As someone who just quit an event gig where the owner skipped out on vital supplies despite my concerns(and a recent OD that could have gone bad) I second this.
Also between the snitch comment and OPs agency having bodycams God forbid what their local PD may be like.
Ah ok. I mean I figure due to HIPAA they weren't a thing in EMS. The paramedics who tended to George Floyd has them though which is why I assumed it was a thing in a few places but not broadly
Side note, I don’t personally see a problem with body cams for EMS if the crews immediately have access to use for charting, and would be good for affidavits and for me recently would’ve been good for helping with a possible child abuse case
Maybe your QAQI person should do their job? This reads like a lawsuit waiting to happen... you did good, I would've been very concerned if I was in your position.
Your QA/QI guy sucks. I don't know how many new guys realize that an RMA is one of the easiest ways to get jammed up in this job and potentially get fired/sued. If someone is that stupid they can't take the time to accurately refelct the information of their patient, i dont' want them touching the paperwork then. We actually created a form for people to self report QA issues. Because we shifted to a just cause culture where we don't go to discipline right away, we have actually seen an INCREASE in self reporting of errors, but a decrease in overall errors.
>Because we shifted to a just cause culture where we don't go to discipline right away, we have actually seen an INCREASE in self reporting of errors, but a decrease in overall errors.
This is the way. If you treat employees like children they'll act like children. If you treat them with respect and understanding they'll respond in kind.
Uh.. that's not concerning at all! Let the poor medic and QAQI do their job! Lmao
Nah, report that shit asap, bring everyone down. Had my partner and (my equivalent) QAQI acted like that I'd report them to the state immediately. *Unless they haven't already* that's the type of behaviour that kills pts. They really need to find somewhere else to work, but no one should hire someone with that gross negligence.
Seriously this. It’s not like the pay is enough to keep people around who don’t like the work, you could work at almost any factory and make more. Why work the job if you have no interest in caring for your patients?
Some only want exciting calls so they can be like Mighty Mouse: **"Here I come to save the day!"**. Their imagination is deceiving them; when they arrive at a real MCI their first reaction is likely to be spontaneous micturition.
Report that shit to the state and tell your partner if he doesn’t want to do the work he is being paid for then he needs to find a new job, charting sucks but that’s no reason to NOT do your fucking job. Especially in EMS.
Charting does suck.
Head hang and cramped fist bump from a resident bro to a paramedic bro or lady bro.
I do love your very frequently immaculate prehospital narratives. Emerg is usually good but one night one staff was just like: plz see (patient identifier, pod, bed) ortho dx and then snows them and had no other details when asked on like 10 patients. I mean good they're not in agony, but also,
Bruh, where do these bones live? what do they do for a living, what were they doing when they got all broken? was it work? What mechanism of injury? (It informs us of other injuries and investigations). Which bones are dominant hand bones? What kind of work do they do? Where does it hurt? Did you hit your head (nothing worse than fixing bones while a brain bleeds... I imagine..) Do these bones have allergies, especially to ANCEF?! Have these bones had surgery before? Do these bones have other diseases our gassy colleagues might experience consternation about? And on and on.
Not to worry, its all in the emt chart, 10/10 times.
But OPs buddy is a fuck up that jeopardizes all that.
Sometimes the EMS professional is the best source of info for the patient from collateral history at the scene. We're not calling family on the way to trauma surg. We scroll the unified database, if no allergies there, no hx there, no hx on emerg or emt charting we roll with it if theyre snowed, what else can you do, play phone tag with relatives at 330 am with 50 consults, 10surgeries slated, and 3 trauma pages?
Nope.
Please keep being awesome and don't not be awesome. Every link in the chain is critical.
Thank you to every awesome EMT/EMS allied health person.
Tell your QA guy to suck the fattest dick and report them to the state and ghost the company the next day. Also fuck your partner. They're a shit medic.
I wouldn't say ghost the company only just because not leaving with professional courtesy may come back to bite OP when looking for other work/the company being vindictive. Give two weeks notice and drop your remaining shifts, and you can't drop them then quit on the spot with a proper letter of resignation. It's what I did with my own shady boss.
It's my experience that "don't be a snitch" is most aggressively used by the deliberately incompetent.
Report away, to whatever mechanism you have, because this attitude excuses such poor performance that it kills patients.
Document document document and any retaliation just results in quite the windfall from the ensuing lawsuit. Sounds like this employer is about to enter stage 2 of fucking around, and will soon find out.
