Update

Earle Horton · medicine forum addict Joined: 17 May 2005 Posts: 51

---------Read on. This is good.---------

It's been about eighteen months since I quit nursing school, and I couldn't
be happier. My wife finished her BSN in December, and is now a genuine
honest to God RN. My daughters are getting master's degrees, one in
Chemistry and one in Human Nutrition. I am getting my second bachelor's in
Spanish, literature concentration, and am getting ready to spend the fall
semester in Vitoria-Gasteiz, País-Vasco, España. I think I might want to be
a writer as my second career.

After quitting nursing school* I continued with emergency medicine on a
volunteer basis for my community. This ended after I caught our self-styled
"head medic", a retired RN, violating protocol, patient rights and good
sense all at once. It could have been the ethics course I had taken three
years previous, or the ethics content in the nursing program (doubtful), or
maybe just good upbringing, but I couldn't let this one go. Now the nurse
is under investigation by the Colorado Board of Nursing, the Medical
Director is under investigation by the Colorado Board of Medical Examiners,
and most of the ambulance association members and employees have quit.
Little Colorado mountain towns may appear quaint when you are a tourist, but
if you stay year 'round you get a whole new insight into the human
condition.

The following letter, which I sent to every registered voter in my town,
explains some of what happened. None of the names have been changed, and no
one disputes the facts as summarized below.

--------------This really happened.------------------
An Open Letter Concerning Silverton San Juan County Ambulance Association.

Silverton San Juan County Voters
P. O. Box Number
Silverton, CO 81433

Dear Voter,

Silverton San Juan County Ambulance Association (SSJCAA) is the only
emergency medical service in the Silverton San Juan County, CO area. It is
supported by public funds and it is accountable to the public. Its Board of
Directors has been concealing relevant information. Mike Bertch, a nurse
and ambulance volunteer, disrespects patients, emergency room nurses, medics
and medical doctors, fails to consult medical control and intentionally
violates patients' rights. Dr. Louis Winkler of Montrose, the medical
advisor, a retired orthopedic surgeon, is not an emergency medicine
physician. He does not meet Colorado State law minimum requirements for
medical advisors.

· He does not involve himself in emergency medical care of patients from
Silverton.
· He does not supervise the field performance of medics.

I tried to resolve these issues with documented, written complaints using
all of the proper forms and official channels. The State lacks laws to
prosecute misconduct in Emergency Medical Services (EMS). Foolishly, they
rely on local people to do this. SSJCAA's Board of Directors (BOD) refuses
to take action. Paulette Schmalz, a BOD member, saw Mike Bertch abusing a
patient on the ambulance. BOD members Sheriff Sue Kurtz, County
Commissioner Ernie Kuhlman, and Town Trustee Mike Emery have known about
this for months and they have done nothing. (These three haven't even had
the common decency to reply to my written complaints about Mike Bertch. Two
years ago, they also ignored my written complaints about a disturbed and
hostile Town of Silverton employee issuing false citations, threatening
residents and harassing women.)

Mike told me that he had inserted Foley catheters in six patients, without
approval from any medical doctor. This was an invasive and risky procedure,
contrary to SSJCAA protocol and without medical justification. It is the
same as practicing medicine without a license. I myself saw the last
patient attempt to refuse the catheter and pull loose from the backboard to
remove it. He would have been seriously injured if he had succeeded. Mike
said that this patient had a "head injury". He did not have a head injury,
and only a medical doctor can legally overrule the wishes of a conscious
patient, head injury or no. (This is in Section G-1 of the SSJCAA Protocol
Manual.) When he finally arrived at Mercy Medical Center, Dr. Bader
questioned why, if it took several hours to get critically injured patients
to the hospital, Mike had the time to perform unnecessary and unauthorized
procedures on them? Mike's reaction was, "Dr. Bader has no business
questioning what I do in the field". Mike Bertch violated a patient's
rights, ignored protocol, and showed disrespect to the medical doctor who
had legally been in control (via phone) of the incident. Would you want a
nurse like this taking care of you?

After this, Mike admitted in front of Dr. Winkler and ten SSJCAA members
that he had done wrong. Later he came to my house. He yelled at me,
"YOU'RE NOT A NURSE. YOU DON'T KNOW WHAT I KNOW. I
HAVE AN ASSOCIATE'S DEGREE! YOU HAVE NO RIGHT TO
QUESTION WHAT I DO. YOU THINK I'M STUPID, DON'T YOU?"
My neighbor later told me that he had heard Mike "screaming" at
me.** Mike ran away after I failed to react to his infantile antics. Later
he told Kristina Maxfield, the EMS Director, that he didn't want me on call
because "Earle would be watching me". I found out later, from people with
similar experience, that this is Mike's customary means of getting rid of
people who disagree with him, and that the BOD and Dr. Winkler actually
condone it.

After I complained about Mike's incompetence, lying and anti-social
behavior, his wife Tracy sued me, alleging that I had committed "abuse of an
elderly or at-risk adult" against her, and she tried to get a restraining
order against me. (San Juan County Court records, Case Number 04C6.) Here
is what happened then.

