Abuse of a pt. by officer

[ERAngel]

Currently, I feel like I am between a rock and a hard spot. Our asst.chief if our fire station is also an EMT-B, and often goes to calls with my medic and I to either assist or to lift or if it is a mva set up anything we may need. Because he is an officer, I try to be respectful of his position and follow the rules laid out for all of us at the fire station but lately I am having a difficult time.

We have a frequent flyer who we know on a first name basis. This man can become curt, he lives upstairs in his home and when we have to use a reeves, it can be difficult as he has gained weight and the width of his hallway and how we have to carry him out is time consuming. Appearantly a few weeks ago our asst. chief and dept. chief ran a call to his house, they "firmly" told him how hard it is for us to get him out of his upstairs bedroom, that often times we crew's come with two people, a driver and a tech, so getting manpower could become an issue, then about moving downstairs into his rather large living room. The man tried to explain then that because the front door was there, he felt that it was rather intrusive to his privacy as well as those coming to the house to see his two teenage children and he was genuinely sorry for the trouble but wasn't going to change.

Again, yesterday we ran him and asst. chief was with us. While trying to obtain a pt. history, assess the scene and get our reeves in position, asst. chief became very verbally abrasive and nasty with our patient, they started to argue and fight, words were exchanged which caused everyone to become uncomfortable and the patient quite ****ed off, especially when he was told all his problems were in his head. We got him down to our ambulance, where asst. chief told us to wait outside the ambulance he wasn't done "talking" to the patient. In the meantime his uncle is outside with us and is rather ****ed off, saying there is no call for what is being done, not in his nephews home, that what had transpired was uncalled for.

At the hospital our patient said that he does have a good lawyer and was thinking about contacting him, it was then confirmed by his uncle that they are going to pursue what happened through legal channels. This has my medic and I very worried as we acted very diplomatically and are very embarassed as well as realizing what we stand for and our own values were compromised by our asst. chief as we would never treat a patient in such a manner as to give our station a bad name and our values are much higher as to how we treat our patients, regardless of if they are a frequent flyer or not.

How would you all handle this? We can't go to the chief, he is but a figure head, dept. chief is our asst. chief's father so that too would be rather volitile as the old saying goes, "**** rolls down hill" and it would make my medic and I's life miserable if we did complain. Can we be pulled into court as well as other than witness's? Could our EMT liscense be pulled?

Thank you for any advice.

[emsff32515]

I see the predictament. I would consider speaking with the Ast. chief involved. If you dont feel comfortable abut this, do you have commissioners you could go to. Definitely keep in mind what happened in case you do get called on things. You dont want it coming back on you too. Best of luck

[DrParasite]

so he's an officer. big deal. sounds like he did something inappropriate. document it. you and the medic. you got to CYA. give it to the chief. let him make the decision if someone acted inappropriately.

just because someone is an officer doesn't make them infallible, nor does it make them any better than you.

your medic and yourself need to document everything that happened, and submit it immediately. if there is legal fall out, you documenting what happened will be the best thing you can do to cover your own *** and prevent your cert from being yanked.

I know it sounds like you are looking out only for yourself and looking to screw the AChief, and you are. but if everything you said is true, then you need to be looking out for yourself, and if he did indeed act like you are describing, there is a chance that he shouldn't be an EMT and treating patients.

just my opinion.

[nmfire]

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[fireman4949]

Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document Document

EVERYTHING!

Write down every singe detail!

If you are subpoenaed to be deposed, or to testify, make certain that you tell the absolute truth.




Kevin :D

[ERAngel]

THANK YOU all for the words of wisdom. As for going to the chief, as I said, he is only a figure head, and last time I went to him about something I got my butt chewed and told to keep my mouth shut by the person I filed a complaint against. So you can see why I am so hesitant to say anything to him. I will get a hold of my medic and we can go over what happened.

[mitllesmertz1]

Ahh, a question of ethics, I love these...

At the hospital our patient said that he does have a good lawyer and was thinking about contacting him, it was then confirmed by his uncle that they are going to pursue what happened through legal channels.
Funny, every ****ed off pt I've met has a good lawyer on call. Even the ones that live in a cardboard box. Guess those good lawyers do alot of charity work.

How would you all handle this?

