Ambulance Driver: The New Taxi Service

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.

When Seconds Count (Shared)

I read this story today and I have to share it with you! I love reading stories by patients, about paramedics that do an exceptional job of taking care of them! My first boss instilled the “customer service” upon me. See…people don’t care that you got the big IV, or knew which part of their heart was being attacked, or how many hours of schooling you went to…what they care about is how they were TREATED! How friendly you were, how you took care of their needs, how you made them feel comfortable…that’s what the patient cares about! I can’t stand when I’m stuck with a partner that can’t be nice, it’s simple! Be nice to the patient AND their family! So here is the story I just read, please take a moment to read it for yourself, and see the link below if you want to go to the page where I found the article. Thank you.

After a crazy-busy Saturday, lying in bed late at night watching Big Brother was a welcomed retreat while browsing Twitter on my iPad. A peaceful, relaxing night until suddenly, a daze fell over me almost leaving me feeling like I couldn’t breathe with sharp pains traveling through my chest, clammy skin and an immense amount of dizziness. I’d never felt like this before. After a few steps out of my bed, I found myself lying on the ground holding my chest trying to remedy the excruciating sharp pains. I couldn’t move, breathe, talk. It hurt too much. Everything hurt.

Minutes later with the unbearable pain not subsiding, I look up to see two paramedics and three firefighters running up my stairs towards me. “Patrick, can you tell me what’s wrong?” queried one paramedic. Sharp pain still ran through my chest, sweat still pouring off me like I had just run a marathon, my head pounding. Next thing I know, both paramedics had me sitting up with ECG leads placed on me from head to toe. “This is going to make you feel better,” said one paramedic as he placed an oxygen mask over my mouth.

Wrapped up in blankets in the back of the ambulance, the paramedic with me in the back chatted about The Sopranos and other random topics in an effort to keep me calm while I was connected to an array of cords and monitors. While he continued to reassure me that everything would be OK, it hit me; when the paramedics were dispatched to my call, they had no idea what they were going to deal with. They didn’t know me — I was a complete stranger to them. Yet they treated me like I was a close family member.

Simply put, how can someone care so much for someone they don’t even know? While so many try to avoid trauma, paramedics put themselves into harms way to help those in need and at the end of each call, they may never know what happens to the patient. Tasked with saving the patient’s life, it’s no easy fete. They work feverishly for the crucial moments they are with the patient, before doctors and nurses can intervene.

Lying on the stretcher in the hospital, I didn’t notice the two paramedics who worked so hard making sure I was OK, slip out. I didn’t get to thank them for helping me when I was in such pain — for making sure I didn’t feel anymore frightened than I had to be and for being there when I needed them. Although I didn’t get to thank them, they didn’t want to be thanked — me being fine was thanks enough.

To all the paramedics and emergency responders who risk their lives, miss family gatherings, work long hours and experience such trauma with every call, thank you. You truly are the people who run in when everyone is running out when seconds count. You dedicate your lives to helping people when they are at their lowest, and you work every shift saving lives.

So to the two paramedics from Durham Region, Ontario who treated me like their own child and who whispered to each other when I was in a groggy daze, “I was worried for him” — thank you. Thank you for being there and thank you for caring. Thank you for making such a scary experience that much easier.

It’s when seconds count that it all matters.

http://www.huffingtonpost.com/patrick-mott/teen-health-scare_b_3644810.html

Just Another Day At Work

One of the jobs I work at, in fact this is the ONLY thing I like about this job,  is that the police carry AED’s in their cars and are not afraid to use them. They usually have the initial medical care done, history, vitals, oxygen, and much more done before I get on scene. They are AWESOME! They know where everything is on our trucks, know how to drive us to the hospital, know how to work ALL our equipment…they are by far the best cops I have ever worked with! We have had several clinical saves because they got on scene, started CPR, and used their AED’s. One guy was unknown down time and is walking around today because of his wife and the cops that used their AED.  Now, with that being said let me share a little story with you, about a guy that is alive today because of his wife and the officer that arrived and knew something was wrong.

First thing after shift change we got sent to an “unresponsive patient, unknown problem”. What a way to start the day. The dispatcher is fairly new, not very good, and just…well…he’s new. Only he’s not, he’s been a dispatcher for over 10 years, but only with our department for a little under a year. We never got an update en route to the call, but heard the officers responding. As soon as I called on scene, the officer that was there about 3 minutes before us, got on the radio to us and said, “Be advised, one shock by the AED, CPR in progress.” I was like, “Well fuck! Grab everything!” So we load up and head into the house, as we enter the room the officer says, “he’s breathing and has a pulse.” Sure enough, snoring respiration and a strong pulse. By the time we moved him to our ambulance he was talking to us, confused, but talking. Got him to the hospital, fully talking, not confused, and off to cath lab. Later I got a call saying he was awaiting a defibrillator. That officer and the family doing CPR saved his life!

