I work for an IFT company, my first Ems job and just 5 months in. One shift, I was paired with a temporary partner because my regular partner was out for the day. This temporary partner was a bit unusual.
At one point, it was my turn to drive the rig while he cared for the patient. We use a Ford Transit ambulance, also known as a “vanbulance.” We had just finished loading the patient into the back. He was closing the doors and told me to shut the first door so we could close the second, but I instantly stopped the door from closing because he wasn’t in the back yet. I asked him what he was doing, and he walked around to the side door to enter the patient compartment without saying a word. I thought, okay, that’s fine, I guess.
Then we noticed another rig from our company nearby in the ambulance bay of the hospital, we were at. Their hood was up, and a few people were standing around, apparently dealing with car trouble. My partner decided he wanted to go see what was going on. I asked him what he was doing, and he said he was just checking it out—even though that meant leaving the patient alone in the back. So I stayed with the patient until he returned.
He eventually got back in the ambulance, and as soon as I went to start the engine, he got out again, leaving the patient behind once more so he could talk to the other crew. The side door was still open. Later, I spoke to him about how this might be considered a form abandonment and he should be careful about it, but he insisted it wasn’t because he still had “full view” of the patient, even though he was about 10 feet away. He even argued that it wouldn't fly in court, and he yells at me about how I always do these things cause we've worked before, even though I’m always trying to be careful to do the right thing. 
This has bugged me for a while and just wanted to know what everybody else thought and would if it be a form of negligence or not.
Unprofessional behavior? Yes. Negligence? Maybe - and if so I'd say only mildly.
What is your motivation here? I can tell you this is not something worth rocking the boat for...
It’s just something that bugged me for a while. Just wanted to know would anybody else thought about it?
It’s pretty common to not get in through the back as it’s kind of an awkward motion, especially in a van, it’s a pain in the ass. Some (like myself) would say that having a provider at the back with the door open until somebody gets in provides better comfort. Personally, you’re doing IFT, if it’s not psych or peds then it’s not a big deal at all.
Probably a little unprofessional to do that, he should have been like “hey man, you mind watching him for a second, I just want to see what’s going on”
Although I don’t agree with him getting back out, and he should have told you, this won’t constitute abandonment. I can’t tell you how many times we’ve stood outside the back door talking for a second on BS calls. Ive also been on numerous calls where I don’t stay right next to my patient the entire time.
A good example would be going a room or two over to discuss the elderly patients medical history with a family member.
Could the patient spontaneously die? Absolutely. But I have no reason to believe that they will. Even if they do, me being right directly on top of them is going to make no difference in this scenario.
I’m not trying to be rude here, I was in IFT myself and it was disheartening to say the least:
Your sole function is to generate revenue, anybody saying otherwise is lying directly to your face. When we switched over to doing IFT in addition to 911, the money was incomprehensible. I was doing QA/QI at the time and had access to the finances as well. Money literally FLYING through the doors within a few months. Cleared over 1.5 million dollars (IFT only revenue) for the year. Thats with only 2 ambulances during the day and 1 overnight, almost all of it BLS.
Have a talk with your partner, tell them what made you uncomfortable. I wouldn’t elevate this further, there’s no abandonment, no negligence, and no reason to fuck yourself over. You’ll get a reputation for running to management for nothing, your coworkers will act accordingly and you will notice.
tldr; legally no abandonment and definitely no negligence. Your partner was acting a little unprofessional which I’d have a 1 on 1 about (without telling him what will and won’t fly in court, you’ve only been in for 5 months). IFT is terrible, the only reason anybody is there is to leave. Don’t make the experience any more painful than it has to be.
Our BLS IFT service literally churns out medics for us. We employ them as EMTs, pay for them to go to medic school, pay them during clinicals, pay them for doing their studying at the station, etc. then when they pass the registry we move them over to 911. We run 10-15 trucks as medic-medic in a metro on the smaller side.
BLS IFT is crazy income.
You have shed a lot of light on this, and you're right. I thank you for the advice, and I shall better myself in the future.
While this isn’t professional, it does not meet criteria for abandonment. If it did, I abandon patients all the time doing triage on MVCs.
That’s a totally different situation though. Kinda like how talking about PHI of one patient in front of another isn’t a HIPAA violation if you’re in an MCI and you have two green patients in the back of your ambulance. You’re SUPPOSED to be moving from one patient to the next while triaging. You are never supposed to leave a patient alone in the back of the ambulance to yap to your coworkers.
Will anything come of this? No. Worst case scenario is probably OP’s partner getting a stern talking to. If something actually happened while OP’s partner was chit chatting with the other crew I can almost guarantee they would nail him for abandonment though. Fuck around at your own risk.
This is definitely not abandonment. It’s not even a close or debatable call.
You don’t abandon a patient simply by letting them out of your sight for a few minutes. Abandonment in a medical context is not unlike child or elder neglect. It is essentially a situation where someone requires specific care to have a fundamental need met, and the provider unilaterally refuses to provide that care after establishing a provider-patient relationship without making adequate provision for the patient to receive that care another way.
