the life of an overnight medic

So it is interesting. There is a difference between working a day tour versus working an overnight tour. Heck, even working during the day, there’s variances between morning and evening. On overnights, there isn’t always as many crews on as during the day. I personally have also seen more interesting interfacility transfers happen late at night, or at the very least into the evening hours. Just last night, I had a patient that medically should not go via ground ambulance because hitting all of the bumps and pot holes could very well cause his condition to get worse quickly. Through talking with the doctor and advocating for the patient’s safety, the patient was ultimately sent via helicopter to a different hospital that can best serve their needs.

This patient wouldn’t have been the first that I have taken that would be classified as critical, had I taken the patient. Sometimes, the right thing to do for the patient is to refuse the job, or turn right back around because their medical status hitting the crapper. Sometimes doctors want a patient sent out because they are too unstable and don’t want the negative statistic on their clock. That unfortunately puts a burden on interfacility EMS when we ultimately have to take the unstable patient and do our damn best to keep them alive against all odds.

But what happens when the patient’s status turns bad and they do not survive the transport? Fingers get pointed. A lot of times, the focus may be pointed towards the EMS crew as to what we did wrong that the patient did not survive. There needs to be a culture of change similar to what we had yesterday where there was an active conversation between the MDs and EMS regarding the patient’s best interest and how both sides can fulfill this need.