# My partner is a moron.



## redbull (Dec 7, 2010)

My partner is a moron. 

I'm fairly new, was hired by a private a few months ago and am paired up with this cocky, confident pretty boy EMT who takes the lead on all the non trauma medical emergency calls as opposed to working with me. 

We had one call where we went to an assisted living home to answer a call about a woman with "back pain." We arrive, she'ss with her son, lying supine on the bed, complaining of back pain. After I interviewed the nurse, there was no suspicion of foul play, and I went back to see my partner and the pt. My partner asks where it hurts and she touches her right hip then starts wailing. Here's what my partner does, and you tell me if this is right: 

1) "I've never seen anything like it." Picks up his phone, calls a paramedic *not part of our company* and asks for advice. 

The paramedic suggests putting the pt on the stretcher. Really? 

2) My partner calls the pt's primary care facility and ETA's us (to have a medical team awaiting). 

Are you fcuking kidding me? He ETA'd us for back pain??? She didn't say the pain radiated anywhere else so I wasn't suspecting myocardial infarction or anything serious that would require us to call it in to her hospital. Therefore, he was rushing me to get my paperwork and things so we could get on the bus and haul ***. Gimmie a break. The hospital was one exit away from where she was.

We get the pt on the strecher and, thanks to you guys, I padded her voids and where it hurt just to help make her feel a bit more comfortable. The pt's son ends up carrying OUR longboard out for us as we roll the pt into our bus. 

This to me was embarrassing. I did not say anything to my partner, I only started to think of this a few weeks after it happened, as I was talking to my EMT buddy last night over the phone (her partner's a moron too)

What do you guys think about this matter? I didn't think this needed an ETA or a second opinion. If anything don't you think he should have called medical director instead of his pal? SMH!!!!!!!


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## TransportJockey (Dec 7, 2010)

I don't get teh big deal about calling the ED to give a heads up. But then again, in every system I've ever worked in, we called on all patients going to the ED, including run of the mill IFTs from SNFs


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## redbull (Dec 7, 2010)

jtpaintball70 said:


> I don't get teh big deal about calling the ED to give a heads up. But then again, in every system I've ever worked in, we called on all patients going to the ED, including run of the mill IFTs from SNFs



The hospital was already notified as per the assisted living home. That was the destination on our pager as well as the patient's paperwork. the hospital KNEW we were going there. But to call them for it and add more pressure on himself by hustling me *he was the driver*.


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## MedJPavlo (Dec 7, 2010)

sounds to me like your partner is just green and over zealous to be an emt.


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## Sasha (Dec 7, 2010)

Have you looked at yourself and your problems and not your partner? Maybe he takes the lead because you are incompetent or give the air of hesitation. Maybe he steps up and takes the lead because you're too slow, or not doing what needs to be done.

I see no problem with what he did.


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## redbull (Dec 7, 2010)

Sasha said:


> Have you looked at yourself and your problems and not your partner? Maybe he takes the lead because you are incompetent or give the air of hesitation. Maybe he steps up and takes the lead because you're too slow, or not doing what needs to be done.
> 
> I see no problem with what he did.



No actually I'm not incompetent, where did you get that from? I used the words "cocky", "confident" not to mention he spends most of the time on his phone with his girlfriend and hits on aides. Why would I be incompetent starting out? I'm trying to do the best I can and not get CANNED.


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## redbull (Dec 7, 2010)

MedJPavlo said:


> sounds to me like your partner is just green and over zealous to be an emt.



Thank you. He's a basic, just like me. Worked in two other privates prior to this one.


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## redbull (Dec 7, 2010)

@ SASHA: 

So let me get this straight - you don't see anything wrong with him hitting up the ER, thus putting more prsesure on himself to get there when they were already notified of the emergency? You also don't mind him calling an ALS buddy of his for an opinion as opposed to asking his PARTNER first?


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## Sasha (Dec 7, 2010)

Because you're not experienced and maybe your education was lacking? Not saying it is definite but it is a possiblity. I spent all shift talking to my boyfriend, but I have been told I'm a good medic.

I often find people who put out by their partners are not getting the job done and are ticked when someone steps up and picks up the slack.

How is he talking on his phone all shift if he's taking the lead on your calls?

Just because you think you're god's gift to EMS doesn't mean you are.


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## TransportJockey (Dec 7, 2010)

redbull said:


> @ SASHA:
> 
> So let me get this straight - you don't see anything wrong with him hitting up the ER, thus putting more prsesure on himself to get there when they were already notified of the emergency? You also don't mind him calling an ALS buddy of his for an opinion as opposed to asking his PARTNER first?


I still don't see the problem notifying the ED. And calling an ALS provider for a quick consult sounds liek a good idea if he has suspicion of something else wrong. Even if the medic doesn't work for your service.


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## Sasha (Dec 7, 2010)

> So let me get this straight - you don't see anything wrong with him hitting up the ER, thus putting more prsesure on himself to get there when they were already notified of the emergency? You also don't mind him calling an ALS buddy of his for an opinion as opposed to asking his PARTNER first?



Nope. I've called report it when still on scene before, after the nursing home has given report. Problem with nursing homes is they don't always paint the whole picture, and you often find more. Example: A common one, getting called for abdnomal labs and finding AMS. Getting called for a fall and figuring out they fell because their heart is going crazy.

If my partner is a brand new EMT sure I'll call my mentor (who also happens to be my boyfriend) for advice before consulting them.


