Do you ever give patients "tough love"?

[ladyemt51_2000]

Patients who abuse the system are the ones that tend to get a rise out of me. In the county I work in there is one individual who calls 911 two or three times a day because she needs help moving her husband from wheelchair to bed or bed toilet, etc. The two of them live alone. This may sound mean or cruel, but get a home health aide or go to an assisted living facility. I am getting sick of being paged to this address for "assist invalid" three times a day. Helping grandpa to the toilet is not our job. This paramedic level truck is tied up moving this man while another unit that is 15 minutes away from the neighboring district has to respond to codes, chest pains, and shortness of breath calls. To top it off, the county cannot bill Medicare for this call, but it is tying up an ALS ambulance. The county has not done anything about it. It makes me mad.

I can certainly sympathize with her not wanting to put him in a nursing home, but what about when serious call comes out in that district and another ambulance that is far away has to respond, and the patient dies?

Riblet,

I just spent the last 6 years watching my mother die of Alzheimer's disease. I lost her two weeks ago. We kept her at home. I quit my job to help with the caregiving, my marriage almost fell apart and my dad suffered healthwise. She was able to die at home. My folks had been married for 61 years this past June. I am now my fathers caregiver.

Getting home health or placing a loved one in an ALF is not a walk in the park and can be very costly and emotionally devastating. And when you are dealing with two elderly people who are trying to go it alone, think if the implications. Maybe they have no family, they have family but they are not aware of what is going on in the home or they have family who don't give a damn, which is most likely. Caregiving in the home is a 24/7 job. And it is the most rewarding job I will ever know, besides EMS.

So I am sorry if you have to run your BS calls and wipe grandpa's bottom because his wife is too worn out to do it. Too damn bad you have to be bothered to pick grandma up off the floor because her husband is too frail himself to help her any longer. You big bad paramedic, can't be bothered with such meanial tasks. Worried about not looking cool or being a hero because you aren't on a "cool" call? To that caregiver, you ARE a hero.

Take your self righteous crap and your "it's not my job" attitude and stick it.

[ladyemt51_2000]

And BTW, did you ever stop to think your patient may have FTD (frontal temporal dementia) and that is why she is getting an attitude with you? Or perhaps she has been up for most of the night with no respite or support. I would probably have an attitude too if I had medics coming to my aid with a chip on their shoulder.

Geeze people, do the job or get out of EMS. Do yourself and your patients a favor. You can't stand around and look cool in your uniform forever.

[Dustdevil]

Geeze people, do the job or get out of EMS. Do yourself and your patients a favor. You can't stand around and look cool in your uniform forever.

Plus 10 for the quote of the day. :thumbright:

You have to admit, you kind of stepped in that one, Riblet. This topic was about self-destructive patients. Going off on a tangent about invalids and the elderly in the same discussion wasn't really a good way to show anybody that you are cut out for the job.

Ladyemt just gave you what this topic is all about: Tough love. You'd be wise to heed it.

[spenac]

Riblet,

I just spent the last 6 years watching my mother die of Alzheimer's disease. I am now my fathers care giver.

Getting home health or placing a loved one in an ALF is not a walk in the park and can be very costly and emotionally devastating. And when you are dealing with two elderly people who are trying to go it alone, think if the implications. Maybe they have no family, they have family but they are not aware of what is going on in the home or they have family who don't give a damn, which is most likely. Caregiving in the home is a 24/7 job. And it is the most rewarding job I will ever know, besides EMS.

So I am sorry if you have to run your BS calls and wipe grandpa's bottom because his wife is too worn out to do it. Too damn bad you have to be bothered to pick grandma up off the floor because her husband is too frail himself to help her any longer. You big bad paramedic, can't be bothered with such meanial tasks. Worried about not looking cool or being a hero because you aren't on a "cool" call? To that caregiver, you ARE a hero.

Take your self righteous crap and your "it's not my job" attitude and stick it.

My dear lady I feel your pain. Many of us have been in similiar situations. But I must come to the defense of riblett. If a persons family and friends cannot provide a safe place then it is better to have them in an assisted care home. I have seen injuries to both patient and caregivers where inappropriate care was going on because they loved the person to much to allow others to care for them. I do not feel it is self righteous to complain about going to the same house multiple times a day or even a month when it is because family can no longer properly take care of patient. Some of my most memorable calls have been to assist a family member to get back up, but it was rare for them to call. In cases of abuse which is what is happening if family is not able to care for a person alone but refuses to get help, I have reported them to multiple agencys at the same time. The result some have been taken from family and others were given home health assistance.

