EMTs as supervisors

[GBev]

I had an interesting conversation with an FTO about basics being supervisors. In my organization, supervisors often work on a sprint truck first responding to calls, getting refusals and putting out small fires with ticked off ED staff and patients. If a basic has the experience, education and protocol knowledge, why should he or she not be able to apply for a supervisor position?

 

[akflightmedic]

There was a thread on this before...in short, it can be done. It all depends on what all the role entails.

 

[SpecialK]

In the "old days" it was required for all managers to be an Intensive Care Paramedic; or essentially you had to reach the top of the clinical career structure before you "timed out" off the road. This is no longer the case.

Station Managers, Territory Managers and District Operations Managers can be EMT or above. In Auckland because of the large workload, there is a hybrid Station Manager role called a Group Manager who looks after several stations and they can be an EMT. In Auckland and Christchurch. the Shift Supervisor must be an ICP; the rationale for this is they are a flexible and relatively mobile resource which can provide second-line clinical backup.

The Director of Clinical Operations is a Registered Nurse, and the Assistant Director of Operations is a Paramedic. The former DCO was a First Responder.

Managers are not primarily response resources which the exception of the Station or Group Managers (because they crew an ambulance) and Shift Supervisors. The primary role of managers is well, to manage and run the ambulance service! They can't very well do that if they are out doing jobs. Now, in saying that. most managers do some response work but the level varies between each. The Auckland District Operations Manager, for example, does a half-day or full-day shift approximately once a week.

If the person has the right skills and ability I'm not sure it's really important what level they have.

 

[EpiEMS]

I had an interesting conversation with an FTO about basics being supervisors. In my organization, supervisors often work on a sprint truck first responding to calls, getting refusals and putting out small fires with ticked off ED staff and patients. If a basic has the experience, education and protocol knowledge, why should he or she not be able to apply for a supervisor position?

I was under the impression that FDNY EMS had (until a couple of years ago - paramedic is now mandatory I believe) and Boston EMS has EMTs as field supervisors ("lieutenant"/"supervising emergency medical services specialist - the latter is the civil service title - is the FDNY EMS nomenclature, and Boston uses "lieutenant" as well). FDNY moved to paramedic as a minimum a couple of years ago.

From the operational perspective, there are few issues with having an EMT as a supervisor, especially for a BLS service. For an ALS service, however, the operational/logistical issues do exist: For example, can an supervisor who is an EMT carry narcotics to ALS providers who are out? Clinically, as long as you make it clear that the ALS crew is in charge of the *clinical* decisions, it should be fine - but practically, I'd wager that some less than scrupulous BLS supervisors will try and take charge, but not all ALS providers will do the right thing and stand up to them...

So, yes - it makes sense. However, you need lots of process controls - controls that sometimes wouldn't be necessary with an ALS supervisor.

 

[Qulevrius]

We had 3 field supes who were EMTs. All three had at least 5-6 years on the job (the oldest was in the system for 15, if memory serves) and had filled various roles prior to. The OPs supe, however, was a medic (with a separate medic supe). Their job description had very little in the way of field work and they mainly served in a fire team capacity; anything the crews needed assistance with, they did it.

In the end of the day, it all depends on the company's MO - with us, it was minimum involvement and very little micromanagement. Their doors were always open and 2 out of the 3 were very chill, friendly blokes. Definitely helped the morale.

 

[NomadicMedic]

From the operational perspective, there are few issues with having an EMT as a supervisor, especially for a BLS service. For an ALS service, however, the operational/logistical issues do exist: For example, can an supervisor who is an EMT carry narcotics to ALS providers who are out? .

Why does a paramedic have to be the one who resupplies the narcs?

 

[VentMonkey]

Why does a paramedic have to be the one who resupplies the narcs?

They don't and it is system/ county/ state/ country/ continent dependent I'm sure. Back home, the (EMT) supervisors had the key to narcotics for all ALS providers for our service (paramedic, and RN/CCT narcotics).

Here, our system has all but phased out EMT's in an administrative, or supervisor role. Our field supervisors and administrators staff units, and/ or first respond pretty much everyday, thus our supervisors and administrators are all paramedics and still very much function in that capacity, as well as perform front line management duties.

As far as narc restocks, again, at least here it's done by the supervisors (paramedics), but typically, and more specifically, by our administrative supervisors; it's more practical this way it seems. I don't know for sure if it's mandated or not that they have to be paramedics here. SoCal it didn't seem to be, at least at my old EMT service that wasn't the case.

 

[Qulevrius]

Why does a paramedic have to be the one who resupplies the narcs?

Just to expand on this - prior to transitioning to EMS, I had a small business contracted with one of the major med/pharm distributors on the west coast. The distribution company handled the sales, we handled the logistics & transportation. As a CPhT, I had to sign off the items from the 'cage' (this is what the scheduled substances storage was called) and hand them over to the drivers, whose level of education was high school at most. They then proceeded to carrying hundreds of thousands of $ in drugs, to the end customer, every day, 2 shifts per day. I really don't understand how, in terms of liability, having someone with absolutely no pharm/medical background, transport C-IV/C-II items, is more viable than having an experienced on-duty supe, with a very specific education, do the same.

 

[EpiEMS]

Why does a paramedic have to be the one who resupplies the narcs?

As some other folks have said, this is probably a state or service specific requirement. I could very well be mistaken, but out of an abundance of caution, I thought this might be a plausible reason to have an ALS provider as a supervisor.

 

[Underoath87]

Depends on what the supervisor's role is. If they are just there to play politician and enforce company policy (like at many private companies), then no ALS experience is needed.