You should know better if you’re a nurse

Code 2 for the fall. At McDonald’s.

This is going to be a great call. I can tell already.

A developmentally disabled 35-year-old woman was with a bunch of people from her group home along with some staff members when she tripped and fell. She appears to be fine; maybe she has some minor head pain, but nothing visible. The staff members certainly think she’s OK, and they want to bring her with them back to the group home.

Except the overeager McDonald’s manager called 911. Why are some people always so quick to call 911 without first asking the supposed patient while others don’t even bother to give a shit? Yes, yes, it’s probably company policy. Just like the stupid airline companies. Just like Wal-Mart, Starbucks, and all those other stupid store calls – usually falls – that we always go to. But c’mon – whatever happened to “Hey, are you OK?”

Now, normally it wouldn’t be such a big deal, except this group home did not have ANY relevant legal paperwork designating any authority for anyone to make medical decisions on this patient’s behalf.

We are always saying this: GET YOUR PAPERWORK IN ORDER.

OK, no big deal, I guess we’ll take her to the hospital. It’s an easy call.

Except the group home staff called the patient’s brother, who over the phone is already being a dick. He demands that we wait until he arrives so he can take her home. The rest of the call, over the course of 30 minutes, goes something like this:

“I’m her brother. I’m taking her home.”

“Do you have any paperwork?”

“No. I’m a nurse at <insert hospital>.”

“Then you should be plenty familiar with legal documents concerning medical decision-making.”

“We have it at home.”

“OK, but you don’t have any paperwork physically here with you.”

“You can’t hold her here.”

“Can you even prove that you’re her brother?”

“I’m her brother!”

“You can’t take her without showing us some paperwork.”

“She doesn’t want to go to the hospital. Ask her.”

“She’s not exactly what I would call competent as far as decision-making is concerned.”

“That’s up to a judge.”

“Without a judge here, it’s up to us. Are you seriously trying to tell me she can make reliable decisions?”

It turns out, after he calls some other family member, that the “paperwork” they “have at home” isn’t even anything that is remotely relevant. So, in other words, they have no paperwork.

I think on a different day, I would have taken the easy route and let him take her home, since he clearly is interested in her well-being and is likely her brother. But because he is being such a douchebag, I’m feeling a little more interested than usual in following proper procedures, black-and-white procedures with no allowance for common sense that could easily be used to hang me out to dry, probably 4 years from now.

Besides, he should be happy we’re not going to turn her over to some Joe Schmoe sex offender just like that.

So I call the base hospital.

Usually, base physicians are terrible with EMS policies, especially those regarding disposition options, and what street-level medical care really entails. I’m fully expecting to eat crow in front of the brother and I’m totally expecting, “Eh, just let her go with her brother, you stupid ambulance driver.”

Not this female doctor. She apparently is familiar with everything there is to know about dealing with a family member’s refusal on behalf of an incompetent patient. In fact, she is even more interested than I am in following procedures properly, and legally.

At one point, I hand the phone to the patient’s brother, who continues to be a dick, even to this doctor, to whom he is speaking for the first time, much like the way he’s been a dick to us.

She patiently talks him down, just like we did.

He finally gives in.

Conceding defeat, he softens his attitude.

“Sir, please arrange to get her paperwork handled properly.”

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