We all have to pick which battles to fight.
If you feel real strongly about it, call the pt up and offer to testify on his behalf ( I'm sure their good lawyer is filing a lawsuit right now, not sure what the grounds would be though. Being mean isn't illegal).
Was the pt's care or treatment affected in a manner that caused harm to the pt?
Call the City/County Attorney and let them know about the incident if it bothers you.

and it would make my medic and I's life miserable if we did complain.
Well, like I stated, if you really feel strongly about it, a little misery on your behalf is nothing compared to the horrible pain and suffering the pt experienced as a result of this verbal abuse. You are going to stand up for the poor pt, right?

Can we be pulled into court as well as other than witness's?
We can all be pulled into court for anything, at anytime. The wondeful world of frivilous litigation. Did you break any laws? Did you violate the pt's civil rights? No? Then you have nothing to fear sir.

Could our EMT liscense be pulled?
Again, if you did nothing wrong, why would your EMT cert get pulled?
If the pt goes way off the reservation and starts making up stuff that didn't happen (wow, he wouldn't do that would he? he's just an innocent guy minding his own business :rolleyes: ) you could get hammered. But that can happen anytime. Better make sure everyone there saw the same thing you did, you don't want to end up in a "he said-he said" court case.

Bottom line is some areas of our country have lot's of people like this that EMS sees daily.
Was the Chief out of line? Yeah, probably. Did he say what many of us might want to say? ABSOLUTELY!
So now look into your soul and ask yourself, do I like this Chief enough to back him up in court? Will you say that the pt and his Uncle misunderstood what he said, and the whole thing is overblown?
The time to figure out what you're going to do is now (actually it's before it happened, it's when you took the job, it's when your character was molded as a kid).

Document what you saw; send yourself an Email with a good description of what happened. An Email gives it a good time/date stamp. But keep the document to yourself until you decide what to do.
Of course, sharing the incident on a public forum makes any attorneys job of discovery a little easier.
TALK!!! to the Chief and ask him what the hell happened. TALK!!! to your medic, ask him what he's thinking.

sounds to me like you need a gut check:
If you want to wave the flag of pt advocacy, you should have already reported this due to your overwhelming sense of shame and horror at what happened.
Or, you can do the "brotherhood" route, and back up your Chief.

No one on the internet can tell you how to make a decision like that.

[ERAngel]

Mitllesmertz you sound like maybe you are one of those who sees nothing wrong with yelling at a patient and telling him it is all in his head? Were we taught in EMT school that it was alright to be verbally abusive or was I absent that night?

I have a strong ethic about how we, in the health care profession, should treat anyone who calls for emergency services. Yes, there is abuse, yes we do put up with a lot of bs, but there are those who are genuinely not feeling well. And I don't care how often one calls, if they look sick or act sick, I am going to be polite and professional, it is not my place to judge or to argue or harass.

I have seen what the flip side of the coin can do and how it makes people feel. Perhaps you need to go back and look at how sarcastically you answered me when I was only trying to find a way to deal with this situation as well as get others ideas.

[mitllesmertz1]

Yes, sometimes I have seen patients receive a verbal tongue-lashing, and I fully agreed with that treatment plan.
I have even delivered a few myself.
(ie treating a 65 yo with chest pain that doesn't mention he was smoking crack.Were ya gonna mention that eventually ****&%???oops.)

And my sarcasm online is often my attempt to shield someone from what really needs to be said, just like we usually try to shield a pt from what really needs to be said.
Some people are better at delivering those comments than others.
I might look at it like this:
1. Did the pt's care suffer as a result of this exchange?
2. Was proper care and treatment delivered?
3. Was the concept the Chief was trying to get across valid, but just poorly delivered? (ie, is the pt a lazy fat-a**, does he abuse 911, does he need to change his living situation, are crews endangering their health needlessly?)
4. If you were the Chief's Supervisor, how would you deal with the situation if it was brought before you?

For some reason many in EMS feel like we can't point out any faults or flaws in the patients we treat, as if they are untouchable golden beings that we must treat with absolute respect at all times.
If some guy smokes crack, has a heart condition, and now has chest pain, I don't think it's wrong to point out that smoking crack probably wasn't a very good idea. Crazy me.
But many EMS people would see that as being horribly offensive.

