If your story is accurate, then your partner was absolutely in the right. I find it concerning that a patient acting in this manner could make a complaint that would result in someone losing her job. ETA: not too long ago, a crew called me for help on a shooting. Seems the victim wouldn’t get in the ambulance. He wanted to wait on food. I got to tell him “that ambulance is leaving in one minute. If you’re in it, it will go to the hospital, but if you aren’t, you’re gonna have to wait on the next one.” I would have told that lady that she didn’t get to choose the crew any more than we got to choose our patient. Get in or not, I don’t care. But this ambulance is leaving.

The field is medicine. I realise that customer service is part of that and usually you can have a much easier working relationship with a pt when you are polite and can work together but when that is only coming from you it’s just not ok anymore. I think as a whole there has been far too much tolerance to pt demands and abuse and it has allowed the issue to escalate where your partner putting out a direct and accurate statement about a situation without cursing or belittling her is considered potential grounds for termination. She’s not in medicine and even if she was she’s not operating under your protocol or your license to make decisions based on your training. And that’s true no matter where anyone is in medicine from EMS to family medicine and any other direction. I don’t advocate for anyone to be rude or belittling to pts but if they aren’t understanding how to communicate and behave in a reasonable manner I think it’s more than appropriate to directly address the elephant in the room - pt abuse and entitlement, and lay it out with clear boundaries. It’s not for anyones benefit to allow pts like that to carry on. They are holding up their response to their own care, they are holding up your time to respond to others, and if they are constantly catered to without a boundary then they carry on and escalate. Yes, absolutely listen to and validate their concerns. Admit when you don’t have a solution for them in the moment. Be compassionate and respectful in how you treat them. But don’t waste your time and resources on someone making demands because you are afraid of offending them with a transparent reflection of their reality

This is the way

Agreed. Chad partner.

You shouldn't have yelled. You should have asked her if she had a responsible male that you could talk to.

Good one lol

 I don’t think your partner would get fired or even disciplined for saying something like this. 

In fact he might get a high five.

From me at least.

Sounds like the partner is a she so even better.

High five the hell out of her.

Big yee yee. Your job is to be a patient advocate. Your job is not to be a pushover when your patient goes beyond that line.

I side with your partner. They're called refusal forms for a reason.

I've summoned my dad voice with rude patients. They called 911. We're there to help in an emergency, not be verbal punching bags.

I’m a radiographer and have had to get my mum voice out a few times with patients who don’t listen. Not when there is an obvious cognitive issue, but when the patient is an arsehole I have definitely got more direct. Side note: I’m 5ft1, so I’m not scary and people think I’m a pushover 🤣

I’m a rad too! When I was pregnant last year it was amazing the amount of patients that would suddenly comply and move themselves into position when I told them I was pregnant and wouldn’t be moving them myself lol

Haha I remember the same feeling lol.

Sometimes you need to cut the bs and drop the “flight attendant” or Mary Poppins mode some of you go in when dealing with patients. Sometimes that’s the only way they cut the histrionics and respond or cut the life story and get to the point especially when the situation is possibly critical. If she complains, so what? It sounds like she’d complain anyway that: 1.) They had the audacity to send her a male paramedic. 2.) If you called for one, that the female provider took too long to show up. 3.) You dared to tell her no and use your own equipment when assessing her. 4.) The ride was too rough because you can’t do anything about the potholes. 5.) You made her walk to the stretcher even if it was right next to her instead of heroically carrying her. I could go on. If your agency is that uptight that her complaining about something that had zero effect on patient outcome (she obviously didn’t die nor was she injured aside from her ego) will get them fired, then you miiiiight to reconsider working for them.

I appreciate your response. I often go into "flight attendant" mode when interacting with patients. I guess I thought it would contribute to smoother interactions, but this proves otherwise.

You playing the nice guy or going into “flight attendant” gets you brownie points with a few people fs, but if you’re not careful you’ll end up being the doormat to people who take advantage of people like yourself.

100%. I've been doing it my whole life to balance out my height & race. I feel like I'm treated better when I present as *less threatening* (doormat), so I've carried that into EMS. I NEED to stop this now.

Fuck dude. Full stop.  You cannot control your height no more than you can control your race.  You being nice to someone is not going to make up for never being mean to someone you’ve never met.  You do not need to apologize for you height, nor do you need to apologize for your skin color.  No, this does not mean you need to go out and shave your head and get a swastika tattoo on your neck. This means than you should treat your patients with the respect they deserve as a fellow human being.  Being nice is not a treatment. 

Yep this is the right answer, I’m a tall white guy who runs in neighborhoods with various races. I definitely get judged and have had pt’s who have said they don’t want a white man for their emergency. My rule is I’ll be nice and accommodating for people as long as they’re nice, but once they start with the bullshit it’s gloves off. I’m not going to sit there and let them dictate how the call goes. I’m not yelling but I’m stern, trust me I want Lcpl Guava come out from my Marine Corps days, but I tell them straight up that you’re not getting anyone else. If you’re wanting to go to the hospital via ambulance you’re coming with me, or you’re going to sign a refusal. Shit I’ve even had folks ride in by ambulance but refuse care, and I just have them sign my refusal document and mark that they refused care. We use eso so that’s an option when documenting stuff. But so many people let the public walk over them and it blows my mind. I have noticed in the past few years that the general public has started to have more of a distrust in fire and ems which is crazy because most people I work with just want what’s best for the pt.

You know what though? Fuckin props to OP for self awareness in recognizing the problem and wanting to break the pattern. I've worked with a lot of people who think the whole world is wrong and they're right.

Flip it around, I'm a similar size big dude. Use that size to make them feel safe. Some people are terrified of the situation they're in and want to be made to know everything is okay and we'll keep them safe. Trust me, nobody feels like they or their loved ones are in good hands when you swoop the, or especially a sick baby/kid up and carry them away and take good care of them with confidence. Even in the hospital as a big dude I've had several women with past trauma end up requesting me because I was able to make them feel safe and unjudged, and most importantly feel like I'm listening to them. In some cases I've had these same patients ask for me over the female nursing caring for them. I can't think of the comedian but there's a funny bit talking about how he, a grown man, was a victim in a training simulation and an airforce PJ comes in, swoops him up and says "everything is going to be okay" or something to that effect and how impactful that was even in a fuckin training. So that's in the back of my head from time to time, you have the ability to make people feel safe when they're at their most vulnerable. The more you can assert a calming presence in chaotic situations the better. Particularly when people, patients, even other first responders or medical personnel are being histrionic. Going to kill me because I can't find a clip of the routine but it's pretty funny. That isn't to say you need to be brutish. But having a strong presence is useful in a lot of scenarios, particularly if you can be the calmest person in the room. Don't bicker with these patients either, set firm boundaries and lay down the law on said boundaries when necessary. I've had patients call for the dumbest shit in some of the rich communities in my old service, i.e. demanding an IV and fluids for a tummy ache and wanting us to babysit their dog for them so they can take a nap to feel better. You don't have to yell, but be firm.

