crotchitymedic1986

It could be a violation depending upon how you handle the situation. If you are in the US and divulge confidential information about that patient to someone else not involved in their care, then you have violated HIPPA. Here is how I see it: You have three patients in back of the ambulance and you ask them about their history. They answer on their own accord in front of the others, you have not violated the law. But if one of the patients told you they had AIDs confidentially, and then you mentioned that in your radio/phone report to the hospital, in front of the other patients, then you have violated HIPPA.

Could be the plastic wrapping from the grape bag. I remember working the ER, had a toddler came in with constant drooling, been to 2 ERs and Pediatrician, x-rays negative. When they scoped her, found the top piece of plastic wrapping that goes on cigarette box.

Look them in the eye, tell them you scrubbed the curb with tire, looked at the wheel, but didnt see the damage, so you didnt report it. Apologize, offer to pay for the damage, if they fire you, you are probably better off. None of us are perfect, and if they can afford to fire good employees for unintentional minor mistakes, then I wish them good luck. But if the precedent has been set, and they have fired others for the same, then you probably are screwed. Read the policy, see if there are any loopholes. Last ditch, do you know anyone else who did this, but was not fired -- maybe a supervisor, or the company slut ? If they have let others get away with it, but fire you, you have reason to appeal through HR. Last last ditch, if you know you are about to be fired, ask if they will allow you to resign if you think you can get another job quickly. If it will be hard to get a job, take your termination and collect your unemployment benefits.

Easier Method: write the blocks in order, and write CICI in order beside it (think CICI's Pizza) 1st degree C 2nd Type 1 I 2nd Type 2 C 3rd I The C stands for consistent, the I for inconsistent. Now look at your PR interval, if it is consistent, your block must be 1st degree or 2nd type II. More than one p-wave makes it 2nd type II. If your PR interval is Inconsistent, then you either have Wenkebach, or 3rd degree. If the PR gets longer until a QRS is dropped you know what you have. If the opposite is true, you know what you have.

First and foremost, remember that it is never as bad as people make any new thing out to be. The sun rose this morning, and will rise again, despite all the claims of the pending armegedon. This debate is much like that of the "fair tax" issue. People who are against the fair tax claim it is bad because everyone would have to pay a new huge tax on top of consumables that they buy; what they don't understand is that you are currently paying that tax now when you buy something, it is just embeded. For instance, if you buy a loaf of bread for $2.00, the cost of taxes paid by the farmer, the bread company, and the transportation company (and any other assoicated cost you can think of is in that $2.00/loaf price. The same is true of healthcare. We are all paying the price for the uninsured through higher fees and premiums. Thats why an aspirin cost $10.00 in the hospital, because you (who are insured) are paying for all the free aspirin that was given to others. If they can get everyone to buy insurance, all of our rates will come down.

I don't understand why you do not understand why they were punished: 1. They were on-duty. Being hospital-based employees, I imagine they fall under the hospital's policies and procedures, which probably clearly state that you can not "play" on the computer while you are at work (especially if it was the hospital's computers). If the clerk in the billing office can not surf facebook while she is on-duty, then the EMS employees can not either. 2. They used images of the hospital property and their uniforms in the pics. Big NO-NO. And I seriously doubt that their posts on the internet were very professional, or painted the hospital in a professional light. 3. When you are at work, you should be at work. I applaud those departments who do not let you carry a cellphone or personal laptop while on-duty. Play on your own time, be a professional at work.

i wouldnt let the patient get unrestrained

Come on guys, time to pay them back. Everyone go to your politicians and explain to them how much cheaper their Fire Department could be run, if it were run by the EMS Department. Show them that only 20% of their call volume is fire calls, and that about 12 of every 24 hours paid to the firemonkeys is for them to sit on the couch, scratch their balls, and fart on each other.

hey ruralghetto, are the rumors about the intimidation of employees that is going on true ? Is it as bad as it sounds down there ?

If you truly are living in a rented room, eating ramen, and getting clothes from the salvation army (which I doubt), then you need to reassess your budget. How much is your vehicle payment, how much are you spending on cigarettes/alcohol/eating out, what percentage of your paycheck are you "saving" ? We all want more than we have, but you cant blame your employer for not having those things. You are where you are, wherever that is, because of your actions or inactions.

