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/green__1]

in my jurisdiction they are also the only ones who can force someone to get care against their will.

[u/RJM_50 → u/green__1]

What! That's BS, here PD generally looks to us for that cue they're not allowed to refuse or leave. I'm just waiting for the magic words of an intent to harm, or a suspicion they have a Medical guardian and they're mine. (You can't sign? Then we're walking up these steps!)

But PD gets to force everyone who's been tased, suspiciously drunk, etc to get evaluated for their liability.

[u/green__1 → u/RJM_50]

here only a doctor or the police can force someone into treatment, doctors won't do it over the phone, and won't come to scene, so that leaves police, and they will only do it if they believe the patient to be suicidal or homicidal.

yes, that leaves a HUGE grey area that I absolutely hate between "competent to refuse care" and "formable"​

[u/RJM_50 → u/green__1]

That sucks, I work in a really good area where we can get a physician to call a patient in the field too. I know many areas that have to work every patient no matter how long they've been stuck to the carpet or how many limbs (and blood) are missing. It's nice for the medical examiner, Law Enforcement investigations, and the family when we can just get a time of death and allow the next steps to proceed, no awkward false hope or messing up a crime scene with all our equipment.

My first intubation was in an area like that. They knew she wasn't coming back, the medical examiner eventually showed up and was confused why I did so much work. They explained I was a rookie and needed practice. Everything was awkward about it, the lady hung herself after getting paid for sex by the homeowner, not sure if she wanted his wife to know, or what her toxicology would show for making bad decisions.🤷🏻‍♂️

[u/green__1 → u/RJM_50]

our protocol for codes is pretty good. for anything obvious, we don't need to call a doctor at all. Dispatch just has the medical examiner call us, for anything somewhat expected or were no foul Play is suspected, the family has to call a funeral home, and then we can leave. for anything where there are question marks or it appears suspicious, the medical examiner will come out, and we can leave once the police arrive. for codes that we actually run, we have a protocol for when we can discontinue them, again most of the time we do not require calling a doc. there are a few situations where we are supposed to call, but for the most part no medical consultation required.