# Bad Blood between the emt and the p all input is appreciated



## sinthia (May 2, 2015)

There is to much bad blood between the basics and paramedic's where I work. We are a private transport service that runs ALS units.


I am a 3 year old Paramedic who hasn't worked as a P anywhere else, but who spent my basic life in a high volume 911 service where I am pretty sure that I've seen everything at least once even if I didn't know what it was at the time (except for those elusive purple unicorn calls)


As a 911 basic I was support staff. No 911 call except 'I ran out of my meds today and need a new prescription from the ED' were ever run by basics, but I never had an issue with being bored or not getting to utilize my skills. I was truly my partners partner. I took pride in the fact that they could always without hesitation know that I was going to do what I needed to do and that they could concentrate on the P stuff. I loved being a basic... I truly didn't want to be a P. I made more than some of my P's (don't tell them that) Then I did it I got my P and changed services after moving just before testing my P.


Now I have B's of my own, this is what I'm dealing with.

Oh you don't know that piece of equipment on the truck even though its part of your scope?
Oh you don't need to check off the truck, you were here 4 days ago and I'm doing it anyway?
Did you really just suggest on 2 separate occasions that our perfectly fine pt had s/s only a brain dead pt would have... out loud... to the RN... after interrupting my report?
Did I hear you right when you said that you would not listen to anything I try to teach you because I was not the training officer?
Did you really think I was over reacting when I told you that we couldn't take lol out of the ED even though her BP was 65 systolic?
So pop quiz diphenhydramine is what? Yes, a drug. No, we do carry it. Yes, its in a basic protocol. Yes, I'm sure!

Oh so you've been an EMT for 6 years... and you think I'm a bully, and condescending and that I step on your toes and have no right to do anything or ask any questions because I should have faith in you as a basic and as my partner because as your partner my only job to perform while you have patient care is to assist you in any way that you see necessary unless of course it pertains to providing the appropriate level of care and I must deduce this by not talking to the patient or the nurse or listening to the report or looking at the paperwork or asking you questions or assessing the pt because it is your call and you know how to do your job and don't need me to look over your shoulder because it hurts your feelings and you don't care if I do it because you have yet to show competence because it is not my job? Well I apologize let me know when you feel over whelmed and want me to step in, and please in the mean time will you be mentally preparing my petition to MY medical director (because as a basic you don't have one, I don't know why, but you operate under my license and I operate under med controls) not to tear up my ACLS card when things go south and maybe also consider getting on with a basic service so you can arm wrestle for seniority or maybe even go for your P. Thanks.


I wanted to blame this on being an IFT service instead of a 911 service but I've known B's in 911 that are the same. How oh how do I deal with this.


I'm not talking about the incompetence, that I know how to deal with. The animosity between the B's and P's is bad... I don't know how to appease them and make them happy – er so as to have a better working environment while still making sure that the pt is receiving the level of care that the pt needs. I am not worried about making friends but I don't want to make enemies, and I am grossly outnumbered in this day and age where a white man, accusing another white man of discrimination is going to get the full court press my job is on the line, all they have to do is call me bully enough times.


The only thing I have been able to come up with is being a narc and writing them up for every little thing in hopes that I'm not burnt at the stake alone, since corporate surely doesn't want to 'burn em all' please offer some advice on how to handle this, I'd really like some B's input. Just because I am saddled with the bad apples doesn't mean that I'm not aware that there are more goodones than badones. I'm a black cloud for partners. :-(


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## islandmedic (May 2, 2015)

You're a 3 year old paramedic? You must be great with peds!


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## nick Joseph (May 2, 2015)

3 yr old paramedic? damn you started early


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## squirrel15 (May 2, 2015)

I'd make the 3 year old joke but I think I'm late to the party. I'd also give input but I got lost in what exactly you were trying to say... Mostly what I gathered was you have no trust in EMT-Bs because they are a lower level provider than you. I understand double checking your equipment on a rig, or reassessing what came as a BLS call, to make sure it shouldn't be run ALS, but your distrust sounds like an issue as well as whatever it is being directed to you from the EMT-Bs.

And how does an EMT-B not have a medical director and operate under your license? As far as I'm aware it doesn't work that way, we have protocols and work under medical direction as well...

If you could clarify some of your rambling I will gladly give more input, but what you said is confusing.


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## Underoath87 (May 2, 2015)

I'll be blunt: it sounds like you need to loosen up or you'll be miserable and make everyone around you miserable.
Your partners probably discount your concerns because you're always overreacting out about something (The Boy Who Cried Wolf, if you will).  

If this isn't the case and they really are ALL just incompetent (which is statistically unlikely), then the advice still applies, even though you may have more reason to be upset.


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## Ewok Jerky (May 2, 2015)

Maybe try stop being so condescending?

Maybe you have ****ty partners, maybe you don't, I don't know all I'm getting is your side of the story. But if I had a newly minted paramedic come in to my service where I have been working for years as a basic and order me around and give me the attitude you have in your post, I would not be all nice and cheery for you.

There is a difference between bossing and educating. There is a difference between being friends and treating someone with dignity and respect.

Also, where do you work that basics can give benedryl without medical direction?


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## mgr22 (May 2, 2015)

To the OP, since you're asking for advice, the first thing I'd suggest is go back and read your post, then imagine you're an EMT, and a medic wrote that complaint about you. What impressions would you have of that medic? Be honest with yourself.

If you were having a bad day when you wrote that and you'd change it if you could, no problem, everyone has those moments. If you don't see any issues with what you wrote, I doubt if any comments from us will fix things for you.