· Her suit was groundless. She filed it to harass me.
· Based on apparent hallucinations and outright lies related in her
complaint, I informed the court that Tracy was delusional and maybe
incompetent.
· She avoided having to explain her actions to a judge by dismissing the
suit entirely.

When Mike Bertch makes a mistake no one can stop him, because "no one has
the right to question what he does". If you stand up to him, he has a
temper tantrum. If you complain, he gets his wife to sue you. The BOD and
Dr. Winkler consistently approve of what he does, but he is not worth even
their support. He is an inexperienced nurse with a two-year mail-order
degree and no emergency medical technician certification. He is combative
and anti-social and drives competent people away. SSJCAA has lost several
EMTs and a paramedic, all of whom have stories similar to mine, because we
refused to tolerate his anti-social behavior. He has intentionally and
systematically gotten rid of all people in the organization who are not
afraid to question him. This is not a good trade.

Until this problem is fixed, God help you if you actually need emergency
medical care in Silverton or San Juan County, CO.

-----------
*Some dispute that I really "quit" but that is what the official record
says. I am sticking to that story.

**Mike is about five-six, one-ten soaking wet, about sixty, bald on top with
long white hair and a Papa Smurf beard. It was like having an evil little
gnome screaming at me. I just stood there and listened. During a pause in
the screaming, I happened to mention the Colorado State Nursing Board
complaint process. It's a good thing we were outside, because the little
f***er would have hit the roof otherwise.

Mortimer Schnerd, RN · medicine forum Guru Wannabe Joined: 09 May 2005 Posts: 208

Earle Horton wrote:

Andrew Heenan · medicine forum Guru Wannabe Joined: 29 Apr 2005 Posts: 112

"Earle Horton" self-promoted as usual...

Earle Horton · medicine forum addict Joined: 17 May 2005 Posts: 51

That is not what the Nursing Board in this state says. Think about it.
Six Foleys without a doctor's order or medical justification. You work in a
hospital so you have probably never seen anything like this, but a nurse out
of control is a scary thing.

I miss you too.

Earle

"Mortimer Schnerd, RN" <mortschnerd@carolina.rr.com.remove> wrote in message
news:hcjie.36731$vi2.1296380@twister.southeast.rr.com...

Starlight · medicine forum Guru Wannabe Joined: 30 Apr 2005 Posts: 186

Alice, SWMBO · medicine forum beginner Joined: 10 May 2005 Posts: 27

"Earle Horton" <earle-NOSPAM-horton@msn.com> wrote in message

Norminn · medicine forum Guru Wannabe Joined: 05 May 2005 Posts: 157

Starlight wrote:

Earle Horton · medicine forum addict Joined: 17 May 2005 Posts: 51

I did write to the BON. I got no reply for four months. Eight months
after the incident an investigator subpoenaed records but has done little
else. I had a long talk with him, and he says that in most cases the BON
expects the employer to take care of things first. I looked on the Colorado
Department of Regulatory Agencies web site. D.O.R.A. has oversight over
doctors, nurses, hairdressers, plumbers, etc. There are a total of ten
investigators for the entire state, for all the professions. He told me it
would take about twelve to eighteen months to get a resolution of this
issue. That is too long to have a person whom I consider to be insane, who
recognizes no external controls on his behavior, to be treating patients on
our ambulance.

I followed proper channels from the beginning. I reported the incident to
the agency EMS Director. She took one look at my complaint and stated,
"Mike assaulted that patient". Then she reported it to the Medical Director.
(An EMS Medical Director is an M.D. under whose license all EMS personnel
work.) He stated that he "did not intend to offer any criticism at all",
but he did explain that Foleys were to be inserted in the future only with a
doctor's orders (Duh!) and according to specific indications. He stated
that "we" would behave better in the future. This was in a meeting with
about a dozen ambulance personnel present. Mike admitted that he had done
wrong, was going to follow protocol in the future, was very polite to the
people who had complained, etc. At that point I was convinced that the
situation had been rectified.

Two days later, with the Medical Director safely out of town, Mike was at my
house screaming at me that I had no right to question him. He is a
registered nurse and he has an Excelsior associate's degree. I already knew
that. I didn't need someone screaming it at me in my own back yard. Only
then did I contact the BON. The Medical Director asked me not to, but he
took no action against Mike.

A month later Mike's wife sued me for a permanent civil restraining order,
claiming that she was an "At-Risk Adult" and that I was stalking her. Her
evidence was fabricated, including an incident in which I allegedly walked
in front of her house on the public sidewalk and she "was afraid". Cell
phone and credit card records place me fifty miles away at the time. She is
not an "At-Risk Adult", not by Colorado law. I got her to dismiss the case
after I threatened to move for Rule 11 sanctions against her and her lawyer.
This scared the lawyer but the wife is threatening to sue me again. This
will be interesting because she agreed to dismiss the first claim
voluntarily and "with prejudice". The D.O.R.A. investigator says I have
"immunity" from being sued in retaliation for my complaint to the BON.
This doesn't stop a paranoid woman, or one feigning paranoia, from claiming
that I walked in front of her house and made her afraid. Maybe I can
establish that I am immune from this harassment, but I still have to go to
court to do it.