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## redbull (Dec 7, 2010)

Sasha said:


> Because you're not experienced and maybe your education was lacking? Not saying it is definite but it is a possiblity. I spent all shift talking to my boyfriend, but I have been told I'm a good medic.
> 
> I often find people who put out by their partners are not getting the job done and are ticked when someone steps up and picks up the slack.
> 
> ...



Um Sasha, whats with the jabs? "Just because you think you're God's gift to EMS" 

Secondly, picking up the slack? He walks in and starts talking to the patient then starts -- it has nothing to do with me being lazy. You're making assumptions. Your responses are lacking. Just stay out of this, how about that? Your boyfriend's calling. Lol.

BUT STILL --- I'd have to question why he didn't ask me what I thought as i was standing right friggin' there. There's no I in Team.

Also -- he pulled over during a transport during an MVA -- there were two fire trucks there. What could we have done? We had a pt on board! He wanted to see if he could help...what could we have done? We had a friggin' pt on board! This guy is all show.


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## Amber2313 (Dec 7, 2010)

I don't see a problem with calling in even if they were already notified prior. My company actually requires it for every patient. I am not one for having anyone other than crew / fd / first resp / pd help carry equipment, but that's just me. Calling a medic friend is useful sometimes. Discussing with your partner should come first, I'll give you that, but you have to build up some trust, too. Talk to him about the call and why he did the things you find wrong. Maybe he saw or thought he saw something you didn't consider and since you weren't mentioning it outright, wanted a second opinion?


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## Sasha (Dec 7, 2010)

That's the attitude you give off.



> He walks in and starts talking to the patient then starts



I walk in and talk to the patient too, then start my treatment. Best way to asses a patient is by talking to them.


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## redbull (Dec 7, 2010)

ems.amber911 said:


> I don't see a problem with calling in even if they were already notified prior. My company actually requires it for every patient. I am not one for having anyone other than crew / fd / first resp / pd help carry equipment, but that's just me. Calling a medic friend is useful sometimes. Discussing with your partner should come first, I'll give you that, but you have to build up some trust, too. Talk to him about the call and why he did the things you find wrong. Maybe he saw or thought he saw something you didn't consider and since you weren't mentioning it outright, wanted a second opinion?



Thanks, will do, but --

Pt did not have radiating pain. Pt complained of hip pain. I spoke with the nurse in charge and got a list of her meds, and documented what had happened (it was acute). Pt's son was with her. Not much else info. I took it for acute back pain and to put the pt on the stretcher and pad her voids. My partner said "never saw anything like it before". I don't know. Maybe he didn't. But still, the best thing for him to do, BEING MY PARTNER was to ask me instead of whipping out his phone and calling his buddy. I covered my *** and documented that he called his buddy for an opinion (that of which he carried out with). 

And like I said, as far as putting more pressure on himself to haul *** to the pt's primary care hospital, thus hustling me, a whole lot of bullcrap that could have been avoided, doesn't anyone else see this? What would you have done? What are your thoughts? Instead of someone attacking me and making assumptions, which also doesn't help this, or my views.


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## reaper (Dec 7, 2010)

Pt wailed when you touch right hip? How is this back pain? Why would you board her?

Every service I have worked for in 20 years require I notify ED of what we are bringing in and an ETA. NH's will give bad reports, call wrong hospital, or tell you wrong hospital. This you will learn with time. 

I see nothing wrong with him calling a medic for advice. He is covering all he can. Someone has to take the lead on a call. Get there first and take the lead!

You don't like him, it shows. You bring up him talking to girlfriend and hitting on aides. How is that an ems problem? You have looked for reasons to not like him, rather then try to work together.


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## Sasha (Dec 7, 2010)

reaper said:


> Pt wailed when you touch right hip? How is this back pain? Why would you board her?
> 
> Every service I have worked for in 20 years require I notify ED of what we are bringing in and an ETA. NH's will give bad reports, call wrong hospital, or tell you wrong hospital. This you will learn with time.
> 
> ...



Well hello boyfriend. Why are you not calling me? redbull said you were.


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## abckidsmom (Dec 7, 2010)

I'll bite.

I think that when you're dealing with a partner who isn't doing things the way you'd like to see them done, you need to communicate with your partner, that day or possibly the next day, to make sure that you all have the same expectations.

Sounds like you guys are working a BLS ambulance in an IFT company, right?  And you just happened to get a patient going to the ER?  So this was not your standard call, and you don't really have the day-to-day experience with this guy to deal with an "emergent" situation without communication.

For next time:  discuss in your downtime what the role of the lead EMT is on calls.  Discuss what you'd like to see happen, and when you obviously have to split up (one to talk to the nurse and one to talk to the patient) you need to have some practice guidelines.

Honestly, I sorta see a little bit of Sasha's point because it seems like both of you are extremely inexperienced, easily jazzed up EMTs.  When you call the hospital, unless you're calling for a trauma alert, nobody's waiting for you.  They're doing their work, and will deal with you when you get there.  So no need to feel enormous pressure.  What did he tell them your ETA was?  10 minutes?  15?  No big deal.

In this call, here's how I would handle the situation with a partner who knew what he was doing:  

I would go to the patient, get the story from her and her son.  Partner would go to the nurse and get the paperwork and the story.  Alternatively, I'd get the story from the nurse on my way through the hall to the patient.

Then we'd load the patient (did she fall?  What's caused her pain?  Why are you ruling out "foul play"?)  (word, BTW:  another clue that you are as hyper and inexperienced as your partner)

Then we'd go to the ER.  