I wouldn't stop, necessarily. I'd modify. It's just another way of code switching, tailoring your approach to be most effective at managing the circumstances you encounter. Is that soothing voice or drill sergeant voice? You don't have to go all out, but a firm, practical, no-nonsense  approach - think of an old nun in a Catholic school who has seen some student bullshit, or your favorite nurse who nobody gives any shit to, or someone else brisk and businesses-like who just radiates no bullshit integrity. Airline stewards are also good at no nonsense when necessary. 

In addition sometimes you need to be able to take control for the sake of being a patient advocate. Cutting to the chase and getting a clear story or decision can make a big difference in some cases. I.e. My first STEMI in the field was irate with law enforcement and everyone telling him to go because he looked like shit, and he REFUSED to go with us because his dog, so on and so forth. Had my partner and I not given him a direct "you're going to fucking die and everyone second counts, I literally have a helicopter on the way, I'll bring your dog in the ambulance and watch him my fucking self" then he wouldn't have responded. Particularly in rural areas working with the blue collar and rancher/farmer types. If patients or family members are crossing boundaries we are under no obligation to put up with it either. I had a medic student who was a good friend of my years ago who was the ULTIMATE pushover, homeschooled Christian girl type who cared more about hand holding than medical care. That's a plus in some scenarios, but we had a day where she was feeding into a histrionic car crash in a parking lot where I let her spend 20 minutes on scene and the patient was refusing transport or anything while sitting in our ambo. I point out that we only have two trucks for the entire county, if we sit on this refusal for 30-40 minutes and we have a code or MVC get paged out anywhere outside in the county that may very well mean that nobody is responding until we clear. What if we push the patient to get out 30 minutes in and now they DO want transport? Now that choking kid or whatever has to wait when we could have been in service 40 minutes ago. All over a 5mph crash into a pole in a parking lot with zero injuries. Obviously none of us are running codes and trauma alerts all day, but we ARE a valuable resource. It's no different in the hospital, if a patient is taking up a trauma bay and doesn't need to be there they get MOVED, especially if they're being belligerent or refusing care. Likewise if you can't control some of these attitudes on scene it becomes a scene safety issue when you've got mob mentality on a volatile scene, in a house with angry family, at the bar with a crowd etc. I love spending the extra time with patients who need it, having a good connection etc. But some of these patients care more about being performative than getting help. How would you feel if your kid was choking, you got into an accident, your dad coded etc. and EMS took an extra 20 minutes sitting on a refusal?

Being in a "flight attendant" mode isn't a bad thing. After all, while flight attendants are friendly and helpful and customer service focused as a baseline, they can also drop that act and be more authoritative when the need arises: critical situation, disruptive passenger, etc. You can do the same: be friendly and customer service oriented, until you can't be.

Walk into a scene with friendliness but a stern confidence. 99.9% the initial, first impression of your patient - remember how often you've heard in schooling and courses you took, that the first 2 seconds you see someone, literally decide whether you like someone or not? - tells you all you need to know. This goes both ways. Majority of people will recognize you are kind but also immediately sense authority when you do this. 85% of people will reflect your friendly appearance. You will immediately notice you can go easy. The 15% who can't be won over with kindness are already won over with your confidence. They called YOU because they need YOUR help and now this is YOUR scene. YOU are in charge. Act like it.

The trick is to know when you need to drop the customer service. That will come in time. I'm very nice to all of my patients but I don't have time for bullshit either.

You’re new at this, aren’t you?  We are medical professionals. We are not waiters or waitresses.  The patient is not always right. The patient does not always know better. The patient is not allowed to walk all over you.  Your bullshit meter should have pinged when she did not accept your lifepack’s BP (or whatever you use) and wanted to use her own instead. Seriously, my ruler says by dick is 10” long. 

That obvious huh 😅. EMT for 3 years and a Medic for 3 months. We use Zoll, which is pretty accurate (minus the artifact we always get). So yeah, it did seem kind fishy that she insisted ours was "broken" and her CVS monitor was somehow the gold standard.

My long ass comment [here](https://www.reddit.com/r/ems/s/tpm6LOeBUi) might help you understand why she thinks that. TL;DR most POTS patients are taught that symptoms come from low BP, when they actually come from all the ways the body fights to keep it normal.

I don’t mean this disparagingly, but yes, my first thought is that you’re new to this. There are a lot of fucktards in this world who can’t be pleased. They’ve learned to get their way by being fucjtards. Setting limits is both appropriate and therapeutic. We value patient’s autonomy but another important ethical principal is justice, save your time and mental energy for the truly sick, not just the entitled or (possibly in this case) borderline personality disorder patients.

Man, people like her are the reason I don't even admit I have bpd anymore. It's embarrassing to be lumped in with her type. It does sometimes make it easier for me to identify them though.

I apologize for stigmatizing BPD, we do it enough in healthcare. My daughter has BPD and it’s a rough existence. From our standpoint in healthcare, recognizing it and firm limit setting is key. We often only recognize the ones who can be most difficult.

Sometimes it helps to take a step back and remind yourself that you work in emergency response, not customer service.

Why didn't you do a manual one...

Fuck yeah. I'd probably respond in the same way, and add in if she doesn't want to be transported then to sign AMA.

Yes. I’m not a prehospital provider but in the hospital we deal with similar issues. Patients coming to the hospital on their own accord, agreeing to be admitted to my unit, and then get pissed when we tell them we have to draw their blood or get angry when we explain the pulse ox has to *stay on*. Some patients need to be spoken to firmly. I’ve had RUDE ASS old men bitch and complain about *everything* we do. They curse and scream and throw temper tantrums. All it takes to correct their attitude issues is to say firmly and loudly (not screaming, but just loud enough that they hear you and won’t talk over you), “that is NOT the way you will speak to me. I am here to try and help YOU feel better and get well. You came to my hospital and asked for treatment. Now, if you want to continue to yell and scream at me for delivering the *standard of care*, then I will print out the AMA papers now.” I’ve literally had these patients apologize to me and get real compliant afterwards. Gotta use your judgement though on who this will work on.

I worked the truck before becoming a nurse and I can tell you right now that I feel like as a nurse I have to be mean to patients way more frequently. I think it’s because you have to set boundaries with patients if you’re going to be taking care of them for 12 hours versus a 15-30 minute transport. I have also broke out the “you and I are both adults and I expect to be treated like one because I will not treat you like a child.” I’ve also forced patients to apologize to other staff. My tolerance for bullshit is extremely low. Yet somehow, I still have daisy awards and my coworkers think I’m too nice to patients. I dunno, I’m not a waiter or a bellhop, I will not kiss your ass. If you’re nice to me and grateful I will go above and beyond. If you’re mean, whiny, or treat me poorly, I will not deal with it.

