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EMS

Johnny and Roy lied to me – I write receipts

I was watching some episodes of Emergency! for an upcoming presentation and I began to notice something.

Johnny and Roy lied to me.

All those years watching Squad 51 wandering from rescue to rescue, to Rampart and to the station I wanted to be there with them.  I wanted to hang out at the table in the morning, chat with Chet while he and Marco cleaned the fittings on the engine.  I wanted to wear my helmet all the time and watch the cops do the same and stand nearby while I worked.

However, there is a HUGE part of EMS that Johnny and Roy never even mention, let alone complete.

 

Not 1 PCR is completed.

Ever.

Folks call for help, help is delivered, then they go away.

Turns out that is what I like best about the show now.  It isn’t the rescues that always seem to go perfectly (as soon as Truck 110 shows up). It isn’t Chet’s bad jokes or Mike Stoker’s ability to follow the Squad up the street, it was doing the job, then leaving.

It got me thinking.  Are we writing Patient Care Reports or are we preparing receipts?

No ER in my 20 years has ever even looked at my PCR, even when my daughter came in on an RN IFT car the PCR never made it to her chart.  We have created laws, policies and guidelines that are remarkably strict on what MUST be included in a PCR, but is it really just to document patient care?  If so, can we streamline it to actually address care?

As CQI for years I was tasked with confirming that the care in the field matched the policies.  I can say, unofficially, that it did overwhelmingly.  There were no documented medication errors, but since the author was the one to make any errors, would they really not fix it in the document?  No, most issues were clerical, not clinical.  The formatting of the report existed simply for oversight and review, statistical reporting and, most importantly to the organization, billing.

Next time your charting takes longer than your patient contact did, think back to Johnny flirting while Roy listens to the radio and wonder how we got from there to here.

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3 Comments

  1. James Rosse January 9, 2016 8:25 am

    The fear of lawyers.

  2. Deborah January 9, 2016 8:32 am

    I had a PCR come back to me about 5 yrs after the fact. This poor man was flown to a VA hosp and supposedly died. His wife buried him. Life went on. Then the VA calls her, your husband is in a VA run invalid home. She brought a copy of my PCR from his chart trying to find out why her ‘dead’ husband was alive and who the poor man was she buried. I suppose in rare instances the PCR serves some purpose other than being a reciept.

  3. BH March 26, 2016 10:10 pm

    One of our guys recently got a phone call from a community hospital ER doctor because his PCR from a self-extricated, ambulatory MVC patient didn’t include the angle of the collision.

    Seriously.

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