I would have a talk with the partner about doing embarassing things in front of staff, patients, and families, but in the end, it's your partner that has to look this stupid.  You only look as dumb if you are treating him like he's to be respected.


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## redbull (Dec 7, 2010)

reaper said:


> Pt wailed when you touch right hip? How is this back pain? Why would you board her?
> 
> Every service I have worked for in 20 years require I notify ED of what we are bringing in and an ETA. NH's will give bad reports, call wrong hospital, or tell you wrong hospital. This you will learn with time.
> 
> ...



Well, that's your company's standards, and while we are on the job, we're not supposed to be talking on the phone, especially when we're around doctors, nurses, etc, or hitting on any aides. Professionalism. I'm looking at it from a third-party perspective.

We have a medical director that works for the company - why call a buddy of his? 

Not only did I make sure the hospital was the correct destination from our comapny and the nursing home, but also from the pt and the pt's son who said the nursing hoem notified the ER.


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## redbull (Dec 7, 2010)

abckidsmom said:


> I'll bite.
> 
> I think that when you're dealing with a partner who isn't doing things the way you'd like to see them done, you need to communicate with your partner, that day or possibly the next day, to make sure that you all have the same expectations.
> 
> ...



Thanks.


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## Pittma (Dec 7, 2010)

redbull said:


> But still, the best thing for him to do, BEING MY PARTNER was to ask me instead of whipping out his phone and calling his buddy.
> 
> And like I said, as far as putting more pressure on himself to haul *** to the pt's primary care hospital, thus hustling me, a whole lot of bullcrap that could have been avoided, doesn't anyone else see this? What would you have done? What are your thoughts? Instead of someone attacking me and making assumptions, which also doesn't help this, or my views.



Did you ever think that you're also his partner? It seems to me like you're pretty cocky yourself, sure he should have asked you, but did you speak up and say hey, let's call later? From what I've seen, you have no interest in working WITH him to better your relationship. 

It's not "pressure" to "haul ***" to the hospital. I've never heard of a service that shows up unannounced to a hospital for something like this. Nothing wrong with getting ED an ETA. "A whole lot of bullcrap" is your JOB. What would I have done? I would have worked with him. I would have voiced your opinions after the call and worked out a way to work with him better. Nobody is attacking and making assumptions- we're going on what you told us. And if you don't like what you hear, why ask for opinions?


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## redbull (Dec 7, 2010)

Pittma said:


> Did you ever think that you're also his partner? It seems to me like you're pretty cocky yourself, sure he should have asked you, but did you speak up and say hey, let's call later? From what I've seen, you have no interest in working WITH him to better your relationship.



No, at the time I was getting the paperwork and the story from the nurse. I am not a cocky person. I'm new, I want to do things the right way but my partner likes to hog the spotlight and jumps on everything first and take all the credit (grabbing my paperwork to show the triage nurse and giving her the report, meanwhile I'm teching). Yes, you guys are right - next time i will communicate with him.


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## Amber2313 (Dec 7, 2010)

redbull said:


> Thanks, will do, but --
> 
> Pt did not have radiating pain. Pt complained of hip pain. I spoke with the nurse in charge and got a list of her meds, and documented what had happened (it was acute). Pt's son was with her. Not much else info. I took it for acute back pain and to put the pt on the stretcher and pad her voids. My partner said "never saw anything like it before". I don't know. Maybe he didn't. But still, the best thing for him to do, BEING MY PARTNER was to ask me instead of whipping out his phone and calling his buddy. I covered my *** and documented that he called his buddy for an opinion (that of which he carried out with).
> 
> And like I said, as far as putting more pressure on himself to haul *** to the pt's primary care hospital, thus hustling me, a whole lot of bullcrap that could have been avoided, doesn't anyone else see this? What would you have done? What are your thoughts? Instead of someone attacking me and making assumptions, which also doesn't help this, or my views.



What do you mean with putting pressure on himself to haul? By calling in?
There was no attacking on my (or several others) part. 
This is a forum. You have to expect the some people will disagree.
Not that I do completely.

I would say definitely call ED. It gives them report and some prep time. When facilities call in, they can only guess ETA and sometimes, more often than not I've found, slack in report. But I think you see from all the posts that most people call in and it's probably a good idea.
If you mean that's what put more pressure on him, I don't understand why you think so. If your partner is rushing, tell him to slow down. Don't cause a scene. That doesn't do anyone any good, but stepping on it a little doesn't hurt, either, as long as pt is taken care of.


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## redbull (Dec 7, 2010)

ems.amber911 said:


> What do you mean with putting pressure on himself to haul? By calling in?
> There was no attacking on my (or several others) part.
> This is a forum. You have to expect the some people will disagree.
> Not that I do completely.
> ...



Understood.


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## Akulahawk (Dec 7, 2010)

abckidsmom said:


> I'll bite.
> 
> I think that when you're dealing with a partner who isn't doing things the way you'd like to see them done, you need to communicate with your partner, that day or possibly the next day, to make sure that you all have the same expectations.
> 
> ...


I'd do basically the same stuff. I like to get a story on the way in, go to the patient and send the partner for the paperwork, close enough by that I can get assistance if I need it. Each specific case may be run a little different, but I like to delegate some tasks to my partner so that I can do other assessment-related things. Usually I like to call while en-route to the ED, but sometimes I've been known to call report while on-scene if the ED is very close. One facility I used to go to was literally about 3/4 mile from the ED. By the time I'd ringdown the ED on the radio, we'd be pulling in. I've made many a report from bedside before transport at that place.

