Speeding to the hospital! or.. Nurses: Above the Law

While reading up on EMS blogs today I came across this link over at Burned Out Medic:

http://burnedoutmedic.com/2010/08/there-are-enough-traffic-scofflaws-already/

It links to a story written in a magazine called the “Cath Lab Digest” penned by a “Lead RN” with a bunch of certainly impressive sounding gobbledygook after her name. She writes the story of her outrage and subsequent fight against a traffic ticket she received while responding from home to a cath lab activation at her hospital.

Her story is written in her article, which can be found here: http://www.cathlabdigest.com/articles/My-Day-Court

Here’s the reply that I left her:

I read this and saw the “I’m Special” mentality breaking through all over this piece.

You indicate that by virtue of your job and your training:

– You’re so special your cath lab team cannot handle their job without your leadership, even for up to 12 minutes.

– You’re so special that your objective and destination are more important than the objectives and destination of everyone else on the public roadways.

– You’re so special that the law should not apply to you.

– You’re so special that the other healthcare providers on-duty at the time you are called in cannot possibly be taking care of the patient as well as you can.

– You feel cool being called in and being allowed to drive any way you want.

The officer who stopped and ticketed you disagreed with all of the above. I do as well.

In many states, volunteer fire and emergency medical services personnel are allowed to operate their personal vehicles with emergency lights and sirens when responding to emergency situations. This is because the situations they respond to are extremely time sensitive, requiring professional action within 5 to 10 minutes in some cases in order to mitigate the consequences of the emergency. These calls are usually in the hands of lay persons until the professionals arrive.

Your “emergencies” are time sensitive as well. The AHA recommends a 90 minute window from recognition of STEMI to Cardiac Catheterization. The patient is in the hands of trained people from the time of recognition. There is a huge difference in these standards that does not warrant the risk to the rest of the public for nurses driving in an emergency fashion… especially self-appointed “special” nurses.

I would think that the minutes could be saved in earlier recognition of the STEMI, field activation of the Cath Lab team, earlier notification by the hospital, and perhaps having more qualified people on duty around the clock. This would certainly pay for itself the first time the hospital was liable for you killing someone or being killed yourself while enroute to a page.

I’m sorry if I was perhaps a bit hard on you… but this comment goes out to the rest of the “special” people out there. Obey the law and be safe. Don’t kill me or my family because you believe yourself to be special.

Was I too harsh?

  • it’s interesting she doesn’t once mention anything about liability – her liability, the hospital’s liability, and even the liability of someone who mistakenly calls an stemi activation that set the events in motion. only someone who either is naive and/or has never driven emergency vehicles doesn’t stop to consider these things.

    • Jasmine

      I think noone truly knows what it is like driving to a STEMI unless they themselves have been on call, have been called in, and are a member of a Cardiac Cath Lab team. A stemi is indeed an emergency. The door to balloon time in NJ being 30mins. We HAVE TO be there in 30 mins. We take call for you and your loved ones. We are on call varying on where you work and how large your lab is (the bigger the lab the more coverage the smaller the lab the less staff to cover call) i myself take 5-7 days of call every week. Just to clarify a few things: In my experience, no. hospitals do not staff cath labs overnight. We are on call from the minute the lab closes till the minute it reopens the following day and are still expected to return to work the following day for regular scheduled hours. Yes this is our choice to pick the job we do… the same way anyone else does. I think its easy for anyone to not come to a complete stop at a stop sign, honestly I don’t know anyone who has not done this at least once. I don’t think she should have been given a ticket for not coming to a complete stop en route to a STEMI. I have been pulled over myself on my way to a STEMI and have not been ticketed, thankfully. But we all drive a little faster and may flash our brights to the person in front of us texting and driving doing 20 MPH under the speed limit, but trust me when i say EVERY second counts. Believe it or not a STEMI is an extremely intense situation. Doctors are screaming at you. And you are moving faster than ever. They do not wait, the second they walk in the room they expect that patient to be ready to go. And mind you we need to be there, with scrubs on, with a surgical table made, ready to go with all of our equipment on and ready, meds ready to be given, etc. in 30 mins. Every single one of those 30 mins counts. As soon as the patient gets on the table we are coming at them, ripping there clothes off, shaving them where it is needed ETC. The patient is usually not in the best health, sometimes in need of intubation etc. Also, the nurses caring for the patients in the cath lab usually have TONS of critical care experience before they will even get an interview for an RN position in a cath lab. So no, they are not just your everyday nurse. Everyone knows someone who has passed away from a heart attack aka STEMI and I’m sure if it were you, or your family member on that table you’re entire outlook would be different… as we do sometimes loose these patients as they are extremely sick. The faster we get there the faster we SAVE SOMEONES LIFE. Again, every single minute counts. The ER nurses are also usually dying to hand that patient over to us… which i can also say from experience as my fiancé has been an ER/ED nurse for 7 years. We don’t feel we are above the law but i can assure you we have the best interest of our patient in mind, i am in NJ anytime i have been pulled over the police officer has let me go and i start driving before they even get back into their car… its so easy to talk about things you don’t know anything about (in terms of the situation and what it is like) we absolutely SHOULD have blue lights… but unfortunately apparently need privileges for them in each town we are driving through en route to the hospital we are on call- obviously this is not something we will be able to obtain. I pass through 3 towns (all different fire departments) not including the one i live in on my way to the hospital i take call at and it only takes me about 15-20 mins to get there as long as everyone in front of me is driving the speed limit.

