Paramedic fired for abiding by patient's request

Discussion in 'Firefighter/EMS Talk' started by Tvov, Apr 17, 2019.

  1. Tvov

    Tvov

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    This is different. Paramedic did not use a certain type of IV for a patient who did not want it - the patient was conscious, alert, and coherent. Her husband was there and witnessed it, and is DEFENDING the paramedic.

    Seems straight forward, but there is probably more background behind this. Probably related to the "Reiki" thing, whatever that is.

    https://www.yahoo.com/lifestyle/par...shes-patient-refused-treatment-152542485.html

    "Michael Senisch told CBS Philly that in February 2016, he was called to the Mays Landing, N.J., home of Wendy Johnson, who was suffering from a severe infection. Johnson was too frail for Senisch to properly insert an IV into her arm, so he informed her that he’d have to resort to inserting an IO intraosseous infusion, which would require using a drill-like device to insert the IV into her bone instead of her vein.

    But Wendy, who believed in holistic healing, refused the treatment. “She said, ‘IV yes, IO no, period,'” Wendy’s husband, Brian Johnson, told CBS Philly. “And I said, ‘Well, that’s my wife’.”" data-reactid="19">But Wendy, who believed in holistic healing, refused the treatment. “She said, ‘IV yes, IO no, period,'” Wendy’s husband, Brian Johnson, told CBS Philly. “And I said, ‘Well, that’s my wife’.”

    The paramedic decided to respect Wendy’s wishes — denying recommended treatment is referred to as informed consent — and called off the IO procedure. Instead, he offered to administer a holistic treatment called Reiki, as he is certified in the practice, and she accepted.

    She was so happy that [Senisch] was somebody who understood her belief system,” Michelle Douglass, one of the attorneys representing Senisch, told Yahoo Lifestyle. “It calmed her and made her feel better, and Brian was grateful.”" data-reactid="21">“She was so happy that [Senisch] was somebody who understood her belief system,” Michelle Douglass, one of the attorneys representing Senisch, told Yahoo Lifestyle. “It calmed her and made her feel better, and Brian was grateful.” "

    Edited to highlight defending the paramedic.
     
    Last edited: Apr 18, 2019
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  2. Blanton

    Blanton

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    Much is dependant on state and national certification but I believe paramedics are required to follow rather strict protocols. As s medical professional I question whether there is an established provider/patient relationship that would allow deviation from those protocols. When I had a motorcycle accident I wanted to be transported to a closer hospital wear I worked but protocols stated transport to a specific hospital for suspected head injury. I had to convince them I did an appropriate neuro and c-spine check then the paramedics had to get authorization from their superiors to transport me to my hospital. Regardless, performing non traditional medical techniques in an emergency situation where paramedics are called is questionable at best.
     
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  3. LostinTexas

    LostinTexas Exploring Alternate Routes

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    When all else fails, dump it on Medical Control.
    It sounds like the Medic followed local protocols one one sentence, then didn't in another, so I'm having a hard time figuring out the gripe. Pt's get the final say and the ER Dr. could be facing battery charges. Malpractice be damned, criminal charges.
    Sometimes I hate ER docs.
     
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  4. WT

    WT Millennium Member

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    As an basic EMT we were not authorized to do those types of procedures. That's why the paramedics got paid big bucks compared to the volunteers.

    We would have done a patient assessment, addressed the emotional state of the patient, and transported pt to the hospital.

    I feel for the paramedic. He has some time and experience on the job. However, paramedics have different protocols than basic EMTs. As he found out, stepping outside the parameters of his practice can have dire consequences.

    I would hate to be in EMS nowadays.
     
  5. 4896worker

    4896worker

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    First rule of a paramedic DONT deviate from protocol .
    Second rule of paramedic DONT document that you violated local protocol
    He screwed
     
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  6. Tvov

    Tvov

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    I just edited my first post... the husband is Defending the paramedic's actions, saying he did the patients wishes when she was conscious and alert.
     
  7. Redeemed

    Redeemed

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    In my over 20 years I don’t recall any protocol that allowed for reiki or “energy healing”.
    Patients could refuse treatment of course, but alternative medicine at medic suggestion or patient request? I think not. I’d like to hear that report over the radio.

    https://en.m.wikipedia.org/wiki/Reiki
     
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  8. larry_minn

    larry_minn Silver Member Millennium Member

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    When I was in EMS. Most of the time calming the patient ( and family) was more important. (I'm not talking then controlling bleeding, O2 in some cases, glucose, stabilizing...)
    Often important part of stabilizing is comforting, calming patient.
    Nail gun spike in knee? "Ok you want transport, Dr. All that junk..or should I find a nail puller". He said it hurt to laugh.
    Elderly who passed out at dinner, dance, VFW party... "Guess your not 28 anymore.. Have you been to your Dr this week? Did he increase you BP meds? Ok it's no big deal. Higher dose,mew drinks, more good then normal. Sir, Mrs. tell your kids to drive slow. (They are using words like stroke, heart attack...)
    "I'm not a Dr. They need tests run but likely med increase 3 days ago, eating huge meal, few drinks, some dancing.".. (Ok those should have cancelled a bit, maybe)
    Turns a rapid heartbeat, shallow breaths (by both patient, spouse) into something more normal.
     