Your partner sucks and so does your QA/QI person. It’s one thing to be lazy; it’s another to lie about it at a patient’s expense. Fuck them both and report it.
Report, report. Go over QaQi head and report it. Hopefully you did not sign the ticket. The laziness of providers trying to get refusals over transporting still baffles me. A refusal chart is so much more difficult to write than a transport one. Plus if you transport ideally the report is done by the time you get to the hospital, you aren't running another call so you get a little downtime. Also being one if the ones who does QA, most providers suck at documenting refusal and showing that the patient actually meets capcity.
Was worried about this from a “my signature is on the chart” point of view, upon review of policies my signature on there simply states “I was on this call.” All our charts can be edited after we sign so they don’t make the secondary signature a liability thing.
I still would be careful signing a chart ypu don't agree with. Ours is if you sign the chart you are agreeing tobeverytjing written in said chart. We have had more than a few people fired/heavily disciplined because their partner refused to sign due to not agreeing. Your QA person doesn't need to be in their position if they feel reporting stuff like that is snitching. The whole job of QA is to improve providers, protect the agency, and prevent harm to patients. Yeah will fully admit I don't like having to do the hard part of my job and start and investigation, but it is my job. Also email yourself on any documents regarding the QA. Write a statement and send it up the chain.
Pardon me OP if this is a dumb question but does anything else in your agency/company culture give you a bad vibe? Do you think retaliation is a possibility? You hear of this stuff in law enforcement but never would have thought anyone in EMS would stoop this low. Is it possible the medic and QIQA guy are friends/related?
Goddamn. You did the right thing man. As others have said, you need to escalate this further to the state’s OEMS. Not reporting it will make you get in trouble as well if something happens. Absolute insanity how some ppl are so callously negligent in their jobs.
He’s going to kill someone one day.
Don’t be a snitch means don’t go to a captain over some bullshit like backing up without a backer in a clearly empty parking lot at 2am. Don’t report your partner for some dumb shit. When people’s live get legitimately put at risk it’s ain’t snitching.
Had a partner that did something similar where I was driving and he was documenting. We get a call and I ended up doing the pt assessment. When he finished writing the report I asked if I can take a look at it, and that shit had about 90% set to default. None of the findings I reported to him were on the report. I checked the other reports and to my horror he was copy and pasting reports and only changing vitals, age, pick up/ drop off locations. Reported him, and got an email saying an investigation was launched. A few weeks later that were canned for negligence. I’ve had a few people in the field have this “no snitch” rule but it’s fucking moronic, and we must hold ourselves accountable in this field or shit can go south quick. I get not snitching for a genuine mistake but for straight up criminal negligence and forgery, fuck that.
You're the type of partner I would like to ride with any day of the week. I'd choose you over any seasoned medic. Congrats on doing the right thing even though there's people like that doing the opposite. These people and company deserve to be publicly shamed if what you stated is true. 0 tolerance to laziness in this field.
It’s extremely rare for a provider to be successfully sued over taking someone to the hospital for any reason even against their will. Not taking someone when they need to be taken gets sued all the time though.
If you have good articulable reasons why a person should go to the hospital and you take them, that is always the best course of action
I (EMT) once had a partner (medic and also an educator) pressure me into having a drunk individual napping in his car sign a refusal, was AAOx2 and couldn’t even lift his hand to sign the papers. Partner hadn’t even bothered to put gloves on and had me lift the patient’s hand up to the clipboard to sign. I asked the medic to do the documentation and he got spitting mad (hates when anyone does anything close to questioning his authority) to which I replied “I was not comfortable with letting him refuse since he’s intoxicated, altered, alone, and possibly has his car keys within reach. So no, I’d rather you write the report because you made that call, and I had expressed my dissent on scene and you pressured me into letting it go.” Keep in mind that in my area, protocol was that paramedic partners have to write up refusals due to every patient being entitled to an ALS assessment prior to making that decision. Within a few months his license was suspended by the state pending investigation on a completely different issue after being reported by fire guys. Glad I went with my gut with that guy and stood up for myself the many times he pulled stuff like that.
So your solution to a guuy sleeping off some drinks is to force an ambulance and ER bill upon them? Also seems like its not in the best interests of the patient who isnt actually experiencing a medical emergency.
If there is a concern for DUI, thats a problem law enforcement can deal with
Unfortunately, it seems like many paramedics want to take drunk people in because they are...too drunk. Which is weird to me. The ones I've seen this attitude from are the really straight laced guys/gals.