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## cruiseforever (May 2, 2015)

sinthia said:


> There is to much bad blood between the basics and paramedic's where I work. We are a private transport service that runs ALS units.
> 
> 
> I am a 3 year old Paramedic who hasn't worked as a P anywhere else, but who spent my basic life in a high volume 911 service where I am pretty sure that I've seen everything at least once even if I didn't know what it was at the time (except for those elusive purple unicorn calls)


 
I do not know why people keep using this line.  The older one gets the more you realize you will never see everthing.


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## Angel (May 3, 2015)

Just reading your post...you sound hostile, and angry and i probably wouldnt want to listen to you either.
You say you saw nearly everything as an EMT which is fine and dandy, but at 3 years of being a medic, I reckon you still have a lot to see, care for and manage as far as patients go, and if for NO other reason than to make your life easier, get a long with your EMT. 
Its not that hard, and yes you probably are taking yourself too seriously.

"Theyre just IFT"---and so are you...so??

Take a chill pill


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## 281mustang (May 3, 2015)

a





sinthia said:


> The only thing I have been able to come up with is being a narc and writing them up for every little thing in hopes that I'm not burnt at the stake alone


I'm sorry, but the fact that you would even suggest resorting to that pretty much explains your entire dilemma. Yeah, we all get stuck with sub-standard EMTs from time to time, but the way you articulate your points shows that you're THAT condescending overzealous partner that no one wants to work with.

Stop taking yourself seriously and life will be much easier for you. Not to mention the fact that this is an IFT company to boot. I don't mean that in a condescending way but on the same coin there is no reason to be as anal retentive as you are if you're doing nothing but transfers.


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## gotbeerz001 (May 3, 2015)

Three rules for getting along at work: 
1. Know your job. 
2. Do your job. 
3. Don't be a d*ck.

In the fire service, you might be able to get away with weakness in one of these areas if you are really good cook.


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## RocketMedic (May 3, 2015)

My awesome partner dragged my brand-new ambulance down the side of a fence yesterday. I didn't get mad. I just adapted.


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## Tigger (May 3, 2015)

sinthia said:


> Oh so you've been an EMT for 6 years... and you think I'm a bully, and condescending and that I step on your toes and have no right to do anything or ask any questions because I should have faith in you as a basic and as my partner because as your partner my only job to perform while you have patient care is to assist you in any way that you see necessary unless of course it pertains to providing the appropriate level of care and I must deduce this by not talking to the patient or the nurse or listening to the report or looking at the paperwork or asking you questions or assessing the pt because it is your call and you know how to do your job and don't need me to look over your shoulder because it hurts your feelings and you don't care if I do it because you have yet to show competence because it is not my job? Well I apologize let me know when you feel over whelmed and want me to step in, and please in the mean time will you be mentally preparing my petition to MY medical director (because as a basic you don't have one, I don't know why, but you operate under Ymy license and I operate under med controls) not to tear up my ACLS card when things go south and maybe also consider getting on with a basic service so you can arm wrestle for seniority or maybe even go for your P. Thanks.


.

The button next to the question mark will place periods into your tale. That would go a long way. 

Anyway, if this is your attitude, you've found the problem. Also I have never heard of EMTs acting under a paramedic's license. Yes, you are responsible for overall patient care, but if your attitude is one that the EMTs work for you, that's an issue. If you're partners do not ever feel like they are part of the care team, how do you expect them to contribute? 



> I'm not talking about the incompetence, that I know how to deal with. The animosity between the B's and P's is bad... I don't know how to appease them and make them happy – er so as to have a better working environment while still making sure that the pt is receiving the level of care that the pt needs. I am not worried about making friends but I don't want to make enemies, and I am grossly outnumbered in this day and age where a white man, accusing another white man of discrimination is going to get the full court press my job is on the line, all they have to do is call me bully enough times.


I don't think you know how to deal with incompetence based upon your posts in the slightest. You appear to consistently fail to have meaningful interaction with your partners, otherwise they would not continue to do things that bother you. As soon as you say "I'm not looking to make friends," you become unlikable. Good luck getting people to respect you then. 




> The only thing I have been able to come up with is being a narc and writing them up for every little thing in hopes that I'm not burnt at the stake alone, since corporate surely doesn't want to 'burn em all' please offer some advice on how to handle this, I'd really like some B's input. Just because I am saddled with the bad apples doesn't mean that I'm not aware that there are more goodones than badones. I'm a black cloud for partners. :-(



Yeah, not a good idea. There are other ways to deal with things, I guarantee it.


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## escapedcaliFF (May 3, 2015)

Me and all of my partners have always had an understanding. 

1) Truck is the basics responsibility. If the basic thinks there is an issue with it mechanically or otherwise it's not questioned as the basic knows how it should operate normally. 
2) Everything in the back is both our responsibility. We work together to make sure it's properly stocked.
3) Patient care is first and if the basic feels the medic missed something the basic can speak up without fear of the medic being a ****. 
4) If one of us doesn't know a piece of equipment on our rig we work together and learn.  
5) You can discuss freely any issues without fear of reprisals.
6) We are a team and not working against one another.
7) Before any administrative punishment is pursued we talk about our issues and if all else fails then write ups are a last resort. 

To be honest you sound like you have an ego problem and feel like you demand respect. Respect is earned not demanded.


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## gotbeerz001 (May 3, 2015)

RocketMedic said:


> My awesome partner dragged my brand-new ambulance down the side of a fence yesterday. I didn't get mad. I just adapted.


That means a paid afternoon off while he pees in a cup, right?


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## Trauma Queen (May 3, 2015)

From the sounds of it, you're the reason you deal with "bad blood" between EMTs and paramedics. Respect is mutual, and you sound like a real terror to work with, so no wonder you're having bad experiences.