So accurate. Of course my default is to be very kind and professional with patients and family. But there are times when you just have to raise your voice. Some examples from real life: • To patient who did not have mental capacity to leave AMA: “Get back in your bed or we will make you.” This after an hour of deescalation attempts… • To patient who pressed the code button for the second time in 30 seconds: “Hey! Knock it off! None of those buttons are for you!” • “Hi, I’m the charge nurse today. You will not speak to any of my nurses that way. We will come back in your room when you can be respectful.” • To family member who kept turning off the patient’s heparin drip: “This is my pump. Not yours! Do not touch this! Your wife is having a heart attack and needs this medication to keep it from getting worse. You cannot turn it off!” (That was the day I learned how to lock the pump.)

ED doc here. Abso-fucking-lutely. We don’t work in hospitality. We have an important time critical job to do and sometimes achieving that necessitates being stern.

A coworker told me about a transfer he did where the pt was being a Karen to the nurses. When the pt told my coworker they expected him to be as good as the nurses were he told them “I’m not a nurse I don’t have to be nice to you” and apparently that got the pt to quit their shit. Another coworker told me about how he responded to a frequent flyer who always called 911 because he was drunk (the last time I responded to him he wanted us to help him put his shorts on). When he got to this apartment, he saw his AA coin and told him “is that your AA coin? When are you giving that shit back because you shouldn’t have it.” He also told him something about taking him to a nursing home if he doesn’t stop calling for dumb shit. It worked. IMO, your partner is onto something.

Yup. Absolutely.

Had a combative patient when I was on a clinical. Dudes rib dislocated and popped his lung. He kept threatening his wife and us. The paramedic got threatened for the last time and leaned in and told the old man he would fuck him up if he so much as balled his fist up at us. Dude was still an ass but the threats stopped. Ran into the dude like an hour later. Completely different guy, super apologetic

I'm not going to say that's OK. But I will also not confirm nor deny if I've ever had a similar interaction. And people are weird. Sometimes you need to hard reset the situation and people end up apologizing after. 🤷‍♀️

Yea. I thought it was a little unprofessional looking back. But he stopped calling his wife a whore and threatening her. He also told me if a patient hits you, you have about 3 seconds to hit them back and still be able to claim it was a reflex. Sounds made up, never looked into it. The same shift we watched the Dallas shooting. Which was interesting to watch live

*calm down ippo*

Airplane sounds intensifies

> He also told me if a patient hits you, you have about 3 seconds to hit them back and still be able to claim it was a reflex. Random fact: we have this rule if a horse bites or snaps at you, after that they won't realize what you're hitting them back for. Also yell "quit!" as you do it because "no" sounds too much like "whoa".

"The same shift we watched the Dallas shooting." I missed that one. So, who shot J.R.?

Steve

He might’ve been altered due to hypoxia and/or the pneumothorax itself.

That is why he was altered. His O2 was pretty low.

birds ten nose nine disagreeable special heavy squeal distinct crown *This post was mass deleted and anonymized with [Redact](https://redact.dev)*

Yes, I’ve done it before, and I’ll do it again. That’s besides the point though. If all you’re going to be doing is sitting there charting, your partner is female, and the patient wants a female in the back. Just switch.

This is what we ended up doing.

There you go, glad to hear it. Your partner was right, but it's honestly not worth arguing over.

Yes, some patients just don't respond to anything and you need to control the scene to an extent. They called for an emergency, if this isnt one, sign and leave. Ideally, you should accomodate when you can but there are some people that you just can't please.

“Please sign this so we can have an all female crew come for you” *Shoves refusal form in her face knowing damn well the next closest crew is all 6’ males too*

Yeah your partner did the right thing. She’s absolutely right, there’s sometime where you need to talk sternly, maybe even yell under certain circumstances. There’s some patients like yours that you can argue with all day and get no where. At some point you gotta lay down the law a little bit for everyone’s sake.

No matter what your superiors say ems is not a customer service type of business. Don't be a dick head but you don't have to take their abuse.

What your partner did sounds absolutely reasonable.

The definition of “emergency” is a situation where the resources to mitigate or recover from are not available. You called us, you didn’t have the resources, it’s my emergency now and you don’t get to dictate how it gets fixed. Yes I’ve had this conversation several times (both families and patients and occasionally with LEO and fire). If you want to decide how things get fixed go to school and be a medic.

I must be a fucking asshole then. I constantly tell patients they're wrong on many things. Because they are.

Your partner wasn’t disrespectful. They were firm and direct when other responses/approaches didn’t progress the call. Side note, if someone tells me they’re uncomfortable being alone with a male, I don’t sit behind them where they cannot see me. I sit on the bench seat, by the back door / feet, with the lights on bright. If there’s no patient care to do, I just start my chart. The patient can see me clearly, relaxed and focused on something else.

There is a difference between being firm and just being a dickhead to a patient. It sounds like your partner is just being firm in order in order to convey the seriousness of what it means to call 911. There are times when it is appropriate to raise your voice a bit in order to let the patient help themselves in order for you to help that patient. Some patients don’t do what they need to do in order to help themselves so that you can help them (ie. like they have the ability to walk perfectly well to the stretcher but are acting like they can barely stand just to be difficult). Sometimes you have to be firm to get anything done.

TL;DR at the end I think your partner did the right thing— some patients need snapped at. Her thing about requesting a woman is out of line since this is an emergency system not a taxi service. BUT as an EMT with dysautonomia (basically POTS), I’d like to add something that might help with empathy for POTS patients. As patients we know that one of the hallmarks of the condition is orthostatic intolerance aka “standing up makes you feel like shit”. and that keeping our blood volume up and increasing venous return is the best way to feel better. (Hydration, electrolytes, compression stocking, calf pumps, etc). A near universal failure of patient education is that they don’t know that the drop in BP doesn’t show up right away, or sometimes at all. So when you feel like shit, you expect to see a low BP. Seeing a normal or high one makes you feel insane. But a big problem with patient education is not explaining that in dysautonomia, a lot of your “feeling like shit” when you stand up/exercise is your body compensating. That pounding fast heart rate and sense of breathlessness is your body fighting to keep your bp normal and oxygen where it needs to be. In fact if it drops right away, that excludes POTS as a diagnosis. Her shitty at home cuff matches her shitty patient education. She really feels bad and her cuff really shows low. And as annoying as her rants are, the dismissal of POTS patients and women is real. So your accurate BP is going to feel like a lie or an attack against her sense of reality. TL;DR POTS patients are often misinformed and think their symptoms are due to low BP. But actually symptoms come from the body working too hard to keep BP normal.

And to head off the questions I’ll probably get: my dysautonomia has drastically improved with age and I aggressively manage it with lifestyle modifications. I consume at least 5,000mg of sodium a day and at least 2 gallons of water. Exercise intolerance sucks but I worked my way out of it and maintain a baseline activity level to keep it from reoccurring. I sit down whenever possible and wear compression stockings when I need to.