For those of you interested, and able to read it, bellow is the AED data we pulled after the event and our EKG and 12-Lead. This was one lucky man!

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EMS Week

It was a wonderful EMS week full of goodies! : ) Now it’s time to get out there and thank your veterans for your freedom! This holiday wasn’t free!

As you know, I hate being called an “ambulance driver” and there are many people that don’t know much about EMT’s and Paramedic’s. It’s ok if you don’t know, but please do not call us ambulance drivers. The picture pretty much sums up what we are.

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Working My Ass Off!

Not that I have one to work off. One of my job, when I started there last year the guys swore they were going to make me fat. Well, they have failed so far because not only are they not making me fat, I seem to weigh less now. I’m one of those girls you hate because I can eat anything and everything and not gain an ounce. The difference between me and some of those girls though, I don’t go around calling myself fat. I also HATE that I can’t gain weight! I’m too freaking skinny and don’t like it at all!

Now with that said, I started my newest job this week. It has been my dream job! They keep telling us to be proud of ourselves, that not many people make it there. They picked us because we truly are the best in the field. Boy is the pressure on! I’m loving it! Loving the people, but the pressure…I’m freaking nervous! I’m afraid I don’t know enough, I’m afraid I’ll mess up, or not know the drugs or doses, or just…I’m fucking scared!!! But my man swears I know my stuff, that it all comes natural on a call, and that I was just born to be there. We shall see.

What does this job  have to do with having no ass? Well ALL of my uniform had to be ordered! I’m too freaking small! They had no shirts, dress shirts, polos, pants, boots, job shirts, coats…NOTHING in my size! They didn’t even have gear for me for vehicle accidents and what not. It’s horrible! But other than that…I FREAKING LOVE IT!!!!! They people are great, the job is great, the Chief is really cool, the officer staff is awesome…I just love it! I’m SO happy with the job! I will tell you more about the pressures and stuff, but for now I need sleep. I’m stuck at hell job tomorrow…it’s going to ruin my week!

Rural Medics vs City Medics

Around here there a many debates about which is better. We have one particular city department that swears they are way better because they treat way more patients. This is a department that has a hospital without 5 minutes of EVERY part of their venue, and I’m serious when I say that, they are NEVER more than 5 minutes from a hospital. They rarely start IV’s, they are arrogant, they have piss poor attitudes, they won’t give medications. Hell, I witnessed them bring in a full arrest patient, NO monitor, NO IV! How can you be better than someone when you pull shit like that? Not everyone is the same, I have seen a FEW decent people on this department, but that is rare and those people never last more than a few months.

There are a few medics I know that consider themselves “city” medics, however they have a bit more time to get to a hospital. These medics usually have anywhere from 10-30 minutes of transport time, depending on the hospital the patient chooses. These medics have told me before that rural medics are way better than city medics. Why? For many reasons. I’m currently in Critical Care Paramedic class. It’s kicking my ass some, but one student in there is really struggling, he’s a “city” medic. He has more than 10 minutes to get to a hospital. The drugs we are learning in this class…I already know them because I’m one of those rural medics and we have this stuff

Quick lesson here to help you understand better. There are 4 classifications that hospitals can have and you are about to learn about them, they are Level 1, Level 2, Level 3, and Level 4. Let’s start with the lowest level and work our way up.

Level 4 – Do you have an Urgent Care near you? Or a hospital near you that is so small they have 2 ER room beds and can not admit patients for a long stay? Chances are you don’t, not unless you live a good drive from the big city. I have one, at 2 different jobs I work at, they each have one in their area. This is basically like going to visit your doctor. You show up there with anything more than a paper cut and they are calling 911 for your butt! Yes, hospitals call 911 for ambulances, mine do all the time.

Level 3 – This is just a step above the Level 4 class. These hospitals can admit patients, are larger, and have the power to do more, they just do not have the staff. These hospitals usual accept sick patients for long stays but if you broke anything you are going to be sent else where. If you have a heart attack or stroke, they only have the ability to diagnose these problems, if you need it treated then you will be sent else where, either by helicopter or the bandaid box. How many of these do I have in my area? One job has 3 of them, the other has 1.

