Rosenbaum EMT Reinstated

[JPINFV]

2. Is everyone in this room saying they have never made a transport decision or suggested a transport decision that did not benefit them personally. Have you ever suggested that:

a. A patient not go to their facility of choice that is 5 hospitals away, when a closer facility could handle their non-emergent need. No

b. A patient not go to the urban teaching hospital on a friday night, because you know they will have to wait 16 hours for treatment, and you will have to wait an hour to find a bed.No

c. the pateint go to the closest hospital so you could get back to the station to eat or sleep.No

d. refused to take a drug seeker to the hospital that is an hour away (because that hospital hands out drugs like candy). No

e. that the patient who called you at 30 minutes before shift change should go to the closest facility versus the one that is an hour away (putting you off work and late to your part time job by 2 hours).No

f. agreed to take a patient to a more distant hospital, sacrificing coverage in your county because that hospital feeds you for free, or is close to that great 1/2 price restaurant. No, and anyone who seriously pushes about doing something stupid like that will probably get an incident report. While discouts are a good jester, nothing will get them taken away faster than abuse.

Unless there's a medical necessity (either from an operational standpoint [e.g. coverage] or a treatment stand point), I have zero problem taking a patient to their preferred hospital.

[VentMedic]

I am not trying to justify this EMTs actions, as they are deplorable, just realize that legal precidence can have some unforseen consequences. And before you jump on your soapbox, read the above again, and make sure you have never, not even once, been guilty of one of the things I have posted.

There are also a few of us that had quality medical oversight and QA/QI in place to review the care we provided, time on calls and if the appropriate hospital was chosen. Of course there are others who may never be held accountable for crap work ethics or crappier assessment skills due to laxed medical oversight and the mentality of those who are in control of EMS.

[spenac]

There are also a few of us that had quality medical oversight and QA/QI in place to review the care we provided, time on calls and if the appropriate hospital was chosen. Of course there are others who may never be held accountable for crap work ethics or crappier assessment skills due to laxed medical oversight and the mentality of those who are in control of EMS.

I can honestly say I have never taken a patient to the wrong hospital just for my benefit. In fact I have never take a patient to the wrong hospital. I have a perfect record on this matter. Guess that is a plus of only having one choice of hospital you can't get it wrong.

[WolfmanHarris]

My protocol is closest, most appropriate hospital. They don't get a preference. I can do a trauma bypass, stroke bypass or STEMI bypass. I can't do a convenience bypass. Now in Toronto's its different. I know they have hospital coordinators that help ensure certain hospitals don't get overloaded, but they make the decision not the patient.

[CBEMT]

For further clarification, the patient in the DC case was not capable of expressing a preference, nor was anyone present to do so for him. The destination decision was made solely by the crew, and then changed for the convenience of this fired EMT.

[DwayneEMTP]

...Is everyone in this room saying they have never made a transport decision or suggested a transport decision that did not benefit them personally. Have you ever suggested that:

a. A patient not go to their facility of choice that is 5 hospitals away, when a closer facility could handle their non-emergent need. Yep

b. A patient not go to the urban teaching hospital on a friday night, because you know they will have to wait 16 hours for treatment, and you will have to wait an hour to find a bed. Uh huh

c. the pateint go to the closest hospital so you could get back to the station to eat or sleep. Nope

d. refused to take a drug seeker to the hospital that is an hour away (because that hospital hands out drugs like candy). Yep, refused but with support of medical control.

e. that the patient who called you at 30 minutes before shift change should go to the closest facility versus the one that is an hour away (putting you off work and late to your part time job by 2 hours). Oh hell...I'm a bad, bad medic...

f. agreed to take a patient to a more distant hospital, sacrificing coverage in your county because that hospital feeds you for free, or is close to that great 1/2 price restaurant. Yeah, I'm thinking I've not met the medic that hasn't taken the stubbed toe to the hospital with the best grub!

Again, notice the bold, "suggested." I've not cajoled, bullied, threatened, tricked, etc...But if I remember the original story correctly, the police and EMS were arguing over who was responsible for the "drunk" and EMS lost...and was not happy about it. Not a matter of anything you suggested above. I just felt compelled to respond before every do-gooder on the City had a chance to scream their indignance at your honesty.

Dwayne