I have no problem with occasionally going to render aid but when we become the primary care givers that is abuse of the system.

[spenac]

[Going off on a tangent about invalids and the elderly in the same discussion wasn't really a good way to show anybody that you are cut out for the job.

Ladyemt just gave you what this topic is all about: Tough love. You'd be wise to heed it.

Thanks Dust for getting us heading back on the topic. I will give tough love. I will tell them what I think. Especially the guy that calls monthly going thru DT's because he can't afford a fix and crys all the way to the hospital, and promises he will never do drugs again. The first few times they ask for help and I try and get them sent to some of the agencys that provide help. After they keep walking away if they call they can get what ever I want to tell them, yes waste of air but hey it helps the 90 miles go by faster, and actually have had a couple of people that have been clean a while, probably just tired of hearing me gripe at them.

[Riblett]

To all of you who have felt the need to attack me about this, go back and read the post as to my real concern in the matter. Sure, I do not like getting these calls, and no it is not my job. But other patients could be seriously harmed by them continuing to do this. They are in a part of the city that is served by a municipal service with county run units in surrounding areas with extended response times. And if she does indeed have dementia, as EMTlady suggested, and he is to weak to even move himself to the toilet, then it is dangerous for the two of them to be living alone.

Despite your smart a** comments about me wanting to look good in a uniform, being a big bad paramedic, and not wanting to do "my job," no one with a shred of common sense can say that it is not a valid point. EMS is not a service that you call a few times a day to come help you use the toilet, and it should not be used as one. I have no problem picking someone up of the floor if they fall, and will do it with a smile and a call us back if it happens again. But when the only ALS unit in the area is getting called out there several times a day and tied up for thirty minutes at a time for this then there is a problem.

They are in need of a little 'tough love' in the form of an intervention and be told that they cannot keep doing this and need to make other arrangements. While I sympathize with their situation they should not be allowed to continue putting other patients at risk by tying up a paramedic level ambulance for something it is not intended.

They have been refered to case management several times and nothing has changed. So if anyone has any real advice about how to intervene or if it would even have a point, please post, otherwise show yourself a little 'tough love' for being too much of a bleeding heart too look objectively at the widespread implications of their actions. The phrase, 'don't be so open minded that your common sense falls out,' comes to mind.

[Dustdevil]

All valid points. But it is really unflattering that you do not seem to understand that this has zero to do with the topic at hand. That's what makes you look silly.

[NREMT-Basic]

The closest I have come to "tough love" so far was telling our frequent flier-three pint a day jack daniels drinker that, when he started man handling my partner in the rig, that he could either settle down, we would start an IV and let him sleep it off in a SNU room, or he could get back out of the rig, go back in handcuffs and sleep it off at the Striped Light Hilton for a night before being arraigned on charges of public intox, D and D and assaulting emergency medical personnel, a class 3 felony. He chose to go to sleep. I save my love for 4 year old burn victims and old ladies. I doubt the guy that passes out in the same parking stall in the same grocery store parking every frigging night lot gives a flying flip what I have to say and that anything I could say is not about to bring about his one and only moment of clarity before his liver falls out. I try to be kind and compassionate to my patients, especially those that have just been assaulted, etc... But my "drinking buddies" arent likely to give a flip after all. They will get all their tough love from their friends of Bill.

[Riblett]

Dustdevil, I thought it did have to do with the topic. Tough love and objective interventions are not reserved for drug addicts and alcoholics. It can apply to anyone whose continued actions are posing a danger to themselves or others, particularly when EMS service is being abused. It may not be on the same level as those who tie up units for repeated drug usage, drunks who have passed out in public, and repeated attention-wanting half hearted suicide attempts, but the end result is the same.

It seems that people have spent more time arguing that I am off topic than posting anything on original topic.

[Dustdevil]

Dustdevil, I thought it did have to do with the topic. Tough love and objective interventions are not reserved for drug addicts and alcoholics. It can apply to anyone whose continued actions are posing a danger to themselves or others, particularly when EMS service is being abused. It may not be on the same level as those who tie up units for repeated drug usage, drunks who have passed out in public, and repeated attention-wanting half hearted suicide attempts, but the end result is the same.

That's a flaw in your system, and it should be dealt with by your system management. Perhaps it is your dispatchers who you should take your "tough love" to. If your system is dispatching you to these patients, then it is your job to take care of the patient. Period. Whether or not they should be dispatching you to these runs is certainly a fair point of discussion. But as long as they are, it's not your place to lecture those patients about how your system sucks. A lot of administrators would boot you out the door in a heartbeat for that kind of thing, so I'd be very careful about who you brag to about this.