The rest of us try to look out for our fellow alcoholics. If I was drunk and someone took me to the hospital against my will I’d slash their POV’s tires when I got out.
It blows my mind how people don't realize that even a normal level of drunk person can act really erratically if awaken out of a drunk sleep. Waking up a drunk person and trying to get them to act normal is rarely going to work out. Using that as an excuse to then shuffle them to the ER as though we can never be intoxicated minding our own business is a bit authoritarian.
I can be sober and still act erratic and confused if I get woken up.
I often joke that the time driven to a call in the middle of the night is time spent for me to figure out who I am, what I’m doing and what’s going on.
Yeah leave. They are putting your license at risk. One lawsuit on a call you are on and you are now involved. innocent or guilty you will have to defend yourself. Why spend that money?
Plenty of places will hire you the next day right now.
You need to report this to the state and leave that agency ASAP. There is an old adage that goes something along the lines of “hang around idiots long enough and eventually they’ll claim you as one of their own” that I think applies here. This agency has demonstrated to you that they do not abide by the law. It’s only a matter of time before you’ll get caught up in some investigation. Don’t allow yourself to carry that kind of liability. Report them and get out as soon as possible.
That’s a SHIT organization that will get your license yanked with the quickness, and your partner does integrity like old people fuck. If that were a military unit it would be called the Blue Falcons. Pop smoke.
Dude, open up a case to be honest if it's that bad. If you had someone from your own qaqi office tell you what to do with yourself, I would honestly put in a formal request to your local department for Public Access to their body cam records, and submit this to whatever Department of health and safety. Or Hell call OSHA
Oh man you’ve hit the jackpot! Have you seen the guy on TikTok that talks about he’s sued every job he’s had because of retaliation? He got rich! This is your time to shine. Report that shithole to the state ASAP. Then take it above the QAQI guy, email ALL of leadership in a group email. Tell them everything and document it the very best you can. Then when they retaliate (which they will), you can sue to retaliation and report that to the state too. You’ve got 15k to take a victory vacation before you start at a decent service AND you’ve helped your community!!
Edited for video link https://www.tiktok.com/t/ZT8j6wHKs/
If not for the patients, you have to take a stand for yourself. One day something will go wrong, and anyone and everyone involved wil pay a very heavy price for it. Never mind just losing credentials and profession, that could very well end up in criminal court. Take it to the MD and State.
Damn that I am late to this, but I never thought this would be in EMS. I mean falsifying PCRs may happen, but the don't snitch thing I thought was reserved for corrupt cops.
Just quit that place and report. Being a pariah at a place that you rely on for money is pure suck. Leaves you open to retaliation by upper management too. If the qaqi person has the balls to say that imagine the others.....
Yeah nah, you should always advocate for the patient.
The only (and very few) incidents we have someone sign off while not being Alert×4 is in dui wrecks with police on scene.
Where I work, as soon as someone is no longer fully AO×4, it goes to medical command. Of medical command signs off, that's a different story.
Hmm... Y'all use ESO to chart, by chance??
That's some lazy and dangerous shit, by both parties. I'm really bummed your QA person dismissed it so readily. I'm all for letting patients make a within-their-rights bad decision but this sounds like a clear case where they *need help*, not rights.
If you ever have to testify (on anything) stick to the absolute truth and hire a private (not company provided) lawyer. LegalShield has saved my ass a few times.
Thanks!! I haven't messed with Traumasoft, before. The way they worded it just made me think ESO, immediately.
I use ESO at one job and ImageTrend at the other.
CYA is always the name of the game. Is and always will be. I had an MVA about a month ago with 2 patients, a semiconscious wife and ambulatory but altered husband who was the driver. Documented 6 ways from Sunday in my chart for the wife that she initially presented as the more critical patient so I requested a 2nd BLS unit for the husband and transferred care to them once they arrived. The other BLS crew came to me before I left for the trauma center and said “he really doesn’t wanna go”. I said “he’s definitely altered and should go, but if you’re comfortable with an RMA/AMA bring an officer with you so the whole thing is on bodycam.” The other crew cleared the scene “no patient contact”.
The driver had a CVA behind the wheel which caused the accident, and coded while his brother was driving him to the trauma center to see his wife.
As far as RMA’s on AMS patients and inflated GCS’s, I really hope OP corrected the GCS and mentioned the accident in the narrative. Fuck what your medic said, your name’s on the chart too. CYA.
> Our QAQI person approached me after and said “Don’t be a snitch,”
That attitude is completely unsuited to their job.
