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nick72

dealing with verbal abuse

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Where oh where has nick gone. Me thinks he does not like the advice given, maybe be went to that other site where they glorify that type of thing?

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Those that have responded to you so far in this thread have decades of experience in the EMS field, dating back into the early 1970's , so take our word for it there IS something wrong with the need to tie folks down on your cot.

With respect (and this one one of those rare times, where "with respect", really does mean "with respect"), I find myself regularly physically and chemically restraining a fair number of patients. These patients are usually restrained because they are acutely psychotic, or have attacked the police or my crew members.

I'm quite a nice guy, and try not to go out and provoke fights. I make a lot of money doing EMS, and quite enjoy it. In addition to being a fun and challenging job, it pays for a lot of things that are very important to me, like my house and children.

Verbal abuse is nothing. It is a price of being a paramedic, or, more broadly, working in healthcare, despite what the "zero tolerance" posters in the ERs state. If someone is being verbally abusive towards me, it's rare that I care about their opinion of me. It is like water off a duck's back. Most of the time.

If someone requires physical restraint for safe transport to the hospital, then to me, the humane approach is to provide physical and chemical restraint, usually with a combination of midazolam and haloperidol. This is to protect them from injuring themselves, or potentially being injured by law enforcement, as much as it is to protect me. As an earlier poster noted, it's quite important that they don't eject themselves sideways from the vehicle at high speed.

I don't think this makes me a bad provider, or that I'm lacking in interpersonal skills. In fact, I'd argue that, in many cases, to physically restrain without chemical restraint would be negligent, and is probably a standard of care in most ERs.

With regards to dealing with verbal abuse, something that works for me, is to ask first, "Do I really care about this person's opinion of me?", and "Why do I care?". Because most of the times, that personal tied down on the stretcher, handcuffed with cops, or sitting in a puddle of their own urine, has some pretty glaring personal issues and problems of their own. If I don't give them the power to make me feel bad, then all of a sudden a lot of the things they're saying lose their sting.

All the best.

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fully taken as meant systemnet.

Thats why I asked him if he was working in an urban environment. Thats where I found a larger percentage of those on the edge of needing restraint.

Cities seem to be the dumping grounds for the mentally ill.

Still , even when I worked in a major New england "old city" we didn't have to restrain too many folks we encountered.

Did we encounter folks with psychotic episodes ? Certainly all the time. We just used our charm and wits to keep them under control and compliant.

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Guess he is gone, but it is a fair question that newbies might need an answer too.

1. Question your own bedside manner first, if this is a common occurrence, maybe you have an issue. We had a smart ass yankee who nearly got his ass whipped every time he went in the hood, i went in the same hood and never had a problem.

2. Speak softly if the person is enraged. If you speak quietly, they have to stop their rage and attempt to hear you. Often calms them down.

3. Play the "why me card" ! Dude, I am just here to help, why are you yelling at me, I have not a done a thing to you, and I am showing you respect, I would expect the same respect in return".

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Systemet, respect returned. And I can also say that my days in a urban environment(KC MO and Independence mo) that I did restrain more patients than I have ever restrained when working in a very rural domain. It seems that the urban environment brings these types of people out.

And dammit, if they swing at me, or swing at my partner, you can bet they are going to get restrained, no exceptions. I won't allow them into my ambulance without restraints. But I have been doing this nigh on 20 years and I think that it's all in how you approach the subject.

But Nick is gone so I think we might just be pissing in the wind.

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Restrain the patient for the physical abuse.. That being said this, type of work whether it be a emergency run or a simple non emergency medical cot transport you primary role is patient care. By all means just listen, most of the time all they want is someone to do this. If this becomes unbearable (which it should not) ask for a different run for personal reason. if this is a small company and not able to provide you with an alternative run you will have to deal with it. after all,this is what YOU signed up for whether stated or not.

Bobb Camden

CCO of local EMS

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