hospital. Shortly there after the operations manager (not an EMT) contacts me on the radio and tells me that she canceled medics and contacted the hospice center who advised us to keep transporting to their center (still 2 county's and miles away) Not to disobey my manager I comply turning off my lights and siren and start heading to the hospice center. Of course now we have a deceased patient in our ambulance crossing over several towns and 2 countys. Prior to our arrival at the hospice center my manager again contacts us and tells us to not cover up the patient and look like hes sleeping (Clearly a public relations thing). That got me slightly more agitated then I already was. We arrive there and the hospice nurse who arranged this whole thing said she was never in this situation before and did what she thought was right. I however was, about 5 months prior the same thing happened and I called medics who met us enroute and went with us to the nearest hospital where they would pronounce there (with no manager intervention) Anyone have any suggestions about how this could have gone better?
Needless to say this very rarely happens when a patient codes in the back of an ambulance has a DNR and is going for inpatient Hospice care. I did what I thought was right and contacted the dispatcher to call ALS. The dispatcher confirms that he dispatched them and that we should proceed to the nearest hospital. Shortly there after the operations manager (not an EMT) contacts me on the radio and tells me that she canceled medics and contacted the hospice center who advised us to keep transporting to their center (still 2 county's and miles away) Not to disobey my manager I comply turning off my lights and siren and start heading to the hospice center. Of course now we have a deceased patient in our ambulance crossing over several towns and 2 countys. Prior to our arrival at the hospice center my manager again contacts us and tells us to not cover up the patient and look like hes sleeping (Clearly a public relations thing). That got me slightly more agitated then I already was. We arrive there and the hospice nurse who arranged this whole thing said she was never in this situation before and did what she thought was right. I however was, about 5 months prior the same thing happened and I called medics who met us enroute and went with us to the nearest hospital where they would pronounce there (with no manager intervention) Anyone have any suggestions about how this could have gone better?