OP, you did the right thing convincing the patient to go and flagging an inaccurate report. You should find a new employer, and don’t let this place break you before you get out.
As a QA officer myself, dude fuck your QA/QI person, and fuck his lazy self for not following up on proper chart review. I get it, being QA’d isn’t fun for ANY provider, and yeah reviewing charts is a hassle, but it’s literally how we hold ourselves accountable and how we progress forward as a profession. Your partner is a shitbag and your QA officer is a scumbag. I’m sorry you’re dealing with this bullshit.
A couple takeaways from this one:
1. When you file anything with management, QA/QI, etc. retain a copy for your records. This can even be photos of the document (or screencaptures is submitted via your smartphone) before you hit submit if they are electronic. I would also advocate for emailing yourself copies. This way should something happen to your phone you still have the copies safely and securely stored in a cloud based service.
2. If they don't want you to raise questions about subpar care? They can choose not to place you with lazy, subpar partners who clearly have no regard for their patients. It's up to them which one they want to follow through with.
This is so common in EMS and one of the main reasons I'm leaving. Culture is horrible. Patient care is not a priority and interactions between staff are awful. I'd get out if I was you.
Part of my job is doing QAQI. I couldn't fathom doing that. If I were in your position I'd be planning my exit and once I had a plan I'd report that incident to the highest level. Make sure they can get the body cam footage. I promise the powers that be in your department do not want the culpability that accompanies a sleezy QAQI.
MD who found myself here - you could not be more right. Absolutely unacceptable. Story is very concerning for ICH, which could be life-threatening. Good for you for doing the right thing and all the best.
Thank you! I work as PMHNP in ED and will read the EMS run reports especially when I get like delirious geris and or when I'm considering a psych v Medical v intoxication (it shows me if the patient status has changed since EMS encounter, if something had been given prehospital ECT) which can help me with my differential and management
And EMS documentation also be used in court and often times court cases don't come around for years so you want to have a good record of what occurred ECT.
https://www.ncbi.nlm.nih.gov/books/NBK448107/ -good recourse in EMS documentation
I appreciate all the services you guys offer, and it has saved my life before. People who disregard important information and patient care to get through the day faster simply need to be shown the door. There is no place for unempathetic or jaded professionals in the healthcare world. This is how people lose their lives needlessly. I would absolutely place my reputation and accept probable bullshit/drama to happen while working with them after reporting just so someone like that could find themselves flipping burgers. Lack of empathy probably suits a person well in the fast food industry.
There is no thin blue line for ems. That said, one ought not narc. The part of your story that tips the scales in favor of your side for me was your partner not recognizing consent was implied. (Gcs being so low)
My FD would be much more upset about the shit bird medic and glad someone reported that.
The "don't be a snitch" thing is slippery. Typically, if someone's fuck up was innocent/accidental and doesn't cause any negative to happen to a coworker or the public, a good crew should usually help their brother/sister out and keep downtown/chiefs out of it. Still talk about it and make it a teachable moment since it should not happen again.
Your guy was clearly negligent and needs some serious discipline/retraining to remind him our job is to take sick people to the hospital, not leave them home with a brain bleed.
Yeah Naa man, report that to the state or your medical director and quit. That’s not a place you want to work
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And OPs name is on the report too. Get dragged down with the rest of the scum.
As someone who just quit an event gig where the owner skipped out on vital supplies despite my concerns(and a recent OD that could have gone bad) I second this. Also between the snitch comment and OPs agency having bodycams God forbid what their local PD may be like.
I don’t think OPs agency has bodycams. I think when they said it was on bodycam, it was about PDs bodycams since they were on scene.
Ah ok. I mean I figure due to HIPAA they weren't a thing in EMS. The paramedics who tended to George Floyd has them though which is why I assumed it was a thing in a few places but not broadly
Side note, I don’t personally see a problem with body cams for EMS if the crews immediately have access to use for charting, and would be good for affidavits and for me recently would’ve been good for helping with a possible child abuse case
Agreed.
This is the way
This is the only answer. Get out of there.
Maybe your QAQI person should do their job? This reads like a lawsuit waiting to happen... you did good, I would've been very concerned if I was in your position.
Yeah wth our QA guy even comments on how our narratives could have been more detailed.
Your QA/QI guy sucks. I don't know how many new guys realize that an RMA is one of the easiest ways to get jammed up in this job and potentially get fired/sued. If someone is that stupid they can't take the time to accurately refelct the information of their patient, i dont' want them touching the paperwork then. We actually created a form for people to self report QA issues. Because we shifted to a just cause culture where we don't go to discipline right away, we have actually seen an INCREASE in self reporting of errors, but a decrease in overall errors.