Just because you're a medic doesn't mean you're done learning. And it especially doesn't mean that there is nothing you can learn from an EMT. At 3 years you're still a baby medic. And judging by your statement that you've seen and done "everything," you seem to be a whole lot more inexperienced and close minded than you think.

Settle down, don't get so bent and flustered, and breathe. You're going to give yourself an ulcer if you keep this up.


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## CALEMT (May 4, 2015)

escapedcaliFF said:


> Me and all of my partners have always had an understanding.
> 
> 1) Truck is the basics responsibility. If the basic thinks there is an issue with it mechanically or otherwise it's not questioned as the basic knows how it should operate normally.
> 2) Everything in the back is both our responsibility. We work together to make sure it's properly stocked.
> ...



Just wanted to reiterate this. 



sinthia said:


> I truly didn't want to be a P.





sinthia said:


> I am not worried about making friends



I think I found the root of your problems.



sinthia said:


> The only thing I have been able to come up with is being a narc and writing them up for every little thing



So you're writing up your partners for every little thing they mess up on? And you're wondering why theres bad blood? I would be flat out lying to you if I said after 3 years of being an EMT that I don't screw up every now and again. Its not the mistakes that get you, its how you learn from them so it doesn't happen again is what matters.


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## Amelia (May 4, 2015)

Now... I'm just a student... but, now please correct me if I'm wrong... isnt this supposed to be a "team" effort? Not just in EMS but with police and fire as well? Last I heard, there was no "I" in team. Hold on, let me check..... I have to still see if my Bachelor Degree in English still works...

T-E-A-M

Nope! No "I!"


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## epipusher (May 4, 2015)

My guess is you are insecure regarding your own level of competence as a medic.


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## 281mustang (May 4, 2015)

epipusher said:


> My guess is you are insecure regarding your own level of competence as a medic.


 That looks to be a fair assessment. Her post implies that she's never even worked 911 as a Medic while in the same breath perpetrating a persona of someone that has seen and done a little of everything. That sounds like a wee bit of a stretch by anyone's imagination...


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## sinthia (May 6, 2015)

epipusher said:


> My guess is you are insecure regarding your own level of competence as a medic.



I absolutely agree. As an IFT unit we don't see much that requires acute care and so I am worried that I'm going to miss something.


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## squirrel15 (May 6, 2015)

sinthia said:


> I absolutely agree. As an IFT unit we don't see much that requires acute care and so I am worried that I'm going to miss something.


So you dont listen to your EMT no matter their experience, who may or may not be correct in something they see and you have missed?


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## gotbeerz001 (May 6, 2015)

sinthia said:


> I absolutely agree. As an IFT unit we don't see much that requires acute care and so I am worried that I'm going to miss something.


I have had some great EMTs shed light on an unusual presentation that they had seen before.


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## sinthia (May 6, 2015)

squirrel15 said:


> So you dont listen to your EMT no matter their experience, who may or may not be correct in something they see and you have missed?



I never said that. I've worked with some great B's whom I would trust with my life, and some others who can do their job with their eyes closed and working with them is refreshing, being able to have confidence in them however that is not the caliber of EMT I'm working with now and it really doesn't necessarily have to do with experience.

My 8 year veteran Basic never takes vitals and makes them up on the report.
My 12 year veteran Basic thinks I should asses my ALS transfer pt in the back of the truck so that we can get on the road quicker because checking orders and meds and attatchments should be done enroute.
My old <1 year Basic could anticipate what I needed as well as handle any situation until someone got there to help (she saved a staff memerbers life in a NH who coded while the other staff stood around scared) 

My problem is I don't know how to have peace of mind, making sure something isn't missed without coming across as being condescending.

Should I just chill out? Calm down. And whatever will be will be?


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## sinthia (May 6, 2015)

squirrel15 said:


> I'd make the 3 year old joke but I think I'm late to the party. I'd also give input but I got lost in what exactly you were trying to say... Mostly what I gathered was you have no trust in EMT-Bs because they are a lower level provider than you. I understand double checking your equipment on a rig, or reassessing what came as a BLS call, to make sure it shouldn't be run ALS, but your distrust sounds like an issue as well as whatever it is being directed to you from the EMT-Bs.
> 
> And how does an EMT-B not have a medical director and operate under your license? As far as I'm aware it doesn't work that way, we have protocols and work under medical direction as well...
> 
> If you could clarify some of your rambling I will gladly give more input, but what you said is confusing.



I am sorry for the rambling, I did get a little carried away.
I don't have trust in my B's because they continually show their incompetence. Most of which can be pointed out as their laziness or them taking on the mind set that this is just IFT stuff so it isn't important.

My double checking as you say is what causes the animosity. I have never told any of my B's that I don't trust them, nor have I yelled at or called them out. I simply want to know what's going on so that hopefully nothing is missed. (When they ask to see my pt chart or step in to ask my pt questions I have no problem with it, after all that is technically our pt and there is information that they need to know, and truly we are working together so it shouldn't matter.) When I ask their pt a question, or confirm something with the nurse concerning their pt they feel as if I am undermining them. That is what I don't know how to get around. How to check in order to be confident that nothing is being missed without them feeling like I'm being condescending.  

As far as them working under my license. Where I work basics cant operate without a paramedic present, their protocols simply list what certain things they can do on the P's call ie; 12lead EKG (they can perform the skill, where the P interprets), administer 4 baby aspirin, (after being instructed to do so my the P with the paramedic at bedside double checking), Set up and administer an albuterol treatment (again after being instructed and observed by P) 

A basic cannot be an attendant for anything acute. They operate under borrowed servant. I don't understand it much myself, but under these rules they can actually perform more skills than I could as an EMT it just all has to be on scene.


