I’m Disgusted and Disturbed

[angeloublue22]

I had an event happen last night that completely disturbed me and I haven’t slept because of it. I’m using this forum to unload and possibly help. I work a psych hospital as an admissions coordinator. I obviously can’t give a ton of details. We accepted a pt from an ER that was supposedly medically clear post drug OD.  Pt was calm and cooperative the entire time there. After transport via Sheriff left their facility. Nurse called to warn me that when they tried to get the pt in the car, the pt fell to the ground and started thrashing her body. They called it behavioral and forced her into the vehicle. Sheriff pulled in after an hour drive and told us he can’t get her out because she's “faking sleeping and even snoring” within 2 seconds I recognized it wasn’t snoring, it was stridor breathing and she was is resp distress: sats in the 80’s, pupils pinned and not reactive and unresponsive, lung wheeze inspiratory and expiratory. 

911 was called and I told them this a true emergency. EMTs arrive I tell them my report and they completely ignore me and sternal rub the pt she grunts but becomes unresponsive again. They see her pupils and confirm what I saw. Then they proceed to scream at the pt and drag her/jerk her out of the car telling her to stop faking it while hitting her head repeatedly on the car roof. Once they get her out she falls to her knees and they are yelling for her to get up and stop trying make it hard on them. Then said fine we’ll do it the hard way. I keep trying to tell them this a true emergency but they pretend I’m not even there. They man handed her on the gurney flipping her limbs around like a rag doll, insulting her. I kept trying to stop them. It was the most horrific tx of a pt I had ever seen in my almost 14 years of nursing. We found out that the hospital had to immediately incubate her and now she’s in the ICU. 

I’m actually having trouble going back to work or ever calling 911 again. I keep thinking about it and I’m sick. My co-worker who was also there is having difficulty dealing too (10 yr ER RN). Obviously, our administration is in uproar and contacting CEO and administrators or the transporting hospital and reporting the EMTs. I have seen blatant disregard for the medical safety of mental pts but never this bad. I’ve also had a lot of struggles with bias toward psych nurses too as we are treated like we don’t know what we are doing and frankly I’m tired of it. I’m not angry for myself, I angry for my pts. I know people are burnt out and psych pts do require different strategies to care but they are people and psych nurses are still nurses with a medical education and experience. That is all you can delete if this is too much info but it helped to write it down. 

[CKPM2RN, ASN, EMT-P]

Hearing the chain of events, I would think it likely that she:

A. Didn't want to go to a pych facility.

B. Had a little extra stashed in her belongings which she consumed all of because she knew you would take it away. 

Neither of these things even slightly excuse what happened. In fact, when I think about it more, I think she downed her stash before she left the ED. I mean it's standard for medical clearance to include knowing that the opiate is no longer a threat and no further narcan will be needed. 

 

16 hours ago, Leader25 said:

From my experience,I found emts rude,condescending to whatever nurse is there trying to give some type of report.This was same on the street as well as in an airplane removing a sick passenger.They would not listen to whatever was explained to them.Just grab and go.

I'm sorry that was your experience. If they are awful they should be reported. I was a Paramedic for almost 25 years before I became an RN, I always considered PMs and RNs as a team and gave them the respect that I expected. I do hear horror stories of course, and this thread outlines one of them.

[JKL33]

On 11/28/2021 at 2:52 AM, angeloublue22 said:

Ditto on so much of this. I'm one of those nurses that doesn't take crap from them.

There are a lot of very conscientious EMTs out there. I've also run across some who seem to mostly like the idea of the role (adrenaline junkie type, for lack of better description). They have little knowledge and instead spout off versions of things they've heard medical professionals say in other situations, not even knowing whether the situation is actually similar or not. That's my guess about this scenario. They are, at baseline, inept (and immediately behind that, cruel). They saw something, they have zero skills to assess anything, and so they threw out the whole "faking" thing.

I've seen nurses do it, too, sometimes due to novice status and lack of experience to consider a wide differential, and sometimes just inept nurses who have had enough opportunity that they should know better. I was once training someone who triaged an ED patient in pain and change in respiratory status (and it was a mostly very classic presentation of a certain condition) and walking with crutches. After hearing the story I asked what might be going on with patient and the ONLY response he (orientee) had was that it was very suspicious that the patient was walking with crutches and he thought the guy was "faking." Well....the patient had crutches due to a fractured ankle. And lost his balance and fell sideways while walking with his crutches, striking his torso on the coffee table. He told this entire story in triage, it isn't like I even had to sleuth it out. So I'll leave it to people to guess what was causing the pain and change in respiratory status....

People don't often say "faking" when they know what they're talking about. Even if they think there is not a physical cause for the presentation they use words more appropriate to the situation.

All of this is first and foremost: Idiocy. Extremely poor knowledge base + stupidity on top of that.