And OP: You need to rise above that and allow him to look stupid on his own. The more that happens, the more everyone around him will realize that he's the problem, not his partner, not the company...


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## brentoli (Dec 7, 2010)

1) You don't take the ER by surprise. And you don't trust the nursing home to give an accurate report.

2) Try talking to him, its amazing what communication can do. If you're gonna be a good EMT you have to be a good communicator.

3) This isn't the place to air dirty laundry. Think if your partner posted this thread about you. You've given enough clues he can figure it out. I've seen people get fired for less.


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## MedJPavlo (Dec 7, 2010)

brentoli said:


> 1) You don't take the ER by surprise. And you don't trust the nursing home to give an accurate report.
> 
> 2) Try talking to him, its amazing what communication can do. If you're gonna be a good EMT you have to be a good communicator.
> 
> 3) This isn't the place to air dirty laundry. Think if your partner posted this thread about you. You've given enough clues he can figure it out. I've seen people get fired for less.


yeh this reminds me of the ems golden rule. CYA


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## lampnyter (Dec 7, 2010)

Did he do lights and sirens to the hospital?


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## redbull (Dec 7, 2010)

lampnyter said:


> Did he do lights and sirens to the hospital?



Yes/ The hopsital was 1 mile away from the assisted living home. Ok everyone maybe I was a little overzealous. I have jsut been stressed out by the work week. My apologies to everyone (even Sasha). I just thought when it comes to these emergencies, you work with your partner as a team to problem solve and if need be, call the medical director as opposed to one partner trying to solve everything himself and doing it his way.


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## brentoli (Dec 7, 2010)

redbull said:


> Yes/ The hopsital was 1 mile away from the assisted living home.



Good situation to give report before you head to the truck.


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## Minnick27 (Dec 7, 2010)

If I have someone going to the ER I call them. The facility can say they called, then you get to the ER and they never did. Happens a whole lot at one of the SNFs we go to. But I think you should say something to your partner. If you are the tech he should back off slightly. He should still be there to back you up, but he should not be giving report because he was not in the back. Just ask him if he wants to take lead on the call and you drive. Or talk in your down time. Tell him you know you are new, but you were certified by the state to do the job. Not to say his experience isn't helpful, but how are you going to learn and gain experience if he takes the lead? And don't be rude about it when you do it. It sounds like you have alot of anger about your partner so calm yourself first and just talk. Maybe he will understand. Or maybe e will tell you to shove it. Either way you have voiced your concerns. If he is still a jerk talk to management


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## WVEmt (Dec 7, 2010)

i get evil looks from the ed staff when we don't call in report. even on routine ift. as far as your partner goes, why not let him run his calls and you run your calls? i know i get pretty irritated when its my patient and she decides to run things her way.


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## Phlipper (Dec 7, 2010)

I count my blessings every time I come here, because it seems there is always a new "my partner sux" thread.  

Out of the entire paid/volley staff there seems to be only two members/staff that everyone appears to dislike on a personal level and everyone hates working with.  There are a couple more weak EMTs or Med Responders, but they're nice folks and they're trying.  Only the two real nutjobs, one of which is completely incompetent and unmotivated to boot.

I am a very lucky EMT/ParaGod Wannabe.  I am surrounded by competent, patient professionals who are respectful and like to teach, and who are team players.  The EMS Gods must like me or sump'n.


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## the_negro_puppy (Dec 7, 2010)

On the flip side, over on this side of the world, we only inform the hospital that we are coming if they are critical/trauma/STEMI or going to a private facility.


I can understand the OPs frustration, seemed like the guy was going over the top for a simple case and acts like a bit of a lone wolf. Such is life. Ive worked with good people and bad. Learn what to do from the good people, and what not to do from the bad.


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## SanDiegoEmt7 (Dec 8, 2010)

abckidsmom said:


> I'll bite.
> 
> I think that when you're dealing with a partner who isn't doing things the way you'd like to see them done, you need to communicate with your partner, that day or possibly the next day, to make sure that you all have the same expectations.
> 
> ...



I think this is solid advice.  If you were the patient person (in my opinion) you should be the one doing the initial assessment.  Let the driving EMT handle auxillary duties liking grabbing your paperwork and nurse's report as well as any vitals you haven't already gotten.  

You definitely sound like you don't like the guy, is it only this "emergent" call that you had problems, or is he stepping on your toes constantly on IFT calls as well.  Even if you don't like the way that Sasha suggestions came across, they are valid.  Its easy to blame others without considering that it is at least a possibility that it is you.  Instead of retaliatory comments, a much better response would have been "I do blah blah blah on the calls, try to lead in blah blah ways, yet he still takes the lead".  Your response does lead me to believe that you might be lacking in experience or on scene command skills.  But I don't know only suggesting its something to consider.

If you have reflected on your own skills, communicated openly with you partner (instead of complaining on a forum), and still the problem persists talk to a supervisor and switch shifts, but don't use it as an out when the problem can be solved in one of the other ways.


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## SanDiegoEmt7 (Dec 8, 2010)

redbull said:


> Yes/ The hopsital was 1 mile away from the assisted living home. Ok everyone maybe I was a little overzealous. I have jsut been stressed out by the work week. My apologies to everyone (even Sasha). I just thought when it comes to these emergencies, you work with your partner as a team to problem solve and if need be, call the medical director as opposed to one partner trying to solve everything himself and doing it his way.



