Advice for LT. in regards to crew member

[soflomedic14]

Alright I’m gonna shoot my shot and ask for some advice. As an LT, my rig has 3 medics. Well, one of my crew members for the life of him cannot grasp the concepts, differences or similarities between the following: pulmonary edema, emphysema, L/R heart failure.
Correct me if I’m wrong, but this is not difficult and now I’m questioning how this individual passed to become a medic since the test clear as day has these questions on it. I have pulled the individual aside and worked with them on these concepts, ran scenarios, even made flash cards but nope nothing is clicking.
We ran a call last night with a pt who has textbook emphysema and he had not even the slightest clue how to approach it. I brought it to the attention of some other elders in my department in hopes they could help but man I’m at a loss here. Any advice on how to approach this? Obviously this is stuff you NEED to know like the back of your hand.

 

[DesertMedic66]

Do you have a continuing education person that is able to get him the needed help?

Can you have the struggling medic teach a class to your shift about the issues he is having trouble with? Give him the objectives of the class and give him some time to create the class and look up information.

 

[DrParasite]

pulmonary edema can be a sign of heart failure...... emphysema is a different story. treatment plans are completely different (other than you can use CPAP in both severe cases).

the first thing I would say is document the issue. Speak to someone in your department's training department, as he might need to additional help. document what you have done to remediate the problem, as well as the results.

If he has issues with this concept, how does he handle a cardiac arrest? or a septic patient? or a patient who needs RSI? or an eclamptic patient? some people have issue with a certain topic, but are great at others. is this a localized weakness, or is he failing to meet standards for other calls too?

As a shift leader, you are doing the right thing by working with him, but it seems like you are trying to help and it isn't sticking... time to speak to someone in training on a formal recommendation, because otherwise his failure to perform as a competent medic can endanger your patients.

As a general statement, if he's an incompetent medic, but a good firefighter, is that grounds for termination? I hate for anyone to lose their job, but EMS is a huge component of the fire service, and if your agency is at the medic level, yet he is having issues (i'm assuming he isn't a probationary employee anymore), maybe this job isn't for him?

 

[soflomedic14]

pulmonary edema can be a sign of heart failure...... emphysema is a different story. treatment plans are completely different (other than you can use CPAP in both severe cases).

the first thing I would say is document the issue. Speak to someone in your department's training department, as he might need to additional help. document what you have done to remediate the problem, as well as the results.

If he has issues with this concept, how does he handle a cardiac arrest? or a septic patient? or a patient who needs RSI? or an eclamptic patient? some people have issue with a certain topic, but are great at others. is this a localized weakness, or is he failing to meet standards for other calls too?

As a shift leader, you are doing the right thing by working with him, but it seems like you are trying to help and it isn't sticking... time to speak to someone in training on a formal recommendation, because otherwise his failure to perform as a competent medic can endanger your patients.

As a general statement, if he's an incompetent medic, but a good firefighter, is that grounds for termination? I hate for anyone to lose their job, but EMS is a huge component of the fire service, and if your agency is at the medic level, yet he is having issues (i'm assuming he isn't a probationary employee anymore), maybe this job isn't for him?

No, he’s not probationary as of 2 years ago and yes we are at medic level department-wide.
I would hate for him to lose his job as well, but EMS is 97% of what we do and we are very busy. Unfortunately, he’s more of a hands-off medic and will only help if asked, or will make it look like he’s helping (another issue.)
Overall skills are lacking in general (even very basic things) and I think the medical aspect of it all scares him from watching his approaches to treatment of our patients along with lack of confidence in skills to meet the standards. Thankfully, we’re a 3 person rig so I’m not alone here.

I think taking this to the training department might be the best idea in hopes they can find a solution for him and help him get to hopefully get to where he needs to be.

 

[soflomedic14]

Do you have a continuing education person that is able to get him the needed help?

Can you have the struggling medic teach a class to your shift about the issues he is having trouble with? Give him the objectives of the class and give him some time to create the class and look up information.

We have a training department and they do all the CE stuff so I’m thinking I’m going to take the issue to them.

But I really like the approach of having him teach the concepts. This is something I think I’m going to utilize! Thanks for the idea!

 

[joshrunkle35]

No, he’s not probationary as of 2 years ago and yes we are at medic level department-wide.
I would hate for him to lose his job as well, but EMS is 97% of what we do and we are very busy. Unfortunately, he’s more of a hands-off medic and will only help if asked, or will make it look like he’s helping (another issue.)
Overall skills are lacking in general (even very basic things) and I think the medical aspect of it all scares him from watching his approaches to treatment of our patients along with lack of confidence in skills to meet the standards. Thankfully, we’re a 3 person rig so I’m not alone here.

I think taking this to the training department might be the best idea in hopes they can find a solution for him and help him get to hopefully get to where he needs to be.

-Would you trust him with your family’s care?
-If yes, do some minor training. If no, what would have to change for you to trust him with your family’s care?
-Why should he be trusted with other people’s families if those changes have not happened?
-If there is nothing you could do to change him to be worthy of your trust, try to cut him loose.