What is RMA I hate acronyms in this world lol
It's one of the 80 billion ways of saying AMA or Patient Refusal lol
Refusal of medical advice.
>Because we shifted to a just cause culture where we don't go to discipline right away, we have actually seen an INCREASE in self reporting of errors, but a decrease in overall errors. This is the way. If you treat employees like children they'll act like children. If you treat them with respect and understanding they'll respond in kind.
>RMA is one of the easiest ways to get jammed up in this job Exactly. That's why I don't do them. "No Patient Found" and mark yourself in service.
in this case everything was caught on bodycam.
r/whoosh
there was no woosh. that is a genuine thing that people do.
Uh.. that's not concerning at all! Let the poor medic and QAQI do their job! Lmao Nah, report that shit asap, bring everyone down. Had my partner and (my equivalent) QAQI acted like that I'd report them to the state immediately. *Unless they haven't already* that's the type of behaviour that kills pts. They really need to find somewhere else to work, but no one should hire someone with that gross negligence.
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Seriously this. It’s not like the pay is enough to keep people around who don’t like the work, you could work at almost any factory and make more. Why work the job if you have no interest in caring for your patients?
Some only want exciting calls so they can be like Mighty Mouse: **"Here I come to save the day!"**. Their imagination is deceiving them; when they arrive at a real MCI their first reaction is likely to be spontaneous micturition.
Mighty mouse spontaneous micturition at real MCI lol
Quite the opposite. The low pay attracts people like this, who can't cut it in more competitive assignments.
Report that shit to the state and tell your partner if he doesn’t want to do the work he is being paid for then he needs to find a new job, charting sucks but that’s no reason to NOT do your fucking job. Especially in EMS.
Charting does suck. Head hang and cramped fist bump from a resident bro to a paramedic bro or lady bro. I do love your very frequently immaculate prehospital narratives. Emerg is usually good but one night one staff was just like: plz see (patient identifier, pod, bed) ortho dx and then snows them and had no other details when asked on like 10 patients. I mean good they're not in agony, but also, Bruh, where do these bones live? what do they do for a living, what were they doing when they got all broken? was it work? What mechanism of injury? (It informs us of other injuries and investigations). Which bones are dominant hand bones? What kind of work do they do? Where does it hurt? Did you hit your head (nothing worse than fixing bones while a brain bleeds... I imagine..) Do these bones have allergies, especially to ANCEF?! Have these bones had surgery before? Do these bones have other diseases our gassy colleagues might experience consternation about? And on and on. Not to worry, its all in the emt chart, 10/10 times. But OPs buddy is a fuck up that jeopardizes all that. Sometimes the EMS professional is the best source of info for the patient from collateral history at the scene. We're not calling family on the way to trauma surg. We scroll the unified database, if no allergies there, no hx there, no hx on emerg or emt charting we roll with it if theyre snowed, what else can you do, play phone tag with relatives at 330 am with 50 consults, 10surgeries slated, and 3 trauma pages? Nope. Please keep being awesome and don't not be awesome. Every link in the chain is critical. Thank you to every awesome EMT/EMS allied health person.
Tell your QA guy to suck the fattest dick and report them to the state and ghost the company the next day. Also fuck your partner. They're a shit medic.
I wouldn't say ghost the company only just because not leaving with professional courtesy may come back to bite OP when looking for other work/the company being vindictive. Give two weeks notice and drop your remaining shifts, and you can't drop them then quit on the spot with a proper letter of resignation. It's what I did with my own shady boss.
your post is very sexual.
It's my experience that "don't be a snitch" is most aggressively used by the deliberately incompetent. Report away, to whatever mechanism you have, because this attitude excuses such poor performance that it kills patients.
This might be getting into dangerous retaliation territory, but can you go to your County's governing agency?
Document document document and any retaliation just results in quite the windfall from the ensuing lawsuit. Sounds like this employer is about to enter stage 2 of fucking around, and will soon find out.
Your partner sucks and so does your QA/QI person. It’s one thing to be lazy; it’s another to lie about it at a patient’s expense. Fuck them both and report it.
Report, report. Go over QaQi head and report it. Hopefully you did not sign the ticket. The laziness of providers trying to get refusals over transporting still baffles me. A refusal chart is so much more difficult to write than a transport one. Plus if you transport ideally the report is done by the time you get to the hospital, you aren't running another call so you get a little downtime. Also being one if the ones who does QA, most providers suck at documenting refusal and showing that the patient actually meets capcity.