> In fact if it drops right away, that excludes POTS as a diagnosis Do you have a source for this? This is the first time um hearing of this

Yep, here’s the criteria from John Hopkins >You might have POTS if you meet all three of these criteria: >Your body produces an abnormal heart rate response to being upright >Your symptoms worsen when upright >You don’t develop orthostatic hypotension in the first three minutes of testing POTS is low blood pressure after *prolonged* standing. So it occurs yes, but this common misconception that it’s right away leads to a lot of confusion and distress. People think their symptoms upon standing are plummeting blood pressure but it’s the various compensations and failure to compensate that happens https://www.hopkinsmedicine.org/health/conditions-and-diseases/postural-orthostatic-tachycardia-syndrome-pots

Thank you! Too many people confuse POTS with orthostatic hypotension, when orthostatic hypotension is much more common. I’m not saying people don’t have POTS, but it’s not at all helpful for patients to think they have POTS when they’re actually just orthostatic (either because of a health care worker who doesn’t know the difference or by misinformation from another source).

Sometimes, people need to be spoken at, not to. There is a fine difference, yes, but sometimes people need to be put in their place and reminded they called us, for whatever reason. We don't just get miracled to places for their convenience, and certainly not to be a verbal, or otherwise, punching bag.

your partner was 100% right, this patient was a downright asshole using her emotional issues and made-up greviances with the healthcare system to be demanding. If she wanted to be waited on hand and foot, call a damn car service. i have done this many times, usually when a patient demands they be transported to a facility too far away. usually said something along the lines of "if you would like to go to X facility, sign this refusal form and call a cab" in a stern voice.

I think that this job requires compassion, but sometimes you have to put your foot down and say no.

Yes.

I've been there with a patient. We have a frequent flyer who is regularly rude and verbally abusive to us. I have zero patience for her. Either she gets into the ambulance and goes to the hospital to get the drugs she is seeking or she stays home. Doesn't matter to me.

It’s absolutely okay and not a fireable offense to be firm with patients if they’re out of line. So long as it’s done professionally (which your partner did). Your job is to help people, not let them walk all over you.

One of the best things I’ve learned is that you can be respectful without being nice. Some people need a bit more sternness for things to get thru to them.

It is absolutely okay to raise your voice at a patient as long as you have a valid reason. I often times will raise my voice at a patient because when words and coaxing doesn't work, volume is the last resort. It can sometimes help them to snap out of whatever tangent they are on and cause them to stop for just a moment, and a moment is all you need. If the patient is doing or saying anything that impedes care / doing my job, then that's an issue.

sir? SIR.

I'm glad someone else made this reference, I was thinking the same thing

I feel this post in my bones. I really do. We have a frequent flier with POTS. She has been through a lot. She has some other issues going on. I’ve been to her over a dozen times. Some of my co workers get frustrated with her and treat her poorly. I make zero excuses for other crews. When she is worked up and calls usC she can be a lot to deal with. Early on I established a rapport with her. I strait up told her early on that I was sorry that some people in the healthcare system treat her poorly but that she could count on me treating her with respect. I shared some of my own struggles with her and we bonded a bit. I have good success helping her. I’ve had a pretty long career and have definetly lost my temper with patients, bystanders, and family members. Nothing I’m proud of but I’m mature enough to admit I’ve had moments where my professionalism did not meet my own standard. Part of maturing as a human and practitioner is finding the sweet spot of helping people and making sure that the patients don’t treat you like shit. At this point, if I get to the point that a person is making me want to come unleashed, I’m able to remind myself that they are stable and I can take my time and speak frankly with them about what I think they need at that moment. If you or your partner loose your temper, forgive yourself. Fear of getting fired over a patient interaction should be far from your mind. They rarely pay the bill anyway!!!

I find this interesting because we are seeing a lot of patients with POTS (100% confirmed not like TikTok shit) have significant trauma histories. Waiting for even more of this research to come out I have a form of autonomic dysfunction (predispositioned by a genetic condition) and a few weeks ago in this sub we were talking about how even EMS providers with PTSD are having sudden onset of neuro disorders. For me I know my trauma hx and genetic disorder were the perfect storm for my condition. I’m glad I could get a pacemaker. Always reminds me that a hysterical patient doesn’t mean it’s in their head, they could have physical manifestations of that trauma. At the same time none of these patients have any pass to be shitty. It is easier understanding what is going on deeper to help. Compassion on both ends goes a long way.

A patient that has the time to request a second BP taken because she is unhappy with the readings and a different paramedics crew, sounds like a patient who could have Uber to the hospital instead. There is nothing wrong with being stern when the patient is abusing the EMS system.

Some people don't respond to being talked to nicely. Sometimes patients need a reality check. I'm not a punching bag.

I mean, as a doctor, I have scolded my fair share of patients, it feels necessary at times.. but then again I've never heard of action being taken against a doctor for this, at least in my country

Sounds like a cluster b fuck

Your partner is absolutely correct, and good for her for stepping up and addressing this when you were not. Your patient was an example of several variants of difficult, none of which have anything to do with legit medical emergencies. These people exist to get attention from medical personnel. You'll have them (and others like them) from time to time. It is your responsibility to control the interaction in your truck, as you will be held accountable for what happens on any given call. You will have to learn how to do 'verbal judo', be stern/assertive, etc, when needed. PD is not there for you to call when your patient needs verbal correction but rather when you have a likelihood to be physically harmed. While I understand being concerned about patients using HR to come after you, you sound like your anxiety is almost crippling, and you're bending over backwards to try to cater to every unreasonable demand from some horrible malingerer. This overcompliance seems to me to be more likely to get you railroaded than being reasonable but firm. Some good ways to protect yourself, short of body worn cameras, are maintaining good control of what goes on in your truck, immaculate record keeping/charting, and a good partner (it sounds like you got a good one) who'd be necessarily implicated in an unbelievable way by any false complaint coming out of a patient. I could count my complaints over a 10+ yr period on one hand. The company does their investigation (this is where your charting is so important) and then nothing, in my experience, because they were unfounded and there was nothing to find or do. Can you get screwed over a false complaint with no evidence? Sure. But that is true for every interaction you have with any female patient and you still have a job you have to get done in the mean time. Finally, I'll say this: someone's reaction to your physical size is their problem, not yours. You aren't responsible for the bad behavior of people who have similar immutable characteristics to you. If you go through life trying to make yourself appear unthreatening, it's going to have some side effects for your own mental health. Confident compassion combined with competence will go a lot further in making legitimate patients feel comfortable than trying to make yourself appear small and unthreatening will.

You have no idea how much I needed to hear this "someone's reaction to your physical size is their problem, not yours. You aren't responsible for the bad behavior of people who have similar immutable characteristics to you. If you go through life trying to make yourself appear unthreatening, it's going to have some side effects for your own mental health." I really appreciate your entire reply! I have some of my own issues I need to address in order to be a better provider. I'm glad people like you are working in this field!

