Medic working BLS only.

[CAOX3]

Here's the problem with this. Just because someone is limited to EMT interventions and EMT diagnostic tools (however, being in California, I could play word games with how the scope of practice is written in terms of diagnostics. "Evaluate the ill and injured" and "obtain vital signs including, but not limited to" are broad), doesn't mean that the assessment is necessarily limited to an EMT level assessment or EMT level clinical reasoning. If I went back to work on the ambulance tomorrow, even though I would be an EMT, that doesn't preclude me from using techniques such as percussion or considering the medications that the patient is on, even though I didn't learn it in EMT class.

Absolutely, I'm not saying your not allowed to use your training and education to our advantage and patient benefit but all this screaming I'm in charge, I'm in charge because I'm a medic isn't going to get you very far in my service unless your
approved, promoted and operating as one.

 

[Mzcr]

Patient care should take a back seat to egos. The medic, with or without equipment, should be better able to evaluate a patient and determine best available treatment and when/if to call for appropriate assistance. Getting your feelings hurt isn't helping the patient.

 

[Akulahawk]

Absolutely, I'm not saying your not allowed to use your training and education to our advantage and patient benefit but all this screaming I'm in charge, I'm in charge because I'm a medic isn't going to get you very far in my service unless your
approved, promoted and operating as one.

That's fine, but if your partner does something wrong, YOU are also responsible because YOU still have the higher license. Does your service also indemnify you for this? Last time I checked, a local agency doesn't and can't override a state agency or state law... Chances are, while it could happen, it probably relatively rarely does. But they could just leave your butt hanging out to dry over something you were present for.

 

[CAOX3]

I have worked BLS as a Medic before. Normally, I'd switch off calls with my BLS partner. However, I'm also responsible for my partner's actions as I'm far more educated. If the SHTF... I'm the one that's going to be held responsible because I'm the most medically qualified.

I understand what your saying here a medic working as an emt isn't held any more responsible then an emt working as an emt.

For example if we re transporting a sob patient and your driving and I decide to give an albuterol treatment the patient flashes and the :censored::censored::censored::censored: his the fan, in my service your not going to be held responsible for my actions if we are both only approved to work at the bls level even if your a medic.

My medical director is the only one who can grant you permission to operate at your level of training, if he says you can only operate at the emt level, then that's what level you operate at. You may feel more responsible since your training level is greater then mine, but you wouldn't be held any more responsible then I would. I should know the aspects of my job and if I make a decision detrimental to the patient then its my responsibility and I take the heat.

 

[firecoins]

Absolutely, I'm not saying your not allowed to use your training and education to our advantage and patient benefit but all this screaming I'm in charge, I'm in charge because I'm a medic isn't going to get you very far in my service unless your
approved, promoted and operating as one.

A medic working on BLS truck should know more and act in accordance.
Even if your medical director does not approve said medic to work as a medic, the medic will be held at a higher standard when working in the capacity of EMT-B. Why? He is certfied by the state as a higher level than an EMT and his credentials are at risk if he does something unbecoming.

If a medic working on a BLS truck fails to catch something or his EMT-B does and fails to call ALS or makes some other improper transport decision, it could still come back to the medic, theoretically.

 

[Lola99]

Patient care should take a back seat to egos. The medic, with or without equipment, should be better able to evaluate a patient and determine best available treatment and when/if to call for appropriate assistance. Getting your feelings hurt isn't helping the patient.

It's not an ego issue. If it's a call something worthy of him looking it over, by all means, go for it. However, when my patient cuts himself reaching across a motor fan or gets punched in a fight, I don't see the need for Mr. Medic to jump in. Why, in the case, is his treatment better than any other tech out there? Every one of us can handle a band-aid and a bruise. Nothing hidden is going to jump out at me and take my patient due to those injuries and I know it. Stop assuming it's about feelings. It's about all this annoying, unnecessary shuffling of patient and a paragod.

 

[Lola99]

A medic working on BLS truck should know more and act in accordance.
Even if your medical director does not approve said medic to work as a medic, the medic will be held at a higher standard when working in the capacity of EMT-B. Why? He is certfied by the state as a higher level than an EMT and his credentials are at risk if he does something unbecoming.

If a medic working on a BLS truck fails to catch something or his EMT-B does and fails to call ALS or makes some other improper transport decision, it could still come back to the medic, theoretically.

