Guest guest Posted October 16, 2003 Report Share Posted October 16, 2003 In a message dated 10/16/2003 9:28:19 AM Central Standard Time, vidorfire249@... writes: Would anyone like to offer suggestions to this? What can we do about our crews getting stuck in the ER hallways for hours? The staff at the hospitals in Beaumont WILL NOT take report or assume care. If the patient deteriorates it is still no guarantee that care will be provided. I have been in that situation before, and I have gotten on the phone for the EMS Supervisor, Charge ER nurse, or House Supervisor, and by the time everyone gets to the er, all of a sudden, care is transfered....it's funny how that works Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 16, 2003 Report Share Posted October 16, 2003 GETAC handled this issue a couple of years ago and either GETAC or TDH issued a position paper in regards to. Contact the TDH Central Office, or a member of GETAC from two years ago. Basically, the position paper states that the ER has the responsibility to accept patients in a timely manner, and GETAC, RACs, or TDH might be willing to come in, if invited to help solve the problem. This is my recollection, if I am wrong about some of the details, please correct. aloha, -mikey Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 16, 2003 Report Share Posted October 16, 2003 I was having the same trouble on the floor at a local hospital. After I sat for 40 minutes one night, I went to the charge nurse the next morning. After a civil and professional conversation, the issued was resolved. If you and your crews talking to the ER administrator does not help, you need to get your director involved and step it up the hospital chain of command. The ER staff calling your administrator and trying to " remove " you from the salary rolls is wrong. That is why you MUST get your administrator involved BEFORE the situation escalates. If you have to, call your administrator when it happens and have him meet you at the ER in question, so he can see how long it is taking to get your patient handed-off, and any " unpleasant " attitudes on the part of the ER staff. That way he can get a proper, first-hand evaluation of the situation, and take appropriate action immediately. Failing to take report and assuming care of a patient in THEIR emergency room is bad form at the least; negligence at the worst. Leaving a 911 truck in an already taxed system out of service with a loaded stretcher for any longer than necessary is incompetence on their part, in my humble opinion. If the hospital is so full, that they can't handle the in-flow, why are they not going on divert, or closing completely? Good luck with your situation. I hope you can resolve it soon. Just my two cents, Barry E. McClung, FF/EMT-P Fire & EMS Patch Collector Webmaster: " The FyreMedic's Space URL: http://www.fyremedic.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 16, 2003 Report Share Posted October 16, 2003 The CMS letter is worth a read. We have had this problem with a Dallas hospital. It was curtailed by placing the LSB'ed patient (after a detailed discussion) in the floor of the ED and leaving (for out second pt). This is not abandonment. Once the pt is " presented " to the ED, it is their responsibility (presentation can even mean the ED drive). I would suggest that you contact your supervisor ASAP and describe the anomoly (to keep yourself out of hot water). P.S. The call for the pt report is a courtesy, not mandatory. > Would anyone like to offer suggestions to this? > > What can we do about our crews getting stuck in the ER hallways for hours? ... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 17, 2003 Report Share Posted October 17, 2003 Once the patient dies in the er with you asking for help you might see the hospital in trouble if a family member is present and sues them and hopefully not you. Then you see a change but as for placing a patient on a bed and leaving that would be abandonment of a patient and you would be in a lot of trouble, I don't think I would try that one. Re: other issues > I wish to second Irlynda's response. > > (As a paramedic student, we get the technicalities of the concept of > abandonment pretty well drummed into us--and it came instantly to mind when > reading 's post.) > > Conley Harmon > > > > Wiseman wrote: > > > >Once you are on hospital property, the patient is THEIR responsibility, > >whether or not they take report! > > > >If the patient is not critical, place them on a bed, in a chair and get out! > > > > > > >, do you know what abandonment is? > > > >Irlynda , EMT-P > > ---------- > > > --- > Outgoing mail is certified Virus Free. > Checked by AVG anti-virus system (http://www.grisoft.com). > Version: 6.0.525 / Virus Database: 322 - Release Date: 10/9/03 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 17, 2003 Report Share Posted October 17, 2003 I would like to weigh in on this issue a little bit. I agree with that I hope " throw and go " doesn't start to occur...howewver, when hospitals and EMS agencies fail to have substantive conversations about how to solve these problems locally, and it becomes a default problem of the EMS agency, we have to respond. I read with interest the conversation about " abandonment " when you leave a patient in a chair, or on a backboard on the floor (like some Arizona EMS agencies used to do), or on a " found " hall bed (surgical recovery after hours is a fantastic place to find these BTW). CMS makes it very clear that the hospital is responsible for the patient as soon as you drive on the property...now this does not relieve us from all liability and I would never endorse leaving a patient without letting someone know what was going on and with out the completed run sheet tucked in their belt....but when we are in a situation where there is little if any communication or cooperation in solving these issues and we are stuck in the ER hallway for HOURS...why does that become an EMS problem??? And, the topic most people