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Old 09-16-2007, 10:30 AM
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Quote:
Originally Posted by kathypbib View Post
I agree with the well written response by BACRNEMTP. A bit of a misuse, but the response by the ambulance personnell was over the top, and he/she could have handled it much better. I work for a hospital based/county supplemented 24 hr service and have been in an ambulance for 11 years, soon to be an ER nurse. Keep in mind when calling 911 that medicare does not pay for non urgent rides to the hospital. I would find it supprising if an insurance company would pay either. An ambulance should not be used as a taxi service unless someone is absolutely unable to ride in a car for some reason. Most of these crews work 24 hour shifts and getting jerked out of bed by alarms after midnight really gets the adrenaline going. Which is probably why you got the over the top response.
Some cities have bus services that are able to pick up wheelchair bound people and transport them for $4 or $5 as opposed to a $500 ambulance ride.
This really is a fantatic service and we have them available in my county...but not at night. No w/c van or anything after 9 PM. Usually we get nursing home patients who are non-ambulatory but don't necessarily require medical monitoring on the way home, or are demented and not safe to put in a cab (our other option) but at night a BLS ambulance is all that is available. I wish there were other options around the clock. I see SO much abuse of the system - some of it unintended, some totally intended!
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  #12  
Old 09-30-2007, 07:21 PM
Polaris
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I don't think it was abuse of the system but do agree it was a misuse. But if I recall correctly from your original post, you did not tell them to call EMS, they did that on their own. So to them it seemed like an acceptable use.

Unfortunately, we cannot ensure that all people that need it would have a ride to the hospital. We also can't expect friends to be obligated to care for and transport people. Would most of us? Of course - but we don't know the extenuating life circumstances of these people.

I think it's a hard situation all around. One where you know you want to do the right thing, but also know that it would be not financially responsible. It also took a crew away from responding to a potential real emergency call.

Stuck between a rock and a hard place. Sometimes you just have to call a truce and do what you can, ya know?

Regardless - that EMS "professional" (and I use that term loosely) was completely out of line and I'm glad you got an apology.
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  #13  
Old 11-18-2007, 04:00 PM
Mr Ian
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I know the thread's old, but I have an opinion and I'm gonna use it. Besides, not slept all night and I start work in an hour. Need to do something....

It's one of those dilemmas where, unfortunately, the poor RN trying to do their best is left with an ethical decision to make and nothing but condemnation whichever way you choose.

Suffice to say, if you'd left her, woe on you.
As it was, you didn't, so woe on you again!

The issue is not whether you should have done so or not, the issue for me is; this is a foreseeable problem and we as nurses are not responsible for making the policies. Elderly couple, the one left at home as frail as the patient, is it that unusual that someone couldn't have thought that scenario out already?

Of course, mon-fri 9-5 it would have been a lot easier. But it wasn't. Family available it would have been a lot easier, but they weren't. Someone had a car.. etc etc....

What you had was an extreme example of a situation that required on the spot ethical decision making. You weighed it all up in your head and made a judgment call. Beaurocrats might not like it; EMS (and I understand their plight) might not like it; but the patient and family needed it and trust me, the newspapers would have crucified anyone who stopped it.

You did fine. Yes there should be better options, but there weren't at that time in that situation. That's not your fault and it sure wasn't Mr & Mrs "paid my taxes a whole life and probably fought a war or two while we did it".

I just get annoyed, when we make ethical decisions, with the lack of professional support received as if you don't think of other peoples issues too.

Stuff the system. Big up to ya gal )

I'd have probably made them go back for the cat... ethically speaking.
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