Was worried about this from a “my signature is on the chart” point of view, upon review of policies my signature on there simply states “I was on this call.” All our charts can be edited after we sign so they don’t make the secondary signature a liability thing.
I still would be careful signing a chart ypu don't agree with. Ours is if you sign the chart you are agreeing tobeverytjing written in said chart. We have had more than a few people fired/heavily disciplined because their partner refused to sign due to not agreeing. Your QA person doesn't need to be in their position if they feel reporting stuff like that is snitching. The whole job of QA is to improve providers, protect the agency, and prevent harm to patients. Yeah will fully admit I don't like having to do the hard part of my job and start and investigation, but it is my job. Also email yourself on any documents regarding the QA. Write a statement and send it up the chain.
Pardon me OP if this is a dumb question but does anything else in your agency/company culture give you a bad vibe? Do you think retaliation is a possibility? You hear of this stuff in law enforcement but never would have thought anyone in EMS would stoop this low. Is it possible the medic and QIQA guy are friends/related?
Goddamn. You did the right thing man. As others have said, you need to escalate this further to the state’s OEMS. Not reporting it will make you get in trouble as well if something happens. Absolute insanity how some ppl are so callously negligent in their jobs.
*when something happens It's only a matter of time
Damn right about that, but im too lazy to edit my comment lol.
He’s going to kill someone one day. Don’t be a snitch means don’t go to a captain over some bullshit like backing up without a backer in a clearly empty parking lot at 2am. Don’t report your partner for some dumb shit. When people’s live get legitimately put at risk it’s ain’t snitching.
Had a partner that did something similar where I was driving and he was documenting. We get a call and I ended up doing the pt assessment. When he finished writing the report I asked if I can take a look at it, and that shit had about 90% set to default. None of the findings I reported to him were on the report. I checked the other reports and to my horror he was copy and pasting reports and only changing vitals, age, pick up/ drop off locations. Reported him, and got an email saying an investigation was launched. A few weeks later that were canned for negligence. I’ve had a few people in the field have this “no snitch” rule but it’s fucking moronic, and we must hold ourselves accountable in this field or shit can go south quick. I get not snitching for a genuine mistake but for straight up criminal negligence and forgery, fuck that.
You're the type of partner I would like to ride with any day of the week. I'd choose you over any seasoned medic. Congrats on doing the right thing even though there's people like that doing the opposite. These people and company deserve to be publicly shamed if what you stated is true. 0 tolerance to laziness in this field.
It’s extremely rare for a provider to be successfully sued over taking someone to the hospital for any reason even against their will. Not taking someone when they need to be taken gets sued all the time though. If you have good articulable reasons why a person should go to the hospital and you take them, that is always the best course of action
I (EMT) once had a partner (medic and also an educator) pressure me into having a drunk individual napping in his car sign a refusal, was AAOx2 and couldn’t even lift his hand to sign the papers. Partner hadn’t even bothered to put gloves on and had me lift the patient’s hand up to the clipboard to sign. I asked the medic to do the documentation and he got spitting mad (hates when anyone does anything close to questioning his authority) to which I replied “I was not comfortable with letting him refuse since he’s intoxicated, altered, alone, and possibly has his car keys within reach. So no, I’d rather you write the report because you made that call, and I had expressed my dissent on scene and you pressured me into letting it go.” Keep in mind that in my area, protocol was that paramedic partners have to write up refusals due to every patient being entitled to an ALS assessment prior to making that decision. Within a few months his license was suspended by the state pending investigation on a completely different issue after being reported by fire guys. Glad I went with my gut with that guy and stood up for myself the many times he pulled stuff like that.
I mean if I was drunk and sleeping in my car I'd be pretty upset at being forced to go to the hospital.
Me too, but our drunk lack of planning isn't worth anyone's livelihood.
So your solution to a guuy sleeping off some drinks is to force an ambulance and ER bill upon them? Also seems like its not in the best interests of the patient who isnt actually experiencing a medical emergency. If there is a concern for DUI, thats a problem law enforcement can deal with
Unfortunately, it seems like many paramedics want to take drunk people in because they are...too drunk. Which is weird to me. The ones I've seen this attitude from are the really straight laced guys/gals.
The rest of us try to look out for our fellow alcoholics. If I was drunk and someone took me to the hospital against my will I’d slash their POV’s tires when I got out.
