My Day in Court
- July 01 2010
- Posted on: 7/1/10
- 11 Comments
- 3114 reads
September 14, 2009 at 0500 my on-call beeper went off with a STEMI notification. Within seven minutes I was in my car and on the way to the hospital. At 0519, I was stopped by a patrol car for failure to come to a complete stop at a stop sign. I told the young officer that I was on my way to an emergency case. I was in full scrubs, wearing my ID badge, and carrying the beeper with the texted message. The officer apologized for the inconvenience. He then went on to explain to me that he had to write a ticket because I did run the stop sign. It took him twelve minutes to complete writing out the ticket, then explain my court date. I reached the hospital at 0545. I was the lead RN in the cath lab crew.
The American Heart Association and the American College of Cardiology have set the door-to-balloon time that is most fortuitous for ST-segment elevation myocardial infarction patients as 90 minutes or less. Here at St. Luke’s Episcopal Hospital, in Houston, Texas, we have gotten our after-hours door-to-balloon time down to an average of about 50 minutes. Studies have shown that the sooner the occluded vessel is opened, the more heart muscle is saved from infarction.
Although that young officer was polite and professional in doing his job, he made a serious error in obstructing me from doing my job. I accepted my ticket, then proceeded to the hospital. Luckily another nurse just happened to be in the lab early that morning and was able to help with the case.
When I got home that night, I thought about the options open to me in dealing with the ticket. I had three. I could pay the $230.00 ticket outright, I could plead guilty and ask for defensive driving class, or I could plead not guilty and fight. If I plead guilty, the ticket would go on my driving record (raising my insurance premium). If I pled guilty and asked for defensive driving my record would be clean, but I would still have to pay $110.00 for the privilege to take the class, which then cost an additional $45.00. If I pled not guilty and lost, I could still take the defensive driving course. I was mad and full of righteous indignation. So, I pled not guilty.
November 2, 2009, I went to court. I did not hire an attorney. I didn’t believe that any attorney could tell it like I could. Now Shakespeare has written that anyone who represents himself in court has a fool for a client. Giving Mr. Shakespeare his respect, he wasn't an attorney or a nurse.
Before court, I searched the literature supporting door-to-balloon times. I got a letter from our STEMI Coordinator, Larry Brown, RN, verifying the page and the importance of my presence in the case. I had a copy of the staff assignments for that day with my name as the lead call nurse. I had also pranced around in front of my mirror for a month practicing my defense.
My husband went with me for moral support. I really appreciated him at my side. I was ready for battle. When my turn came, the case was thrown out because the officer did not appear. I had mixed feelings about that. I was relieved that it was all over. But, I also felt that I had been denied my day in court. I wanted to tell the judge, the jury, the policeman, and that courtroom just how important it was for me to get to the hospital expeditiously. I wanted to say that I did not recklessly blow a stop sign or drive dangerously.
I was not able to tell my story in court, so here I am now to tell the tale.
I am currently working on getting an appearance before the City Council. They need to know that each one of them, as well as I, could fall victim to myocardial infarction. I want them to realize that there is not a single cath lab in Texas, along with most of the U.S. (that I know of, and I have searched) that has twenty-four hour in-house trained cath lab coverage. I am aware of programs that have trained emergency department (ED) staff and rapid response (RR) nurses to take steps to getting patients steps closer to the lab before the trained team arrives. As a matter of fact, here at St. Luke’s, our ED and RR nurses are trained to take steps to getting the patient to the lab and set up for the cath team. However, the training and expertise to proceed with the case rests with the cath team.
So, for each minute that a cath team member is delayed receiving a traffic ticket, one minute is lost to getting the most expert care to a heart attack victim.
I am conducting this fight not just for myself, but for the many other team members that have received and are still receiving tickets. As I asked around, I also encountered several doctors who also said they received tickets en route to STEMIs and other cardiac emergencies.
When I approach City Council, I will present my case, and possible solutions. This issue can be addressed in several ways. First, when appropriate ID and evidence of a call is presented to the officer, I would like a city ordinance passed to allow the driver to go without further action.
Next, if the driver is caught on the red-light camera, he/she should be able to present evidence of a call and be forgiven (if an adequate stop was made). I have also received a ticket from the camera. I was answering a call at 0200 on another day. I stopped, checked for oncoming cars, then went through the light. That ticket was $75.00. The third option is for the officer to accompany the driver to the hospital to verify the call.
I wish the officer would have been there. You have no right to disobey traffic laws when you are not in an emergency vehicle. You have not taken Emergency driving courses.
YOU were at fault. It is YOUR fault that you had to wait 12 minutes for him to write a ticket--all because you couldn't wait mere seconds at a stop sign.
YOU do not have the right to put other drivers at risk when responding for a hospital page. In fact, you very likely could create a whole new(and more critically injured) patient in the process.
Do not speed. Do not blow stop signs/lights. Do not complaint about being caught breaking the law.
The fact of the matter is that ambulance transporting code 3 do not save much time at all. Whatever made you think you deserved some privilege to break the law is foolish, at minimum.
In my state Volunteer Firefighters, even with flashing blue lights, cannot speed.
The 3 seconds you would have wasted at that sign are not worth putting the citizens of your community at risk. It is your fault that the patient waited 12 minutes to see you, not the fault of this officer.
Obey the God Damn Law.