I think respect of profession, ability to make a difference, and the ability to do a job that many can not, ranks higher than pay any day.

Just look long before you leap. All EMS jobs have some negative to them, or else we would all be working at the same perfect provider. Even if the job is better, the location may have its drawbacks. The job market has tightened significantly, and if a department has alot of openings right now, it may signal a problem.

I am not saying you should abandon all technology, but at the same time you have to know the technology's limit. Without googling or dragging out your glucometer's trusty handbook, tell me at least 6 medical conditions that can cause a false high or low on a glucometer (not even going to go into the fact that most EMS glucometers are not properly cleaned/maintained, and glucometer controls are usually ran monthly at best (if at all, after the controls machine and strips are housed in ambulances that are too cold or hot per manufacturer recommendations). I imagine many of you can, but I imagine the vast majority can not; and there lies the problem. The medic who will push or not push D50 based on a glucometer reading ALONE, is just as dangerous as a medic who gives NTG tabs to a patient who has chest pain, because they just struck their chest on a steering wheel in an MVC.

Croaker hit the nail on the head, "TREAT THE PATIENT, NOT THE MACHINE". But don't feel bad, this is a common problem throughout healthcare. Just find a labtech who is over age 50, and ask them their opinion of today's doctors who can not make a diagnosis without a minimum of 7 labtests. As we become more technologically advanced, many in our profession rely on that technology way to much.

So true Herbie, but as I understand it, the Fire Department can not take over this zone as long as there is a private provider who will do it. The rumor mill states two providers have volunteered to run it if they can get both zones. Looks like alot of Rural Metro staff are about to take a huge pay-cut, if they can find a job. My buddy states that the new services will probably hire off-duty firefighters (at a much lower wage), and not use ex-RM folks because they perceive that they will have attitude or will intentionally do things to mess up and make the new company look bad. At the same time, apparently the Burgerking has declared that any employee who applies for another job will be fired on the spot (sounds like lawsuit time to me, or maybe most of their employees should suddenly get back injuries). Looks like a bad time for alot of medics due to their incompetent managers, who let this happen. I can not believe that RM would hire a GM with no EMS experience to run one of their best zones, hopefully they will wake up and fire him and the whole management team this week.

Hearing rumors from friends in Atlanta, wonder if anyone knows the truth. Here are the rumors: 1. RM in Atlanta hired a manager who had no EMS experience, he formerly managed a burger chain. He was brought in to cut the budget and jobs by about 40%. RM had two thirds of the Atlanta 911 zones (a rich zone, and a poor zone). The plan was to pull out of the poor zone, fire the highest paid employees in the field and dispatch, and then rest comfortably on the profit from the rich zone. 2. Apparently when RM tried to get out of the zone, questions were raised as to why both zones should not be put up for bid. Now RM is faced with losing both 911 zones, and being totally out of business, thanks to the genius of the burgerking. 3. I also hear that 12 employees have filed harassment charges against the burgerking and one of his marketing reps through the corporate office. Kharma is a bitch !!! Here is the only link I could find, is it really that bad down there ? http://www.cbsatlanta.com/news/22536651/detail.html

Go to Paramedic School, then it wont be an issue. Your best chance is to apply at government agencies that are self insured if you choose to not go to medic school. The more rural and low-paying, the better your chances will be.

Hey doc, guess i missed your comments back when you made them originally, but I am not sure what you are referencing. I just asked a simple question regarding how long orientation is for most services ? I imagine it varies from one end of the spectrum to the other. I made no dire comments about the end of the earth, being blind, or why you should feel guilty. But being a "Doc", i assume you are familiar with the fact that JCAHO makes most hospitals prove (well, not prove, but create paperwork) that their staffs are competent, including part-time and contract employees. This is usually done through orientation check-lists and an annual credentialing process. I wonder how many EMS services could provide documentation regarding employee competence ? Or prove that any new employee is ready to start an IO or could pace a patient without hesitation ?

