Overruling captain!

[u/Ok_Assistance69]

Just getting opinions here. Other night we had a well known psych patient who’s not only know to verbally accost medics/hospital staff, but can get aggressive. Delt with her multiple times where our local PD had her cuffed, hands on a taser. On scene for the THIRD time that week same patient, different captain (not mine, was working OT) and I told this captain “we’re going to need PD” Captain replied back “THIS IS NOT A PD ISSUE” very loud and aggressively I might add. I stated “she can get aggressive” he replied back “SHES NOT AGGRESSIVE”and he denied calling PD. Once she was loaded on the stretcher, she started to become verbally hostile, then and only then did the captain call PD. Then I was instructed to go to my patient. She started getting verbally hostile with me. I was told to get in the engine at this point and the other medics would run the call. PD followed the medic unit to our local ER.

Now, we all learned “BSI/scene safety” right? I always thought it was a medics discretion if it came to safety. KC firefighter died over a psychiatric patient after being stabbed by her. Another psych call, patient flew out the back doors and ended up being killed by a semi truck.

Does anyone think this needs to go up the chain? I feel mine AND my crews safety was compromised by a captain with a superiority complex and this captain has been known for his temper. His behavior was unprofessional, unacceptable and unbecoming an officer.

Opinions???

[u/Sudden_Impact7490]

Speaking as someone who deals with psychs on a near daily basis. Law enforcement presence alone can escalate these situations from tense to hostile.

In the hospital anytime someone calls police or security it immediately goes downhill when they show up. If someone calls for them I will intercept and have them wait out of sight.

If you want them nearby - I get it, but keep in mind the effects they have on the situation when dealing with a psych or mental health issue.

[u/laeelm → u/Sudden_Impact7490]

This isn’t a hypothetical pt. This specific pt is known to be ‘hostile’ and ‘aggressive’. The question is about this specific pt. He was correct to get LE involved. In the hospital, you are not going down the road in a small metal box with a violent person by yourself. The hospital is a much more controlled environment than a moving vehicle. It’s easy to get away from a psych pt in the hospital. You just walk out of the room and wait for security. You can’t do that in an ambulance.

I think I would have to take this up the chain. At least to understand how to deal with this situation in the future. Because if a medic wants to call for pd but a supervisor says they’re not needed, is the supervisor now going to tech the call or am I going to have to be scared in the back of the truck by myself? Because I won’t do that. A good supervisor won’t tell you to do anything that they wouldn’t do.

[u/Sudden_Impact7490 → u/laeelm]

The hypothetical is going from verbally aggressive already on a cot to an active shooter.

Im aware of the differences between hospital and an ambulance having done both. The problem here is the armchair quarter backing.

As stated it's OPs call and I'm not going to fault him for making it. I'm just giving an alternative perspective having handled 17+ years of them

[u/Ok_Assistance69 → u/Sudden_Impact7490]

While I understand that logic completely, as a medic we are taught at the Basic level “BSI/scene safety” even if we have the slightest inclination a scene may potentially be an unsafe environment, we have the right to PD presence, or to not go into the scene at all and stage until PD arrives and deems the scene safe for medics. Unfortunately if it escalated the issue, that just means PD should have been there in the first place. At the end of the day, I have a family to go home to and I take ZERO chances.

[u/Sudden_Impact7490 → u/Ok_Assistance69]

Sure, but police also aren't trained in mental health. Which is why some places have stopped having them be the initial responder (they tend to shoot/kill these patients demographics)

It's your call. I'm just saying sometimes their presence will escalate violence, not deescalate or prevent it.

On a verbally aggressive person already on a stretcher with plenty of fire/EMS on scene I'm personally not calling. It really depends on the scene, the resources and the overall risk assessment. You have the ability to do far more, safer, for this person than PD can (Ketamine, versed, etc)

Overall, being situationally aware is important but its still a job where you face more risk for injury driving to and from calls than you do interacting with patients.

[u/splinter4244 → u/Sudden_Impact7490]

We’re not trained for mental health either, not extensively at least. OP cited a legitimate concern due to a recent KC medic that got stabbed and killed. These people are unpredictable wether law enforcement is present or not. I’m absolutely not going to risk my life even if there’s fire/ems on scene and I’m sure as shit requesting PD to at least check for weapons.

[u/Ok_Assistance69 → u/splinter4244]

This 👏👏👏

I wonder why this is common sense to some?

[u/Hosedragger5 → u/Sudden_Impact7490]

If the choice is between a violent patient getting shot or me going home at the end of my shift, I know what option I’m choosing. I’m not going to be some hero and risk my life for an unstable person.

[u/Sudden_Impact7490 → u/Hosedragger5]

We're escalating the call type pretty quickly

[u/Hosedragger5 → u/Sudden_Impact7490]

Yea, well taking it easy didn’t work out for the firefighter in KC.

[u/Sudden_Impact7490 → u/Hosedragger5]

How would police have changed the outcome of that call? They wouldn't.. they were on scene and it still happened.

Not every mental health call is a pink slip, so police aren't going to search every patient just because - especially in the days when everyone is hyper aware of unlawful search and seizures.

You can ask, but they can lie. How many CCW owners do you think get transported with nobody ever knowing? More than you'd think.

So absolutely maintain situational awareness and be vigilant, but no matter what sometimes flukes will happen. We have to acknowledge that is extremely far from the norm when viewing it from a macro personality.

Again, if you want to call I'm not saying you shouldn't. I would never judge someone for wanting PD on scene. There are times it's more than appropriate, but there are also times it will make everything much worse and I think this is where the Captain in this scenario was coming from.

[u/epicfartcloud → u/Sudden_Impact7490]

Because most of us don't work in a hospital.