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## Brandon O (May 6, 2015)

http://www.amazon.com/How-Win-Friends-Influence-People/dp/B008GAT3BI/ref=sr_1_2?ie=UTF8


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## squirrel15 (May 6, 2015)

@sinthia so the same system that allows a B to administer drugs is now extremely restrictive and they can only work if a paramedic authorizes it? If you don't mind me asking, where is it you work? And how much of this is company policy?

And if everything is done under you, why is there such a thing as BLS under what you're describing? Because even if its not an acute call, my understanding of what you said is an EMT cant even administer O2 in the back without the paramedic present in the back. It sounds like everything should be run ALS and the EMT shouldn't be doing an assessment anyways. 

And as for the saying you don't listen to your EMTs that's just how it came across in your first post, I apologize if I misinterpreted that.


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## sinthia (May 6, 2015)

Ewok Jerky said:


> Maybe try stop being so condescending?
> 
> Maybe you have ****ty partners, maybe you don't, I don't know all I'm getting is your side of the story. But if I had a newly minted paramedic come in to my service where I have been working for years as a basic and order me around and give me the attitude you have in your post, I would not be all nice and cheery for you.
> 
> ...



I get what you mean by the newby coming in being bossy, but how do I not come across as bossy or condescending but still be able to feel comfortable with the level of care provided?

I've tried educating, I was told that if the company didn't make it mandatory then they weren't going to do it, and besides they didn't need to know it, they were on the ALS truck, I would always be there.

And I have a really hard time giving respect where none is earnd. I have had some fantastic Basics but I am currently stuck with some seriously bad apples. Who constantly go to management calling me a bully for not having confidence in them. 

NC I was extremely surprised my self at the extent of the basics scope. Like California every county is different. Where in one county you have basic units running around with Epi ampules to give IM injections, PO Benadryl, Ibuprofen, and Tylenol as well as nitro albuterol and narcan in other countys they can do so but not without a P present. We actually had a B unit with a monitor so they could obtain a 12 lead and Bluetooth it to the hospital.


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## sinthia (May 6, 2015)

Angel said:


> Just reading your post...you sound hostile, and angry and i probably wouldnt want to listen to you either.
> You say you saw nearly everything as an EMT which is fine and dandy, but at 3 years of being a medic, I reckon you still have a lot to see, care for and manage as far as patients go, and if for NO other reason than to make your life easier, get a long with your EMT.
> Its not that hard, and yes you probably are taking yourself too seriously.
> 
> ...



I was angry in my post... but I don't talk to my partners like that. I was frustrated.
I do have a lot to learn, and my emt career is all I have to compare my B's with. I was trying to show how I was support for my partner and so not having partners now that support me is a little uncomfortable.

I absolutely agree that I need to get along with my emt , that's my problem, I don't know how. Should I make all the concessions and bend to them, and let them do as they will and not worry that they apply the same mindset to their pt care as they do with their ideas about cleaning the station (if I don't do it someone else will) that's what I feel they want.

I'f I take a chill pill and relax am I not being to blasé about paramedicine?
Am I taking everything to seriously? Can I calm down without compromising pt care?

Maybe my perception of my paramedic partners is skewed, I honestly thought they had one eye on the patient and one eye on everything else.


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## Brandon O (May 6, 2015)

I think this comes down to people skills, not medicine. Handling this kind of issue is one of the fun little challenges of any clinical role. And I'm not sure how teachable it is, especially over the internet. (Double especially not by me.)


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## Kevinf (May 6, 2015)

Faking vitals is creating a fraudulent legal document / medical record and would likely result in serious repercussions if reported to overseeing authorities of any stripe. Not to mention potentially endangering the patient. This should be reported immediately if you have knowledge of it happening. I caught one of our newer hires doing this as it turned out his patient was very hypotensive, enough so to warrant a trip to the ED for evaluation. He charted 120/80 yet the patient had a systolic in the mid 60's. Chart review turned up an impossible pattern of 120/80's and he was terminated.

That said, you need to learn how to influence your peers without coming off as condescending or uptight. If you truly can't get along with someone you need to request not to be partnered with them. If the problem looks endemic that's either a sign that _you_ are the problem or that it's time to abandon ship.


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## Brandon O (May 6, 2015)

^ what he said.


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## sinthia (May 6, 2015)

escapedcaliFF said:


> Me and all of my partners have always had an understanding.
> 
> 1) Truck is the basics responsibility. If the basic thinks there is an issue with it mechanically or otherwise it's not questioned as the basic knows how it should operate normally.
> 2) Everything in the back is both our responsibility. We work together to make sure it's properly stocked.
> ...