If a pt has COPD, and calls 911 for SOB, but is smoking a cigarette at the front door, I might point out the utter stupidity in continuing to smoke, but again some of our brothers and sisters would be morally offended and need a critical incident debrief after hearing me say so. Crucify me.

Maybe I'm just sick of people that are afraid to tell the patients the truth, and instead just continue the cycle of health care system abuse.

Either way, I personally doubt I would hang one of my co-workers out to dry for something like this.

Maybe the Chief is going through a bad divorce, maybe his dog just died, maybe he just quit drinking, maybe it was just a bad day. So should he potentially loose his job, his career, over this? Some cities, if they found out about it, would terminate him.
Perhaps talking to the guy, man to man, like in the old days, would be a better way to resolve it.
Something like, "Hey, it seemed like ya jumped all over that guy, Chief. I know he's a dirt bag, but damn! ya gotta watch what ya say on scene. So was there something else going on that I didn't catch?"

You let the Chief know it's probably not ok to chew out a patient, and you give him an opening to say, "Yeeah, well you didn't here the guy call me a motherf**** when you were taking a BP!!!"
Wow, look, problem solved.
Now, if he does it again, he maybe needs a further level of education.

Sorry for the lengthy post guys, but this is a subject that I feel rather strongly about.
Our society has devolved to the point that everyone is so afraid of hurting someone's feelings that patients aren't even told when they are killing themselves.

So to clear it up for you, either buck up and tell your boss you think he's an ***, and file a complaint against him, or forget about it.

[fireman4949]

Mitllesmertz you sound like maybe you are one of those who sees nothing wrong with yelling at a patient and telling him it is all in his head? Were we taught in EMT school that it was alright to be verbally abusive or was I absent that night?

I have a strong ethic about how we, in the health care profession, should treat anyone who calls for emergency services. Yes, there is abuse, yes we do put up with a lot of bs, but there are those who are genuinely not feeling well. And I don't care how often one calls, if they look sick or act sick, I am going to be polite and professional, it is not my place to judge or to argue or harass.

I have seen what the flip side of the coin can do and how it makes people feel. Perhaps you need to go back and look at how sarcastically you answered me when I was only trying to find a way to deal with this situation as well as get others ideas.

Abuse of a patient, in any form, simply cannot be tolerated. Ever!
We are professionals. We must conduct ourselves in a professional manner...Always! Even to those that call on us repeatedly, no matter how childish, whiney, or crazy they may be. They deserve the same respect and level of care as the true "emergency" patient does.

You were the one(s) who witnessed the events that transpired. The course of action you take must be based on those facts.

It is a difficult situation you have been placed in, yet I feel your choice is a clear one. What you do from this point is up to you, your co-workers and your conscience.

I feel that you have already decided what you should do and you are looking here for support for your decision.
Do what you know is right. You will sleep better. ;)




Kevin :D

[ERAngel]

You may feel that you are justified in telling a patient they are a POS or what they are doing with their body is wrong, but who are you to tell them anything? Do you not think they don't already know that?

I was a hospice CNA for a long time, I cut my teeth doing hospice. I had a lady who had COPD and smoked. Every morning when I arrived to take care of her, she had a pot of coffee on and was outside lighting up. I would councel her on the hazards, she knew. But she taught me so much in the 3 months I cared for her before I came in one morning and found her dead in her bed.

We run a lady in town here who is a crack addict. Because I treat her like a human being even though I personally think what she is doing is wrong, she has gotten to the point she will only let me take care of her or touch her. I don't tell her what a worthless human being she is, instead I have talked to her about the dangers of her addiction and how to go about finding intervention and help. She knows she is worthless, she is told on a daily basis and treated as such.

We have even run a woman who jumped out of a friendsb moving vehicle after her cigarettes. She was high on some narcotic, combative, Hep B positive and HIV positive. Screamed, cursed, and scratched the whole way to the hospital, asking the same set of questions over and over and over again. My daughter and a medic from another town were in back and I drove the rig. Did she get less than stellar treatment? No, she was treated as we were taught to do.