It blows my mind how people don't realize that even a normal level of drunk person can act really erratically if awaken out of a drunk sleep. Waking up a drunk person and trying to get them to act normal is rarely going to work out. Using that as an excuse to then shuffle them to the ER as though we can never be intoxicated minding our own business is a bit authoritarian.
I can be sober and still act erratic and confused if I get woken up. I often joke that the time driven to a call in the middle of the night is time spent for me to figure out who I am, what I’m doing and what’s going on.
can you file a complaint against the person you complained too? becuase if they won't do their job someone else needs to that situations messed up
I give your agency credit for having a QA/QI mechanism for you to report that. Mine doesn’t. Turns out, the weak point is who receives it.
Yeah leave. They are putting your license at risk. One lawsuit on a call you are on and you are now involved. innocent or guilty you will have to defend yourself. Why spend that money? Plenty of places will hire you the next day right now.
Dude that is an awful place to work. Where I work, that would never fly. Much higher standard of care. Find a better employer and get out.
This is fucked. Report it.
You need to report this to the state and leave that agency ASAP. There is an old adage that goes something along the lines of “hang around idiots long enough and eventually they’ll claim you as one of their own” that I think applies here. This agency has demonstrated to you that they do not abide by the law. It’s only a matter of time before you’ll get caught up in some investigation. Don’t allow yourself to carry that kind of liability. Report them and get out as soon as possible.
I would quit so fast and report to everyone I could. State, OEMS, medical director. You name it.
You might have snitched on a head bleed lol
That’s a SHIT organization that will get your license yanked with the quickness, and your partner does integrity like old people fuck. If that were a military unit it would be called the Blue Falcons. Pop smoke.
Dude, open up a case to be honest if it's that bad. If you had someone from your own qaqi office tell you what to do with yourself, I would honestly put in a formal request to your local department for Public Access to their body cam records, and submit this to whatever Department of health and safety. Or Hell call OSHA
Oh man you’ve hit the jackpot! Have you seen the guy on TikTok that talks about he’s sued every job he’s had because of retaliation? He got rich! This is your time to shine. Report that shithole to the state ASAP. Then take it above the QAQI guy, email ALL of leadership in a group email. Tell them everything and document it the very best you can. Then when they retaliate (which they will), you can sue to retaliation and report that to the state too. You’ve got 15k to take a victory vacation before you start at a decent service AND you’ve helped your community!! Edited for video link https://www.tiktok.com/t/ZT8j6wHKs/
If not for the patients, you have to take a stand for yourself. One day something will go wrong, and anyone and everyone involved wil pay a very heavy price for it. Never mind just losing credentials and profession, that could very well end up in criminal court. Take it to the MD and State.
You’re amazing. Thank you for putting in the effort to get her seen by professionals. Jesus fucking christ that is not ok.
QA saying don't be a snitch lol. That's literally QA's job
Damn that I am late to this, but I never thought this would be in EMS. I mean falsifying PCRs may happen, but the don't snitch thing I thought was reserved for corrupt cops.
Just quit that place and report. Being a pariah at a place that you rely on for money is pure suck. Leaves you open to retaliation by upper management too. If the qaqi person has the balls to say that imagine the others.....
Yeah nah, you should always advocate for the patient. The only (and very few) incidents we have someone sign off while not being Alert×4 is in dui wrecks with police on scene. Where I work, as soon as someone is no longer fully AO×4, it goes to medical command. Of medical command signs off, that's a different story.
Find a new job, good lord.
Hmm... Y'all use ESO to chart, by chance?? That's some lazy and dangerous shit, by both parties. I'm really bummed your QA person dismissed it so readily. I'm all for letting patients make a within-their-rights bad decision but this sounds like a clear case where they *need help*, not rights. If you ever have to testify (on anything) stick to the absolute truth and hire a private (not company provided) lawyer. LegalShield has saved my ass a few times.
Traumasoft has a Normal Assessment button.
Thanks!! I haven't messed with Traumasoft, before. The way they worded it just made me think ESO, immediately. I use ESO at one job and ImageTrend at the other.
Yes we use ESO :/
"No Abnormalities" gave it away. My main jam runs ESO.
