Saturday, May 22, 2010

Lazy Douche County EMS

OH MY GOD. I swear, you guys. I generally feel for EMTs. They have to wake up from their sleep to saving lives immediately. I could not do that without pulling through Starbucks first. They have to carry ginormous fatties down flights of stairs. I most definitely cannot do that. They deal with foolishness just like we do. But damn. I'm sorry. There's a difference between doing everything you can, even if it isn't enough and being a lazy douchebag. And I can tell the difference.
The hospital I work at services a pretty big area- we service the southern part of a big city and all the po dunk counties in the 20-30 mile radius below it, as all the hospitals that used to be out there got closed down because they sucked. I have no complaints about the po dunk EMTs. They generally work hard and actually know stuff about the patients. My only complaint might actually be that they do a little too much- some of them are a little IV and med happy- but I would never actually complain about that.
Big city EMTs are another story, however. Half of them are pretty good, but just seem beaten down by life in general. The other half are lazy, self important ass clowns, who do nothing for the patients. I have nearly lost my shit on at least 3 crews in the last 2 weeks. The first was a crew that brought in an older lady in respiratory distress. They miraculously started an IV (+1 point) and hung a fluid bolus (-2 points, as the lady was a CHF patient who couldn't breathe), but that's really fine. Whatever. I had no beef with them at that point. My problem came when me and one of our externs were starting a catheter on this lady and one of their dumb asses tried to start walking through the door and the curtain. Take a hint, bro. You don't belong back here at this particular moment. We don't know who it is, so I just yell, "Hey, give me 5 minutes or so, I'm starting a catheter." This idgit just stands there halfway behind the curtain. I call out again. "Can I HELP YOU?" Continues standing there like a moron, then asks me what I'm doing. Putting in a catheter. I just f-ing told you. Holy balls. He asks me how long it's going to take. Really? Really? Finally I ask who it is. "Unit such and such. I just wanted to see if she was responding to the BIPAP." We JUST told you to wait, about 500 times. Are you slow? Get the hell out of here. NOW.
So a few days later, I'm sitting in triage, and a crew rolls in with an ambulance to triage. I am in the midst of triaging a patient when one of them walks in and sticks a toughbook in my face trying to get me to sign that I received report. Bitch, please. First of all, get that shit out of my face. I am in the middle of something and interrupting is rude, yo. Second of all, did you give me report? I don't care if the patient called you and asked to be transferred to the ER for a stubbed toe, I am not signing that I assumed care until you tell me at least some information. For all I know, I could be signing that I assumed care of an effing CPR in the waiting room. I wouldn't put it past you. They then gave me a half assed report and acted as if I was an uber bitch for even wanting one. Whatever bro. It's my license. Suck it.
I think it might have actually been the same two dudes that I nearly punched tonight. Douchebags. Seriously. These turds roll in with this young guy. They start blurting off report at the nurses' station to no one in particular about how the dude had just gotten surgery at the county hospital 3 days ago, and now he has severe abdominal pain and distention. Might I also mention that the county hospital is at most 15 minutes from us, and that it was about 4 in the morning, and this crew ran no other calls to us the rest of the night. The ER doctor straight up asks them, because she is sassy and awesome and doesn't care, "Why didn't you take him back where he came from?" Donger EMT immediately gets indignant and starts talking to her like she's stupid. "Um, because his house is like, right there." SO? "Well, he didn't ask to go there." Really? Maybe because he was writhing in pain on your stretcher? And if you had him any longer, you might have had to do something? It's not like they were worried about his medical stability, or they might have started an IV. They did manage to put him on a backboard for some reason I could not ascertain. When I asked, their response was "Well, I mean, he doesn't need it, but it like, made it easier to move him." Fabulous. They don't help me clear him from it, though- they do get coffee while I the patient cries and hangs onto the IV hanger from the ceiling and I pull the backboard that's twice my size out from under him. After I do that, hook him up to a monitor and am starting an IV, the less douchey of the two comes in and sheepishly asks if I need anything else. Um. No. Not now, but thanks. Shoot. At least he asked I guess. So. Naturally the guy's belly is full chock full of blood and he can't answer any questions about his surgery or who did it. And shocker- we transfer him to the county hospital in a matter of hours. And a private ambulance company has to come pick him up and take him 15 minutes down the road. Awesome. Great use of resources, guys. Strong work. The best part is, I'm reading the run sheet, and after the whole showdown with a doctor they added some bullshit note that the patient insisted on being transferred to the nearest hospital. Lying bastards.


  1. Here a douche, there a douche, everywhere a douche douche! Hahaha.

  2. I know exactly how you feel! While we generally get decent EMTs (fire dept shows up first to assess because they are closer) there are definitely some douches. Recently a guy was sent out because he had an increasingly bad wound infection and we kept notifying the MD but nothing was done. His foot dressing was changed all the time but the problem was, the ordered wound care was completely pointless. Essentially a dry dressing on a wound that was clearly infected from the day he got to us. After about a week on of the nurses called the on call MD and had him sent out. She had just changed the dressing that morning. Well this EMT woman tells the people at the ER that we had not ever changed the dressing since admit about a week prior. Despite the fact that the nurse dated the dressing for that morning...she also told the family. We sent all kinds of wound documentation, contact with MD, etc to the hospital (who were very understanding) but the family didn't want to see any of it. They were assholes anyway. Luckily our director of nursing is hardcore and she wasn't having any of it. Reported the EMT. Hopefully she got some kind of crap for it. Don't talk trash lady unless you know what you're talking about!

    We've also got one of the fire dept captains that arrive first while waiting for the EMTs and he basically thinks we're always wasting his time. One day this guy who had been admitted (less than 24 hours prior to this) for PT/OT after some sort of cardiac surgery (I can't remember specifics) needed to be sent out. At baseline (for us) he was cranky, obsessed with going to sleep and using his CPAP machine. So around change of shift he needed some pain medicine for his chronic back pain. He was a big guy and took Oxycodone 10mg pretty regularly. No biggie. Well about 2 hours later I go in to check his blood sugar and he's even more lethargic, non-responsive. His vitals are all fine with the exception of a really weak, thready pulse, even O2 was fine. Everything else that was out of the norm had been since admit and in the discharge report from the hospital. But he proceeds to be non-responsive. He's a full code and nothing is waking this guy up. So the jerk fireman/EMT rolls in with a major 'tude. He asks what meds he's had recently so I mention the oxy. At this point the patient is speaking a little bit but he was still pretty out of it. The fireman states to the EMTs and the patient that he thinks 10 mg of Oxycodone was way too much for him (note, the guy was over 300 lbs and took it about twice a day for years) and didn't want to take him. He literally said "just give him some narcan". Well MD order trumps him so he went to the hospital. Guess who died from cardiogenic shock about 12 hours later? The guy came a couple weeks later and asked about the "oxycodone patient" we quickly put him in his place.

  3. So I guess you wont be dating any than! haha