I can give you other stories but I don't think you really want to hear them so I won't bore you. As I said, I don't care if you are the crack lady down on 5th and Main or the upper class citizen from up on the hill, I will treat you the same as I do anyone else. With dignity, patience, and caring. We aren't here to judge, if that is the case, your either burned out or in the wrong profession so unless you can be tactful with your sarcasm or attitude, working with human beings isn't your field.

Like you, I care too very strongly about how we treat others. So lets call it a draw....

[Tnfiremedic]

I have three things:

1. Don't compromise your treatment and Document everything.

2. Never leave your patient, regardless of the presiding rank. Tell your partner,
"Let's go."

3. Wait for the subpoena.

[Ltmdepas3280]

Yes, sometimes I have seen patients receive a verbal tongue-lashing, and I fully agreed with that treatment plan.
I have even delivered a few myself.
.

I'm with you .....sometimes they need to be told where the bear sh1ts in the woods :cool:

[FyrGuy176]

Yes, sometimes I have seen patients receive a verbal tongue-lashing, and I fully agreed with that treatment plan.
I have even delivered a few myself.

That's not a tongue lashing nor should it be considered abuse, That is simply educating the patient and educating the public is part of what we do!

[mitllesmertz1]

That's not a tongue lashing nor should it be considered abuse, That is simply educating the patient and educating the public is part of what we do!
Thanks, that is a better choice of words.
Apparently some of our more noble, Florence Nightengale-inspired comrades think it is wrong to ever point out that what a pt is doing/has done about their current condition is unprofessional.
I think we do a dis-service to them every time we pat them on the head, give them a Mr Rogers hug, and say
"we understand, it's not your fault".

Sorry, but sometimes it IS their fault, and maybe if someone told them to cut it out, it might help.
If not us, then who?
If you are really so caring and compassionate about them, does it really help them to say everyting is ok, the decisions they are making are ok, and no matter what they are doing to themselves, everything will be ok?

At least I'm honest to myself, and my patients.

[RoryEl]

Mittles gave you some sage advise in his first post. Pick your battles cause the road to hell is paved with good intension. Consider yourself a fact witness if this is pursued, otherwise your window to act has passed. Again, document and send yourself an E-mail documenting the incident while the event is fresh.

[the1141man]

I think we do a dis-service to them every time we pat them on the head, give them a Mr Rogers hug, and say
"we understand, it's not your fault".

But medicine is all about making people feel better, and the Mr. Rogers hug does just that, right? ;)
I'm sure the "education" doesn't make them feel any better about themselves, which kinda negates the whole point of "medicine". *LOL*

I think a lot of them, like your aforementioned crack addict, know that what they're doing is just hurting themselves even more....they just don't care. The temporary "feel-good" apparently outweighs the long-term suffering yet to come, so who're we to question them for wanting to screw themselves up further? *shrug*

Disclaimer: The above written mostly tongue-in-cheek.

[emsforlife69]

The hel* with rank and file. I mean if this guy is grossly abusive toward the pt. that goes against the EMS standard of care. Im sure your state EMS office would not condone this. If he is an officer conducting himself in that manner, my money is he aint gonna be an officer for long. As I say, luck runs out, maybe not today or tommrow, this year or even next. But rest assured HIS LUCK WILL RUN OUT!!!!! KEEP YOUR HEAD IN THE GAME!

[FireMedAS]

Abuse of a patient, in any form, simply cannot be tolerated. Ever! We are professionals. We must conduct ourselves in a professional manner...Always! Even to those that call on us repeatedly, no matter how childish, whiney, or crazy they may be. They deserve the same respect and level of care as the true "emergency" patient does.

Setting aside the issue of whether or not it's acceptable to reprimand a POS EMS abuser, does everyone really deserve the same level of care? For example, who is more deserving of the world's best hand surgeon? A POS EMS abuser who smokes crack all day, or the world's greatest violin player? Who deserves a liver transplant more? A child with a congenital defect, or a chronic alcoholic? I know we're not supposed to make value judgments, but the truth is that some people are more worthy of our care than others. Should we be professional and treat people fairly? Absolutely. I try to treat every patient like a member of my own family. In other words, how would I want EMS to treat my brother if he was a POS EMS abuser? I've had to tell patients to shut their mouth and get on the cot before. It's just what had to be done. The patient was drunk, had just been in a fight, and was beyond reasoning. It was either that or he was going to be arrested and taken to the hospital in handcuffs. Was that abuse? I don't think so. It was effective communication.

