101 Things the Fire Department wishes you knew



Wednesday, August 12

Double Closing Time Drama

I know one of the tricks some clinics use to clean out their waiting room is to exaggerate patient conditions and request ambulances, but this response got ridiculous. Fast.

THE EMERGENCY

Staff on the 8th floor of the hospital building report a man unconscious

THE ACTION

Come on now folks, we are not your office clearing taxi service. We arrive as the ALS engine backing up the BLS engine and a private ambulance arriving on the scene as we do. We are directed to the eighth floor by a security guard very intent on getting our names and badge numbers for his "report."

On the floor we're led over to the office exam room where a nice envelope is stuffed with a printout from the office computer which has the patient basics and a time noted of about 20 minutes ago.
"Not him, guys, over here," we're instructed by a different nurse.
"But mine needs to go too," the first nurse tells the second.
"But I have to leave first, so mine goes first." she replies, trying to physically move us down the hall.

"Do you have a 911 emergency here or are you looking to head home early?" we ask and drop the bags in the hallway.
"I need to see the MD. Right now." I tell them and open the door to the exam after a quick knock.
The man inside is not only awake, but alert with a chief complaint of diffuse groin discomfort.

The MD is now in the hallway asking where our gurney is and I inform him we received a 911 call for an unconscious.
He looks from one nurse to the other and sighs. "They both need evals across the street (at the ER) but neither is a 911 run. Did you really get this as 911?"
As I try to respond we are interrupted by the second wave of rescuers arriving for the second patient.

The MD apologized for the trouble and promised to keep a better eye on his staff and their use of the 911 system. The ambulance assigned to us receives a page on their system that they should transport both patients if they can.

As they discuss it between themselves the first man, sitting in front of us for the whole exchange, stands and says, "I can just walk across the street if that's all I need to do."

The ambulance medic beat me to it when he said, "Sir, that is up to you, I'm not going to chase you."

He grabbed his jacket and walked away. The smile on his and my face as the nurse stood slack jawed was quite comforting.
"Isn't that abandonment?" She asked.
"When you 911 the job, you are no longer in the loop unless the MD takes us over. And I'm pretty sure that isn't happening." the private car medic said and asked to be shown the other patient.

We cleared the scene and were glad the clinic was now closed and we wouldn't have to come back today.

2 comments:

Medic(three) said...

This is the kind of crap that really pisses me off. EVERY clinic run we go on is Code 3(or 2--no fire). What a joke. Usually for a SOB(and no, not the breathing kind) that they want to get rid of.

Magic how must clinic runs happen between 3 and 5 pm(or 7 and 8 for urgent care)

medicblog999 said...

A truly international phenomenon!

If I get sent to a job at 5pm to a GP surgery, I can guarantee it will be for a chest pain (Cat A). I can count on 2 hands the amount of times that the patient has been a true cardiac emergency. For everyone else, the doctor and his staff just want to go home.

I then make it my duty (if I am on the Rapid Response Car) to ask for a room so that I can fully assess the patient and take a 12 lead so that I can send it to the Coronary Care Unit, whilst I am waiting for my back up crew to arrive. If it is a non cardiac emergency, and sometimes even not even an urgent problem, I will downgrade the call to a Cat C (without lights and sirens) which means the crew will take even longer to get there!!

There isnt out of spite (honest!), but if I have risked my own neck driving under emergency conditions for a doctor wanting to get home on time, I will not risk the crew backing me up!

Oh, and dont even get me started on docs leaving '? MI' patients in the waiting room, unattended, without even an aspirin, or GTN spray!!