Your partner did lights and sirens for back pain?  How does your company allow this?


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## Aidey (Dec 8, 2010)

redbull said:


> Also -- he pulled over during a transport during an MVA -- there were two fire trucks there. What could we have done? We had a pt on board! He wanted to see if he could help...what could we have done? We had a friggin' pt on board! This guy is all show.



All other stuff aside, that is a bit hinky. 


On the IFT thing, our policy on IFTs is that you don't make contact with the patient until you've made contact with the staff. There are a number of reasons for this. Infection precautions, staff wait to tell patients they are going until we get there, dementia patients get freaked out when a stranger is in their room, some patients are being sent in because they are violent/combative etc.


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## EMSLaw (Dec 8, 2010)

the_negro_puppy said:


> On the flip side, over on this side of the world, we only inform the hospital that we are coming if they are critical/trauma/STEMI or going to a private facility.



Funny, I'm half the world away, and we do the same thing.

Medics, on the other hand, are currently required by state regulation to call medical control for a mother may I on /every/ call.  Even a M&T within their standing orders.  And preferably before any interventions (even an IV start).  The latter tends to be more honored in the breach than the observance, but...  yeah.

By the way... moron is a pretty strong word.  Doesn't sound like your partner is anything more than a little overeager.  Sometimes, that's a good thing, too - we all get a bit jaded after a while.  Maybe his inner whacker is not assuaged by IFT work.  Give it time, he'll get over it.


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## Rescue0ne (Dec 8, 2010)

*Take a deep breath...*

I've worked with excellent partners, and I've worked with less than competent partners.  Unfortunately, such is the nature of this beast.

First of all, flirting with the facility staff is a mark of a less than professional provider, no matter if the provider is brand new, or "saltier" than Thom **** himself.  Just don't do it.  CYA.

Contacting a senior EMS provider for consultation is ok, is some respects. Best to do it away from the patient and family though, imo.

I find it funny (and disturbing) that your partner said, "never seen anything like it".  That does not insipre confidence in your patient, their family, or facility staff.

Never seen back pain or hip pain, w/ no other symptoms?  Ok then, is there trauma involved?  Regardless, properly package your patient (or not, if not indicated), and transport to the hospital.  Unless lights and sirens are your protocol for everything, I don't see the need for them in your described case.

Calling into the ER is standard protocol everywhere I've worked on an ambulance, whether it's 911, ground IFT, or HEMS.  The facility MAY have actually contacted the hospital with a report, but keep in mind that the report was given to the hospital by someone with probably no inkling about emergency care.  The facility has no idea what you are doing to the patient in the ambulance, current vital signs are appreciated by the ER, as well as knowing if the pain level has increased/decreased, and also a current LOC update.

As far as your partner having his mobile device stuck to his ear 24/7, if it does not interfere with patient care and company policy in any manner, then just consider yourself fortunate that he isn't talking YOUR ear off.  Make sure he isn't driving and doing it, however. Emergency Vehicle Operations is no place for distracted driving. Does your company have a cell phone policy?  If so, is your partner following it?

Take a deep breath, count to 10 in Swahili, and consider yourself fortunate that you're at least working with another EMT.  Some services out there often partner an EMT with only a driver.


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## Amber2313 (Dec 8, 2010)

Rescue0ne said:


> I've worked with excellent partners, and I've worked with less than competent partners.  Unfortunately, such is the nature of this beast.
> 
> First of all, flirting with the facility staff is a mark of a less than professional provider, no matter if the provider is brand new, or "saltier" than Thom **** himself.  Just don't do it.  CYA.
> 
> ...




<<Check.
Not terrible, not really helpful though, either.

But to the OP, maybe you'd like that. You always take the lead on pt there. Drivers drive and load and help where they can and the rest is your call.


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## MrBrown (Dec 8, 2010)

Your partner is a moron .... disassociate yourself from his as fast as poss 

Would you like some ketamine?


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## DarkStarr (Dec 8, 2010)

didnt read the whole thread but 2 things came to mind.

1: we call the hospital en route either bls/als advisory with ETA via medcom.

2: if the other guy wants to do all the work, thats fine with me.  if i think of something he didnt cover, i will.


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## JPINFV (Dec 8, 2010)

redbull said:


> @ SASHA:
> 
> So let me get this straight - you don't see anything wrong with him hitting up the ER, thus putting more prsesure on himself to get there when they were already notified of the emergency? You also don't mind him calling an ALS buddy of his for an opinion as opposed to asking his PARTNER first?



I've always given an ETA to receiving facilities, but I don't make them long drawn out if it's not life threatening. A quick "En route with a ___ y/o (male/female) with a c/c of atraumatic lower back pain starting approximately ___ long ago. The pain is ___/10 going to 10/10 on palpation. ETA ____. Any questions?" Add in any abnormal V/S or immediately pertinent history (e.g. cancer), and you should be done in 15 second and the hospital isn't surprised when you show up. If you're ETA is off, so be it. That's why it's an estimate. If you're partner is feeling pressure to get there faster because he gave an entry note, then he needs to get a lot more experience. 


As far as what to do next, I have a problem calling a random paramedic for advice. Should he have asked you? Sure, even if he doesn't think you know the answer (I hope to God that he was looking for more than, "Stretcher. Transport," as an answer.)? Yes, because you might surprise him and it keeps you in the loop. Additionally, calling either a paramedic at your service or calling medical control would have been better options. However, there is no shame is asking for a consult.


