Transfers

When I started in EMS paramedics rarely did transfers. Out of twenty cars, maye six were medic. Sometimes only two. One of my first partners used to get very upset if we were even dispatched to an ETOH. We were to be kept back for the bad ones.

Who you work with, particuarly when you start out, can be very influential on your own outlook. If your partner is pissed and frustrated, then you may tend to be the same way. If your partner is easy going, then your day goes a little easier. At least I feel my partners moods tend to rub off on me.

Over the years as we have added more medics, transfers have become a regular part of the job, so much so that I tend to not even mind them too much. I guess sometimes I get mad if I’m sent on a transfer as a medic while a BLS truck is kept on-line and they end up having to do a code without a medic available. That clearly isn’t right.

Half the week I work in the suburbs as the paid contracted medic on a volunteer ambulance. Our call volume has soared in recent years, mainly due to “emergifers” — nursing home calls that used to go to the commercial ambulance, but are now kicked to us because the patient is going to the ED for evaluation. We get a lot of fevers, swollen legs, skin tears. It’s all part of the job. Our call volume is also up because the town has a high elderly population and so many of them live at home and are cared for by visiting nurses, who call us whenever the patient has a fever or a cough or any kind of dsypnea on exertion. We do a lot of these calls.

A number of years ago — I don’t know what was going on that particualar day or why I was in the mood I was in, but we got sent to a private home for respiratory distress. We went lights and sirens and came charging into the house only to find a man laying in bed, seeming in not much distress at all. He could speak in clear sentences and he said he had a bad cough and wanted to go down to the ER. He was very pleasant, almost cheerful. When I asked, he said his doctor wanted him to go down to the ER. On the radio another call was going out — for a chest pain — and I made some out of line comment about how maybe he should have called a taxi instead of us.

“But I have no legs,” he said.

Sure enough, I pulled back the sheet and the man just had two stumps.

I felt a little foolish.

***

The other day I did three calls — all regulars, including the man with the stumps, who I have picked up quiet a few times — always for fever and respiratory infection. We know each other by name and always make small talk on the way to the hospital. I know all about his family and he knows some about mine. I don’t do much for him, but put him on a cannula. He has an IV port. It is not the biggest emergency, but taking him to the hospital is part of my job.

***

Yesterday I worked the HP – high performance car — for the first time. The deal with the HP car is you do nothing but transfers. As soon as you have done eight, you can go home and still get paid for your 9-5 eight hours. If it is slow or you have to wait too long for a transfer to be ready, you still get credit for a call. I took the shift because an old partner of mine was working it. He recently came back to work for the company after being away for four years, working a variety of other jobs — group home, security, research lab, er tech. He likes the HP shift. “I did all those calls with you, the shootings, stabbings, digging babies out of toilets, I don’t need to do that anymore. I come in, I do my job, and most days I get out early.”

We had a good time, catching up on news and rehashing old times. We did our eight calls and were out an hour and a half early.

I can’t say as I really enjoyed humping all those transfers — we didn’t have a break — but I was impressed with my friend’s work ethic and bedside manner and impressed with the idea of the HP car. The first four calls were all dialysis patients. He does the same patients every Tuesday and Thursday. One of the calls involved helping an amputee down some narrow stairs, using two of those stair escalators, and then an outside elevator. You could tell the patient was comfortable with him and he joked easily with her and her daughter. I knew the patients liked having the same guy come for them every time rather than an endless procession of new faces. At one diaylsis center, he helped dress an old woman the way she liked, putting her hood up and wrapping a scarf around her. On our next to last call, we took a woman home from the hospital to her daughter’s house. We showed the daughter how to put a cannula on the mother, how her 02 machine worked, how a foley bag needed to be kept low so it would drain, and pointed out a sore on the woman’s ankle. We gave her the company’s number and told her to call us if she needed scheduled transportation and to call 911 if any emergencies developed. She thanked us as she let us out the front door.

3 Comments

  • Jim says:

    Transfers are a way of life in EMS now more than ever. Especially with rising costs to run an ambulance company or service.Plus you can learn a lot doing transfers, especially when you are new.I also find it important to remember that it is the patients emergency and not mine. A person neded help witha nasal cannula hook up may not be a true 911 call, but to them it was important.

  • Anonymous says:

    WHY are your dispatchers sending ALS rigs on BLS transfers if there are available BLS crews sitting around? The paramedics in the areas I work in wouldn’t be caught dead doing, say, a dialysis to nursing home call, or, more realistically, since transports like that are always done by the private companies, say, transport from a 911 call from a nursing home for someone with a mild fever. Medics wouldn’t even get dispatched to things like that that are clearly BLS.

  • PC says:

    When private EMS handles the 911 for a town, or in this area, a group of towns, a medic’s day is often a mix of 911 and transfers. Our service tries to put a medic in every car so every car is available for every type of call. This gets the dispatchers in the mode of always sending the closest unit. Sometimes a medic gets given a transfer when a BLS car is left on line. It certainly isn’t ideal and shouldn’t happen.Also, in our state there was a peculiar legal ruling that often causes nursing home calls to be funneled through the 911 system. A nursing home can call a commercial service saying a patient with pnemonia needs transport to the hospital, and if they tell the call taker that the patient is having touble breathing, it gets passed to the 911 provider. Half the week I am on the commercial ambulance, half the week I am on a town specific 911 provider. I can’t escape the nursing home “emergifer” calls.But at this point in my career, it really doesn’t matter to me. A call is a call and a patient is a patient, and I get paid by the hour.

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