I don’t like to take passengers in the ambulance with us to the hospital. They are a distraction to me in the back, the patient, and to my partner, who theoretically could be referred to as an “ambulance driver.”
Gasp. I said it.
But yeah, I prefer not to take riders. I don’t really mind if a husband or wife wants to ride along, or a parent of a young child wants to ride along, but that’s pretty much where I draw the line.
So we get called to an office tower for a “female in her 20s with difficulty breathing.” I know what you are thinking, and no, it was not a panic attack. Turns out the office was painted or something, and the fumes triggered her asthma.
Poor girl. (She is better now.)
Her boss approaches, wearing an ill-fitting pantsuit with an air of attitude about her.
“I’m going to ride to the hospital with her in the ambulance.”
“Actually, we only take riders if they are family. You are welcome to follow in your car if you would like. Maybe you could give her a ride back to her car when she gets discharged?”
“No. I’m going to ride in the ambulance with her.”
Now, in general, I don’t appreciate when people tell me what they are going to do, I prefer that they ask me. Unless it’s vomit related. Then a person is free to tell me they are going to vomit.
“Well, actually, we have a policy that says only family members can ride to the hospital in the ambulance, I’m really sorry.” I catch the eyes of the patient during this conversation and I can see her trepidation. Something is on her mind, and I have the feeling that I am doing the right thing for the patient.
“I want your supervisor’s phone number!” she yells at me.
“No problem” I say, handing over a business card with the requested phone numbers.
After loading the patient in the ambulance and giving her some medications to start fixing her situation, I ask the patient about her the medications she takes aside from the asthma. She is a healthy appearing woman, so I don’t expect too much.
She starts rattling off medications that sound familiar, but that I don’t hear often. I stop writing, and look at her as her office building begins disappearing from the rear windows.
“So what kind of medical problems do you have?” I ask her.
“I have asthma.”
“What else?”
She hangs her head a bit and her voice cracks. “HIV.”
“How long have you known?”
“Only a few months” she replies, and her eyes begin to water.
We spend the next twenty minutes checking vital signs, talking about what she does at work, and (seriously) the sequestration crisis.
As we pull onto the hospital ramp, she looks at me, her eyes asking the question.
“You aren’t going to tell my boss, are you?” she asks.
“I wouldn’t tell your boss, even if I was allowed to. Nobody here will tell her anything, and they will keep her out of your room if you want.”
She seems relieved, and I am glad that I could comfort her in some way.
—
Somebody tell me that she would have felt comfortable telling me such private information with her overbearing boss ten feet away.
It wouldn’t have happened.
So only family rides.
I have no quarrel with not having them ride in the back (with the exception of spouses or parents — I consider that a right) but why couldn’t they ride in the front if the patient has no objection? The “they distract me” argument carries exactly no weight with me whatsoever. It’s a customer service issue and a bad policy IMHO.
My service actually has a written policy stating only a parent of a child under the age of 10 can ride in the back, every one else goes up front. One family member is allowed to ride with the patient, and other riders are taken “at the crew’s discretion.”
My partner and I maintain a ‘sterile cockpit’ if you will during responses to calls and while transporting patients. It is something I learned from a pilot friend of mine. That means we don’t talk except for vital information, and we turn off the AM/FM radio, and the non-driver performs the communication with dispatch. It is the same way when we are transporting.
I’m sure there are many other things you and I would disagree on, though.
Clearly.
This Is good to know, but a family member ,this maybe the last time they see or hear from them! depends on situation!
I agree totally. I do not like taking riders in the ambulance. It is different with a child is my patient but I do want the parents up front. I will admit, my last shift I had to have a parent in the back just because it was the only way to calm the child. I am called for the patient, not for riders to go with me. More times than not the rider just wants a ride to the hospital to get closer to the place they really want to go without calling a taxi. I decide who I want to ride in the ambulance. Believe me, I understand customer service but I also understand safety of my crew and my patient.
I took two riders last summer, because #2 was going to drive her own car- after already admitting to having smoked weed. The extra aggravation was worth not putting an impaired driver on the streets.
Throughout my career we generally limited riders to one person who sat in the front with the driver. There were some exceptions, such as parents accompanying minor children, people who could act as translators, and other people who in our judgement could help with the patient in some manner.
Family or friends who were rude, obnoxiously drunk, or belligerent, didn’t get to ride at all. Anyone who insisted that they were going to ride was also informed in no uncertain terms that we, not they, made those decisions. It’s rather impertinent of anyone to start telling me what I am going to do in that regard.
Once in a while, we have to have that reinforced by law enforcement.
http://tooldtowork.com/2010/05/lessons-learned-maybe/
On occasion we’d allow one person up front and one in the back with the patient.
It all comes down to the crews evaluation of the situation. Even when management came out with formal rules, crews still could use their best judgment.
Our ambulances have always been without any sort of doorway between the cab and patient compartment. This keeps passengers from getting into the patient module.
Customer service is all well and good, but patient and crew safety take priority.
Well, I can’t fault CCC for reading the tea leaves here and sensing that something was amiss – and he obviously got it right. That’s the bottom line.
I’m inclined to read each situation individually. Our service says that all passengers are at the “discretion of the crew.” This means that you can exclude them but if you piss someone off and they complain, they’ll come looking for your for bad decision making, and if you allow them and it goes badly – once again, “bad decision making skills.”
Short trips, I could care less. Anyone can ride who can get in a seatbelt.
One lady showed up at a doctor’s office with her sick child and three other children and then wanted us to transport all of them to the hospital when it was determined they’d have to go. No, there was no one who could come and take care of the children. We sent a second unit to transport her and the two of the other children while we took one child and the patient with us. We also needed the second ambulance for the bags and suitcase she had brought along with her. She knew EXACTLY what she was doing when she did what she did – that was clear.
I’m with CCC – one relative only and that only if you behave. No one in the back unless the patient is a minor female child or possibly a very young kid, though I can manage a kid better without Mama in the back babying him and second guessing all that I’m doing.
In the old CD First Aid era, “Rescue the patient from possible further injury,” includes sometimes trouble-making family.
I agree with CCC. Aside from safety and policy issues, the patient’s confidentiality comes before the bosses ego. I would have said no too.
Also, the boss sounded like a bitch – I would have said no just to piss her off.
Some interesting thoughts and comments.. Here’s my take:
http://www.medicsbk.com/2013/03/14/i-dont-like-to-take-riders/
“ma’am, don’t you have work to do upstairs?”