FTO instructed me to “make up” vital signs

AVEMT

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Hey everybody,

I’m new to the EMS field and just had my first shift yesterday. I’m working on a 911 BLS rig in one of the busiest areas of the nation.

As the intro suggests, yesterday on shift I was surprised when my FTO and attendant both told me on several occasions to “make up” vitals for the report. Here our first set of vitals are always done on seen by LA Co Fire ALS. We’re required to have three min. with our team doing the transport and destination vitals. Not a single time did we actually take any during transport and I saw my FTO, attendant and other EMTs completely making them up at the hospital, minus the HR, SPO2 and temp. I didn’t touch a stethoscope the entire shift and only touched the automatic BP cuffs at the ER on my own accord.

Now like I said I’m new to this field. I made a career change from another highly regulated industry where the thought of making important stuff up would get you fired or sued in a heartbeat. Being the rookie, I don’t want to tick off my FTO and call him out and give him any reason to not sign me off, but I can’t help but feel like he’s a scumbag. They’re called “vitals” for a reason and I would be infuriated if a family member of mine was given such mediocre care.

I guess I’m just curious to know from other EMTs if this is standard practice in the field? I know in EMT school that respiratory rate was ALWAYS made up but HR, SPO2, BP, lung sounds, and pupils never were.

I decided that I’m not going to call my FTO out, but simply tell him I’M going to check vitals (all of them) for the practice.

Any thoughts?
 

mgr22

Forum Deputy Chief
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What did your FTO say when you told him you're going to check vitals anyway?
 

mgr22

Forum Deputy Chief
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Sounds like you have a temporary solution to your problem. Long term, you'll have to decide if you want to stay in a system like that.

I haven't worked with anyone whom I knew was making up vitals, and I was never told to do that.
 

Kevinf

Forum Captain
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That's a zero tolerance firing offense everywhere I've worked. Take vitals anyway, you're writing a legal document and it protects YOU.
 
OP
A

AVEMT

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I have a feeling the FTO and the other EMTs he was hanging out with while we were holding the wall are “that group” who have lower standards. Many other trainees I know have told me their FTOs are very strict. I’m just with him for 6 24’s and after that I’m on a permanent shift. I’ll just play the role of over-achiever in his eyes and hope my permanent partner is better.
 

Jim37F

Forum Deputy Chief
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Take the vitals. If they're different from County's numbers, record that.

If you're sitting there staring at the patient, take a blood pressure. Talk to them, OPQRST is just a start. If County tosses you a BLS patient and digs out, reasses everything yourself within your scope. If you cannot obtain something for some reason, document it.

I really hope this isn't McCormick because my FTOs from there would flip out at even the mere suggestion of just making stuff up
 

Ewok Jerky

PA-C
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This is not normal. Do your own assessment if you are providing care. Never document anything not factual. If the rest of the system works like this I would find a new gig
 

jgmedic

Fire Truck Driver
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Im guessing youre in the Antelope Valley? So AMR if you're 911. Get signed off and report his ***. What kind of service is that guy giving new EMTs by encouraging that kind of behavior.
 
OP
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AVEMT

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Im guessing youre in the Antelope Valley? So AMR if you're 911. Get signed off and report his ***. What kind of service is that guy giving new EMTs by encouraging that kind of behavior.
Yeah, you figured it right. My guess is he’s checked out, he has no plans on staying in EMS. Feels more like having a babysitter than a mentor. I plan on getting my paramedics and there’s no way I’m going to let my foundation in this field be tainted.
 

Rano Pano

Forum Lieutenant
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Your FTO is trash. Im not surprised as the main CE/FTO was complete trash and as of recent still holding that position.
 

johnrsemt

Forum Deputy Chief
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While I was in medic school we worked with the city FD a lot. I was told to always go with their VS as our 1st set (by a couple of preceptors). 1 run I realized our BP cuff had a hole in it and asked to use the engine crews cuff: I was told that it was in the other bag, still on the engine. I asked them how they got the BP they reported, no answer. I learned don't trust Fire VS unless you work with them enough to see them taking them and you know you can trust them

Don't ever not take a set of VS or 2 of your own. I have had BLS partners that I would take VS signs on the patient before I would let the patient go BLS to the hospital. 1 partner told the hospital that our patient/prisoner HR was 84 and into the jail unit he went. Next patient 40 minutes later went to a trauma room, and as we went down the hall I glanced into the room before and the last patient was in the bed. So I stopped by after and asked what happened: "We don't give Adenocard or Cardiovert in the Jail unit": his HR was was 260. My partner couldn't feel a good HR, so she made it up.


Never get to the point to being the FTO. Learn from him: learn what not to do, learn how to teach future new people. Learn how to be better than he is (or was).
 

johnrsemt

Forum Deputy Chief
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Yes we do, sometimes I think Iearned more from the bad role models than the good ones. LOL

I learned how not to treat partners and patients
 

spimx

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That's a zero tolerance firing offense everywhere I've worked. Take vitals anyway, you're writing a legal document and it protects YOU.
When will the EMS service learn that firing everyone is not the solution to problems.

Welcome to urban EMS, now you will know that working in a high volume service is a great way to become a terrible paramedic. The truth is that it happens all the time. I would not recommend making up the vitals. If I have 2 sets and I need one more for a non-critical patient I may guestimate.

The best practice for you to learn is that the more elaborate your objective assessment is (vitals) the safer you are. BP, HR, temp, glucose, 12-lead, right side 12-lead, SPO2, CO2, respiratory rate, ISTAT if you got it, ultra sound if you got it; the more the merrier.
 

jgmedic

Fire Truck Driver
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When will the EMS service learn that firing everyone is not the solution to problems.

Welcome to urban EMS, now you will know that working in a high volume service is a great way to become a terrible paramedic. The truth is that it happens all the time. I would not recommend making up the vitals. If I have 2 sets and I need one more for a non-critical patient I may guestimate.

The best practice for you to learn is that the more elaborate your objective assessment is (vitals) the safer you are. BP, HR, temp, glucose, 12-lead, right side 12-lead, SPO2, CO2, respiratory rate, ISTAT if you got it, ultra sound if you got it; the more the merrier.
Firing everyone? Absolutely agree. But this guy is training people. He should be fired.
 

Fastfrankie19151

Forum Probie
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Cover your butt get your own set on every patient and document it if something happens and you end up in court you don’t want someone else’s lies to come back on you.
 

Carlos Danger

Forum Deputy Chief
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I do not condone "making up" vitals. But the reality is, having a hard requirement for at least "X number" of sets of VS no matter how short the transport, no matter how stable the patient, and no matter what else is going on just invites this type of corner cutting. It's human nature to have a difficult time honoring dumb and onerous policies.
 

E tank

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I do not condone "making up" vitals. But the reality is, having a hard requirement for at least "X number" of sets of VS no matter how short the transport, no matter how stable the patient, and no matter what else is going on just invites this type of corner cutting. It's human nature to have a difficult time honoring dumb and onerous policies.
the rest of the story...some folks are too dumb to discern when cutting corners is 'appropriate' and when it's not. When someone is too dumb to keep his mouth shut (like when he's training someone he doesn't know), I have my doubts as to whether or not he's smart enough to know when he should take a blood pressure or not...
 

ffemt8978

Forum Vice-Principal
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the rest of the story...some folks are too dumb to discern when cutting corners is 'appropriate' and when it's not. When someone is too dumb to keep his mouth shut (like when he's training someone he doesn't know), I have my doubts as to whether or not he's smart enough to know when he should take a blood pressure or not...
Training is learning the rules, experience is learning the exceptions.
 

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