The Beginning

So after reading a blog I ran into a while back by "The Angry Pharmacist" (http://www.theangrypharmacist.com/) I have found that not only do I agree with many of the things he is saying, I have experienced a lot of the same people he deals with. The cycle probably goes in this fashion:

- The Angry Patient calls 911 because he is non-compliant with his meds
- The Angry Medic (That's me!) goes to pick him up. The Angry Patient gets upset that we can't give him pain meds, so he insists on being taken to the hospital.
- The Angry Medic Drops of the Angry Patient at the ER where he is treated by The Angry Doctor and The Angry Nurses.
- The Angry Patient leaves the ER and takes his scripts to The Angry Pharmacist where he gets all of them filled.
- The Angry Patient is non-compliant and only takes the pain meds. This results in him not getting better (n.b. you have to actually take the medications for them to work). He doesn't realize he is not getting better since he just takes more pain meds. One day, usually around 3AM, he runs out of pain meds early because he is taking too many, and feels that the end of the world is upon him. He reaches for the phone and...
- The Angry Patient calls 911 because he is non-compliant with his meds...
Rinse and Repeat.

Now don't get me wrong, I often go on runs where the patients are in dire need of assistance, but more and more these days we go on runs which are not emergencies. One of the departments I volunteer for allows some discretion on the part of the EMT in recommending non-transport, but the other requires transportation to be recommended to all patients. I understand this rule, and it was implemented to CYA, but now that our patients are abusing 911, the law needs a serious re-evaluation.

Looking at our run volume over the last 3 years, we have almost doubled our annual runs. Of course, as you can guess the tax revenue that funds us hasn't increased nearly as much. The other thing is that we're not noticing a proportional rise in the "Oh Shit Runs" vs. the "BullShit Runs." I get a lot more BS now than I did just a couple of years ago...

So a little bit more about me: I am a medical student who worked throughout college as an EMT and have put in thousands of hours in EMS. I am an EMT-Basic but have a limited scope of practice to practice advanced skills which allows me to ride as "in-charge" on the squad and give certain medications and do certain advanced procedures. This blog will hopefully serve as an outlet for my (and others') frustrations about the EMS system. I am big on advocating for one's patient, and I will NEVER get upset with a patient who actually needs my help; that is, after all, what I am there for, but this will be an channel for me to vent my frustrations on those who are not willing to be proactive in their own care and results in a burden for the EMS system and taxpayers who pay for it. I will always try to help a patient and advocate for them in their best interests, but when they have no desire to help themselves, or worse, purposely try to cause more issues for themselves, there is simply nothing I can do.

The stories I post on here will be true and accurate and told from my point of view. I say this because some of them are so bizarre that if the other guys I work with hadn't read the run reports, they would be sure it was made up. I'm telling you, I can't make this stuff up! I will also try and let some of the other guys at the firehouse contribute to this blog from time to time, but all of the stories will be verified. Yes, this shit does actually happen out there on a daily basis.

May God help us all,
-TAM