CYA is always the name of the game. Is and always will be. I had an MVA about a month ago with 2 patients, a semiconscious wife and ambulatory but altered husband who was the driver. Documented 6 ways from Sunday in my chart for the wife that she initially presented as the more critical patient so I requested a 2nd BLS unit for the husband and transferred care to them once they arrived. The other BLS crew came to me before I left for the trauma center and said “he really doesn’t wanna go”. I said “he’s definitely altered and should go, but if you’re comfortable with an RMA/AMA bring an officer with you so the whole thing is on bodycam.” The other crew cleared the scene “no patient contact”. The driver had a CVA behind the wheel which caused the accident, and coded while his brother was driving him to the trauma center to see his wife. As far as RMA’s on AMS patients and inflated GCS’s, I really hope OP corrected the GCS and mentioned the accident in the narrative. Fuck what your medic said, your name’s on the chart too. CYA.
Report that to the state ASAP. Not only is this attitude putting patients at risk it also puts you at risk.
Get out of there, that's a whole mess of federal charges waiting to happen.
> Our QAQI person approached me after and said “Don’t be a snitch,” That attitude is completely unsuited to their job. OP, you did the right thing convincing the patient to go and flagging an inaccurate report. You should find a new employer, and don’t let this place break you before you get out.
Sounds like your QA has a personal relationship with your partner and doesn't want them to get in trouble.
As a QA officer myself, dude fuck your QA/QI person, and fuck his lazy self for not following up on proper chart review. I get it, being QA’d isn’t fun for ANY provider, and yeah reviewing charts is a hassle, but it’s literally how we hold ourselves accountable and how we progress forward as a profession. Your partner is a shitbag and your QA officer is a scumbag. I’m sorry you’re dealing with this bullshit.
A couple takeaways from this one: 1. When you file anything with management, QA/QI, etc. retain a copy for your records. This can even be photos of the document (or screencaptures is submitted via your smartphone) before you hit submit if they are electronic. I would also advocate for emailing yourself copies. This way should something happen to your phone you still have the copies safely and securely stored in a cloud based service. 2. If they don't want you to raise questions about subpar care? They can choose not to place you with lazy, subpar partners who clearly have no regard for their patients. It's up to them which one they want to follow through with.
This is so common in EMS and one of the main reasons I'm leaving. Culture is horrible. Patient care is not a priority and interactions between staff are awful. I'd get out if I was you.
Part of my job is doing QAQI. I couldn't fathom doing that. If I were in your position I'd be planning my exit and once I had a plan I'd report that incident to the highest level. Make sure they can get the body cam footage. I promise the powers that be in your department do not want the culpability that accompanies a sleezy QAQI.
Document everything, email an QAQI request. Because if this goes forward anywhere they will try to throw you under the bus and
MD who found myself here - you could not be more right. Absolutely unacceptable. Story is very concerning for ICH, which could be life-threatening. Good for you for doing the right thing and all the best.
The Qa/Qi person may not care but I guarantee your medical director will
Thank you! I work as PMHNP in ED and will read the EMS run reports especially when I get like delirious geris and or when I'm considering a psych v Medical v intoxication (it shows me if the patient status has changed since EMS encounter, if something had been given prehospital ECT) which can help me with my differential and management And EMS documentation also be used in court and often times court cases don't come around for years so you want to have a good record of what occurred ECT. https://www.ncbi.nlm.nih.gov/books/NBK448107/ -good recourse in EMS documentation
I appreciate all the services you guys offer, and it has saved my life before. People who disregard important information and patient care to get through the day faster simply need to be shown the door. There is no place for unempathetic or jaded professionals in the healthcare world. This is how people lose their lives needlessly. I would absolutely place my reputation and accept probable bullshit/drama to happen while working with them after reporting just so someone like that could find themselves flipping burgers. Lack of empathy probably suits a person well in the fast food industry.
I wouldn't be caught dead working for such an agency.
There is no thin blue line for ems. That said, one ought not narc. The part of your story that tips the scales in favor of your side for me was your partner not recognizing consent was implied. (Gcs being so low)
Was she high?
What a shit agency.
wow
If your job isn’t going to take it seriously I’d go to the state office.
My FD would be much more upset about the shit bird medic and glad someone reported that. The "don't be a snitch" thing is slippery. Typically, if someone's fuck up was innocent/accidental and doesn't cause any negative to happen to a coworker or the public, a good crew should usually help their brother/sister out and keep downtown/chiefs out of it. Still talk about it and make it a teachable moment since it should not happen again. Your guy was clearly negligent and needs some serious discipline/retraining to remind him our job is to take sick people to the hospital, not leave them home with a brain bleed.
When the people responsible for ensuring quality care refer to ensuring quality as snitching, it’s time to go.
We had a medic fired for something similar not too long ago.