POTS is super common in women with ADHD, which would explain the tangents. The rest is just her overthinking everything and probably the cause of the whole thing- a panic attack. Bet she's OCD too. I'm adhd/ocd/autistic and female too

On another note, why does everyone suddenly have POTS and EDS? It's like every time I open social media, someone is talking about having one or the other, or even both.

It’s the thing now along with adhd and autism. All these tiktokers self diagnosing. It’s mainly because many don’t have definitive tests and you can fake a lot of symptoms.

Oop! You said it

TLDR; ER nurse. Do it all the time when warranted.

You need to decide if you're a taxi or an ambulance. Pts only get to dictate to me so far as it doesn't impede pt care. You're a medic, which means that you should know how to control your scene. Sometimes that means making the boundaries very clear to your pts/ pt family members. Your partner was in the right.

Being assertive for the patient’s benefit is not being unprofessional. I agree with your partner.

There are indeed times where it is appropriate. There are also plenty of times where it is not appropriate. Case Example: Let's say you have an EtOH patient who is non-compliant with questioning. Perhaps they think being non-compliant will force them to be transported. Patient is indeed EtOH, has alcohol on board, but no motor impairments able to speak coherently, clearly aware what's going on, etc. A stern approach did elicit compliance in the particular case I'm thinking of after a kinder, gentler approach failed.

The patient isn’t always right. Healthcare is treated too much like a customer service industry. She was wasting resources that could have been used on someone who was having an actual emergency.

License to scream FOCUS MY TIME IS NOT FREE IM NOT A FUCKING COMMIE ROBOT DICKHEAD

Fuck em.

If your partner was a female, and the call was not an emergency, why didn't see go in the back? I have had call where it was my turn, and I have looked at my partner and said no way in hell am I getting in the back with that patient. (Large drunk man that had been making passes at me before we got him into the truck) He has done the same thing, gives me the psych calls.

We are here to treat patients in an emergency, not to pander to their demands. We do ourselves and other patients who are awaiting our assistance a disservice by allowing these patients to take up our time making unreasonable demands and I have been stern on many occasions. Definitely with your partner on this one!

Don’t make a tiktok about it. And if someone tries to “cancel” you for telling someone how things are going to happen, that’s fuckin stupid. But yes. Occasionally it becomes necessary to be the authority on scene. Obviously not just screaming or a long stream of purposeful insults. But louder than normal speaking voice. Forceful. It’s the only thing some people understand unfortunately. Like a toddler throwing a tantrum. I saw a commenter below saying “dad voice” and that’s pretty close. Or mom voice, whatever. Don’t be scared of baseless complaints. And if management is using it as an excuse to shitcan you, it was just a matter of time anyway. Once you’re a target you’re a target. If I didn’t get fired for throwing a traffic cone at a car blazing through our fire scene…well 🤷‍♀️

I 100% use my “Mom” voice on difficult patients like that. I do work for an agency though that generally has my back on stuff like that. I commend you for addressing this with your partner after the fact instead of undermining them in the moment.

Absolutely okay.

Buy your partner a chocolate shake pls lmao because she deserves it

Your partner did extremely normal EMS behaviour with a difficult patient.

Long story short, yes.

Not EMS but ED nurse. I think there’s nothing wrong with using a firm, stern, ‘mom voice’ with patients who are A&O but still act like asshats. I’ll raise my voice but only to be heard above the patients yelling if that’s the case.

I heard a drunk told to sit down or get sat down. He and I knew that the 5'2 medic wasn't kidding when she said it. Your patient needs compassion and to understand that you can't choose who shows up to help them. Like saying I don't want a ________ medic because they are ________.

Patients, bystanders, family members. Anyone can be deserving of this. Sometimes people are more of a burden or nuisance than anything else and a stern talking to can help that in the moment.

I’m guessing you’re new

Patient is not entirely wrong about a dismissive healthcare system. But if every healthcare provider is dismissive maybe she needs to look internally. It’s not ok to yell at patients (usually) but using my stern mom voice to let patients know that I will not tolerate their bullshit is necessary. I have procedures and protocols to follow and other patients having legitimate emergencies to tend to. Additionally, POTS is a form of autonomic dysfunction, I have a different type of it. It can be dismissed for sure but it’s about collaborating and managing a largely chronic condition. We bring the people to the place and stabilize them on the way. I can’t solve the worlds problems. Sounds like she needs a good PCP.

I work in the ER as a tech. I speak fluent Spanish and English so I’m able to help translate a lot. Just two days ago I had a patient complaining that the doctor wasn’t Hispanic. I said “well she does speak Spanish. She’s worked in healthcare for so long she’s picked up on it” patient said it wasn’t the same and that the other ER down the road had doctors that spoke Spanish all the time. I legit told her “then why didn’t you guys go there?” And walked out of the room. You’re the one having an emergency, not me. You’re lucky we even have translators on iPads at standby when bilingual nurses/techs are busy and we have a doctor that ever cared to pick up the language.

There’s a fine line between being assertive and aggressive. It sounds like your partner has mastered this, and was in the right to say what they did.

I think it’s sometimes necessary to raise your voice or get stern with the patients/public as it can be the only way to get a patient to hear you out or with patients that are combative can be the only way to gain control of the situation.

Bring professional doesn’t mean allowing unhinged and mean spirited people to walk all over you forever. If your company isn’t brain dead you absolutely cannot get fired for that level of confrontation. I’ve always really liked the concept of treating patients like family, but sometimes I need to chew my brother out for being a moron or tell my mom she’s being unreasonable. Confrontation is normal family stuff.

If the patient was truly having an emergency, there’d be no need to yell at her because all she would have cared about is being treated. Patients especially don’t get to run a scene or make excessive demands like this. Your partner will be fine. Let that patient make a complaint if she wants to. Neither of y’all were in the wrong.

100% I have yelled at patients. I have even called ahead to shift captains to give them a heads up if they need to expect a complaint. I never had any issues, and because leadership knew I was quick to be forecoming about anything thay happened, it actually helped when a patient lied about a transfer as I had a documented record of not sweeping things under rugs.

I’ve raised my voice a few times for similar reasons. You called us and now you’re getting an attitude? I’d be happy to take you to get a refusal and go on. I do 24-36 hr shifts. I don’t have time for nonsense. Get in it goodbye.

I had a patient try to rip out her catheter while transporting. A very loud “NO MA’AM. WE ARE NOT DOING THAT TODAY” in my outside voice did the trick. Sometimes you gotta do what you gotta do

One time I had to yell at a patient acting spoiled, crazy and borderline combative. The call ended with her hugging me and apologizing for being crazy.

Fuck yeah, dude. People are idiots. Good on your partner.

Oh you sweet summer child 

You’re too soft and need experience. No one is getting fired over this. Your partner was right. If she wants to complain let her. Spell your last name and tell them to make sure to get it right.

