Dangerous orders

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jefftherealmccoy

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I've got my first oral interview with the Henderson Fire Department in a few days and I've been going over possible questions that will be asked and I've got one that I can't really come up with a good answer with.
So you've been given orders that you know are dangerous. What do you do about that? I know you should voice your opinion, but if you're still told to go in, then what? What is a good answer that doesn't make me sound like a shmuck or a defiant person? Thanks.
 
Refuse. No job is worth hurting yourself or your patient.
 
Define "dangerous situation." I consider treating patients with infectious diseases to be dangerous, but we understand how to properly mitigate that danger. I consider fighting fires to be dangerous work, but I both expect fire fighters to fight fires as well as understanding and taking proper measures to mitigate those dangers as much as possible. However, just calling something dangerous on its own really isn't a reason to refuse, especially if it's a part of your job description.
 
When i say dangerous situations I mean an unsafe situation. Something where your instincts are telling you to not go ahead, but your commanding officer is telling you otherwise.
 
Again, it depends on the situation. Why are your instincts telling you not to go ahead? Is the situation too dangerous due to a lack of training? Due to a misunderstanding of the situation? Due to a misunderstanding of what's being asked? Due to inexperience?

You're (assuming they don't have EMS only spots) interviewing for a fire department. Are you willing to put your life on the line to make a rescue in a fire?
 
jefftherealmccoy said:
When i say dangerous situations I mean an unsafe situation. Something where your instincts are telling you to not go ahead, but your commanding officer is telling you otherwise.
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Tell the CO you have a bad feeling about it. Most experienced firefighters have come to rely on this, and all the officers I know have had "gut feelings" in their career that have turned out and they have a healthy respect for them.

Usually when you first start out, you will always be paired with an experienced person, so use the chain, tell your partner, they will know how to make those concerns known to command.

If you find yourself under a megalomaniacle officer, quit. Nothing is worth your life.
 
I just thought of something else.

To continue on my motif of "it depends on the danger, training, and resources available" there should always be a twinge of respectful fear when ever entering any dangerous situation. Be it the fire fighter making an interior attack, a law enforcement officer on any traffic stop, a medical provider entering an isolation room, or an emergency responder working on the side of an active roadway or responding emergently. Those are all, by definition, situations that either are, or have a high potential, to be dangerous situations. The second any sort of respectful fear leaves you is the second you become complacent and mistakes, injuries, and deaths occur.
 
ok what do you do if a doctor tells you to give 3 nitro tablets to a patient with a bp of 60/30.

Dangerous? Yes.

What do you tell the doctor? No.
 
No one is saying to blindly follow orders here...
 
Your applying to a fire department, chances are you will be doing something relatively dangerous on a regular basis. I agree with the gut feeling, this comes with experience and useful tool, it has saved my but on more then one occasion.

If your faced with that question I would simpley answer, I hope I would have the training, education and experience necessary follow through on the that order in the safest manner possible.
 
I'm sure the question pertains to the fireground, and not an EMS call per se.

FD's are really pushing "crew resource management" nowadays. That means that the company officer should acknowledge and take in to account anything that their subordinates may bring to their attention. The final decision is the officer's, but they need to use their crew's knowledge and experience, and not be an authoritarian.

The correct answer, IMO, would be to say that you believe in crew resource management, that you would advise the officer of why you feel that would be a dangerous order. You may have seen or heard something that they did not. You may know something due to your training and experience that they do not. The chain of command, however, is important. As such, the final command is made by your officer, having been fully informed of the situation, and the orders are to be followed. It may seem dangerous at the time, but the officer may also know certain things that you do not. On the fireground, the officer does not have the time to explain why they want you to carry out a certain order. That's what call critiques are for. Not following orders can get you or others killed, not to mention a disruption to the overall fireground tactics.
 
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The first thing I was taught in my EMS class, my safety is first, then partners safety, then patients safety. This is a principle I live by. I want to go home at the end of the night, end of story. Besides, if we get hurt, who helps the patient. I have family, family outbids career any day.
 
HaleEMT said:
The first thing I was taught in my EMS class, my safety is first, then partners safety, then patients safety. This is a principle I live by. I want to go home at the end of the night, end of story. Besides, if we get hurt, who helps the patient. I have family, family outbids career any day.
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So I'll pose the question again. You refuse to take care of anyone who might have an infectious disease?
 
JPINFV said:
So I'll pose the question again. You refuse to take care of anyone who might have an infectious disease?
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Si. Shouldnt have gotten sick in the first place. :censored::censored::censored::censored::censored::censored::censored:s.
 
If they have an infectious disease that is airborne that can potentionally kill me, yes, I will refuse care. If it is something that actually involves bodily fluid, different scenario. There are bsi measure we can take to protect ourselves. However, if a man is waving a gun, I am not moving my butt out of my seat.
 
HaleEMT said:
If they have an infectious disease that is airborne that can potentionally kill me, yes, I will refuse care.
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So what do you do with patients who have an undifferentiated fever, cough, or is in septic shock?

If it is something that actually involves bodily fluid, different scenario. There are bsi measure we can take to protect ourselves.
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DING DING DING DING. You (should) have the training and equipment needed to mitigate the danger. Same with running calls on the freeway. That doesn't mean that you should become complacent or that the scene isn't dangerous, just that your training, education, and tools makes it less dangerous to you.

However, if a man is waving a gun, I am not moving my butt out of my seat.
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Agreed, but you aren't trained, educated, or equipped to subdue a man waving a gun. However since the proverbial "man with a gun" call came up, what about people who are legally armed, like armed guards (e.g. banks and armored transport) or people who have a concealed carry permit is not necessarily dangerous.
 
HaleEMT said:
If they have an infectious disease that is airborne that can potentionally kill me, yes, I will refuse care.
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I'm not even sure how to respond to this. After having some time to rethink it, do you still feel this way? If so, I'm not so sure you should be working in EMS.
 
HaleEMT said:
If they have an infectious disease that is airborne that can potentionally kill me, yes, I will refuse care. If it is something that actually involves bodily fluid, different scenario. There are bsi measure we can take to protect ourselves. However, if a man is waving a gun, I am not moving my butt out of my seat.
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Whoa! Seriously? So, you get dispatched to a difficulty breathing and you show up and the pt actually has TB. You are going to refuse to care for them?

How is body fluid any different? I don't refuse to start IVs on HIV and HCV pts just because there is a risk of needlesticks. I don't refuse to care for trauma pts with bloodborne illnesses. I take the appropriate precautions and what do you know? I'm fine!

Besides, there is a reason you are supplied and required to fit test an N95. ;-)

Are you actually in EMS by the way?
 
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