In terms of a mistake, possibly. In terms of having your hands tied behind your back and not being allowed to do what you're trained to because of the company you work for, I think if the state tried to pull his cert for that he'd have fair ground to fight it.
I'm not expert in that company, but I assume that's how it would go down should SHTF.

 

[Shishkabob]

In terms of a mistake, possibly. In terms of having your hands tied behind your back and not being allowed to do what you're trained to because of the company you work for, I think if the state tried to pull his cert for that he'd have fair ground to fight it.
I'm not expert in that company, but I assume that's how it would go down should SHTF.

That's the thing, it's a no win situation for the Paramedic and is the reason why I, and many other medics I know, refuse to work in the capacity of a BLS responder.

In every agency I've ever seen, the Paramedic is deemed in charge of patient care, seniority of lower providers is irrelevant. Granted I've never seen what the guidelines of BLS only departments say, but then again I don't care as I wont be in that position of being handicapped.



This isn't a red patch vs blue patch thing, so don't go thinking the Paramedics (or Intermediates in the same position) in here are egotistical because we say we're in charge. This is protecting the patient as much as it is protecting ourselves and our way of life. Amber... you're in medic school, you'll see soon enough the amount of burden put on you solely due to your patch.


You'll find we're a bit protective about our certification.

 

[firecoins]

In terms of a mistake, possibly. In terms of having your hands tied behind your back and not being allowed to do what you're trained to because of the company you work for, I think if the state tried to pull his cert for that he'd have fair ground to fight it.
I'm not expert in that company, but I assume that's how it would go down should SHTF.

Yes in terms of mistake made by himself or by his EMT-B partner. The medic is responsible even if he is not "in charge" of his partner.

A medic is not required to do ALS interventions unless the medical director allows him to do so. Its also hard to do ALS interventions without ALS equipment which can not be found on a BLS truck.

I myself pick up BLS shifts. I do not have access to ALS equipment and am expected to perform BLS only. I do not order my EMT partners around but I make sure everything is being done by the book. I make sure we have medics if we need them and they are available. I make sure we go to the correct facilities which is usually not a problem but has become an issue on occassion.

 

[CAOX3]

A medic working on BLS truck should know more and act in accordance.
Even if your medical director does not approve said medic to work as a medic, the medic will be held at a higher standard when working in the capacity of EMT-B. Why? He is certfied by the state as a higher level than an EMT and his credentials are at risk if he does something unbecoming.

If a medic working on a BLS truck fails to catch something or his EMT-B does and fails to call ALS or makes some other improper transport decision, it could still come back to the medic, theoretically.

The state gives you the ability, medical control gives you the authority.

Scenario:

If your medical control removes intubation and acls from you r protocols, the state isn't going to hold you responsible if you don't intubate or follow acls protocols right? Even though that's what you were taught.

What I'm saying is the state doesn't supersede med control. If he says your an emt then your an emt. You operate under his lic. and he has the ability to limit or expand your scope of practice as he sees fit.

 

[Mzcr]

It's not an ego issue. If it's a call something worthy of him looking it over, by all means, go for it. However, when my patient cuts himself reaching across a motor fan or gets punched in a fight, I don't see the need for Mr. Medic to jump in. Why, in the case, is his treatment better than any other tech out there? Every one of us can handle a band-aid and a bruise. Nothing hidden is going to jump out at me and take my patient due to those injuries and I know it. Stop assuming it's about feelings. It's about all this annoying, unnecessary shuffling of patient and a paragod.

You don't seem to see any point in him looking anyone over.

Bottom line is you can't change other people. He's a medic. He has a much greater level of training and therefore responsibility for patients than you do. If he's a jerk, he's a jerk. You can't change that. You can either refuse to get upset about it, address it with the company, or find a new job.

 

[firecoins]

What I'm saying is the state doesn't supersede med control. If he says your an emt then your an emt. You operate under his lic. and he has the ability to limit or expand your scope of practice as he sees fit.

I agree but he can not give you something out of the scope of your training but he can limit or expand your abilities within that scope.

 

[Shishkabob]

I agree but he can not give you something out of the scope of your training but he can limit or expand your abilities within that scope.

Don't speak for Texas ^_^

 

[Lola99]

You don't seem to see any point in him looking anyone over.