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## C.T.E.M.R. (Dec 8, 2010)

At my service we always do a radio patch to the destination hospital whether a basic day to day call, usually within the 5-10 minutes before arrival. Its a must on calls for geriatric and trauma patients so the ER can be prepared. as for your partner try to get to know him a little bit.


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## JPINFV (Dec 8, 2010)

redbull said:


> No, at the time I was getting the paperwork and the story from the nurse. I am not a cocky person. I'm new, I want to do things the right way but my partner likes to hog the spotlight and jumps on everything first and take all the credit (grabbing my paperwork to show the triage nurse and giving her the report, meanwhile I'm teching). Yes, you guys are right - next time i will communicate with him.



Who honestly gives a poop about who gives report? I agree, he's a douche if he's doing the entire, "I wanna give report and look super cool 'n awesome to the RN!" So what if he wants to give report? It's stupid, and petty, but there's much worse things than who gets to talk to Nurse Ratchet.


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## JPINFV (Dec 8, 2010)

redbull said:


> Yes/ The hopsital was 1 mile away from the assisted living home. Ok everyone maybe I was a little overzealous. I have jsut been stressed out by the work week. My apologies to everyone (even Sasha). I just thought when it comes to these emergencies, you work with your partner as a team to problem solve and if need be, call the medical director as opposed to one partner trying to solve everything himself and doing it his way.



I'm curious to know what the justification for emergency transport was.


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## Bullets (Dec 8, 2010)

One partner get the chart, hx, rx allergens, ect, the whole story, the other gets vitals and physical info, trauma assesment and the like. Step up and take a role, be vocal, dont back down. your a team, demand he treat you like it

We NEVER call the hospital unless its code, trauma or something incredibly rare, like we called for a AAA last night, requested the cardiac surgeon be preped and ready, guy went straight to the cutters, sewed it all up and hes A-OK now


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## jjesusfreak01 (Dec 8, 2010)

Bullets said:


> We NEVER call the hospital unless its code, trauma or something incredibly rare, like we called for a AAA last night, requested the cardiac surgeon be preped and ready, guy went straight to the cutters, sewed it all up and hes A-OK now



We always call the hospital here, but its just to let them know we're coming. I think the nurses at stretcher triage probably appreciate it, even if they don't know they do.


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## CAOX3 (Dec 8, 2010)

JPINFV said:


> but there's much worse things than who gets to talk to *Nurse Ratchet*.



Medication time!


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## MRE (Dec 9, 2010)

redbull said:


> Also -- he pulled over during a transport during an MVA -- there were two fire trucks there. What could we have done? We had a pt on board! He wanted to see if he could help...what could we have done? We had a friggin' pt on board! This guy is all show.



Massachusetts actually has a policy on doing this.  If the patient you are transporting is stable and you maintain their standard of care (an EMT stays with them in the ambulance) then you can stop at another scene and assist.  Never done it or had the opportunity/need to, but it is allowed here.

We also call in to the hospital for every person we bring in, regardless of their condition or injuries/illness.


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## redbull (Dec 10, 2010)

spoke with my company today

A note to an ER is only necessary if its major trauma, pt's status is declining, etc.

as far as taking advice and carrying out advice from ALS or someone else other than working the company, well, its a POTENTIAL liability. 

spoke to my partner today, he understands and is ok with my concerns.


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## firemedic07 (Dec 10, 2010)

Standing protocalls in my area advise us to call the ER every time we bring a patient in. no matter what the condition.


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## DrParasite (Dec 12, 2010)

EMSLaw said:


> Medics, on the other hand, are currently required by state regulation to call medical control for a mother may I on /every/ call.  Even a M&T within their standing orders.  And preferably before any interventions (even an IV start).  The latter tends to be more honored in the breach than the observance, but...  yeah.


ummmm no,  sorry buddy, not required in New Jersey before anything is done..  Medical control is required to be contacted on all ALS patients, but that also doesn't mean the receiving hospital gets a notification.

and M/C is supposed to be contacted AFTER your standing orders are followed, not before.  if your ALS are doing it before, than it's an agency requirement, not a dept of health requirement.  or maybe your medics need their hands held more than other ALS providers in the state, i don't know.

we only give notifications on sick patients (traumas, sick patients with no ALS, anything where we need a bed waiting for us when we get there).

and considering I have hear horror stories about crews waiting 20 mins to 4 hours to get a bed in the ER, I am assuming that all these notifications for non-sick patients don't really do anything important.



redbull said:


> spoke with my company today


which is probably the second thing you should have done in the first place 





redbull said:


> A note to an ER is only necessary if its major trauma, pt's status is declining, etc.


ehhh, probably.  doesn't mean I don't call the charge nurse while on my way there, especially since it makes her life easier so she can figure out where I am going





redbull said:


> as far as taking advice and carrying out advice from ALS or someone else other than working the company, well, its a POTENTIAL liability.


 hey newbie, i know this might shock you, but EVERYTHING is a potential liability.  listening to the SNF, using L&S, not administering oxygen, not getting enough sleep before the shift, not writing clear enough, not charting good enough, not getting to the SNF fast enough, driving too fast to get to the SNF, it's all POTENTIALLY a liability.  And, not calling for ALS for the patient, along with a helicopter to transfer them to a trauma center is definitely a potential liability.  But potential liability and actual liability are completely different things.


redbull said:


> spoke to my partner today, he understands and is ok with my concerns.


and that was the first thing you should have done.


