I recently saw an article titled, “Paramedics will get the power to refuse to take people to the hospital in a bid to crack down on ambulances being used as taxis“. All over the world ambulances are abused and used for reason which they were not created for, even hospitals and nursing homes abuse them. If you don’t want to open the link, or can’t for some reason, here is the article:
PARAMEDICS will have the power to refuse to take people to hospital in a bid to crack down on ambulances being used as taxis.
The NSW Ambulance Service is trialling the hospital refusal on the Central Coast, following a landmark Auditor General’s report that found paramedics should be able to refuse transport to patients that need a band-aid, not a hospital bed.
Currently paramedics cannot refuse to transport a patient to hospital if they insist on going.
The Auditor Generla’s report found that too often, paramedics were forced to take people to hospital regardless of how minor their condition was.
In some cases, Paramedics were forced to spend time with patients who complained of bed bugs, wanted their prescriptions renewed, or had “vision problems caused by mascara”.
NSW Ambulance Chief Executive Ray Creen said the six month Central Coast trial would be rolled out to other stations if it is seen to be a success.
“Having considered the Auditor-General’s recommendations, NSW Ambulance is trialling a process whereby paramedics can refuse to transport a patient to a hospital emergency department where it is clear that transport is not warranted,” Mr Creen said.
“NSW Ambulance, in collaboration with Central Coast NSW Medicare Local, is undertaking a six- month trial. Under the trial, intensive care paramedics can refer — or transport — low acuity patients to their regular GP rather than to a hospital Emergency Department.”
NSW Ambulance Service chief superintendent Graeme Malone, who is the director of models of care, said paramedics on the Central Coast were trained to assess a patient when they arrive on the scene, and decide how to treat them.
“This recognises that up until now, the majority of patients were transported to an ED. Paramedics didn’t have the mechanism set up to refer a patient to a GP,” Chief superintendent Malone said.
This meant that patients with nosebleeds, coughs and colds, and minor sprains could insist on being transported to an emergency department.
Health Services Union NSW Secretary Gerard Hayes said the union backed the trial.
“Giving paramedics the pay and qualifications to triage an medical call out at the scene will help to take pressure off the State’s emergency departments,” Mr Hayes said.
“This is a practice that ought to be expanded to other areas across the State.”
The Auditor General’s report that prompted the change said the public had “unrealistic expectations about the role of the Ambulance Service,” including that an ambulance will fast-track people into hospital, and that ambulances can be called for minor ailments.
By 2021 the Ambulance Service wants to cut 125,000 “unnecessary transports” every year, amid concerns raised by the Auditor General that every day, the services loses an average of 18 ambulances as a result of hospital delays of more than 30 minutes.
Do I want this? Well, YES! I cannot tell you how many times I take people to the ER that do not need it, the abuse is beyond belief! Some people give reasons or excuses, others don’t bother. I will share some stories with you and tell you the truths and myths of their stories.
The most common one I hear, “if I go in by ambulance, I get a room and don’t have to wait.” WRONG! An ambulance does NOT guarantee you a room at all! here’s the deal, if the hospital is busy and you’re not dying for real, you go straight to triage. Yep, you heard that right, ambulances are not except from triage, if they are busy then you get to wait for the people really sick and injured, so quit calling 911 for a damn paper cut! (You laugh, I have been dispatched for that, they wanted an ambulance ride for it…did it happen? No, he was arrested for misuse of the 911 system and claimed the classic chest pain for his transport.)
I love the houses that have family everywhere, 6 vehicles in the driveway, and tell me, “we can’t take the to the hospital”. Are you fucking kidding me?! So you want to take an ambulance out of service because you don’t feel like taking your relative with a cough and runny nose to the DOCTOR? They do NOT need an ER!
I was once dispatched for “back pain” which is a far too common dispatch. En route we were told, “patient fell one week prior, complaining of severe back pain, requesting transport to the ER.” My partner and I just laughed, what else can you do? It’s better than yelling at the patient, right? So we get on scene to the mother on the front porch, she stated (exact words), “He fell last week and has been having a hard time getting around, he is unable to get out of bed without help and cannot move without extreme pain. He needs to go to the hospital.” My first question was, “have you called his doctor?” To which she answered with, “No, he doesn’t need his doctor, he needs you to take him to the ER for help.” WRONG! ABUSE, ABUSE, ABUSE! I’d like to note here, patient has a history of back pain (don’t get me started on this common history… ) he takes extensive pain medications, like many of our patients calling 911 for back pain.
This house was a split level, you know where you enter to a little landing and either immediately go upstairs or downstairs? So we left the stretcher at the front door and walk inside. This next part…you would probably have to be there to believe me, in fact my partner and I completely froze in amazement…as we start to walk upstairs the patient, yes PATIENT, comes walking, practically RUNNING right past us towards the bedroom. I’m sorry, but…are you fucking kidding me?!?! It must have been a good full minute of pause before my partner got the words, “is that our patient?” our of her mouth while I just stood there with mine wide open. His mother’s response? “I haven’t seen him move like that for days!” Uh huh…we know this story so well. We find him laying in bed, in just “believable pain”. Talk about abusing EMS.
Other stories I get, which go along with the one above, “I can’t get them to the car”. Well if that’s all you need, I’ll help you do that! But what they really mean…”I don’t want to take them myself”, because as soon as you offer to help get the patient into the car, they suddenly say things like, “well since you’re here”, or “maybe they should go by ambulance”. Funny how that works.
Side note here: I often get patient’s demanding hospitals of their choice by stating, “that’s where my doctor is”…let’s think about this…your doctor is AFFILIATED with the hospital, they are employed in the ER! You will NOT be seeing your doctor, you will not even talk to your doctor! It doesn’t matter which hospital we take you to, they can and will be getting the same information as the hospital you are demanding, so it does NOT matter where you go, unless you get special care for cancer, major condition, etc.
Back to the original topic…should Paramedics be able to refuse to take people to the hospital? Yes and no. I would LOVE to be able to do this because I don’t abuse the refusal forms, many times I talk people into going to the hospital. If you called 911 and I came, you’re going to the hospital UNLESS it truly is complete bullshit! Then I will discuss a refusal with you. So for myself and other Paramedics like me, yes having this ability would be outstanding! But I have worked and do work with many Paramedics that completely abuse the refusal form, and I do not trust them with this ability! They already talk people into refusals that need to go to the hospital, having this new ability they will get the green like to really abuse that refusal form.
Let me know what you think. I think this will help with costs, the cost to use an ambulance, insurance costs, and more, but I’m afraid a few Paramedics will spoil the system for everyone. Then again, maybe this will stop the burnout.