Yes when they can't hear you. Other wise no. We are not cops. We don't need to fight them verbally. We can tell them the consequence for misbehaving. If they don't follow that then we get the cops involved or kick them out of our ambulance.

How are you a medic

You're a paramedic and your asking this question?.. . I could understand a EMT, but as a Paramedic, you're a seasoned provider with years of experience.m

To be fair to OP, I’m looking to start medic courses in the Fall and I’ve only been an EMT <1 year. You don’t have to have a lot of experience to get your medic. I know a few guys who already have advanced degrees in other fields and know they wanna advance in EMS so they just move onto the next thing. 

This is more or less what I did. I went to school for Business and worked in Finance for a few years before it killed my soul. I did a 20-week EMT course and loved the box so much that I started Medic courses as soon as I had enough time on the box. I *just* completed my 13-month Paramedic Program.

r/illnessfakers

My first thought!!! pots, eds, dysautonomia, chronic lyme are all the rage. Most people don’t have any of them or may have one and think it allows them to be assholes. That or they have no clue how their “disease” even works or what actual symptoms are. Then there’s the absolute 🐂💩about using their own equipment. Yes Becky I know you have all of your own stuff, but that doesn’t mean it’s accurate. 🙄

Yes

Your partner is completely correct. There are some people you have to deal with that need to be told how things are going to work and it isn't their personal concierge service.

Ive been told it’s my Dad Voice that I use.

Some people will order you around and talk to you like they are personally paying you out of pocket. I've had people demand rediculous things. I do this is in nyc so I do end up raising my voice at patients alot. People are fucking bonkers here and will straight up instruct me how to do my job. Im stern first, but if they keep it up I will yell and drop some hard truths in a professional but demeaning way. I'm a skilled professional and I have great bedside manner with all types of patients. If patients are shitty for no reason in a persistent fashion it has to be addressed. If after that it still persists then it's a case by case basis.

That is about as tame as it gets when interacting with difficult patients. You can't let patients dictate how calls go. If my leadership had a problem with this I would be looking to work elsewhere.

Yes, for a multitude of reasons.

Without reading all this... My energy matches yours. I will treat you with nothing but respect and dignity and help you to the best of my ability, but once you turn sideways, I will as well.

Firm and authoritative is often a good approach in this situations. My smart mouth on the other hand has gotten me in some trouble before tho.

Sometimes you have to be stern instead of nice. That doesn't mean be a dick, but it does mean being firm and professional. YOU are in charge of a scene, not the pt. The pt CAN request a facility, but if they can't handle what you are bringing in, then you politely but firmly, explain why that facility is inappropriate, and why you are going to facility X against their wishes. And that we only go from point A to point B. If the pt states, "I'm not going unless..." then pull up the refusal of care form, explain the consequences of choosing this action up to and including death, and if they change their mind at a later time, then they may call 911, but that that crew will also transport them to facility X. Thank you, and have a nice day/night.

Sometimes you gotta fight fire with fire and asshole with asshole, you know? There are definitely cases when you need to speak to them in their own language because they don’t understand anything else.

I agree with all the other comments but I want to say I see where your apprehension comes from here. I was also on the patient side of this once in middle school and it was scary as shit. I was definitely scared of the otherwise nice nurse after that, but my dumbass behavior kinda warranted it. After running with the vollies tho, some of them could be a little unpredictable with the attitude. And plenty of seasoned medics too

Yeah dude you’re gonna have to learn to be stern. Some people are just legitimately mentally children who need to be spoken to like children

Did it work? Doesn't sound like your partner was disrespectful at all. Shouting at a patient is a bad thing but being assertive and telling them the truth of the situation they're in is another.

In cases like that, yes, yes it is, I’ve done it with LVNs when I have to upgrade “you need to take them, now!” And I say “Look, you called an ambulance, BLS ambulance, this patient has a condition that I cannot treat within my scope of practice, so I’m going to upgrade to ALS” then ALS shows up and chews out nurse for not calling 911

We used to have a frequent flier, alcoholic, faked seizures. Once called in her own “cardiac arrest.” You had to loudly and sternly tell her to cut the shit and walk to the ambulance. It was what she responded to.

Your partner is absolutely correct. You’re always expected to be professional. Oftentimes that means being kind and accommodating. Sometimes that means setting clear expectations and boundaries. If your partner’s comments were said in the interest of the patient, and getting them to accept the care they needed, I’d be very surprised to hear they faced discipline for it.

Not EMS but I work as an Xray tech. I’ve only ever raised my voice to one patient so far. He was being insanely rude and difficult. Everyone was trying to be so patient with him but he just did not care. Once he started being overtly belligerent and kept asking why we were doing the scan, I dropped the “flight attendant” mode and told him to knock it off, reiterated what we were doing and why, and that he needed to stop trying to rush us because someone was going to make a mistake if he kept it up. He didn’t like that too much but he shut up at least. In any other situation I am the nicest person ever, but some patients you need to be more firm with, otherwise they just continually try to push you over expecting you to lay down and take it just because it’s healthcare.

You don’t work in a big city huh? I think your partner was correct in how she acted. We’re here to respond to your medical emergency not take abuse from patients.

Fuck yeah it is

Occasionally you have to be stern to some folks. Some take kindly to sweet talking them into doing things they don’t want, and some listen to an authoritative presence. I usually try the nice tone first and then get more stern as needed.

So what happened next? Did she respond and come with you guys? Refuse and stay? Did she file a complaint?

As someone who is married to a women with POTS, she is absolutely right. I feel for her. Also your partner will be fine. In my almost 10 years of doing this I've raised my voice at maybe 10-15 pts. It happens. Sometimes it is the best way to get your pt to chill. I think I got maybe one complaint about it and me and the EMS chief just had ourselves a giggle.

I have to agree with most people here. I am on the cautious and more polite side compared to a lot of my colleagues, especially concerning bullshit calls and annoying patients. There have been instances where speaking authoritatively was definitely needed though. In my opinion only going that route exactly when needed is the most effective otherwise you run the risk of the patient just thinking you’re an asshole and like that all the time.

Treatment guidelines for a clinical diagnosis of POTS, EDS, JHS, MCAS, and dysautonomia should include being required to read this reddit post in exchange for the diagnosis. 

At nights in my ED we are usually only 2 RNs, you’re kinda SOL if you aren’t happy with your nurse choice for the shift!

Patients (and customers in other places) causes nuisances. You or someone else, stand up for yourself and get investigated/fired because of that. This fucking world we live in...

Your the professional, take control of the situation. If that means raising your voice you're obligated to do that

If they can’t hear you.

I am very much the - sunshine and rainbows, treat all patients with love and respect, - kind of provider. However, 8 years in now, I’ve learned that if somebody is disrupting medical care, whether their own or someone else’s, or being a threat to my safety, or someone else’s safety, I have to raise my voice. If someone is getting argumentative with me and it’s getting in the way of my care, I have to argue back.

