Tuesday, 25 October 2011

Experts and Law Suits

This post over at Rogue Medic reminded me of the day our youngest child was born. Being as stubborn as his older siblings, it was decided that two weeks after his scheduled arrival, it would be a good idea to serve him notice and have him evicted. Bags were packed, plans made, babysitters arranged, and a fortune was spent in the hospital car park. 

As we headed towards the main entrance, a scene so familiar to me, yet alien to a heavily-pregnant-about-to-be-induced MrsIM, played itself out in front of us. A group of people were stood in an almost perfect circle looking down at the ground, as a middle aged lady lay on the floor crying in pain. Much like Rogue Medic's story, the lady probably had a fractured hip. The crowd were a mixed group. Some visitors to the hospital, and several staff, including a few doctors, at least one of whom I knew and several nurses who looked familiar. All told, a group of about twenty people, standing, talking, gesticulating. 

A bed had been wheeled from a nearby ward and stood next to the patient as a discussion took place on the best method of getting the patient from the floor to the trolley. As we neared the actual scene at the rate of a nine-plus-month-pregnant-waddle, I could see six pairs of hands trying to move the patient up to the height of the trolley in a tangled mess that would have any back-injury specialist cringe and cry for their mother.

The upshot of it all was that none of them, not the visitors, or the nurses, or the doctors could work out how to do what comes to any EMT or paramedic as second nature. Having admitted to being a paramedic, I offered my help, and after a couple of "What do you know that the doctors don't?" type questions (from certain nursing staff no less), and using only two pairs of hands, the lady was moved gently, safely and with minimal pain from the floor to the bed.  

I don't claim to know what doctors know, I don't claim to have the skills to nurse a patient either. I do, however, claim to be an expert at what I do for a living. I've said it before - we need to have pride in our profession. We need to know that our skills and expertise are exactly that. We need to know that we are the specialists in our field, and that any doctor or nurse worth their salt would do well to understand and respect that. My remit may end at the entrance to the A&E or ED, but up until that point, the patient is my responsibility. That responsibility extends past mere transport - it can also include extrication, removal from scene, treatment, resuscitation and stabilisation. And just simple pick-ups from the floor.

I would love, one day, to hear news presenters, career advisers and general Joe Bloggs speak about paramedics in the same respectful tone as they do about doctors and nurses. Actually, first of all, I'd like to hear paramedics speak about paramedics in that same respectful tone, instead of doing ourselves a disservice by constantly saying things like "Well, I'm no doctor..."

Whilst the USofA as a whole needs to learn a little more about caring for others, as opposed to staving off law suits (not that the UK is all that much better), paramedics the world over need to learn that we are no less experts than the doctors and nurses to whom we're compared, often in such an unfair light. We need to show that we don't do things just in order to avoid yet another American-style law suit, or just to cover our over-exposed behinds. We do things because they are the right things to do, the expert thing to do, and are in the best interests of our patients. 


Anonymous said...

Very well said. If not for you paramedics, there would be many more DOA's from lack of your first responder care.

My daughter is a Paramedic and I am so proud of what she does. She absolutely loves her job and is excellent at it. She doesn't take any crap from the nurses OR the doctors either, she tells them what is going on. Save many a patient that way.

Lynda Halliger-Otvos said...

“I know what I know” as Paul Simon sings to us. So true—we are very good at what we know how to do. My experience enables me to truthfully say when a situation is beyond my skill set.

Silly Safety Girl said...

My go to saying is "If your car breaks down do you want a mechanic or a mechanical engineer?" Same story with emergency medicine. If you aren't in a nice warm hospital that's well lit and has all the equipment handy, who do you want?

GrumpyRN said...

Ah yes, and what about the pair of paramedics who when approached by members of the public for help to remove someone from a car outside our A&E entrance came into the department and told us then pissed off leaving the nurses to remove the patient and place on a trolley. So much for extrication experts.
In fact we have a very good relationship with most of our paramedics but there is always someone who spoils it.

Anonymous; if your daughter really is that good, why is she getting 'crap' from nurses AND doctors?

Tj. said...

Our expertise goes right into the heart of the hospital.

3 lead ecgs from the syncopal pt who have their ICD rate set by them. Stroke pts who have thrombolysis on the basis of the history we give. Pts with # who have limbs saved due to our immediate treatment, who need minimal surgical intervention.

If we treat pts professionally, hand over professionally and document professionally, we'll get treated professionally.


Nicki said...

IM, great post!! I totally agree that no matter what we specialize in, we should be proud of it! I am a basic EMT in the states and only once have I said to a paramedic, "I'm just a basic." He ripped me a new ass and said, "Don't ever say you are JUST a basic! If you didn't do such a damn good job, I wouldn't be able to do MY job as a paramedic." I will never forget that and yes, I do a damn good job!

Grumpy RN, can you be my practitioner? You seem like you would have awesome bedside manner. Don't let the few paramedics who "spoil it" cloud your view of all EMS personnel in general...just like I won't let my impression of you cloud my view of all Nurse Practitioners.

Tom102 said...

Very good post IM.

InsomniacMedic said...

GrumpyRN - I'm not even going to try to excuse the behaviour that you mentioned, but there are rotten apples in every walk of life. I wish there weren't, because they are the ones who give any given group a bad name. All it takes is the smallest minority to tarnish the good name of so many.
As for taking crap from other professionals, again, this happens both ways. We need to learn to trust each other more, to understand each other more, and generally to cooperate. Once we can work as a real team, there is so much more that we can achieve!!

Thanks all for your comments. They are greatly appreciated - both pros and cons!!!

ambogirl said...

Excellent post, well said. And my, some people ARE grumpy!! :)