Here are a couple of thoughts: 1. I have a friend who works at a bank, and is required to wear a suit to work. He makes about $30k, and his suits are $200-500.00 each, and he has to have enough to make it through a 5 day week. His employer does not contribute towards his clothing. 2. I have a friend who is a Nurse, she makes over $40k/year and her employer mandates that she wears a certain color scrub uniform. Although she makes more than friend 1, she still is not reimbursed for clothing. Be happy that someone buys your clothes for you. Better than that, be happy you have a job.

I seriously doubt that you will find to many "internet accessible" proof of firings for poor documentation. For one, personnel issues should be private, so you will not find the reasons for most people's terminations on the internet, unless they did something incredibly stupid (and poor documentation usually does not rise to that level). Two: Most departments have a progressive disciplinary process which means that for something like "poor documentation" the offender will be given the chance to improve, and most will improve before the point of termination. You might be better off talking with medics in your area to see if they will share some anecdotal stories of how poor documentation almost or did negatively affect them (in trouble with supervisor, sued, patient later died).

Serenity now, Sernity Now ! Something you will learn through experience; no matter what you do, no matter what you say, no matter what plan you have, you will NEVER MAKE EVERYONE HAPPY IN YOUR LIFE. So rather than give any of these morons any control over your day (that is what you do when you let your B/P go up because of something someone else said or did = if they are controlling your mood, they are controlling you). You have to stand-up and decide what battles are worth fighting and which ones are not worth your time. As suggested earlier, smile (dont be rude), thank them for their input, tell them you will look into it, and go on with your day. Let the small stuff roll off your back, or you will soon have an ulcer. As for issues like the one with the track (where there is no doubt that you are on the logical/right side), just present them with the logic; you should have just said what you told us, "This is where the track owners want us, if you have an issue, please go see them". When you have a kook like the Ranger, where you have intruded on their authoritiiiii, you should have said, "I am sorry, I had no idea we broke the rules, maybe you can attend our next departmental meeting on such&such date and educate my staff to your rules and needs". You ran Barney's road block and hurt his ego, so just like Thelma Lou, you have to let him feel important.

This is a big problem in our industry, maybe because of the perceived shortage, but we spend way too much time with problem children in my opinion. Maybe this person is one of the few who will somehow see the light, but I doubt it. I am not saying we should not try to help everyone, and mentor them, but there becomes a point where you are spending 95% of your effort on 10% of the employees. And then what do we do with the GREAT employees ? We reward them by sticking with the worst partner, worst truck, and worst shift. When will we wake up ?

About two weeks before Obama won the presidency, a friend of mine shared a story of a mental patient who was being admitted against her will. She had freaked out about the possibility of Obama's election, was seeing apocalyptic visions, started reading her bible 24/7, and had contemplated murdering her kids to save them from the horrific future she saw. You can dedide with the knowledge you have now, whether or not she was crazy or visionary. Realize the one of the most common causes of hallucinations is medication related, especially the phenothiazines.

Guess you never had a dying patient look you in the eye and ask, "Am I going to die ?" And what's the difference between lying to your boss (I am too sick to work today) or lying in your documentation to cover your butt versus lying to a patient. If you lie you lie.

Dear Johntown 2000 or whoever you really are, please let me assist you by asking a few questions: 1. In ths economy, with your present educaton, what higher paying job can you realistically go get tomorrow ? 2. If you can not afford to make it on an EMT salary then you need to live within your means (how many car payments do you have, how much is your house payment,how many times do you eat out per week ? 3. Who lied to you about EMT pay rates ? Its nt like it dramatically dropped while you were in school. 4. Yes,you may have to work 100 hours per week to make $100k, but what other job can you do that in ? If you were an accountant or whatever 40-hour week job you want to pick, most work 5 days/week, leaving you only 2 days to work extra (but if you live within you means, you shouldnt have to work two jobs). 5. Yes the test is difficult, and it shoul be. In most systems you are pretty much granted full reign to do as you please as a Paramedic, so someone needs to make sure you are up to snuff, even at the EMT level. 6. If you are a bad test taker, there are books and classes that will help you.