WARNING: Medical terminology to follow, but I will try and keep it to a minimum.
I was the first medic on scene to a 54 year old male, whose chief complaint was that he nearly passed out while he was lifting a heavy object from the back of his minivan. He had a History of insulin dependent diabetes, a heart bypass, high cholesterol, and high blood pressure. His vitals were as follows: HR 72, RR 20, BP 136/72. He takes lopressor, insulin, lipitor, and aspirin. His 12 lead showed nothing acute, except LVH. I was in the middle of finishing my assessment when the transport unit arrived.
The medic on that truck told the patient that the near syncope was probably due to stimulation of the vagus nerve that lifting the box caused. I pointed out to the patient that while the other medic was probably correct, due to his extensive history, it would probably be best to take him in, just to be sure. You see, diabetics frequently do not have the classic symptoms of a heart attack, and often the first sign that a diabetic has of a serious heart attack is fainting, nausea, or shortness of breath, and not chest pain. The patient agreed with me, and decided to go to the hospital.
Apparently, that angered the other medic, who had been hoping to talk the patient out of going to the hospital. After he dropped the patient off at the hospital, he decided to come talk to me about "taking over his patient." I pointed out to him that he is a new medic (less than a year on the street) and that patient refusals are not there for his personal comfort- paramedic inconvenience is not a reason to avoid transport.
If there is any piece of advice I can give you new medics out there, it is this:
If you are ever undecided as to the proper course of action, whichever option it is that causes you the most work is usually the correct one. Don't ever forget that we are the patient's advocate, and all of our decisions need to be in the best interests of the patient, not ourselves.