I agree with your list. My day to day workings run like this.
1) If I ask my partner if they checked the oil and the O2. One will lie, two and three will actually do it and four will suggest I do it since hes washing the truck.
2) Only one of my 4 partners will help me check off the truck.
3) I have no problems with my partners speaking up, or suggesting something, I will be the first to admit that I don't catch everything. We are supposed to be a team. But none of them want me to speak up, if I do I'm being condescending.
4) There is no working together or learning together. One feels as if she knows enough to get by, two says his job is just to drive, three will actually pull up the owners manual and talk about it with me, four will suggest I do it my self since hes washing the truck.
5) I've suggested over and over that I am easy to talk to and non confrontational and if they have an issue with me that they can speak up and we will work it out. One is a drama queen and pathological liar and I have to let her have her drama moment and apologize that she didn't know that it was my job to make sure that she didn't do something that could hurt the patient as it is her job to do the same with me. And to either let her have her lie or argue until I'm blue in the face. Two will tell me his problems with me after his anger calms most of which revolve around him having issue taking direction from a girl who's young enough to be his daughter. (His words not mine.) Three will offer her opinion and listen to my reply but decide that her opinions on the matter are correct, but doesn't cause issue with me not doing it her way. Four offers no opinions about anything except to bad mouth any and all other Paramedics specifically, usually ones hes never worked with.
6) One Two and Four are just getting a pay check. Three is truly my only 'partner'
7) One will lie about anything to anyone, the more drama the better, tattling is one of her favorite past times if things are to quiet around the office she'll change that. Two gets angry and huffy and will go the entire shift without talking to you if you suggest that something could be done different. Three is all about talking it through (unless shes mad... then she requires at least 3 hours of quiet time first) Four is to busy complaining about what ever it is we should be discussing to actually have a conversation about it.


I am not sure why my post came across that way. I do not demand respect, and I am well aware it is earned. I also know that almost all things that happen at work are either individual situations (station duties, turning in completed paperwork on time etc.), or partner situations (checking off truck, providing prompt polite pt care, providing care period etc.) and almost never I'm the paramedic I'm in charge situations (informing my Basic that they are not allowed to do what they want to because that is battery). I am not arrogant nor do I think this is the paramedic show.


I do feel as if they should support me on my calls as I am there to support them on theirs. I get their vitals for them. I clean the stretcher and truck while they give report. If they want to do something different all they have to do is communicate what they want, and I will follow their direction without question. But get no support in return. If asked to get vitals they suggest I get them in the truck. If I start to make the stretcher after turning over pt care they want to know why I can't just wait until we get back to the office. If I ask them to wait before they place blankets and straps on the pt so that I can untangle the iv lines I get hands thrown in the air step back 3 steps and a declaration that they wont touch the pt unless asked to do so.


I am not super bubbly and friendly, nor do I know how to be fake and pretend to be interested in things they are interested in, I am by nature an introvert. I know this has me come across like a snob but pretending to be friends with them isn't going to fix any of my problems. I need to know how to get along with my partners and how to communicate with them so that I don't come off as condescending. Even if I need to calm down. (need some suggestions on how to do that, worrying about pt care and missing something is not something I know how to not do) I would prefer some suggestions on how I can come across as calm while still making sure the pt doesn't suffer from in attention.


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## sinthia (May 6, 2015)

squirrel15 said:


> @sinthia so the same system that allows a B to administer drugs is now extremely restrictive and they can only work if a paramedic authorizes it? If you don't mind me asking, where is it you work? And how much of this is company policy?
> 
> And if everything is done under you, why is there such a thing as BLS under what you're describing? Because even if its not an acute call, my understanding of what you said is an EMT cant even administer O2 in the back without the paramedic present in the back. It sounds like everything should be run ALS and the EMT shouldn't be doing an assessment anyways.
> 
> And as for the saying you don't listen to your EMTs that's just how it came across in your first post, I apologize if I misinterpreted that.



I work in NC, every county has a different Medical Director (county based and system based)

The county I work does not allow for basic providers. Its a County thing, nothing acute. They can take discharges out of the hospital, or dialysis runs. However basics cannot attend an acute call if it originates in this county and terminates in this county. If it terminates in a different county (BLS long distance Hospital to Hospital transfer) then it falls under our systems medical director where they are allowed to operate at the basic level following State protocols (instead of County) but as an ALS truck we never take long distance BLS calls.


If picking up a dialysis return they find the pt blood sugar is 69 or below they have to call for ALS intercept, even if their transport time to the ED will be only 2 minutes they still have to call for ALS and they can not divert from the ER and take the pt back to the nursing home even if the pt insists that their blood sugar is normal for them, they still have to call for ALS.


No they can not administer O2 unless the pt is on O2 at home. As far as I know this isn't the only county that is this restrictive but it is one of only a few.


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## sinthia (May 6, 2015)

CALEMT said:


> So you're writing up your partners for every little thing they mess up on? And you're wondering why theres bad blood?



I don't write them up, I was saying that was the only thing that I could think of to do, otherwise it is them writing me up and complaining about me being bossy and condescending without my side ever being heard. I'm anal, I like things a certain way and I'll do them that way myself without expecting my partner to do it my way but expecting them to do their job (either pt care or as my partner) is not in my opinion being bossy or condescending. I can occasionally be sarcastic, for example... “so you know how you said that our main O2 was good this morning... yeah well its actually empty.” and the response I get usually is something along the lines of “hehehe sorry, I didn't actually check. The crew we relieved didn't tell me it was empty so I assumed it was good.”


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## Kevinf (May 6, 2015)

Sounds like a **** place to be a basic, I would not be surprised that they aren't attracting the best and brightest. I'd wager the basic pay is near minimum wage too?

If there is a culture of half-asking this stuff, nothing you are going to do will change it. It's gotta be top-down from the start. Talk to management, it's their job to sort it out. If there is no action taken, move along before it bites you in the ***.


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## squirrel15 (May 6, 2015)

sinthia said:


> I work in NC, every county has a different Medical Director (county based and system based)
> 
> The county I work does not allow for basic providers. Its a County thing, nothing acute. They can take discharges out of the hospital, or dialysis runs. However basics cannot attend an acute call if it originates in this county and terminates in this county. If it terminates in a different county (BLS long distance Hospital to Hospital transfer) then it falls under our systems medical director where they are allowed to operate at the basic level following State protocols (instead of County) but as an ALS truck we never take long distance BLS calls.



What? That means there are basic providers then....


