Dumb Asses

Ok, little old woman falls and breaks her hip. Not a big deal, simply done. I medicated her before moving her, morphine is a wonderful medication. But we have to take her to a hospital that has orthopedic surgeon for evaluation. Again, not a big deal, simply done...except one hospital. Now for the sake of this discussion, I will not name the facility on this blog, but everyone around this area is greatly familiar with this local hospital and the stand off rude persona that they give off to the patients.

We transport her to the hospital quietly and during the trip, I explain to her what typically occurs with these types of fractures. They will admit you, put traction on your leg which will help with the pain and then have surgery either tomorrow or probably Monday.

This little old 80ish woman isn't happy about being down with a broken hip. She kept telling me that she was suppose to get a special flower on Sunday for being the oldest mother at her church. She is alittle scared, she holds my hand for the entire ride to this hospital, approximately 25 miles in duration.

Upon arrival to the local hospital that advertises orthopedic speciality and that under the CMN website that lists the specialities available has orthopedic listed, the ED doctor, a rent-a-doc from an agency, walked in and without looking at or assessing the patient, looks at me and asks "why did you bring her here?"
"she has a probable broken hip, this is the closest orthopedic hospital"
"Our orthopedic isn't on call"
"I have no way of knowing that"
"You should have called us before transporting"
"Fax us a call schedule everyday like we have asked for over a year now"
"We are going to have to transfer her"
"OK"
"Which hip is broke?"
"left"

The ED physician is in blue, I am in red in this conversation, the color is important later. The doctor leaves the room, a nurse still has not arrived to see the patient. Notice that the doctor talked to me the entire time and never ever evaluated the patient.

Now, I have been a paramedic long enough that I know that physicians and nurses have the tendency to look down on EMS, like we are stupid. But I'm not a stupid paramedic. I am actually one of the best ones in the state. I have also been working with my current employer long enough to know that the owner likes to know when external complaints are sent our way. So I excuse myself from the ED finally after a nurse finishes accepting the patient and call the owner. I explain the situation and his only words were "They have to send us a call schedule every day. If they would do that, we would be happy to follow it." Again, not a big deal.

As I walk back into the ED, the local "rent-a-doc" told me that he is going to have to talk to my boss about this. Not a problem, I gave him the owner's telephone number and offered to dial it myself for him since I just got off the phone with him. I also gave the doctor the Regional Trauma Coordinator's number and offered to dial it for him, and the State Department of Health Bureau of EMS ALS Coordinator's number and offered to dial it for him. Of course, he refused all of that. I offered to let him contact our medical control physician and for me to dial it for him, again he refused. I guess being polite to the bully worked.

As I sat down and was finishing my paperwork, the local ED physician asked me about who covers the area that my station is located at. I told him we have many ambulances that covers many areas, there is just no way of knowing who exactly is covering right now. Then he said, "I understand now. Yall brought her up here to get out of the transfer" And I SAW RED!!!

I immediately get up and walk outside and call the owner again. When he picks up the phone and says hello, I say "This mother fucker has now accused me of dumping this patient on him!!" The owner is trying to calm me down and I am steadily saying "I am fixing to lose my job cause I want to cuss this mother fucker out". My boss is good about letting me vent to him as he vents towards me. Hell, him and I have stood nose to nose scream and cussing each other out and I still have a job. Good boss.

The owner tells me to explain to the ED physician that we did not dump this patient and that we are standing by to take this patient where ever he decides to transfer the patient to. I go inside and tell this son of a bitch doctor this in a professional manner. He says that it is not necessary. Then I start. "Hell no, you stand here in front of your staff and accuss me of dumping this patient off on you, accuss me of not doing my job when all I did was my job within the guidelines of the regional trauma destination guidelines." "We are going to take this transfer because we are a professional ambulance service and we provide excellent care to our patients." "And don't you ever talk to me the way you have talked to me tonight. You have absolutely no say in what I do and how I do it. Your job is to just accept the patients and say Thank you Michael"

In the meantime, the owner of my company has called this local ED and is talking to the head staff person, who all can is "yes sir, yes sir, yes sir". I now know some of the conversation that took place and I know the steps that are going to be taken against this local hospital, but it is not for me to write here (but it involves the Regional Trauma System, State Department of Health, and the EMTALA people).

The transfer is ready a hour and a half later (over 3 hours since falling) and we go in and get our patient. The patient and family is in the room and they are so excited about us taking this patient to a regional hospital in Jackson, MS. She expresses such a dislike for this local hospital and its staff.

As we were rolling the patient past the nurses station on our way to our ambulance, the patient shouts out "Im so sorry that yall don't give a shit about people". I immediately start laughing very hard.

She made the trip to Jackson very well. The staff at Mississippi Baptist were excellent. Exactly what you would think an ED department would be like. To compare the two hospitals is like night and day.

Come to find out, the staff and ED doctors at this local hospital routinely talk down to the ambulance crews of MedStat. WTF is up with that?