A Pox On This Place

Welcome, from a backwoods rural Wisconsin service. You will be the highly trained professional ALS rig I intercept with.

And, thank you for that.

OK. I know I'm VERY far behind the loop here. I've been a cop or bailiff 25 years, I took EMT Basic this Spring because it's what I'd like to do in retirement. Joined a local fire ambu service. I'm bumming out at how slow I am, how far behind I am at getting gear ready let alone patient assessment.

My saving grace is a very demanding local semi-retired Nurse Practioner who is a very exacting 30 year ER nurse.

Ever felt butt assed over your head? The best thing I do is drive the rig out Code 3 through very deery woods.

Welcome. Just joined a Fire Ambu volly service at 57. They claim I'm going to extrication training with the hose monkeys this summer.

I beg to differ.

It sounds like you're getting great training experiences. Good on you.

Lurking is accredited here, you can get up to 4 CEU's/year for just reading Kiwi's posts.

Welcome!

Welcome!

Just did my first orientation on call shift with my new service, we had a bad tree/car MVA, our only trauma call. I Liked my preceptor I worked with, she thought my interventions and later PCR were ok and my report to the attending at the hospital. Bagged 20 minutes.

God frowns on morbidly obese people who smack up cars.

Welcome, and thank you for your service. You'll be most welcome here, I'm annoying and opinionated as hell and yet, I find this is a very cool community. They tolerate me and only put the leeches on when I'm bad.

(Yes, guys. I'll work on the annoying and difficult aspects.)

Just joined a new local BLS transport service in NW Wisconsin. I've worked in a courts/jail correctional environment and the the thought of riding a rig at 57 kicks my ass.

I joined this site to sit and stalk and learn. Thank you all for that.

BTW, I'm a difficult person.

Prayers, kind thoughts and wishes to your friend.

Doc, thank you breaking my balls and moving me beyond my comfy been-there response to problematic seizures. While PNES is a disagnosis beyond my pay grade as a lowly Basic in a bupkus volly service in Wisconsin, it's a very real diff diagnosis thing.

Thank you.

First they came for the communists,

and I didn't speak out because I wasn't a communist.

Then they came for the trade unionists,

and I didn't speak out because I wasn't a trade unionist.

Then they came for the Jews,

and I didn't speak out because I wasn't a Jew.

Then they came for me

and there was no one left to speak out for me.

...and really, "Will a disrobed patient video be more fun at your next Occupy meeting?" Will a video of you destroying someone else's property be more fun at your next Fascist Anonymous meeting? I can meet hyperbole with hyperbole.

And you want to practice medicine? Wow. I'd apologized to you publicly for snapping at you, and now I'm a Fascist? Really?

I'd say you're something less than a man. But certainly a med student, right? That's likely enough for you.

Former reporter, listening to this discussion. I have opinions but I choose not to share them. I'm being good (NO! Don't put the leeches on again! I've been a Good Boy!)

The defense of civill rights of simpletons who'd like to record patients being treated in public doesn't engage my brain ... Really?... Will a disrobed patient video be more fun at your next Occupy meeting? If you mess with my patient in field, you'll be moved back. Fool.

What happened to trust, respect, reticence, modesty, confidentiality and humility? Of the great medical people I've met in my life, the best freakin' providers, from M.D. to nanny seem to share thosee qualities.

Glad to hear that. I like happy endings.

I honestly don't know, Doc. Are there any lawyers out there? I'm a public sector employee and can pretty much be recorded whenever, wherever. I think the legal concept of patient confidentiality is so strong it likely trumps some traditional First Amendment activities but I have no idea where the line is.

JP, I apologize. This is a topic that makes me so damn pissy it brings up some very unpleasant experiences. I've worked a lot at our local Occupy rallies and twice had to ask coppers to move aggressive picture takers back. One was an elderly woman who'd taken a tumble on some steps at one rally. She had some superficial lacs and some minor abrasions but didn't appear to have anything serious going on. A FF was still holding C-spines because we were'nt finished doing a head to toe and an Occupy member with a boxtop press credential around her neck was leaning in and trying to interview her. I got the attention of an MPD officer who moved her along in a ham-handed way I rather enjoyed.

What's a reporter these days? When I was one you worked for a network, a broadcast station, a paper or a wire service. Your credentials identified you as press, which got you some non-public access (at times) and admission to press conferences. (The best part was free swag, booze and meals.) Now, anyone with a blog, a laptop and a camera can choose to style themselves as press. Technology has made this a murky distinction. What bugs me about the anything-in-public-is-fair-game school of thought is there's no real ethic involved. I think recording someone's prehospital care in a public place is a wrong and tawdry activity, and I struggle to see its newsworthiness.

I get very bent out of shape that not only do citizen reporters seem to lack ethics is their belief the First Amendment is an absolute, fixed thing. It's so not. If an ER visitor starts walking around snapping pictures they're gonna get their butt arrested. Doesn't someone in a prehospital setting out in the

community have the same right to privacy and personal dignity as an ER patient?

OK, that's my rant. I'll sit back and listen to cooler heads.

I realize those members of the legendary Citizen Information League feel they have the right to record wherever/whenever in public. In Maryland, Illinois and Massachusettes it's illegal to record police operations, even in a public place.

Legality of videotaping a patient being treated in public? I'll leave for a moment the shoddy ethical choice and general asshattedness of such an act and go back to legal constraints. Ever heard of disorderly conduct? Public conduct that tends to anger, annoy or intimidate?