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## sinthia (May 7, 2015)

Kevinf said:


> That said, you need to learn how to influence your peers without coming off as condescending or uptight.



That is what I am asking... I was hoping for some suggestions. Especially from EMT's as I'm sure you've run across a difficult partnership and there were things you wish you could ask your partners to do in order to make for a better partnership.


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## sinthia (May 7, 2015)

squirrel15 said:


> What? That means there are basic providers then....



Not within the county we are based out of. But in other counties and with the company yes. There are even counties where I can only do CPR and AED as I am not approved to operate in that county as an ALS provider, and the good Samaritan law only applies to lay people, if you stop to render aid off the clock it is considered practicing medicine without a license.


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## squirrel15 (May 7, 2015)

sinthia said:


> Not within the county we are based out of. But in other counties and with the company yes. There are even counties where I can only do CPR and AED as I am not approved to operate in that county as an ALS provider, and the good Samaritan law only applies to lay people, if you stop to render aid off the clock it is considered practicing medicine without a license.



Your wording is extremely confusing then, sorry. If they are taking discharges, or even dialysis runs, they are acting as providers. 

And I don't know about NC but if you originate in a county in CA, those are the protocols you follow, even if going out of county and therefor, basics could not originate a transport in your county. And as for only doing CPR or AED are you not considered an EMT in other counties? In CA to be a paramedic and work ALS you must be certified in each county, and be working under an ALS provider, and cant operate as a paramedic off duty, but you can work as an EMT in other counties. 

But I'll back out of that conversation and address your main question because I'm lost as to how your county operates, because it sounds as if EMTS can't even assess.

The person lying on reports needs reported. Everyone else is either bad luck on partners you've been put with. Or you are overbearing. If you start a shift off and do nothing but make it obvious you think your better and your going to oversee everything because youre paramedic, I'd be annoyed too. You shouldn't be double checking everything your EMT does and should trust them to make the correct decisions, and trust their assessments. If I get an AO status and BP and you come in and recheck both, I'm going to be jaded towards. I understand if you point something out that I miss, but I don't want my partner double checking everything I do. And I doubt the patient wants that, and that's no longer great patient care when the patients annoyed at constantly being assessed


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## RefriedEMT (May 7, 2015)

Kevinf said:


> Faking vitals is creating a fraudulent legal document / medical record and would likely result in serious repercussions if reported to overseeing authorities of any stripe. Not to mention potentially endangering the patient. This should be reported immediately if you have knowledge of it happening. I caught one of our newer hires doing this as it turned out his patient was very hypotensive, enough so to warrant a trip to the ED for evaluation. He charted 120/80 yet the patient had a systolic in the mid 60's. Chart review turned up an impossible pattern of 120/80's and he was terminated.
> 
> That said, you need to learn how to influence your peers without coming off as condescending or uptight. If you truly can't get along with someone you need to request not to be partnered with them. If the problem looks endemic that's either a sign that _you_ are the problem or that it's time to abandon ship.



Can't understand why someone would do this, it is so damn easy to get some quick vitals. Hell I have access to a lifepak but still do vitals manually very often not only to continue practicing the skill but also because I do not always trust the lifepaks vitals.

As for the OP, I always consider what my paramedic says to me and take into account all my previous encounters with similar situations. I never pass up an opportunity to learn more in my field even if it is out of my scope at the moment. No Tigger, I don't care if you find anything wrong with my grammar since I speak and write American, not english. So i guess we need to write an Americanized english book since Tigger is a english grammar nazi.


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## Kevinf (May 7, 2015)

Kevinf said:


> That said, you need to learn how to influence your peers without coming off as condescending or uptight. If you truly can't get along with someone you need to request not to be partnered with them. If the problem looks endemic that's either a sign that _you_ are the problem or that it's time to abandon ship.





sinthia said:


> That is what I am asking... I was hoping for some suggestions. Especially from EMT's as I'm sure you've run across a difficult partnership and there were things you wish you could ask your partners to do in order to make for a better partnership.



How do you influence your peers while remaining personable? If this isn't a skill you've acquired by the time you are an adult, you need to observe people with this skill and learn. There is no other way to do it if it doesn't come naturally to you. But it sounds like this is a top down problem with your coworkers not taking the job seriously... move on.


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## Ewok Jerky (May 7, 2015)

Here's how I see it. You like things done your way. You have a set of principles which guide your behavior. And you are anal about the way things get done. Add to this a sarcastic introverted manner. Plus you are in a system where EMTs apparently have no authority anyways. 

It quickly becomes easier to let you do everything yourself than to try and help for fear of being told I did it wrong, or how your way of doing it is better,  have you do it all over again yourself, and then make a sarcastic comment belittling me.

If the EMTs are that ****ty, then you need to own up to being a hardass or find another job. If perhaps its your attitude causing a problem you need to lighten up and let them do their job the way they do it and let it go. Life us too short to worry so much about what other people are up to.


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## Amelia (May 7, 2015)

sinthia said:


> I am sorry for the rambling, I did get a little carried away.
> I don't have trust in my B's because they continually show their incompetence. Most of which can be pointed out as their laziness or them taking on the mind set that this is just IFT stuff so it isn't important.
> 
> My double checking as you say is what causes the animosity. I have never told any of my B's that I don't trust them, nor have I yelled at or called them out. I simply want to know what's going on so that hopefully nothing is missed. (When they ask to see my pt chart or step in to ask my pt questions I have no problem with it, after all that is technically our pt and there is information that they need to know, and truly we are working together so it shouldn't matter.) When I ask their pt a question, or confirm something with the nurse concerning their pt they feel as if I am undermining them. That is what I don't know how to get around. How to check in order to be confident that nothing is being missed without them feeling like I'm being condescending.
> ...



