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On The Need For Hazard Pay, Part 15
Bad Behavior, Bizarre, Emergency Services, Georgia, Revolting, USA | Healthy | March 10, 2018
CONTENT WARNING: This story contains content of a medical nature. It is not intended as medical advice.
(I am a brand new EMT; I’ve had my license less than six months. I am working for a non-emergency transport service that specializes in psych patients. I go to a hospital to pick up a patient going to a mental health facility for a court-mandated 72-hour hold. The nurse advises me that the patient tried to overdose on some pills after a family crisis, but has been calm and cooperative since being in the ER. My partner and I introduce ourselves to the patient, get her on the stretcher, and load her into the ambulance. I begin to assess her.)
Me: “Do you have any pain anywhere?”
Patient: “Yeah, my stomach is hurting from my cycle. Can you give me anything for that?”
Me: “No, ma’am. I’m sorry, but I cannot give medications.” *pain medication is not within my scope of practice*
(I finish my assessment and start on my patient care report. All the while, the patient continues to complain about her pain. I advise her that I will tell the receiving facility about it as soon as we get there so the doctor can give her something, but in the meantime I get a heat pack out of the cabinet and give it to her with a towel. At about the halfway point of a two-hour trip, the patient announces that she has to use the restroom.)
Patient: “I have real bad diarrhea and I need to go now.”
Me: “Well, I don’t have a bedpan, and we cannot stop, so I need you to hold it.”
Patient: “I can’t hold it.”
Me: *to partner* “Hey, we are in [Town], right? I need you to divert to [Hospital] so I can take her into the ER. She needs to use the bathroom.”
Partner: “Can’t she hold it?”
Me: “She said no, and I would rather not have to deal with the smell.”
Partner: “Okay.”
(We get another five minutes down the road and the patient manages to slip out of all restraints and stands up.)
Me: “Ma’am, I need you to sit on the stretcher and put your seatbelts back on. If we were to get in a wreck or if my partner made a sharp turn you could be hurt.”
Patient: “I can’t hold it anymore. I’m going to s*** my pants.” *begins to undo her pants*
Me: *to partner* “Hey, pull over. She is off of the stretcher and she is about to s*** on the floor.”
Partner: “What?! Put a sheet down first.”
(As I put a sheet down I plead with the patient to reconsider, to no avail. The patient proceeds to force herself to defecate, urinate, and menstruate on the sheet. She does not have diarrhea and definitely could have held it. After the patient finishes, she uses her clothes to wipe herself and sits back down, half-naked, on my stretcher. I cover her with a sheet, re-secure her belts, turn on the exhaust fan, and try not to breath any more than absolutely necessary.)
Me: *to partner* “Hey, I need you to get there fast; I can’t take this.”
(For the next thirty minutes, the patient sits silently on the stretcher. When she realizes her previous attempt for pain meds was unsuccessful, she decides to up the ante.)
Patient: “My stomach is still hurting so bad. Can you please give something now?”
Me: “No. Like I said before, I can’t give pain medications.”
(The patient goes on a rant for several minutes before becoming silent again. Just when I think we might get to the destination without further excitement, the patient puts her fingers in her mouth and causes herself to vomit all over the floor.)
Me: “Seriously? What makes you think this is helping your cause?”
Patient: “Why don’t you just give me something for pain?”
Me: “I am an EMT basic. I can assess you, take vitals, and do CPR. Only a paramedic can give pain medications, and they still would not give you any, because menstrual cramps don’t qualify for narcotics use.”
(The patient continues to complain, but we have no further trouble until we get to the mental health facility. The patient tries to beat up the orderly after they tell her she will have to be seen by the doctor before she can get anything for pain. As we are decontaminating the truck, my partner looks at me.)
Partner: “I have been in EMS for 12 years, and I have to say, that was a first.”
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