In the case of a perfectly stable patient who requires no specific care at that moment, it is not abandonment to leave them alone in the back of the truck. You could go get a coffee, watch a movie, and take a shower and come back, and as long as there was no unmet need, it still wouldn’t be abandonment.
Even though this isn’t abandonment, it COULD be negligent if something happens to the patient while you’re gone. Suppose you have a toe pain patient with no medical history in your truck, and you step outside to help another crew jump their truck. While you’re outside, your patient codes and dies. That’s not abandonment- the patient was not in need of any particular care when you left, and you didn’t have any reason to suspect he would code. BUT it may very well be negligent because the standard of care in EMS is to provide ongoing monitoring for all your patients, and by failing to provide ongoing monitoring, resuscitation efforts may have been delayed, thereby contributing to the patient’s death.
See the difference between the two concepts?
Yes you aren’t supposed to, but this doesn’t meet the legal definition of patient abandonment.
if something happened to the pt? it absolutely does lol what
That would be negligence. Words have meaning.
Closing the door and walking around to the other door is super common, and in some small/old/weird ambulances it’s literally the only option.
Jumping out to chit-chat with another crew … sketchy and kinda dumb, but it depends on patient criticality and operational need. It’s a crew of two - how hard is it to say “hey, keep an eye on this guy for a sec?” Definitely a problem for a psyche patient or pediatrics, not really a problem for most others.
Not technically “abandonment” though. That’s a specific legal term that more or less means “leave them to fend for themselves without medical care,” and while this is unprofessional, it doesn’t quite rise to that level. You and your partner are still on scene, the patient is still in your general area of control, etc.
saying “hey keep an eye on this guy” is different from just walking away while your partner is up front tho
Yes… that’s his point. Glad we’re all on the same page.
yeah i think i misread it
You said you’re new? This isn’t abandonment or negligence. The way your partner acted was unprofessional bc he didn’t even bother to just say hey watch them for a minute while I go out there. I won’t be harsh with you but yeah, like the others said this isn’t an issue to bring to management bc you will be labeled as a tattle tale and nobody will trust you or want to work with you. As for him yelling at you? FCK THAT! Don’t take any sht from anyone. Don’t fight them lol, just let others know that you can’t be walked all over or other people will treat you as such. You had a problem with him, you kinda talked it out more or less and it’s over. The only thing I would’ve said if I had a problem was to just lmk next time you’re hopping out. Yes, it’s obvious he’s getting out of the truck and implied for you to watch the patient. But, be considerate. Whether or not the patient was stable a little common courtesy would be nice. If I was in the back I’d say hey I’ll brb to the patient and you bc I’m not an a**hole haha. Yeah, trust me you don’t want to be known as “that guy”. You’ll never feel comfortable there and if nobody wants to work with you and your schedule is flexible you run the risk of getting the worst shifts and being paired up with someone else who nobody wants to work with. A cool partner makes all the difference. I was lucky that I always got along with everyone and also I had competent partners. Nothing worse than working someone wondering how in the hell did they get their cert?! I’ve worked with some truly dumb as a rock people who I swore bribed the state to get their certs 🤣
Not abandonment, not negligence unless there is harm to the pt.
Closing the doors and walking around is entirely normal, weird that you don't think so.
The guy may be the tool, you may be the tool but only the tools know who they are.
People forget with negligence to have legal standing there must be some kind of damage. That can be economic damage, lasting pain/suffering, requirement of a medical procedure etc
💯 that's why I said it that way. Lots of people should spend more time understanding the law that touches what we do.
Correct. Actual harm/damage is a necessary element of negligence. Negligence is an unintentional tort, and in the world of unintentional torts, no harm = no foul, no matter how stupid or unprofessional you are.
You need to relax a little. Being in view of the pt...10 feet away...and you're throwing around the abandonment word. That's a big accusation to be making to someone. Make sure you are 100% right before you say something like that next time
I guess you’re right, this is just my first ems job and I just want to do everything right
Stop drinking the HR koolaid. Having your partner’s back is a big part of the job and doing it right, and you should be very careful using $5000 words like “abandonment” for $50 crimes.
Hold yourself to your own standards. Don’t let others make you compromise your integrity. Report serious misconduct, patient harm/jeopardy, sentinel events, crimes, etc. But this is going to be a very hard job if you can’t see shades of gray.
I understand, and I realy thank you for the advice
I want to say, thank you for caring about your job and reaching out to ask the question. We all have to start somewhere and these are things we figure out along the way 😊
Thank you!
A stable Patient without special (usually psych-related) circumstances necessitating constant care does not need a provider with them every minute.
Especially getting in through the side ist just more ergonomical and sometimes you can use a few moments to clear up some details with your partner in private.
I think it is unprofessional to not deliver the patient and THEN go back and help the other crew. And I agree with people if your partner would be courteous and say "hey, can you hop back here and monitor the pt while I step away for a few minutes ?" That's courtesy to you as their partner and to the patient.