Wow, now I'm really baffled by where you live and curious because we don't need a Ps permission to perform our SOP, but again, it is not a boss/employee relationship... maybe?


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## NomadicMedic (May 7, 2015)

Worth a read: http://what-when-how.com/paramedic-care/the-law-and-paramedics-ethics-and-law-in-ems-part-1/

Here's the salient points

*Borrowed Servant Doctrine*
*EMS practice dictates that the* Paramedic with the highest level of education or experience is responsible for patient care. Therefore, the Paramedic is responsible for directing and supervising any patient care performed by any other EMS providers on the team with lower levels of training.

*In those circumstances,* called the borrowed servant doctrine, the Paramedic is not only accepting assistance from those EMS providers but is also accepting responsibility for the actions and the errors of those providers. Therefore, the Paramedic’s failure to supervise a subordinate, who in turn makes an error and causes harm to befall the patient, leaves the Paramedic liable for the assistant’s actions.


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## escapedcaliFF (May 8, 2015)

Brandon O said:


> http://www.amazon.com/How-Win-Friends-Influence-People/dp/B008GAT3BI/ref=sr_1_2?ie=UTF8



Oh come on most of those self help books are written by limp wristed panzeys. I use self help books to fire the furnaces that turn out my home made silver bullets to take on the army's of darkness.


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## gotbeerz001 (May 8, 2015)

escapedcaliFF said:


> Oh come on most of those self help books are written by limp wristed panzeys. I use self help books to fire the furnaces that turn out my home made silver bullets to take on the army's of darkness.


Well some of us may need a little extra help since we weren't born with your natural gift for tact.


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## RocketMedic (May 8, 2015)

You should move. Pm me


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## escapedcaliFF (May 8, 2015)

gotshirtz001 said:


> Well some of us may need a little extra help since we weren't born with your natural gift for tact.



If you noticed on my early post regarding this subject I have a provided some simple solutions that I have employed with past partners. Granted my supervisors realize I hate the childish antics of this newest working generation and has always made sure to give me partners that are not self centered people who think the biggest issue is people not liking them on facebook. I think the OP is a egotistical self centered cry baby. I have no place for people like that bringing me down to their level. I once had a medic who acted like this and locked them out of the rig until dispatch called me telling me my medic was on the phone basically crying cause I locked him out of the rig. Supervisor thought it was funny but my point was to teach my medic a lesson.


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## Tigger (May 8, 2015)

RefriedEMT said:


> Can't understand why someone would do this, it is so damn easy to get some quick vitals. Hell I have access to a lifepak but still do vitals manually very often not only to continue practicing the skill but also because I do not always trust the lifepaks vitals.
> 
> As for the OP, I always consider what my paramedic says to me and take into account all my previous encounters with similar situations. I never pass up an opportunity to learn more in my field even if it is out of my scope at the moment. No Tigger, I don't care if you find anything wrong with my grammar since I speak and write American, not english. So i guess we need to write an Americanized english book since Tigger is a english grammar nazi.


What in the world are you talking about. I don't particularly care how your write (and nowhere have I said otherwise), just know that the above comments seriously undermine what (little) credibility you have.


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## Tigger (May 8, 2015)

escapedcaliFF said:


> If you noticed on my early post regarding this subject I have a provided some simple solutions that I have employed with past partners. Granted my supervisors realize I hate the childish antics of this newest working generation and has always made sure to give me partners that are not self centered people who think the biggest issue is people not liking them on facebook. I think the OP is a egotistical self centered cry baby. I have no place for people like that bringing me down to their level. I once had a medic who acted like this and locked them out of the rig until dispatch called me telling me my medic was on the phone basically crying cause I locked him out of the rig. Supervisor thought it was funny but my point was to teach my medic a lesson.


Who is the child here again?


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## escapedcaliFF (May 8, 2015)

Tigger said:


> Who is the child here again?



If you spent one hour with this medic you would lock them out too. I am not a hard asss by any means but when someone spends almost the whole shift complaing to me about social media and issues that have no effect on real life it was either that or I take my ear drums out with a pair of trama sheers.


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## RefriedEMT (May 8, 2015)

Tigger said:


> What in the world are you talking about. I don't particularly care how your write (and nowhere have I said otherwise), just know that the above comments seriously undermine what (little) credibility you have.



Heil to you to.


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## RocketMedic (May 8, 2015)

escapedcaliFF said:


> If you noticed on my early post regarding this subject I have a provided some simple solutions that I have employed with past partners. Granted my supervisors realize I hate the childish antics of this newest working generation and has always made sure to give me partners that are not self centered people who think the biggest issue is people not liking them on facebook. I think the OP is a egotistical self centered cry baby. I have no place for people like that bringing me down to their level. I once had a medic who acted like this and locked them out of the rig until dispatch called me telling me my medic was on the phone basically crying cause I locked him out of the rig. Supervisor thought it was funny but my point was to teach my medic a lesson.



I would crush your little Basic soul.


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## squirrel15 (May 8, 2015)

If I may say so myself, I think this conversation has veered off course and isn't really going to come back...


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## Tigger (May 8, 2015)

escapedcaliFF said:


> If you spent one hour with this medic you would lock them out too. I am not a hard asss by any means but when someone spends almost the whole shift complaing to me about social media and issues that have no effect on real life it was either that or I take my ear drums out with a pair of trama sheers.


I very much doubt I'd behave like a petulant child, but thanks. 

OP as I'm sure you can imagine, don't handle your issues like the above. Also, if you're coworkers do that to you I'm not sure I'd be concerned, says more about them than you.