  • PJ

    BOM: don’t you know that self-appointed heros are above the law?

    You weren’t harsh enough, frankly.

  • Not too harsh. It was well written and got to the point without being rude. Sometimes people just need someone else to show them the other point of view.

  • You were just fine.

  • Wonderful! I would’ve chewed her out as well!

  • how naive of me. in that case, i’m hereby appointing myself “hero” and there are a few people i really don’t like who need to “disappear.”

    =P

  • I agree with PJ, not harsh enough. I have called these type of people self-important twits for years. They are only important, or “special” in their own minds.

  • lump532

    I don’t see your reply on after her article.

  • I tried to add some studies to my tongue lashing…because the odds are my disgust won’t sway things, maybe some research will? Right?

  • B. Cans

    And she’s *humble* too!! Not!

    http://www.cathlabdigest.com/article/8817

  • Just to play the devil’s advocate, isn’t one of the major complaints from EMS providers that we are called in for non-acute “emergencies”. You know… the inebriated, the recreational narcotic user, the anxiety ridden, and the undomiciled.

    So if we spend all this time responding in an “emergent” mode to non-acute “emergencies” (which actually since a STEMI is already confirmed a cath lab activation is a confirmed emergent case), are we calling out the kettle while we are indeed the pot???

    • undomiciled. ha!

      i don’t like going anywhere with lights and sirens, but at least i have a legal exemption, and i am mindful of everything associated with it. she doesn’t and isn’t.

      • Being mindful of the powers and repercussions of such an exemption are important, but then why are ambulances constantly colliding with other vehicles or stationary objects? The EMS safety record is far from pristine when it comes to motor vehicle collisions, and is only perhaps overshadowed by the safety record (or lack thereof) held by the medevac section of the industry.

        So while it’s very true that we are granted a legal exemption and she isn’t… really why isn’t she granted the same legal exemption when she has a confirmed emergent case? Or perhaps why are we being granted that legal exemption when we don’t have confirmed emergent cases?

        • maybe she should be. or maybe her lab should be staffed to begin with. maybe we should drive to less calls with lights and sirens; i’d have no objection to that. (i’m speaking for myself.) maybe we shouldn’t drive to less calls with lights and sirens because we’re the ones doing the “confirming” these “emergencies” around here.

          i understand that you’re playing devil’s advocate and talking about this in a general way, and i don’t disagree with you. i may drive carefully but plenty of us don’t. but, as it is, she’s not being very convincing as far as i’m concerned.

          • Jasmine

            No cath lab i have heard of is “staffed” overnight. The staff is expected to work days that are scheduled… and on call days are extra. But we are not staffed overnight as we don’t do cases all night. Should an emergency come in we need to live within 30 mins of the hospital in order to be aloud to go home. If you live more than 30 mins away you are to stay in an on call room…

  • First Due Medic

    Just curious…what was her responce to you? I sent her an email last weekend, only because she included it in her posting, and I basically told her everything you did. Her only reply to me was, “Thank You”

  • ER RN/Medic

    Speeding to the hospital because you are called in for a cath lab patient is stupid, when you wreck, now the hospital has to call in the 2nd call team to replace you. The patient is currently being monitored and treated by the ER staff. Yes one that has worked on the door to balloon team the goal is 60 – 90 minutes, and its great to get the ones under 30 minutes, but not at the risk of injury to self or others. Don’t speed you are not above the law, you know when you are on call and most hospitals require that you be able to respond with in 30 minutes from contact, plan accordingly. Rest assured that the patient is being monitored and treatment has begun by the EMS Crew and ER staff. Most times the Cath Lab team arrives before the Cardiologist and you cant start with out them.