Negligence? No.
Abandonment? No.
Unprofessional? A little bit.
You are a 2-person crew so it cannot be considered abandonment as the person left you with the pt. Additionally, no harm was done so it cannot be negligence.
I'd say it is unprofessional to priorize chitchat over finishing your patient care first. Even if the pt is not emergent, they are probably still uncomfortable and you are still taking up their time. Every minute you stall is a minute taken away from their discharge time as well as your time to be available for a new pt.
Nothing you can do, unfortunately.
I doubt this meets the definition of abandonment, but it certainly is unprofessional and inappropriate as a healthcare provider in the EMS setting.
You don't need a policy to define every single behavior, there are just some things that are unwritten.
I could see this being a rookie mistake, but even most rookies would understand this is not appropriate once it was explained.
While it probably doesn't fall under abandonment, it might be considered negligent.
Not unless there’s harm/damages.
Uh you do realize that even though you are driving that’s also your patient. I don’t think walking 10 feet away is abandonment if that were true you’d have to be in touching distance of a patient at all times. But it’s up to you to monitor the patient as well as drive. “I was driving” won’t hold up in court if a patient dies and your partner doesn’t notice because they are sleeping
I mean if you were actively driving yeah it 100% will hold up in court.
Now if you mean driving as in you just weren't lead on a call; yeah then you are also responsible for patient care any time you're not literally driving.
But if you were saying we're required to monitor vitals while driving down the road, hard no.
If that's not what you were saying, which is probably the case, my b 😅
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there are plenty of times my partner has been actively talking to the patient in the back the entire time and i didn’t hear a single thing lol
Stop.
You're required to not crash the 10,000 lb machine built by the lowest bidder.
It's a good habit to maintain some awareness of what's happening behind you. But you can get in trouble in court for playing with the radio too much.
Trying to supervise someone with the same cert, who you have no business supervising, while driving is not and should not be your goal.
Tell that to the department of health not me
I don't need to, they already agree
Absolutely unprofessional and no thought for the patient. Regardless of the reason for transport we shouldn't just load a patient in our ambulance and then sit unless its very good reason. Patients are human and being in ambulance IS scary.
You're new and trying to do the right thing. I applaud you. Realize that if you keep the same mindset you have now (patient centered) you will get called "text book" or "cook book" you have to decide what you are willing to accept and not. I've been in this field for 15 years, hold a lot of certs, and i get called a "text book" medic because I refuse to allow my partners and my self fall below standards.
Remember your personal morals dont mean shit when you work. Its all based on ethical code we are held to. I've been to court on negligence claim. This would absolutely fly in court for a couple reason
1) the patient can simply say "I got scared and it caused mental anguish" - damages 2) you failed to initiate proper transport instead doing something non patient care related - breach of duty 3) you were assigned a patient - duty to act
Boom negligence claim all backed up by times from cameras, the hospital notes (they document a pick up time), and time it took you to get wheels rolling. Almost all Ambulance bays have cameras now.
Did the pt die? Was the pt harmed? There will be folks you dont like to work with your whole career.
He sounds super unprofessional and kinda irresponsible.
That's definitely not abandonment though. And negligence kinda only is negligence if it causes damages of some kind.
If he walked away and a patient coded, definitely negligent. But I'd assume the reason he felt comfortable walking away is because the patient was obviously not about to code. How much of that is luck and how much of that is knowledge is a different question though.
The fact you were available to watch the patient in the meantime also makes his actions more benign; the patient wasn't abandoned because YOU were there. Especially assuming you're the same cert level. Although the fact you weren't asked if you were okay with that adds a layer of shitty on top of being unprofessional.
Keeping the back door open until your partner gets in is good practice. It's also fairly pointless. If you're already walking around to get in the side door, realistically your response time to a rapid condition change will be almost identical. But it's still an easy base to cover so it's good to cover it.
Another thing about him is that caught him vaping in the ambulance when driving, when I told he shouldn’t be doing that when there O2 tanks around us, he snapped at me about how it is not a fire hazard and I need to relax. Not to mention it is also a strict company policy not to.
Vaping is not a fire hazard to the oxygen tanks. Honestly dude, you need to chill a bit. People are going to do things that might not personally jive with you like the vaping or not being directly next to their patient non stop but if you continue to have things like this bother you- you’re going to be miserable. Also, a lot of people aren’t going to want to work with YOU because you’re coming off very nit picky and I personally would avoid working with you like the plague.
i mean… vaping really isn’t a fire hazard. is it disrespectful towards your partner? absolutely. is it a violation of company policy? almost definitely. fire hazard? really?
Luckily not a fire hazard but yeah not a great move professionally
Do nurses abandon their patients when they leave them alone in a bed for 30+ minutes? If they are an unstable pt then yeah sure its probably not a good look, but if they are stable then you dont need eyes on them every minute.
There are very few hard rules in EMS, most of what we do is situation dependent, whether this is negligence or not depends entirely on pt complaint and prognostics