Bottom line is you can't change other people. He's a medic. He has a much greater level of training and therefore responsibility for patients than you do. If he's a jerk, he's a jerk. You can't change that. You can either refuse to get upset about it, address it with the company, or find a new job.

Have you read my posts? Obviously not. I suggest trying that before you go being impolite. I don't see any point in him looking over patients that obviously don't need it. No. If there's reason or suspicion, like I said before, he can have at it.

 

[firecoins]

Don't speak for Texas ^_^

I won't speak for Texas if you don't speak for NY.

 

[Akulahawk]

The state gives you the ability, medical control gives you the authority.

Scenario:

If your medical control removes intubation and acls from you r protocols, the state isn't going to hold you responsible if you don't intubate or follow acls protocols right? Even though that's what you were taught.

What I'm saying is the state doesn't supersede med control. If he says your an emt then your an emt. You operate under his lic. and he has the ability to limit or expand your scope of practice as he sees fit.

The State giveth your ability. It also giveth the responsibility. The Medical Director giveth you the authority to perform at a certain level within the system the Medical Director haveth responsibility over. Medical Director can not removeth you from responsibility the state giveth to you. B)

In other words, your medical control removes intubation and acls from your protocols, that's fine. However, it does NOT remove you from the responsibility from recognizing that your patient will shortly need those interventions and you or your partner FAIL to bring the patient or deliver the patient to where those interventions may be done because your education and experience tell you that must happen where an EMT-B may not have a sufficient education or experience to recognize the impending problem.

 

[Mzcr]

Actually, I read all your posts and have said nothing impolite. Why do you insist on taking offense?

 

[Lola99]

Actually, I read all your posts and have said nothing impolite. Why do you insist on taking offense?

Lol. Okay, I'm done. You said what you wanted to. I semi-agree. All I wanted was opinions and it's not a big deal anyway. Have a nice life. I'll probably see you around the forum sometime I'm sure.

 

[CAOX3]

The State giveth your ability. It also giveth the responsibility. The Medical Director giveth you the authority to perform at a certain level within the system the Medical Director haveth responsibility over. Medical Director can not removeth you from responsibility the state giveth to you. B)

In other words, your medical control removes intubation and acls from your protocols, that's fine. However, it does NOT remove you from the responsibility from recognizing that your patient will shortly need those interventions and you or your partner FAIL to bring the patient or deliver the patient to where those interventions may be done because your education and experience tell you that must happen where an EMT-B may not have a sufficient education or experience to recognize the impending problem.

I see what your saying, I just don't believe a medic should be held responsible if the powers that be only allow him to operate at the emt level.

Handcuff ing the medic and then punishing him for something I do seems ridiculous to me. Even if we were operating in a pb system and I do something in my scope that I shouldn't and it determined to be detrimental to the patient I should bear the brunt not the medic.

I'm a certified provider and have the ability to operate on my own by the state, the medic shouldn't be held responsible for my actions, just as a doctor shouldn't if a nurse makes a wrong treatment decision. We are all providers and allowed to make decisions, if I make the wrong one I should be the one punished regardless of who else is there.

Very good topic and discussion.

 

[Akulahawk]

I see what your saying, I just don't believe a medic should be held responsible if the powers that be only allow him to operate at the emt level.

Handcuff ing the medic and then punishing him for something I do seems ridiculous to me. Even if we were operating in a pb system and I do something in my scope that I shouldn't and it determined to be detrimental to the patient I should bear the brunt not the medic.

I'm a certified provider and have the ability to operate on my own by the state, the medic shouldn't be held responsible for my actions, just as a doctor shouldn't if a nurse makes a wrong treatment decision. We are all providers and allowed to make decisions, if I make the wrong one I should be the one punished regardless of who else is there.

Very good topic and discussion.

If the medic is aware of what you're doing and fails to stop you from doing it, then yes, that medic is responsible. Same with the Doc. If the Doc is aware that the RN is making a mistake and fails to correct it, the Doc is also responsible. The person who made the mistake is also held responsible.

When I worked as a Basic while licensed as a Medic, there were reasons why I'd do the things I did... sometimes it might have been perceived as rude or whatever at the time but remember that I'm going to protect my license. I won't let you do something to harm the patient because of that. I may be functioning as a Basic at the time, but I have some liability because I have a higher license and therefore, I should "know better" about patient care stuff, even if you're the one providing care.