Get over yourself.
Reply to this comment »as a nurse who also responds to call emergencies, I thank you. Trauma is preventable. Cath lab call is no excuse to drive dangerously. If you can't make the drive in time, sleep at the hospital on call shifts.
Reply to this comment »Although I am empathetic to your predicament, I do not agree with you that you should be allowed some "leeway" whe it comes to traffic laws. How much time do you actually save by "rolling" through a stop sign or blowing a red light? Studies have shown that the time is actually less than a minute and that was comparing driving emergency with lights and sirens and normal street driving.
I am sorry but you should not expect or be given a "pass" on any traffic law just because you are a part of the cath team at your hospital. I am a firefighter/paramedic for a fire dept where I am the primary Engine driver. If I were to do what you are suggesting while driving the Engine, I would lose my job for violating not only my departments policies but city and state law.
If a judge were to accept your argument that you should be given some leeway, where is the line drawn? Who else is going to be given leeway as well and what happens when someone operating under the assumption of that leeway is involved in a wreck and is injured or killed? Worse yet, what if they injure or kill someone else? Will their employer be held responsible and face litigation?
It would be better if you followed all applicable traffic laws and tried to cut time in some other way than by driving in an unsafe manner.
Dave
Reply to this comment »I'm not sure this makes sense. If you *need* to be there, you should be put on an advanced driving course and taught to drive on lights and sirens. Otherwise, if your presence is not time critical, you should obey the laws like everyone else.
You think it's important you're there as an emergency run? Take it up with your employer to *give you appropriate training*, not the city. If you crash and kill someone running lights without training, it'd be the city's fault if they didn't stop you when they had the chance, so who could blame them for pulling you over?
Finally, do you not think the police officer not showing up may be his way of letting you off for this one? Let it go, for your, and his, sake...
Reply to this comment »Just out of curiosity, when you roll the next stop sign and crush some poor kid in a crosswalk, what will your excuse be then?
Or if you get broadsided by some other poor unsuspecting member of the motoring public, who's going to be the LEAD RN on the cath lab crew?
Reply to this comment »Yeah- because nurses should be allowed to drive the way they want. Please note dripping sarcasm. Ambulances with full lights and sirens MUST come to a complete stop before proceeding- why then should YOU be allowed to do what you will. Oh that's right: You're a nurse
Reply to this comment »It is unfortunate that you were given a ticket while responding to a STEMI. I have been stopped by an officer once during my 8 years of taking call. I was allowed to proceed without getting a ticket. I do agree that the officer should take into account the situation but you did violate a traffic code.
Concerning physicians that received ticket en route that is a different story in some cases. Texas traffic code 545.365 reads
SPEED LIMIT EXCEPTION FOR EMERGENCIES; MUNICIPAL REGULATION.
(a) The regulation of the speed of a vehicle under this subchapter does not apply to:
(1) an authorized emergency vehicle responding to a call;
(2) a police patrol; or
(3) a physician or ambulance responding to an emergency call.
(b) A municipality by ordinance may regulate the speed of:
(1) an ambulance;
(2) an emergency medical services vehicle; or
(3) an authorized vehicle operated by a blood or tissue bank.
Acts 1995, 74th Leg., ch. 165, Sec. 1, eff. Sept. 1, 1995.
I applaude you for going to the city council. I think it would be appropriate for essential members of a team to be afforded the same consideration as the physician when responding to an emergency.
Reply to this comment »Excuse us for being in YOUR way, miss above the law. Why dont you ask the council for lights and sirens on your car, I'm sure they'll do it.
What happens if you didnt come to a complete stop @ the sign and didn't see a morning jogger passing by? Vehicular manslaughter.
Traffic laws are there for a reason.
Reply to this comment »Simply put if you do not have the training (EVOC/EVD) you should not be driving "Emergency Traffic". Additionally, disobeying traffic laws while driving emergency traffic not only puts you at risk, but it puts bystanders and your patient at risk (if you don't show up in one piece).
It may seem counterintuitive, but for the vast majority of responses lights and sirens/running emergency traffic does not save time or lives. The biggest factor in time savings for emergency traffic is in rural settings with long distances.
"Run distance was the only variable that was statistically significant in affecting time saved during a code 3 response." Ho J, Lindquist M. Time saved with the use of emergency warning lights and siren while responding to requests for emergency medical aid in a rural environment. Prehosp Emerg Care. 2001; 5(2):159-162.
Additionally, even trained emergency vehicle operators obeying all posted traffic laws have a significant chance of being involved in a collision:
"Although only 75% of the division's responses are run with warning lights and sirens (WLS), a disproportionate 91% of response mode collisions were during a WLS response. The responsible EMV driver had a history of multiple EMVCs in 71% of the collisions."
Furthermore, the authors of that study advocated, "careful review of drivers' collision history, frequent emergency vehicle operator's course retraining, and appropriate discipline when necessary." Custalow CB, Gravitz CS. Emergency medical vehicle collisions and potential for preventive intervention. Prehosp Emerg Care. 2004; 8(2):175-184.
So if you would like the privilege of driving emergency traffic to the hospital you need to take an EVD/EVOC course, keep a clean driving record, ensure your vehicle has the appropriate warning systems, and obey all traffic laws even during an emergency response.
Nobody benefits if you become a patient.
Reply to this comment »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.
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