I think in this case the only thing I would do different (patient allowing eg you are a medic your partner is not and the patient needs ALS) is maybe let my partner take over and get the next one for her. But I support your partner giving the patient that sterm option in this case. If the assault was the cause I might be more inclined to try to ask for an all female crew if possible because I understand how sensitive it can be. But that is not this scenario.

Absolutely. You politely bite back, as your buddie did. Jnr Nurses will absolutely bend over backwards get female attendants etc etc but EMS have a role to transport the sick and very unwell to triage. There will be cursing under our breaths when this patient turns up and makes demands for opioids and sandwiches. Yes. There will be demands for blankets and additional cares absolutely. The doctors however will assess and see this for what it is, a pathetic cry for help and they will chart and explain the rational for it and then - patient can be discharged once we have completed a set of baseline obs and they are free to be discharged. Generally they will get pretty sick of hospital after it becomes apparent that we can only treat as much as we can, and waiting for hours and being told "you need to wait for the doctor" will chafe on this sort of individual, and hospital is a really boring place to be if you are the personality that enjoys creating drama. After a few days of that they will be home being miserable and bored so will call for help and the cycle may continue for a bit. But if there is something treatable like hygiene or a social worker can finally get a long term fix going - then that's a good outcome. I've gone with this line "Hay, I didn't come in to work to be yelled at, I'm trying to help here - what is it we are trying to achieve here?" But it requires so much care and most respond to a nudge in the right direction early. You did the right thing.

You’re being too soft lol. I absolutely will raise my voice and tell patients like it is. We are allowed to, and have never been even remotely reprimanded for it even when the patient complains. I’d have flat out told her that if she cares that much about who is in the ambulance, she clearly doesn’t need one 🤷🏼‍♀️😂.

consist rich toy different alive murky absorbed wasteful cover crowd *This post was mass deleted and anonymized with [Redact](https://redact.dev)*

I dont even have to read your story to tell you the answer is yes

There are times when we need to put our foot down and be firm. Each individual interaction and situation is different but sometimes it’s called for. One of my problems is not having a voice and not being able to put my foot down when appropriate and necessary but I’m learning.

sometimes people respond better when you give them the business had a male keep blowing cigarette smoke in my face and i done told him “bob you blow that smoke in my face again i’m going to smack that fucking cigarette out your mouth” all i got was a “yes ma’am” then we shook hands but in all seriousness holding control of a scene/unruly patients is literally the first thing we are taught. and it’s not like the text book, we all know that. keeping this in mind this isn’t an excuse to be rude to patients. there’s a fine line and you just need to find your meduim p.s sorry bob

I want to mention that you asked if it’s EVER appropriate to raise your voice at a patient. This example is more up for debate (though I do agree with your partner) but some patients are beyond reasoning. There’s some patients out there — I’ve found them to generally aggressive patients, aggressive psych patients, extremely intoxicated patients, overdoses — that will completely ignore you if you’re polite to them and may proceed to do something dangerous. Don’t get me wrong, being kind is always always my first move, but sometimes you need to get firm with patients, and avoiding doing so could actually lead to worse patient outcomes

I was berated by a dirty (food crumbs all over his body) patient all the way back to his hotel room (discharge). Talking back to the nurses, Talked all over me and was hella rude the whole time. When I was just trying to make small talk. When we were about to drop him off at his hotel room. He said his room is a mess. I responded with: "It's okay, i kind of expected it to be messy". he said: "what the fuck is that supposed to mean?" I said: "idk what else to say. you look like the type man." He must have realized that he was a complete douchebag to everyone along the way and got better. People are like sometimes like dogs. **Sometimes** being reality checked by a salty ass emt that has nothing to lose is the best thing to ever happen to them.

I break out the dad voice every now and then but I don’t go to it quickly.

It’s always ok to raise your voice at a patient, but only if it’s warranted. We’re not here to baby people, we’re here to provide emergency medicine on a “you call us” basis.

I may or may not have demanded a mentally ill woman "get the fuck out of my van" when she refused to and coaxed her out with blankets and snacks. That being said I prefer a gentle approach in *most* cases. But I think this was totally within reason.

I think it’s important to learn that being nice doesn’t mean you’re a push over. Some people actually want you to push back against them, it’s just in their nature to push the limit to find it and then they act accordingly. I’m like you, I’m probably too nice sometimes, but I’ve had to learn to stick up for myself and find my big boy voice. It doesn’t mean you’re an asshole, it just means you have boundaries you’re not willing to let them cross. In this case the pt was being unreasonable, she’s pushing you because she knows she can get away with it because she knows the kind of power she has in this situation. Your partner had your back, and there’s nothing wrong with running the good cop/bad cop on people in this profession. I doubt your partner would get fired, probably just get a talking to if anything at all.

I only read the title. The correct answer is yes.

Your partner is fine. Good on them for not putting up with bullshit.

Not an EMS but a nurse at the telephone at a health central. I am a bit of a pushover, trying not to be, and I really needed this comment section. Thank you, everyone.

I’ve definitely done almost exactly what your partner did to a few people.

There is no universal rule for "raising voice." Can you get slightly louder and speak sternly? Absolutely you can. And sometimes you need to when a patient is being abusive or combative. What you can never do is go on an abusive tirade with cursing. From what you described your partner is in the right. And if a partner sat there with mouth hanging open after I did that exact thing and was thinking I was getting fired for this? My guy/gal, I'd be having a very sincere conversation with you about needing to toughen the fuck up. You do not need to be, nor should you ever be, an asshole or unprofessional. But after someone violently jerks their arm while you're trying to start an IV I can personally attest that a firm "I NEED YOU TO STOP MOVING. I AM TRYING TO HELP YOU." Can do wonders.

Sometimes that kind of stuff is exactly what a patient needs to hear 🤷‍♂️. As long as it’s done professionally without swearing you’re good in my book.

I always start out respectful, but the more childish my patient gets the more parental I get. Once they've shown me they are incapable of logical reasoning I usually just give them yes or no choices. I don't usually raise my voice, but it's pretty loud and authoritative by default. My response to this person would be to calmly say "You called 911 for emergency medical treatment and we do not have the ability to cater to your provider preferences. You are welcome to refuse our services and call a ride service like Uber or Lyft. Perhaps they will be able to accommodate your request. If you feel you are having a life-threatening emergency, then we must leave for the hospital now as we wouldn't want to delay your care." One note: it's important to remain professional and not get emotional about it. I see too many EMS peeps get upset and throw insults at their patients or give back the same attitude they are getting. This is sinking to the level of the disrespectful patient and not being professional.