Level 2 -This level has a significant increase in care over the other two. They can treat just like the highest level, a Level 1, however the staff to treat is not required to be in house. Meaning, they are required to have the capabilities ready within 20 minutes. So, you have a heart attack, go to my local Level 3 center, they diagnose it as a heart attack. The weather, naturally, is shitty so they whirly bird won’t come pick you up, now you get the bandaid box with my partner and I. We can’t bypass the Level 2 center, because they can treat you. On our way we call them, say we have a heart attack and to activate the cath lab, they have 20 minutes to have that staff ready if they want to keep their Level 2 status. Level 2 centers tend to be in the outer layers of the city, also known as the suburbs.

Level 1 – This is the highest classification of hospital. They are usually, though not always, teaching hospitals. They have every capability in the hospital, waiting 24 hours a day. They can treat everything, and treat it well. It so happens that my “area” has some of the top adult and pediatric hospitals in the world.

Now, when I am working and you come in really sick to the hospitals here and have to be transferred out, we have to take you to the city. We call them “city trips” or “city runs”. You know how long it takes me to get from this Level 3 hospital to a Level 1 for you to get the help you need? If the weather is good, 1 hour and 30 minutes! Yes, you read that right. If the weather is good, you’re flying most the time, but not always, each patient is different.

So what do you do during that time? Well you can type all this up like I am, because this patient is sleeping. Some sleep. I had a 4 hour and 45 minutes transport time for special care…yes, I spent almost FIVE hours with this patient and she was amazing! You’ve read that story. We entertain ourselves, bring cards, have movies on our iPads for the kids when we get them. I bring my computer and DVDs sometimes. This weekend alone, in two days, I have traveled over 500 miles in an ambulance! But what else makes us better? Our treatments, we constantly have to watch the patient, change our care, think like a doctor. I can tell you from experience, it is way more challenging to be a rural medic! And way more fun!

Good Evening!

I have been exceptionally quiet lately…sorry. I also want to apologize now, this post might be all over, like my thoughts tonight. I’m all over and I’ve maxed out on my medication so I’m going to attempt to blog some instead of running around the house like a mad person trying to do the billion things on my list! Let’s start with the beginning, shall we.

Critical care paramedic class…just shoot me now. The first day of class they told us how horrible the class is, how tough the tests are, how we can kiss our life good bye, how we’ll want to shoot ourselves (great, add that to the list), and how it’s basically a TWO YEAR Critical Care RN class put into 12 weeks of ONE DAY a week, 9-5 class…just wonderful. So, shoot me now?? Any takers? Just kidding…for now. So if I’m quiet, you know why. In fact, I will probably be very quiet, or I should be very quiet if I want to pass this crap. But for now, a break from studying and my blog to help.

While sitting though day one of this class I started thinking about EMT class. I used to think it was going to be so tough. I thought I’d never know that crap, I was scared and had no idea how I’d make it. Well, I made it and pretty close to top of my class. I ended EMT class with a 98%. It all seemed to come so natural to me, like many things. Then I started Paramedic, scared to hell. I was extremely scared. Somehow I managed to get through that too with an A as well. I don’t remember the exact grade, but I was second in my class with an A. Not too bad. I feel like I know nothing but I managed to make it through

Now I have started Critical Care class, what are my thoughts? My first…what the hell did I get myself into?!?! My second…I’ll never make it through this. And my third…I can do this. Maybe not well, but I can do this. My man promised to help me through this too. I hope this all goes good too, so if you don’t hear from me…I’m either studying, releasing anger in Call of Duty, or geocaching. If you hear from me, then I’m avoiding all of the above.

I spent the last two days geocaching and some nightmare caches. Day one, it was a difficulty of 5 and a terrain of 4.5. Holy shit! It kicked my ass! Went though this post apocalyptic area that was just…weird. But I’m so glad I got that one out of the way and I talked a geocacher I recently met into going. We had fun. Then day two I got talked into a nightmare cache around here that has only been found 30 times in the 3 years it’s been out. Not only is it a difficulty of 5 with a terrain of 5 (more like 20!!!), but it’s a multi stage and when you get to each stage there is a nightmare puzzle to solve too! I skipped the first 6 stages because I was working, but I helped them solve the puzzles each time. I finally joined for stage 7 and that took over 2 hours to hike to, then we couldn’t figure the puzzle out so we headed back to the cars. Soon we will be going back to finish steps 8-11 and hopefully have that damn thing in our hands! I will be glad to have that one done too.