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## Amelia (May 8, 2015)

One thing I love about this board is that there are so many strong personalities, points of view, and experience. That being said.... we shouldn't use our talents to attack one another. On a message board, in the garage, or in the field. 

Everyone take a deep breath......

Goosfraba....


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## escapedcaliFF (May 9, 2015)

RocketMedic said:


> I would crush your little Basic soul.



Doubt it. If you worked with me you would change your tune. You mightily actually be shocked.


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## RocketMedic (May 9, 2015)

If my partner decided to lock the truck, they would simply be unemployed.


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## NomadicMedic (May 9, 2015)

RocketMedic said:


> If my partner decided to lock the truck, they would simply be unemployed.



Amen.


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## gotbeerz001 (May 9, 2015)

escapedcaliFF said:


> Doubt it. If you worked with me you would change your tune. You mightily actually be shocked.


Having read several of your comments, I do not believe you are helping to change the (mostly negative) image of firefighters on this board... Whether you currently are one or not.


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## RefriedEMT (May 10, 2015)

All the firefighters i work with are actually very good at their job, so i don't know what makes you guys hate firefighters so much.


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## squirrel15 (May 10, 2015)

RefriedEMT said:


> All the firefighters i work with are actually very good at their job, so i don't know what makes you guys hate firefighters so much.


They get paid more


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## Mufasa556 (May 10, 2015)

RefriedEMT said:


> All the firefighters i work with are actually very good at their job, so i don't know what makes you guys hate firefighters so much.



You don't work in LA or Orange County do you?


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## RefriedEMT (May 10, 2015)

Mufasa556 said:


> You don't work in LA or Orange County do you?



Nope I work in Washington state. They do of course get paid more but that is mostly because they are paid by the state and not a private company that is withholding as much pay as possible. Also they have more training than a regular EMT or medic since they have to be trained for the fire side.


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## NomadicMedic (May 10, 2015)

Work as a basic for a private in king county. You'll change your tune.


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## JeffT (May 10, 2015)

Sounds like someone has an altered mental status?


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## RefriedEMT (May 10, 2015)

Yea seattle has a minimum wage of $15 an hour so I am sure I would change my tune but the only thing is I don't want to work in seattle.


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## escapedcaliFF (May 12, 2015)

gotshirtz001 said:


> Having read several of your comments, I do not believe you are helping to change the (mostly negative) image of firefighters on this board... Whether you currently are one or not.



Go over to firehouse.com and read the other side and you'll learn it's a two way street.


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## RocketMedic (May 12, 2015)

lol. I would react very poorly to being locked out of the truck.


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## Tigger (May 12, 2015)

escapedcaliFF said:


> Go over to firehouse.com and read the other side and you'll learn it's a two way street.


Not sure how that relates. 

To reiterate, if you locked me out of an ambulance you would likely be terminated and probably deemed unemployable in the region once word got out. No matter how terrible your partner was, that's just a poor decision that I'm surprised (and saddened) you were not punished for.


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## NomadicMedic (May 12, 2015)

escapedcaliFF said:


> I once had a medic who acted like this and locked them out of the rig until dispatch called me telling me my medic was on the phone basically crying cause I locked him out of the rig. Supervisor thought it was funny but my point was to teach my medic a lesson.



The entitlement is strong in this one.


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## CALEMT (May 12, 2015)

escapedcaliFF said:


> I once had a medic who acted like this and locked them out of the rig until dispatch called me telling me my medic was on the phone basically crying cause I locked him out of the rig.



That is just straight up childish, and judging by your attitude on this thread I would be surprised if people want to work with you.


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## gotbeerz001 (May 12, 2015)

escapedcaliFF said:


> Go over to firehouse.com and read the other side and you'll learn it's a two way street.


Bro, I am a career fireman and work PT as a transporting medic in a busy urban system... I think I understand both sides rather well.


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## Ewok Jerky (May 12, 2015)

escapedcaliFF said:


> I once had a medic who acted like this and locked them out of the rig until dispatch called me telling me my medic was on the phone basically crying cause I locked him out of the rig. Supervisor thought it was funny but my point was to teach my medic a lesson.


What lesson is that? Don't eff with the big man?


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## Mufasa556 (May 12, 2015)

escapedcaliFF said:


> I once had a medic who acted like this and locked them out of the rig until dispatch called me telling me my medic was on the phone basically crying cause I locked him out of the rig. Supervisor thought it was funny but my point was to teach my medic a lesson.



We spend endless hours sitting two feet from our partners. Personality conflicts are enivitable in this job. I've seen some unique ways, both right and wrong, of dealing with personality clashes, but I can't seem to figure out what lesson was being taught here.


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## COmedic17 (May 13, 2015)

If someone locked me out of my truck it would be very painful..........for them.



Secondly, I have never understood the hostility between fire & EMS....I get along great with the fire guys.


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## Tigger (May 13, 2015)

COmedic17 said:


> If someone locked me out of my truck it would be very painful..........for them.


People that do dumb things like that get hit where it hurts the most...the wallet. 



> Secondly, I have never understood the hostility between fire & EMS....I get along great with the fire guys.


We have a mostly positive relationship as well. My only issue is when the firefighters like to apologize to me about how much worse I have it than them. I already know what the shortcomings of my job are, don't need them emphasized.


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## COmedic17 (May 13, 2015)

Tigger said:


> We have a mostly positive relationship as well. My only issue is when the firefighters like to apologize to me about how much worse I have it than them. I already know what the shortcomings of my job are, don't need them emphasized.



That's when you go "yeah....that's why lunch should totally be on you today!"


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