don't address....while your unit is in the hallway waiting, who is answering the calls in your area? Our taxpayers expect coverage by 3 units, 24/7...they have paid for it. That means we have 72 hours of time every day to cover all the requests of our taxpayers. Somedays this is more than plenty...others it is no where near enough...but every minute my crews sit with patients in an ED takes away from the time that they are supposed to be covering their citizens. This means that either we have longer responses to them when they call or we infringe upon the taxpayers of our neighboring jurisdictions because we have to use their resources to cover our district...thereby shorting their taxpayer value and response....and this ripple effect continues all the way through the EMS system (much like why your plane is late leaving San when it is raining in New York). So, that being said, this is an issue of the hospitals. It is an issue that responsible EMS agencies should be working on with their hospitals to find solutions that will work best for both agencies....but like and others have said...when it suddenly becomes an " EMS Problem " that your hospitals refuse to even claim as their responsibility, then you need to use the CMS letter, you need to start taking actions to protect your citizens and your territory instead of worrying about protecting the hospitals ED and/or staff. Just my thoughts, Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 17, 2003 Report Share Posted October 17, 2003 Beaumont is the only place I've ever worked where this situation occurs. It's just a fact of life that I've come to accept, and I treat my patients accordingly. Depending on who is charging, they act like it's skin off my nose to sit us in the hall. Big whoop. Seriously, though, the problem is merely overcrowding and lack of staff. They do the best they can most of the time, and you just have to adjust your thinking a bit. The solution would be 2 more ERs and about 50 more RNs.....but that ain't gonna happen. magnetass sends Re: other issues > In a message dated 10/16/2003 9:28:19 AM Central Standard Time, > vidorfire249@... writes: > Would anyone like to offer suggestions to this? > > What can we do about our crews getting stuck in the ER hallways for hours? > The staff at the hospitals in Beaumont WILL NOT take report or assume care. If > the patient deteriorates it is still no guarantee that care will be provided. > I have been in that situation before, and I have gotten on the phone for the > EMS Supervisor, Charge ER nurse, or House Supervisor, and by the time everyone > gets to the er, all of a sudden, care is transfered....it's funny how that > works > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 17, 2003 Report Share Posted October 17, 2003 I agree 100 % I think you said better what I meant, but the issue is an admin. level issue that needs to be addressed by ems admin to the hospital admin not the poor medic who is already having a bad day having to address a problem that should not exist to start with. this in now way is arguminitve with what is said below it is much better stated by him than it was by me. Thank you for saying what I was thinking. I have been the medic in the hall trapped in an argument with an over worked nurse who is also having a bad day. Re: other issues > I would like to weigh in on this issue a little bit. I agree with that I hope " throw and go " doesn't start to occur...howewver, when hospitals and EMS agencies fail to have substantive conversations about how to solve these problems locally, and it becomes a default problem of the EMS agency, we have to respond. > > I read with interest the conversation about " abandonment " when you leave a patient in a chair, or on a backboard on the floor (like some Arizona EMS agencies used to do), or on a " found " hall bed (surgical recovery after hours is a fantastic place to find these BTW). CMS makes it very clear that the hospital is responsible for the patient as soon as you drive on the property...now this does not relieve us from all liability and I would never endorse leaving a patient without letting someone know what was going on and with out the completed run sheet tucked in their belt....but when we are in a situation where there is little if any communication or cooperation in solving these issues and we are stuck in the ER hallway for HOURS...why does that become an EMS problem??? > > And, the topic most people don't address....while your unit is in the hallway waiting, who is answering the calls in your area? Our taxpayers expect coverage by 3 units, 24/7...they have paid for it. That means we have 72 hours of time every day to cover all the requests of our taxpayers. Somedays this is more than plenty...others it is no where near enough...but every minute my crews sit with patients in an ED takes away from the time that they are supposed to be covering their citizens. This means that either we have longer responses to them when they call or we infringe upon the taxpayers of our neighboring jurisdictions because we have to use their resources to cover our district...thereby shorting their taxpayer value and response....and this ripple effect continues all the way through the EMS system (much like why your plane is late leaving San when it is raining in New York). > > So, that being said, this is an issue of the hospitals. It is an issue that responsible EMS agencies should be working on with their hospitals to find solutions that will work best for both agencies....but like and others have said...when it suddenly becomes an " EMS Problem " that your hospitals refuse to even claim as their responsibility, then you need to use the CMS letter, you need to start taking actions to protect your citizens and your territory instead of worrying about protecting the hospitals ED and/or staff. > > Just my thoughts, > > Dudley > > > > > Quote Link to comment Share on other sites More sharing options...
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