  9. FiremanMike

    FiremanMike Way too busy

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    This is likely the reason he was fired. Patients refuse IVs all the time, and if she was awake, alert, and oriented, then she probably wasn’t so critically ill that an IO was even necessary.
     
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  10. jimcorbin

    jimcorbin

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    I need to get a job with that EMS service. It states in the article that the former medic is now a Physicians Assistant making less $$$ than he was as a medic. WTF??? PA’s are well over $100k a year here. Medics not so much.

    As for the termination, it feels to me like the medical director and the medic might have had some bad history. This event was the final straw. Although nothing was stated confirming that. If you are going to deviate from the protocol, be very careful on how you verbalize your report to the receiving facility. And be extra careful how you document things.
     
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  11. Dave514

    Dave514

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    He might have gotten away with accepting the IV refusal but applying his healing energy Reiki touch technique....bye.
     
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  12. seagravedriver

    seagravedriver

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    Late 80s in the county I still work in. A private ambulance medic with quite a few years and respect under his belt tried some sort of massage technique on a patient. GONE! Even if the pt. wanted you to, if it is not in protocol, it does not happen.
     
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  13. DaleGribble

    DaleGribble Sandwich!

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    You guys that are talking about protocols and never straying from them are scaring me.

    Protocols are guidelines, not absolutes. The people that taught you this line of thinking should be ashamed of themselves, and quite frankly, that line of thinking is what keeps EMS relegated to red-headed stepchild status within the medical community. Just don't do stupid **** like Reiki massages and stick to conventional treatments based on sound assessment findings and you'll be fine.

    Critical thinking doesn't mean following the flowchart.
     
  14. Blanton

    Blanton

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    Critical thinking skills ARE required to understand individual state laws and what those laws allow paramedics to do. Those thinking skills are also required to consider the legal ramifications of paramedic care. The paramedics role is to provide specific emergency care until higher professional level care is available, not to independently make decisions.and take actions. That's not in their training nor meant to be
     
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  15. Tvov

    Tvov

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    EMS is "red-headed stepchild" in the medical community?? I have never heard that. My wife, who was an emergency room nurse, said she was always impressed with EMS - no matter how bad the condition a patient was in when brought in, she realized that was AFTER EMS had cleaned them up... she couldn't imagine what the scene was when they first rolled up.

    Sure, as with all things, there are good and bad... my wife would tell me what towns to not get hurt in!
     
  16. seagravedriver

    seagravedriver

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    I was just dispatched as I was on the last sentence, so I couldn't finish it detailed. Our protocols are not absolutes in most cases. Let me be clear, we have a lot of discretion, but not when it comes to massaging someone or something way outside the norm. The system I am in is not a "mother may I" type. While people have been in trouble, it is pretty obvious they were off the rails a bit. We can call our base station and ask for additional ___, or whatever variance we are looking for, but as I said, I think our protocols are very liberal, enough where I have called for going outside of protocols less than once a year over 25 years of Para medicine. I will say that our protocols have greatly expanded over the years, adding meds, RSI, different pain meds etc.
     
  17. DaleGribble

    DaleGribble Sandwich!

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    I dont know where or when you got your paramedic cert but when I got mine, I was trained and expected to think and act independently. As a matter of fact, in every NREMT scenario, calling medical control was not allowed.
     
  18. LostinTexas

    LostinTexas Exploring Alternate Routes

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    OK, now you are getting edgy. Maybe in testing contacting MC wasn't allowed, but the scenario should have fallen into main stream guides. If it didn't someone was free lancing and that is a big No No. I taught, examined, and prepared students for these.
    Protocols are pretty general for a reason, but varying from them will land you in a lot of trouble. Job, litigation, and at times jail. If things fall outside a guide, and they are written so that few situations will, then MC is the obvious answer.
    We very seldom needed permission to do anything, and had permission to do anything in protocol past the "Contact Medical Control" line but those were spelled out plainly. Fortunately the "Contact Medical Control" was almost always the last line of the page. There is a lot of life outside the class room.
     
  19. WT

    WT Millennium Member

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  20. Firecop203

    Firecop203

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    This is one of those stuck “between a rock and a hard place” situations.