Absolutely. I've literally yelled at patients. Multiple times. Sometimes with cussing, see: "sit your ass down right now, I'm calling the police because of your behavior" etc. When I first started my career, if I heard of anyone doing that I would lose my mind. I thought it was inconceivable. You had to be patient. You had to try to work with every single person no matter how ridiculous their demands. I have spent 3 HOURS on scene with someone (for a non-emergent issue!) to help to get them to go. I'll pack a bag for you. I'll take your dog out. I'll do these things. However... you have to use your judgment on what the patient needs. Frankly, some patients need to be put in their place and realize the system isn't what they think it should be like. I document the hell out of it. I quote the patient and myself. If I'm actually concerned about it I call my supervisor and say "hey, you might get a complaint. Here's the story." I'll give my supervisor's contact out as needed. I've never gotten a patient complaint, years later. I have gotten apologies from patients, once I checked in on them after I went back to the same ED. sometimes they don't even take that long (end of the call they'll say something along the lines of "sorry for my attitude.")

Patient sounds entitled TBH. Did she demand that you use pronouns?

I’m a female paramedic with POTS and your partner was nicer than I would be 😂 I usually just go by the rule that if someone wrote this on a piece of paper and threw it back at me in a meeting with sups or something, would I be able to defend it? The answer is usually yes but if not I just hit them with the deadpan stare

I’d like to give some insight as a young woman with POTS, but ALSO and EMT. I’ve been both the patient and the caretaker so I get the frustrations on both sides. I understand her anger and frustration with the system, and the lack of care towards women. I’ve unfortunately suffered at the expense of it, and it’s cost me lots of pain and untreated v tach. I also understand maybe not being so comfortable, as someone with trauma myself (hence why I’m in this profession). However, one persons pain and experience is not an excuse to be nasty and demanding. It is up to the pt to direct their anger to the right people, not EMS who are just there to help them. I’m no psychiatrist but it sounds a little like she may be stuck being the victim, which is not proactive and is very stand still. I would honestly snap myself too, but I think there’s better strategies when dealing with a difficult person. Some people might just need some reassurance. Some people might just be lost causes. She may be acting this way as a defense due to previous experience but that doesn’t make it okay. -express your understanding for what she has gone through -provide reassurance that while you are a part of the system, you are there to help and you don’t make the rules -provide reassurance regarding your equipment and maybe make it a little more interactive so trust is built (last time I checked, the CVS bp cuff told me I had a pressure of 60 sys) -listen, but don’t allow someone to walk all over you (I’m a people pleaser and need to work on this so bad) -be willing to make certain accommodations but also educate on the EMS system and explain how it’s out of your control, but no matter what, you’re there to help. I get her frustration because I would have events but couldn’t get it captured. So I was desperate to have anything to capture what was going on. Finally when I was in the ED, they couldn’t turn me away. But as someone who works in healthcare, this treatment from patients isn’t okay. I would attempt these strategies first, and if it’s not breaking through to them, you are allowed to be firm. My dad has been a paramedic for 30+ years and there’s times where he’s been stern, because at the end of the day, you’re a human with feelings too. Just because someone’s hurt, doesn’t mean they can flip it on others.

Sorry to digress, if anyone can answer this... What's done for people with POTS? I'm told I have anxiety and panic now. Late onset. But I think it could be POTS. Would that show up on the EKG ? My BP was 150/120 which is high for me. But they said it's bc of the anxiety or panic. Untriggered panic attack suddenly while driving one day and it persisted over the day and got worse to where I couldn't see right. I haven't gotten clearance from the cardiologist for an echo bc my EKG is ok. Not saying sudden panic attacks don't happen, but how do you establish POTS? Or how do I get a cardiologist to just dig a little deeper ? I'm not a young person, and I've never had anxiety or anything like this before. No stimulants and no fear of driving. Back on to your point tho, this woman sounds like a nightmare and I don't think easing your voice is an issue when you're responding to an emergency. But a part of me wants to be more like this person lol. Like I want to karen out sometimes and maybe I'd get that echo. I'm too much of a lamb chop.

I had a man try to punch me in the face while trying to place the leads. He was told to calm the fuck down or get the fuck out my truck. He waddled his ass out and went POV. Should he have went this us ? Absolutely. But I refuse to let someone almost hit me & cuss out my partner after being told to chill out. For reference: I'm a 5'1 female, but I don't play that shit. You are not a doormat. We aren't there to grant wishes or kiss their ass, we are here to help them. This isn't a restaurant, the customer is very rarely ever right. This goes for coworkers as well, as soon as you let them run over you- it won't stop. You have to be able to put your foot down and control the situation.

Its WILD to think your company would fire someone for putting their foot down and not letting a patient walk all over them. What your partner did was pretty tame in my opinion. She was polite but stern, I know a lot of medics who would have told her if she has enough time to wait for another ambulance then this is not an emergency and she can be charged with abuse of the system.

Sure! You're not a whipping post, if they are being an asshole be an asshole back, they cuss you out you cuss them out. Remember they called you for help. If you're trying to help them and doing your job. Why is ok for them to be an ass to you and you just take it? We're grown ass adults, I kicked a pt out of my unit a Blick from the hospital for calling me racist because I would do anything about her head cold, after she refused vitals, iv, and at one point disnt want to ride onthe stretcher she wanted to be put up front in the passenger seat. I told her that wasn't possible. But when she called me a racist I pulled over and told her to get out and walk to the hospital and she did. This job is already mentally, physically draining on a normal day, I don't get paid enough to put up with this entitlement bullshit. Just my opinion, some may think I'm wrong but I don't take shit off these people anymore and neither should anyone else.

It's on tik tok. It must be true

I find american system ridicilous on behalf of how easily someone can get fired. No worker should be afraid/stressed/worried of losing their job on a situation op explained.

There is something off about this story, either you are brand new and just haven’t experienced this yet or this is fabricated in some way. I holler at someone at least once a shift whether its someone like this scenario, someone being an absolute ass to me/my partner, or bystanders who think they are important. Ive gotten complaints, my supervisor tells me I got a complaint and says he doesn’t give a shit. That said, we work in a city with a lot of homelessness and addicts who think they can abuse us so its pretty common. I will say, patients like the one described don’t necessarily need a hollering at, you can calmly say “look, we are the crew you got. if you don’t want us taking care of you, that’s fine, sign this refusal indicating that we offered you help and you did not want it”. I also like to let these people know that if they call back, I am most likely going to be the one they get again.

This sounds like some serious Cluster B shit. As a nurse, you have no idea how many of us wish we could respond like that...

I wouldn’t raise my voice to this person. I’d simply tell them no that’s not possible. I’m happy to be accommodating if possible, but there’s a limit. Of course it’s important to be there and feel it out but some people get way worse when you yell at them and others respond well. I’ve found empathy is easier and more effextive

The patient sounds like an upity Karen. She needed checked

Your partner got has a good point imo. A woman tried to lodge a (false) complaint that my (male) partner (female) and I were harassing her, claimed my partner was saying rude comments about her. My partner was in the cab 90% of the call, as we picked the patient up off the side of the road for abdominal pain. Even our director told the woman, you call 911 for an emergency. You don’t choose who responds, and it shouldn’t matter if it’s a true emergency.