Thursday, May 21, 2009

Vindicated...

Ran into a bit of trouble a while ago. All over a damn refusal...

Got a call for a CVA. We get there and this guy ain't having a stroke. All he had was numbness on one side of his leg, which he had a history of. His grand daughter was there, freaking out and she was the one who called us. He didn't want to go, he didn't want her to call 911. So of course he refused. He let us take his vitals and do a stroke screen on him. All were normal. We let him and his granddaughter know that he hadn't been examined by a physician and that we could not tell him definitively that he wasn't having a stroke and that we would be happy to take him to the hospital. He refused all of that. He was obviously competent and he was now informed of his condition. I felt he had every right to refuse further care and transport. So he signed my paper and we left.

About 3 hours later we get called to the local band-aid station for an emergency transport to the big city hospital for a stroke transfer. We get there and it's him. The charge nurse is pissed and she doesn't even give us a report, just points us towards the bed. We walk over and talk to him. The patient has no clue that he is being transferred or why. He said he only came to the hospital to shut his granddaughter up. We load him up and start towards the truck. That's when the nurse grabs my arm and tells me that the patient should have been transported from the scene and she will be making a complaint for further investigation about the situation. My reply was "OK" and we continued to transport.

Later that day the quality assurance guy from our service comes to call on us. He asks what happened, he already had a copy of my report so I told him that it was all there. He wanted to know more, so I pretty much told him the same thing that I had typed. In a round about way, he accused me of selling the refusal or encouraging the patient to refuse. Well that pissed me off and I let him know it. I asked him if he and everyone else in management didn't trust my judgment as a paramedic, then why in the hell was I out there on the road? Why was I able to function as a medic at all if he was going to question everything that I did? He finally left. The next day the charge nurse came to me and apologized for her actions. I accepted and I thought that was that. I was wrong.

Apparently he and the charge nurse are good buddies and he wasn't about to let it go. The next week I was at the office and he calls me into his little corner. He shows me a customer service questionnaire that he says that he sent to the patient about that call. He said that he had made this little form up some time ago but had never sent it to any patient so far. So this would be the first. Well, I start to get pissed all over again, but I managed to keep my cool. I asked him if he was going to start sending these out on a regular basis. He said no. I asked if he was even going to send them out randomly, he said no again. His explanation was that the budget wouldn't allow for it. Bullshit I thought. So I asked, "This is the only survey that you have ever sent out and the only one you're ever going to send out?" He just looked at me and I just about lost it. I turned to walk out and over my shoulder I said, "This sounds a whole hell of a lot like discrimination to me." I kept walking before he could reply.

I left the office steaming. I felt like this was a fucking head hunt and my head was on the chopping block. I also found out that the patient in question got sent home the same day, actually within a few hours of us taking him there. He wasn't having a stroke. I guessed our Q/A guy found that out and it just pissed him off that much more, since I was right about the patient. But that didn't change the fact that I had pissed off his buddy.

Well a couple of weeks go by and I get an email. It's the survey, apparently the patient had filled it out and sent it back in. It contained an excellent review of my care, on both calls; the refusal and the transport. It even had a handwritten comment saying how good the care was. I think I laughed out loud when I read it. It must have put a burr in his ass to get that back in the mail.

So now I am fully vindicated...

BRM

4 comments:

Regpara said...

Recently I commented to a retreival doc that although he might get to think and then get the nurses to do I didn't have that luxury. "Lucky you" I said. "I get to think and do". Nurses don't seem to get it. They are there to do what the doc wants, no more. Paramedics on the other hand have to use judgement as you did. Glad you were finally vindicated. What really bugs me is that event the the insistance of the nurse that the patient be transferred is little different to if you had muscled him out of his home without his consent, and that would have been assault!

Anonymous said...

Your employer sounds like a piece of garbage - you sound like you are much better at your job than they're willing to admit for some bizarre reason.

That QA (ha) guy and the nurse should go get hitched and have some little hairy knuckle draggers of their own. :(

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