Oh, did I mention that both days I hiked with my full pack (16lbs) just in case, given the terrain, and the one day I had to carry my mom’s dog because she refused to walk. That was an additional 8lbs to carry. Ugh. Wish I could take just my pup caching because he loves it, but mom won’t allow that. So what’s in my pack to make it weigh that much? Well, a few things everyone should carry and more stuff geared for caching. A small survival kit (needle, string, wire, mirror, whistle, fire starter, cotton balls, etc), a multi tool, lighter, knife, flashlight, water, emergency food (taffy, crackers), 75 feet and 25 feet of webbing, 3 life safety carabiners, paracord sections in random lengths, medical kit (gauze rolls, gauze pads, large trauma pads, bandaids, neosporin, burn gel, emergency blanket, tap, coban, gloves, etc), SPOT device (highly recommended if you are going without cell service), geocaching items (containers, trade items, etc), waterproof box with medicine, and of course my guns, both of them to be exact plus some ammo. I have more stuff, but that’s the basic of it all. I keep it well packed.

Now, for a completely unrelated story, I have to talk about a patient I had, another one that changed my life. This patient is 102 years old. Yes, you read that right and I wrote it right. One HUNDRED and two YEARS old. And he was amazing. Lived alone, took care of himself, fought in the war, watched the flag get put up at Iwo Jima, had no water or electricity in his house until he was in his late 40’s, and had stories of growing up that I wish I could have heard more of. This was one incredible man. When I was leaving I told him to have a great holiday and happy early birthday, to which he responded, “You too, but I think this is going to be my last.” I didn’t know what to say, I was shocked, and he knew it because he had a great response. “I saw on tv an man was 111 and voted, I don’t think I’ll make it that long. And besides, I’ve lived a good life and after you hit 100 there isn’t much further to go from there. I’ve lived my life time, now I’m ready to join my wife.” He was just amazing. He said he wished him and his wife could have had kids, but they couldn’t afford it. He said that is his only regret in life, but his wife did have 1 kid when they married, so he said he didn’t completely miss out on that. I need to check up on him, he was amazing.

Spending time with this man had me thinking about my childhood and what I miss from that time. I miss play Nintendo, the original. My sister broke it about 6 years ago, but ours still worked until then. My brother then sold off all the games, I still hate him for that. I slept with all my stuffed animals because I didn’t want one to be left out. I had that pen with all four colors in it and I always tired to push them all at one time. I used to watch rain drops fall down the window and act like they were racing. I used the soda cap as my shot glass. The computer was strictly used for paint and boy was that fun. I miss my Tamagotchi. When we swallowed a fruit seed we were convinced that a plant was going to grow in our stomach. The street lights meant it was time to go home. We could, and did, play outside for hours, it was acceptable and allowed without worry. I miss those days, the simple times. I want that for my kids, I want them to be able to have the childhood (minus my parents abuse) in the world I did. I don’t want technology to run their life.IMG_1962

I wish I could go back to my childhood and not have to work. Hell job is still a fucking nightmare! I’ll know with this next schedule if that bitch is screwing me over on purpose. I pray she doesn’t because then I’d have to go to the higher Chief, the real one, the good one, but the scary one. I just can’t freaking wait to get away from this bitch, or get her away from me. I just don’t want to deal with this anymore! She makes me want to jump off a cliff! I can’t stand even thinking about her! But…there may be hope. It just so happens that one person in my critical care class hires on a department around me. She offered to bring me an application, asked about my hours available, and all that stuff. I sure hope this is good news for me! It’s quit a drive, a little bit further than the job I like, but I’ll take anything right now. I need the fuck away from that bitch.

I don’t need help because of calls I’ve ran, that’s not killing me. What’s killing me are the people inside, the one’s I’m suppose to be able to work with and talk to about the calls we ran together. The one’s that are suppose to be helping me are the one’s that are killing me. They have caused me hours of planning my death, they have ruined so many good days, they are just ruining me. I work hard, I bust my ass every day, and for what? To be called names, talked about, ignored, and treated like the dirt they walk in. I’ve had some tough calls, but it hasn’t gotten to me like this assholes. I’ve done more research, on ADHD, PTSD, and abuse. The abuse makes all this worse, but these people from work have become the new abuser. I’ve escaped most of the problems with my parents, but now I have a new problem. I’m stuck fighting this battle alone too because no one is here to help me…again. I just want to be able to get away from this all! I promise not to use plan one, now to find another. For now…class, my focus will stay there.

But now it’s time for me to finish studying because tomorrow is death by text book. Another day of class, I’m ready to get past all this legal crap and start learning. This is why I didn’t become a lawyer like I had originally planned…I’m just not into the legal crap.

Good night my readers. I hope all is well. Know I am reading your stuff, I just may not be able to respond, but I am reading.