Saturday, January 24

...for the code 3 transfer...

Ever walk in a room, recognize a patient and wish you had taken that job at the car wash? Erma has been visited by her home health care physical therapist and...well...that's when things got interesting.

A care taker has called 911 requesting a code 3 transfer for a not alert patient.

Usually this call is for a doctor's office at closing time when they need to clear out the waiting room without rescheduling everyone. But this house is familiar as we pull up in the fire engine after running red lights and opposing traffic after being told this was a life or death emergency. We arrive to Erma on the couch, no distress, and her very vocal middle aged daughter.

"You reported an emergency?"
My standard opening is met with a symphony of responses.

Symphony is the wrong word, that implies order and beauty. A barrage of noises attack me before I can put my bag on the ground.

"I called you," says the woman with the cell phone to her ear and a stethoscope around her neck, "I'm her nurse and she seems to be neglected."
The daughter takes issue with this and begins to scream that the nurse is crazy and Erma is fine where she is, she just needs her exercises.
"Are you the physical therapist?" I ask relaxing with hands into pockets while the EMT confirms Erma is not in distress.
"Yes, this is my first visit and she is clearly altered and look at her mouth, its dry."
"Hello!" I hear Erma behind me "Are you with the Fire Squad?" she seems appropriate to me and that's when the room begins to look familiar. I've been here before.
"Did your mom fall out of bed last week, early in the morning?"
"Yeah those men took my mom in and were so nice to were took her in, you look different rested." I smiled.

The physical therapist is on the phone to someone and I need more information. She hangs up and looks at me like as if she's in charge.
"You called this into your agency and they called us or how did this evolve into what we have now?"
"I called you directly because I need her to get evaluated. She's clearly being neglected."

Again the daughter erupts. My engine officer is able to pull her into the other room and I have a chat with the therapist who strangely has left all her business cards at her office. I explain to her that we are not a contract van service and that her agency can arrange for non-emergency transport to a physician. Then she lays out the truth:

"I can't wait here for a van, I have other patients to visit today."
"So do I."

In the background I hear, "I want to go get checked and make sure everything is alright." Erma speaks and breaks the tension.

The ambulance arrives and packages her for the trip to the busy ER, the one we heard on the radio was only recently turning patients away due to overcrowding, but is now forced to accept ambulance patients.
As we loaded Erma, the daughter followed the therapist to her car and demanded her contact information.
I'm sure I'll see them again. All 3 of them.


Anonymous said...

Different service, different country EXACTLY the same jobs!! Except we can now refuse to transport a patient if we feel there is no medical need for taking them to hospital. Big step from getting a refusal of treatment form signed to actually taking the responsibility to say "No, you don't need to go and I am not taking you"

The Happy Medic said...

That's it, I'm moving.