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## akflightmedic (Dec 12, 2010)

redbull said:


> and while we are on the job, we're not supposed to be talking on the phone, especially when we're around doctors, nurses, etc, or hitting on any aides. Professionalism. I'm looking at it from a third-party perspective.



And since the topic has been addressed, I thought I would point out the interesting sentence structure and/or comma placement.


I read the above quote to mean your company regulates your phone chatting even to the point that you can't chat on phone while hitting on aides...harsh.


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## 18G (Dec 12, 2010)

It sounds like your partner is cocky and not a team player. A partner is supposed to work with you and not go off on their own especially when their driving on the call. I hate it when I am the lead person on the call yet someone else feels inclined to start assessing my patient, asking questions and what not. It messes up my train of thought and takes me longer to go down the path that I am desiring to go down after having to wait for the patient to stop answering the other persons questions. 

I think it is very tacky for an EMT to be calling a Paramedic to ask for advice on a seemingly minor call. Yet alone sharing the patients medical information with someone who is not a part of your company. This is a piss poor practice in my opinion. If this EMT partner was all that than why is he calling to ask a Paramedic why a patient is having hip pain?

And don't mind Sasha... she is just being her usual rude self.


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## reaper (Dec 12, 2010)

It should not matter who's call it is. You listen to the pt for all questions asked. You build your assessment off the information you are hearing.  If you lose focus, just because your rhythm is disrupted. Then that is something to work on. You have to be able to adapt to any situation. When I have a new partner, I do an assessment off everything then ask or find. If they miss something, then I ask more questions. You don't need to start at the beginning to make your assessments. 

The OP's partner may be overzealous, but is not a moron. He provided adequate care and took care of the pt. Nothing wrong with calling a medic for advice on something and hipaa was not violated, unless he gave the Medic personal info on the pt.


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## Level1pedstech (Dec 12, 2010)

From the ER side of the fence may I offer the following on the subject of pre arrival reports. A pre arrival report should be SOP for any private or transport agency. Its not only good customer service for all involved but helps us to best prepare for your patients. I know there is waiting involved sometimes but you are triaged during that initial report and put into our system. The acuity level of your patient is what determines your wait time if any when you reach our facility.

 Just because your an ambulance crew do you think you should be able to come in and displace all the other patients in the ER. There is a common misconception especially among our frequent flyer's that an ambulance ride will get you into a room and help to your bed side in a more timely manner,this at least at our level one facility could not be further from the the truth. Acuity is the number one factor in determining what fate awaits your patient once you hit our doors. 

 We handle level one and two traumas through a different system and of course these as high acuity patients get priority treatment. Most patients will be given a bed on arrival it may be in a room or in the hallway but its a bed and a release of care for the transport crew. This is what we are contemplating while we await your arrival. Even if you are less than a minute out it still lets us at least know we will be seeing your smiling faces and wont be surprised.

 We don't like surprises but we are always fair and your patients care and comfort comes first no matter what. Worse case scenarios are a wait in the hall without a bed or a trip out to wait behind all the rest in triage,once again your patients acuity level is the determining factor not whether are not we like you or your agency. Once again its all about customer service,the thing to keep in mind is that we are all each others customers and should always strive to give the best level of service starting with that first radio report.

 A little about what makes a good radio report at least from our point of view in the ER. Having taking many radio reports over the years and having listened to many more being taken I can tell you exactly what we at our level one like to come away with after your initial radio report. Your unit number,your en route code,ETA,patients stats,BRIEF description of what your bringing us,a full set of vitals including GCS and pulse ox if you think it will help us better prepare,BRIEF details of any interventions followed by asking if we have any questions. At this point we will let you know what other information we might like to have saving all of us time.  Its a pretty simple deal no need for long drawn stories or you trying to impress us,you may well be gods gift to field EMS and may be on your way to bigger and better things which is great but frankly we don't really care and we are usually to busy to care even if we wanted to. Just try and picture all of us within ear shot of the radio that your going to annoy with your ten minute report and please have mercy.


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## 18G (Dec 12, 2010)

Reaper... everyone has their preference... mine is when I am the crew chief then I will interview and assess the patient with my partner assisting me and doing any specifics I assign. It's not that I can't "adapt" and follow, it just makes it more convoluted and harder on the patient when they have multiple people asking them questions. The patient needs to know who the main provider is that is in charge of their care. 

I like to think of it as team directed care and not a free for all.


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## sarweim (Dec 12, 2010)

We call in to ED on every call, too, from MVA, to cardiac, to stubbed toe.  Usually on the radio in the back of the rig, giving ED a more accurate time for them to be prepped, and the most up-to-date report on patient condition.  I don't see how that's a bad thing.

As for the partner not talking to you, I think that's bogus.  You, theoretically, have the same training.  And while he may have more experience (multiple agencies over just a few years, hmmm... I've seen people like that, and there's usually a reason!), he should still get your input, too.  And if NEITHER of you can come up with an answer, call someone up the line in your OWN agency with more experience, or medical direction, not his buddy.  I feel like there's a little HIPAA issue here, too.

Sounds like a significant communication problem all the way around.  There may be no I in TEAM, but there's no TEAM without communication.  And that's a two way street, so you've gotta talk to him, too, and express your concerns.