I really have no venom about this topic, I'm just perplexed that ass hats have apologists.

You're denying the general exception to interfering with public safety/ems operations in most state statutes...

Doc, I realize the First Amendment is not absolute, I was a reporter. I mention interfering with public safety operations as an exception because to me it was posited that it was not.

The concept is called a reasonable expectation of privacy, actually. It can get rather complex. Can people be arrested for filming? Sure as hell. If law enforcement wants to shut off the newsie broadcasting around the block while they're negotiating...think they can?

You're such a linear thinker. Step back and think about LEO's FF's and EMS trying to have a best outcome. Your ACLU sensibilities may be abused but what would you like other than the best outcome possible for your patient?

The first amendment doesn't allow for battery.

If only there was a word for that. Oh, yea, robbery.

So robbery and distruction of property. I hope you have enough money to replace the cell phone.

1. HIPAA doesn't apply to the general public,

2. There is no expectation of privacy when out in public.

3. How is the camera interfering with your prompt and necessary medical care than someone without a camera?

4. How does a camera interfer with a crime scene, assuming it is a crime scene?

5. How does a camera interfer with accident reconstruction?

No more relevant than all of those strongly worded letters that the UN sends to Iran. I have to follow the laws of what ever area I'm in and the UN neither makes nor enforces those laws.

What civil penalties? Cite applicable laws or cases where someone faced actual penalties for the mere act of filming out in public. Not other violations that might have also occured, but just for the act of filming.

Similarly, HIPAA doesn't require me to go take somene else's film. Is there an ethical imparitive to attempt to prevent it? Sure, but moving the patient to a more private area or having someone hold up something like a sheet fullfills that imperative. Assult, battery, and robbery, however, is not justified.

You're kidding, right? Filiming in a public place is generally allowed but for the obvious things like mens and womens locker rooms at the beach, not. But, in almost every state filming that interferes with police/fire ems operations is prohibited, and actionable. Really? You need a road map?

Uh, filming a childbirfth at a protest with the Great Unwashed may be a very beautiful thing to your generation. To mine it's a serious tort.

I'm glad our medical schools are producing such forward-looking informed individuals like yourself. Ignorant AND condescending, you'll do just fine.

I'M TAKING TEH LITTLE PILLZ THE SIGHKAYATRYST GIVES ME! stop judging me

Go back to the Acitivity Room NOW.

Or the leeches go back on.

True, but the other end of that two- pronged steer is: if someone is not in healthcare, no HIPPA violation. Just an ass hat. (But subject to civil penalties.) If someone is in health care there IS an expectation to tell someone to knock it off.

In my other life I was a reporter. 5 years, broadcast. And a stringer for the Associated Press. As far as I know, a citizen with a camera or cell phone has NO First Amendment right to:

1. Violate HiPPA.

2. Viloate a person's privacy (in the civil sense).

3. Interfere with prompt and necessary medical care.

4. Interfere with a crime scene.

5. Interfere with an accident reconstruction scene.

Back those ass hats off! I love the people with Indy Media "credentials" hanging around their necks. Anyone can get them. Even the legit press in my day (1979 to 1984) knew that you don't take pictures at accident scenes without clearance, you don't report unconfirmed medical anything or record patients/victims without permission. You could DO any of those but you'd be shunned by Fire, EMS and the coppers and your employer would pay a hefty fee and you'd be let go.

Well, back in the day at least. But I am older than dirt.

Hmm...He's been asked to stop and the officer wont do anything about it. Depending on whether or not I let my bitch out of the box...here is what I would.

Not letting the bitch out of the box = Sir please stop taking pictures. This woman needs some privacy and what if this was your wife, daughter, girlfriend or sister. Would you like strangers taking pictures of her in her most vulnerable state? I would then again go to the officer and ask him again to make the guy stop and if he cant then we will call his superior and see what happens.

Letting my bitch out of the box= Sir may I see your phone? Wow thats a really nice phone...*insert breaking phone in half here* This is my boss's phone number...My name is blah blah blah...make sure you spell it right. And theres the officer for you to give your complaint too. Here's your phone sir..Have a nice day! Now get on the other side of the street!

I've been called a bitch before on a scene...I dont care. When it comes to my patients privacy I will do what it takes to protect them.

On a side note...I would have a couple people holding a blanket up so the people couldnt see, especially if I am going to cut somebody's clothes off outside of the ambulance. Just for the fact that people have cell phones and video cameras.

I like your Inner Bitch. I've asked people to step away for privacy, then morphed into "Stand off, NOW. This person can sue you for what you're doing." I've retrieved equipment boxes--clumsily--and knocked people on their ass, or off balance. (One complaint from an angry protester, annual eval item for me but no discipline. My boss loved the video.) I've found FF personnel are very amenable to "scouring" an area for possible pathogens with water too.

I've worked probably 100 Occupy protests in the last year. You assume you're recorded and on video but if someone violates my patient's space or privacy, all bets are off. Back off or you'll force me to be snaky.

When I show up and see no bleeding tongue, no poop or pee, no postictal state, then I immediately begin to wonder what else they might have seen and try and catch that. It's just more fun that way...

Dude, your concept of fun is interesting. Mildly disturbing but interesting nonetheless. And quite correct, I think. I'm a dinosaur about assessing in courts/correctional environments... (You can always tell a public safety lifer but you can't tell him much! And please, speakly slowly with no medical terms more than three syllables.)