Sunday, 13 June 2010

Simon Says

Go back to this post about a waste-of-time-but-can't-do-anything-about-it call. I received a scathing comment on it, a couple of weeks after the post was written, which reads as follows:
I just hope that it wasn't a member of my family having a cardiac arrest in the 15 minutes or so it took you to get her to hospital. Quite simply, you shouldn't have took her. The RRV isn't a taxi service.If Paramedic's want to be paid a professional wage, then they need to act professionally. This means assessing your patient and perhaps deciding they don't need to be taken to hospital by ambulance. If ambulance staff are doing to fit the "stretcher monkey" sterotype and just do exactly what the patient tells them to do, then they deserve to get paid the going rate as a taxi driver. (sic)
The first thought that, cynically, came to mind, was that I wouldn't mind being paid as a taxi driver. I'm sure they earn more than I do.
Then I sat and criticised the spelling and grammatical errors in the comment, as though I'm some sort of linguistic expert.
Then, and only then, did I really think about it, and reply to it. Go look at the post again. My reply is there.
I still question both my actions with the patient, as well as my reply to the comment. Ultimately, I feel that I really didn't have a choice. I had no chance of being a "professional" paramedic, as professionalism could equal job-loss.
I was incensed at the time. Called control, asked them to listen back to the call and find out how this was given a high-priority status, only to find that the "patient" knew all the tricks in the book, and answered all the questions to lead the system down the path of a life-threatening emergency.
The call taker had no choice.
The computer system had no choice.
I had no choice.
Sometimes we're all stuck in a big game of Simon Says.
And whatever Simon says, whether it's right or wrong, goes.
Every so often I just wish my name was Simon.


Pie said...

Don't take it personally. They clearly don't understand you or the ambulance service. I've been reading your blog for a while, and that post it was clear that you were aware the patient in question did not really require an ambulance or A&E, but also having read your blog (and other ambulance/paramedic blogs) and worked in an A&E department...we don't always get a choice. If people call you, or turn up with us demanding help/transportation to hospital, there's not a lot we can do, and refusing could lead to losing your job.
You did nothing wrong; I think all/most paramedics would have done the same thing, and it doesn't make you bad at your job, it just means there are a lot of stupid people out there willing to abuse our health care system.

paul said...

yeah dont worry about it, its obvious to anyone who knows a tiny bit about it that even if you refused to transport and stood down the ambulance, which as you say you aren't legally allowed to (neither is it worth risking your job on the tiny tiny chance that the patient coincidentally did take genuinely ill later that day), the patient just calls back as many times as required until someone does transport, either because they're one of those crews who Always Transport, or it happens to be a convenient finish. can think of plenty of crews who could spin this pt out as long as neccesary.

Ambulance Amateur said...

Surely, if the pt had called in with "chest pains" and quite obviously only wanted a free taxi, there is some obscure bit of law somewhere that could nick her for abuse of the emergency services?

Or does that only apply to police & fire, ambo being part of the Health Service?

RapidResponseDoc said...

From my understanding there is no legal requirement for you to have transported the patient. From a negligence claim point of view, you had a duty of care to the patient, which you would have fulfilled perfectly well if you hadn't transported her. However, you would have lost your job, as your contract says you have to abide by your company's rules, one of which is to transport any patient who insists.

You did the best thing, which was to transport her yourself, rather than waste another resource.

(and, by the way, I'm completely with you on the whole linguistics thing...)

InsomniacMedic said...

The to-ing and fro-ing between anonymous and myself continues over on the other post. Go have a read!

Fee said...

For what it's worth, I don't think you could have done anything different. The selfish madam was determined to get a free ride to hospital, and as Paul said, would have kept on calling until she got her way.

The big question is will this government have the stones to take action against people like this? Surely no more than a few prosecutions would be required (with attendant publicity, of course) before the message began to sink in. I do worry that such action would make people who should be phoning an ambulance hesitate to do so, but something has to be done.

oneunder said...

I love debates like this where both sides are right.

This patient should have been denied transportation and fined for wasting ambulance time. The job was a waist of time and may have taken a responder away from a dying person.

If Insomniac had refuse (as some of us would have) all it would have taken is one little letter.
One little letter to the LAS or the HPC saying that 'she was ill and been refused conveyance to hospital' and there would be no more blog as Insomniac would be suspended pending the sack.

I agree with Anonymous, this is a ridiculous situation and one not proscribed by law.
If I meet this patient, in the same circumstances, tomorrow I shall be taking them to hospital while trying not to say all the things I want to say. I will get home, at the end of my shift, fuming at the inappropriateness of it all but safe in the knowledge that I still have a job.

Michael Morse said...

I actually refused to transport a lady the other day. Well, refused isn't totally true, I refused to take her to St. Farthest when St. closest was a stones throw away. I'll probably get called to the chief's office and write some apology to the patient, if she complains. I think she already has, actually.

This system is nuts!

flobach said...

Educating the Public would help to a certain degree.
Educating calltakers would help to a certain degree.
Allowing clinical judgement would help to a certain degree.

But there is a certain degree of stupidity that will never die.

Just gotta laugh it off....

Graham K said...

Hi Ben.

First of all great blog.I have been reading for some time now and always look forward to new posts.

I work perminatlty on an RRV In a county not far from yours and I am in the the lucky postion that I can decide whether to transport or not. We also have ECPs in control who will further question the caller and decide not to send a resource or stand us down if we are on the way. Pure and simple because we like most services are stretched to the limits!

I thought LAS were a progressive service? they my want to look at others for the anwser. It's only going to get worse!