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## Madmedic780 (Dec 13, 2010)

Overall I would suggest to establish better communication with your partner. I see no real reason for getting upset about the consult he did what he thought was most appropriate for the situation at hand. 

I'm not sure what area you are providing service but in my neck of the woods we have a large selection in regards to what hospital to transport to. That being said we sometimes will call a hospital just to make sure they can take the patient we want to bring them. If not we bounce em up the line to a larger facility.  It would be well worth the patient's interest who is in pain, to call ahead and be sure rather than being told to take them to the other place across town.


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## redbull (Dec 15, 2010)

DrParasite said:


> ummmm no,  sorry buddy, not required in New Jersey before anything is done..  Medical control is required to be contacted on all ALS patients, but that also doesn't mean the receiving hospital gets a notification.
> 
> and M/C is supposed to be contacted AFTER your standing orders are followed, not before.  if your ALS are doing it before, than it's an agency requirement, not a dept of health requirement.  or maybe your medics need their hands held more than other ALS providers in the state, i don't know.
> 
> ...



Right, thanks for calling me a newbie. I assume you've never been one.


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## Sasha (Dec 15, 2010)

> Right, thanks for calling me a newbie. I assume you've never been one.



You're new, what else are you supposed to be called?


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## Sasha (Dec 15, 2010)

> And don't mind Sasha... she is just being her usual rude self.



Only to people who refuse to listen and think they know everything.


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## Shishkabob (Dec 15, 2010)

Sasha said:


> Only to people who refuse to listen and think they know everything.



What about deaf Einstein?


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## Sasha (Dec 15, 2010)

Linuss said:


> What about deaf Einstein?



Well if he was so smart he's figure out a way to listen.


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## Shishkabob (Dec 15, 2010)

Point noted :blush:


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## DrParasite (Dec 15, 2010)

redbull said:


> Right, thanks for calling me a newbie.


you are new, aren't you?  it would be a fitting title.





redbull said:


> I assume you've never been one.


on the contrary I have been the new guy before.  however, I have also been open to listen to more experienced people who do know the answers to my questions, even if they don't say it in a way that holds your hand or protects your feelings.


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## Sasha (Dec 15, 2010)

> they don't say it in a way that holds your hand or protects your feelings.



Welcome to the world of medicine.


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## TransportJockey (Dec 15, 2010)

If you want to do this job and do it well, you need to make sure you're enough of a grown up not to get bothered when someone calls you a newbie. Since you're new I'll just call you an FNG. That better?


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## DFW333 (Dec 16, 2010)

redbull said:


> The hospital was already notified as per the assisted living home. That was the destination on our pager as well as the patient's paperwork. the hospital KNEW we were going there. But to call them for it and add more pressure on himself by hustling me *he was the driver*.



Ive learned never trust a nursing home when they say they've called a report. Not that they are lazy, but if someone needs to go out for an "emergency" the nurses sometimes freak out with the huge workload that has suddenly fallen on them. They have notifications to make (family, doctor, the administrators etc), papers to get in order, and 36 other patients to care for at the same time. A little phone call is likely to be forgotten.

Besides, even if they do call, they just say "we're sending you X." They don't give an ETA on when that patient will arrive. It is not only a courtesy to the hospital for YOU to give an ETA, but also a huge courtesy to your patient. Cause if you show up and the hospital doesnt know you're coming, guess where that back pain patient is going to be for 30 more minutes while a room is prepared? On your stretcher.


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## Hockey (Dec 17, 2010)

redbull said:


> We had one call where we went to an assisted living home to answer a call about a woman with "back pain." We arrive, she'ss with her son, lying supine on the bed, complaining of back pain. After I interviewed the nurse, there was no suspicion of foul play, and I went back to see my partner and the pt.



What is this foul play you speak of?  Are you trying to be a cop?  










> Are you fcuking kidding me? He ETA'd us for back pain??? She didn't say the pain radiated anywhere else so I wasn't suspecting myocardial infarction or anything serious that would require us to call it in to her hospital.



Just FYI, get out of that mindset.  Females (generally) present with strange signs when they have an AMI.  And that is one of them.


And you should always look in your protocols on calling the hospital.  The hospital should always at least be contacted prior to arrival with a brief heads up.  Plus you don't know if the hospital is on diversion or not everytime


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## DanielLarson (Dec 21, 2010)

To me it just sounds like you don't fully understand your own feelings. At least not enough to compartmentalize which is a valuable trait to any level EMS provider. You don't like your partner, great, you have a personality conflict/clash with him, but you should leave it at that. It sounds, to me, like you're letting your personal distaste for him spill over into work and looking for reasons to call him incompetent. If you've been working your first job for just a few months and he's worked for 2 prior companies I don't really think you're on a platform to make such a distinction.

Don't take this as a stab or insult, but it sounds like you need to mature a little before working FT as IFT and a GOOD bit of maturing to do if you plan on moving to 911. If you truly wanted to 'solve' the issue you would do something more proactive like take him to the side before or after a shift and calmly tell him in a non-confrontational manner and resolve it rather than complain about it on a thread looking for consolidation of others. The strength of your intent to insult him as a person and as an EMT when anyone has posted their opinions (that you asked for) that oppose your own make it seem you merely want to complain about it rather than try to fix it.

It's called diversity and you will never have a single job in EMS without it somewhere along the line so I'd suggest you get use to it and learn how to manage it properly. I'd suggest trying to actually to HIM and perhaps ask if you could just drive for a while.


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