A good friend of mine is being sued by a former patient. I don’t know if that statement gives you anxiety the way it gives me anxiety. I’ll admit it, I have an underlying fear of having to defend myself and my actions in a court of law.
I’m not scared of being held accountable for the medical decisions I make. I feel that I tend to make fairly good decisions, thank you very much, but the legal process can be expensive. And let’s be honest…because this is just you and me talking right? Sometimes the right thing to do is far from clear.
In a court of law, everyone is allowed the benefit of months of preparation, and then days and weeks are spent mulling over decisions that were made in real time. In EMS, real time moves faster than you might think. And good, well meaning, experienced paramedics labor to do the right thing.
Such was the case on May 24th 2008, when my friend was called to the home of man who wasn’t answering questions appropriately. Gerald Schlenker, a quirky resident of Arvada, CO, was admittedly a bit drunk when he walked back home and went to bed in his own bedroom.
He awoke to the Arvada police department in his apartment. They were there to arrest his roommate for his role in some sort of disturbance issue and they wanted him to answer some questions as well. He clammed up. He refused to say anything except rude and non-sensical statements. That’s when my buddy got involved.
Have you ever been in this situation before? Someone is drunk in their own home. They may or may not have initiated a call for help. Now they want to stay home. What are our options?
Frankly I can see this guys frustration. You find your way safely home, you go to bed and you wake up to a bunch of police officers in your home, wanting answers to questions about who you are and what you’re doing. I could see being pretty pissed off.
I can also see my friends vantage point. (All to well.) The guy won’t answer basic orientation questions. How can you possibly allow him to refuse your care? How can you document that he’s competent and able to care for himself? Is he really safe at home? Where does your need for documentation end and his human rights begin?
My friend opted to transport. If I was in his shoes, I could easily see myself making the same decision. Then Mr. Schlenker got downright belligerent. He eventually needed to be restrained. And then he was sedated. At the E.R. he was eventually granted a psychiatric evaluation. He sobered up, cooperated, and was released the next day. Then he was sent a $6,000 bill for his troubles.
As you might imagine, Mr Schlenker is suing everyone involved, the police department, the hospital, the ambulance service, and even my friend, the paramedic. He made a decision that he felt was in the best interest of the patient and now he’ll need to defend his actions in court. He’s a great paramedic. I’m certain he gave Gerald outstanding, compassionate care. He did everything to ensure his safety and well being. Sometimes you just can’t win.
Maybe it’s my king-of-my-castle mindset, or my mid-west style patriotism talking here, but I’m inclined to give people a lot of leeway when it comes to allowing them to stay in their homes when they choose to stay. Removing people from their homes against their will sits poorly with me.
Sometimes I still do it. It’s my job. But I never like it.
Regardless of their medical condition, the potential for a dangerous outcome, their level of intoxication, or even their willingness to cooperate, I feel like people have the right to make bad decisions in their own homes. And it’s not our job to always fix it. I feel bad for everyone involved in this mess.
What about you? How would you have handled this case. What do you use to guide your decisions when you’re trying to decide if someone can stay home on their own?