Meanwhile, the Board of Directors of the ambulance association, having been
told everything that had happened, expelled one of the witnesses to the
Foley incident from the ambulance association, without giving a reason why.
That's right, they expelled one of the witnesses, and continued to use Mike
on the ambulance. This is an RN who "cannot be questioned" by anyone in
town, because none of us "know what he knows" by virtue of his associate's
degree. Do any of you see the danger in a person, of any educational level,
who "cannot be questioned"? Ironically, he has openly shown gross
disrespect to several BSN nurses in town, who theoretically at least should
know even more than he does.

The lawsuit from the wife and the Board of Directors burying their heads in
the sand were what prompted me to write the letter to the registered voters.
This is a small town and there are only about 450 of them. Still the Board
of Directors did nothing. They haven't even answered numerous letters
and emails, not just from me. Occasionally, a member of the ambulance
association will speak out in a meeting, "You have to address this issue.
You have to answer Earle's complaint". One of Mike's friends will scream at
them then and the issue will be closed. Then the member will finally figure
out what is happening, and she will quit.

At the beginning of this mess, a paramedic supported what I was doing. Now
he tells me, "You can't get them", referring to the Board of Directors. He
has chosen to keep silent, even though he knows a lot more about misconduct
going back years than I do. He does this in exchange for being allowed to
volunteer for the agency. I don't know whether I can really blame him,
although I did call him a "collaborator" and a "hypocrite" a few times.

If you live in a city, you will probably think that this is all unlikely and
that I am crazy, as other posters have stated. If you live in a small
isolated town, you will know what I am talking about. There really are
places like this, not just in the movies. There really are nut cases
walking around free, with no one to supervise their actions. There really
are whole communities of people who "protect" them from any examination of
what they do.

It came up at a Town Board meeting. The answer was that "We don't talk
about these things in public". The price of this "Code of Silence" is that
out of twenty-six volunteer medics that we had last year, twenty have quit.
You can imagine who is left. These are people who don't care that one of
their fellows violated a patient's rights, or that the Board of Directors
has a policy of rewarding the guilty and punishing the innocent. (They have
no problem with minor infractions, but major misconduct has them petrified.)

After I made enough commotion at the state level I got the Board of Medical
Examiners to look at the Medical Director's role in failing to supervise
people working under his license. This is still in an "Inquiry Panel" and
I don't know what will happen with it. It is conceivable that the BME will
revoke our Medical Director's permission to practice here. With all the
other complaining that I have done it is unlikely that we will get a
replacement. If we do get one it will be another retired orthopedic
surgeon, who sees it as a feather in his cap but doesn't want to do any real
work to improve the system.

A number of mistakes have been made here. One is by the Medical Director
and the Board of Directors, who think that an RN license is worth more than
honesty, integrity or even sanity in a medic. Another is by Mike, the RN.
I am a quiet, non-assertive person in most situations. I suspect that most
people who post to Usenet are too. (Why are you posting to Usenet if you
are able to assert yourself in your daily life?) But when I see wrong being
done I have to do something about it. Mike thought that I would be
impressed into backing down by his temper tantrum. I was impressed, all
right, but not the way he intended. Another mistake by the Board of
Directors, who are elected officials and a local businessman, is thinking
that they can ignore their constituents indefinitely. This is a small town,
but it is a busy tourist center in the summer. I don't see how they can
make it through the tourist season with six medics, most of whom also have
full time jobs. There is no way I will go back on the ambulance without
responsible people in authority, and most of the others feel the same way
now.

I feel strongly that this situation should be addressed at the local level.
If it is not, the ambulance association will eventually fall apart because
of the climate of fear and mistrust that now exists and the complete
inaction of those in authority. When there is a problem, neither the
Medical Director nor any of the Board of Directors will back up the person
who complains. When a volunteer sees serious misconduct taking place, his
only choice is to pretend that he didn't see it or to quit the agency. Why
should I go back to that, even if the BON does something about the nurse?

Earle

"Starlight" <homehealth_rnDELETE@yahoo.com> wrote in message
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Starlight · medicine forum Guru Wannabe Joined: 30 Apr 2005 Posts: 186

On Wed, 18 May 2005 16:08:40 -0600, "Earle Horton"
<earle-NOSPAM-horton@msn.com> wrote:

BlueBeard · medicine forum beginner Joined: 06 May 2005 Posts: 9

Hi Earle,
nice to have you back.
still remember that crazy cat video!

-ramon.

--

Get The CrashCart!!
http://www.rncrashcart.com

"Earle Horton" <earle-NOSPAM-horton@msn.com> wrote in message
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