[mitllesmertz1]

Was that abuse? I don't think so. It was effective communication.
I agree, it was probably very effective; sadly, if one of your coworkers thought you were "too mean" to the poor pt, he could report you to the almighties.

[fireman4949]

Setting aside the issue of whether or not it's acceptable to reprimand a POS EMS abuser, does everyone really deserve the same level of care? For example, who is more deserving of the world's best hand surgeon? A POS EMS abuser who smokes crack all day, or the world's greatest violin player? Who deserves a liver transplant more? A child with a congenital defect, or a chronic alcoholic? I know we're not supposed to make value judgments, but the truth is that some people are more worthy of our care than others. Should we be professional and treat people fairly? Absolutely. I try to treat every patient like a member of my own family. In other words, how would I want EMS to treat my brother if he was a POS EMS abuser? I've had to tell patients to shut their mouth and get on the cot before. It's just what had to be done. The patient was drunk, had just been in a fight, and was beyond reasoning. It was either that or he was going to be arrested and taken to the hospital in handcuffs. Was that abuse? I don't think so. It was effective communication.

There is a HUGE difference between doing what is needed to be able to effect proper patient care and treatment, and just being an *******.

One is necessary, the other is not.

[mitllesmertz1]

There is a HUGE difference between doing what is needed to be able to effect proper patient care and treatment, and just being an *******.

One is necessary, the other is not.
An "*******" to you might be a strong medic to me.
Perception is the key, I guess.

[dday05]

I'd say there's a time and place for this kind of behavior,I understand that the "frequent flyer pt" is usually a big pia but this is the kind of stuff we all have to deak with. Now if the pt. starts causing problems and flapping of the mouth and yelling at your people then thats a different story. I agree with everyone else Document everything. Maybe your Asst. Chief needs to get some people skills.(after all dealing with people is part of our job) Tell him to go outside and get something from the squad if you see things go wrong or start to go bad. And after all, your Asst. Chief is a basic and your partner is the medic, so the medic is in charge of the pt.GOOD LUCK!

[tblock]

Not to change the subject, but my son, wreaked, was dead on the side of the road and a other branch of law enforcement was riding with the responding trooper. MY son dead, mind you and this man proceeded to tell everyone with-in hearing distance about a caase he had worked on my son a couple of years before. He went on to tell what the case was about. Inaccurately where it occured and inaccurately how it was resolved. He did not know the facts and was spreading my sons business,inaaccuarely at that, for all to hear. How low and unprofessional can you get. my son was 25. He had never injested a drug, never smoked cigarettes and believed in responsible drinking, he was truly one of a kind. His one mistake this agent was talking about. He stood up and took complete responsibility. He was well respected and I feel this is morally wrong.

[RoryEl]

tblock,
You have my condolence. I can only imagine how hard it would be to loose a son

[tblock]

tblock,
You have my condolence. I can only imagine how hard it would be to loose a son

Thank You, RoryEl,
My son was a wonderful man, boy and baby to me. A child is everything to the parent! He probably had over 600 people come to show their respects. This spoke volumns to me as a parent. It's almost strange how complete strangers have been wonderful to me since this happened 9 months ago. But, you know it's a shame how my son was treated when his wreak happened. He was traveling in one direction and he met, some reports say 2 and some reports say 3 truckloads of 16 and 17 year olds, going in the opposite direction. Not ONE DROP of consideration was given to my son this dreadful night, the enforcement agent's remarks were just a little more icing on the already dripping cake. Sorry, I swear i just wanted to thank you for your comment. tblock

[xtrememedic]

We where not put in a place to be the judge of the patient or his life style. I have a saying that I live with every day that I go to work. QUOTE: Treat every Pt the way you would want one of your family members treated. How would you feel if it was one of your family members that was treated that way.
Because it is people Like him that gives EMS/FIRE a bad name.

[perrypower05]

Remember that just because they are a chief or an officer, they don't know everything. There are chiefs in my area who fail to get their refresher in CPR. Not only document, but furthermore, explain your ideas clearly. I was pretty much able to gather what you said, however, you couldn't quite get your ideas all there. Something you prob. want to watch in any documentation.