The joys of living in a small town........had a patient who was found on the floor of his apartment, barely responding, unable to stand or sit up, unable to answer what day it was, eyes rolling back in head, apnea, in and out of consciousness. The patient lives alone with no family or caregivers available to stay in the home with him. Patient is end stage cirrhosis of liver. Phoned ambulance service for non-emergent transport to hospital. Paramedic comes in (happens to own the ambulance service, as well) and asks patient if he wants to go to the hospital. Patient can barely arouse but says 'no'. Paramedic says "call off the run, we can't take a patient if they say no." WHAT THE......???????
I got a little ticked (understatement) and said "He's barely conscious, he has fallen, he cannot adequately answer questions, and you think he's coherent enough to make that decision on his own????" Paramedic got a little ticked (understatement) and began to lecture about how it's false imprisonment to force a patient to go to the hospital, and I really need to calm down here......That's when I REALLY lost it (not proud of that, but it happened) and said "I wouldn't have called you if I hadn't needed you. He is not capable of making a sound decision at this point in time. We need to get him to a safe place." Paramedic then tells me "It's MY ambulance (it is, really) and I get to say who gets to ride in it. You can't tell me what to do." I looked at him and said "Well, walk out and I WILL report you for abandoning the patient." Then it got a whole lot uglier from there verbally.
Eventually I called in another nurse because I knew I had lost control of the situation and was not coherent myself
. She smoothed it out and patient was transported. Turns out he had overdosed on medications. I found out later there is a law in my state that says if a patient is incoherent, they are incapacitated and MUST be transported to a higher lever of care. I AM FURIOUS. Was I wrong? And should I just let this go or complain officially? Any advice appreciated.