HELP! My EMT-I thinks she's a paramedic!

[djmedic913]

After talking to her she said you don't know how to do your job and if she doesn't step in and act like a Paramedic you will end up killing patients.






h34r:

well, that was unexpected. pull rank. also apologize to your wife before you destroy that friendship. You tried diplomatic, it is time to inform management. I am sure management would love to know that she is going to be the cost of lots of money lost do to her causing law suits to be filed against the company. Strike now before this goes too far and you go down with her.
You need to tell her to get in the driver's seat, sit there and shut up. "When I say drive, you drive". She is gonna kill someone and it will fall on you.

 

[Summit]

Best... emoticon... ever...

 

[Shishkabob]

Huh???? I am confused, did she actually say this? I am not sure where this comment came from. :wacko:

Translated---

"You are in charge, but since you aren't doing your job, she will because if you don't take initiative as a medic, someone will die"

 

[Melclin]

Second what some of these guys have said.
Also I don't much care for some of these "you're the medic, you should never have let this happen" types, like its the end of the world that you didn't wanna have an argument in front of a patient and now you're caught been a rock, a hard place and your wife. I for one feel its understandable how these things just happen. I feel for you. For what its worth heres what I would do: I'd tell my wife everything about what was going on and how I felt about it, just like you have with us here. Then I would speak with the EMT-I and again, explain everything like it is here, and maybe bend it a little so you don't hurt her feelings to much, like "You're a great EMT, I just don't wanna get my balls busted, you know?".

 

[VentMedic]

Second what some of these guys have said.
Also I don't much care for some of these "you're the medic, you should never have let this happen" types, like its the end of the world that you didn't wanna have an argument in front of a patient and now you're caught been a rock, a hard place and your wife. I for one feel its understandable how these things just happen. I feel for you.

When you get a higher license in a medical profession, responsibility comes with it. You personal life should not interfere with your professional life on the job.

We got on at a quasi-critical care service,
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we didn't get any critical patients, so I told her to ride the calls, and I would get us where we were going. Well, that worked out fine for that weekend, but as time went on, she started talking about how she had been in a terrible police car accident and was afraid to drive. So, I drove most of the time, and we never were up for a call when a critical patient came through, so I just went with it.
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Well, one day, predictably, we got a serious patient. It was a time sensitive thing. I got in the back of the truck and started evaluating the patient. She told me to get enroute, she would take care of everything on the road.
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Well, one day, my wife and I went home during the shift, as we are all allowed to do, and a Call came in. It was an ALS call at a nursing home, and this EMT decided to take off with an EMT-Basic and run this call. My wife and I started to head in that direction, and the EMT called and said "it's okay. It's not a bad call." Well, we decided to meet them at the ER, and lo and behold, here they come around the corner lights and sirens. When we all got back to the station, I let her have it, telling her I would not sign off on this activities anymore, and if she screwed it up, it was on her.
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but station policy is to run only ALS units, meaning at least one paramedic on the unit. (from another post)
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we do not run strictly "bls" trucks, in that there is supposed to be a paramedic on every truck. all of our trucks are fully equipped als units, in that the state inspected them, looked for the appropriate equipment, and said "this is an ALS ambulance." we aren't supposed to have bls units in that there is no running out of the station with a firefighter and an emt. that just doesn't cut it.
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the facility barely knows what an ambulance is in most cases, much less knowing enough to ask for a specific type of ambulance.
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The thing that complicates the situation is that she and my wife are very, very good friends. Going to the director would sort of be like a betrayal. Frankly, when the first incident happened, I really didn't want to be her friend anymore. This is just one of many slights that she has done to me. My wife swears she has no problem with her, but I have to still work with this EMT on alternating sundays, nevermind the fact that she is constantly trying to jump my calls. When she is with me, she acts like she has forgotten she is not a senior medic!
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Any of the mentioned incidents would be a serious offense at other companies in this country as well as putting your license in jeopardy with the state.

Withholding facts from your director that he/she has an EMT who is afraid to drive on a truck that is supposed to provide ALS care to a patient if needed puts the whole company at risk of a citation. If the call is ALS, that means the Paramedic must be the one taking care of the patient during transport and not just in the truck as the driver.

Luckily this company seems to be the only game in town since their contract would be in shreds if it was found out patients were not getting the level of care the ambulance was contracted for. There is now case precedence where facilities can be held liable for some of the actions of those they contract. One can argue all they want that the patient is BLS but the argument may be skewed because YOU have the need for that patient to be BLS regardless of what the patient really needs. Criticizing other healthcare professionals that they are clueless about transport won't go that far either as one may find out in a complaint filed to the state or in legal action just how much they do know.

Signing off activities that involved patient care for services performed by a lower level provider is NOT a good practice.

Just allowing all of this to continue without addressing anything with someone in the company who may be hurt far worst by these actions is just unprofessional. It jeopardizes more than just a few tears between friends.

 

[Melclin]

When you get a higher license in a medical profession, responsibility comes with it. You personal life should not interfere with your professional life on the job.

Yes, I quite agree. But its not the end of the world, the problem can be fixed and learnt from, which is, as I understand it, what he was asking for advice about. Reprimanding him and then picking him up on operating procedures doesn't help him with his trouble.

I get that you're big on professionalism and rightly so, its important. But I don't see how starting arguments with people, especially people who are new to the forum, who are just asking for advice, is going to help matters.

Maybe I'm missing something because of cultural differences, or because its all just written down and I can't hear inflections, but it feels like an abundance of unhelpful (and off topic) nastiness was, and is often, leveled at the OP. Speaking of sore spots, this is mine. I don't see why people can't debate more constructively and politely on this forum (and stick to the point of the OP).

 

[VentMedic]

Maybe I'm missing something because of cultural differences, or because its all just written down and I can't hear inflections, but it feels like an abundance of unhelpful (and off topic) nastiness was, and is often, leveled at the OP. Speaking of sore spots, this is mine. I don't see why people can't debate more constructively and politely on this forum (and stick to the point of the OP).

When you post on an anonymous forum, what expectations do you have?

Maybe you don't understand the difference between an EMT and a Paramedic or ALS and BLS in this country. They are two very different certs and licenses.

This poster has tried to justify his actions for allowing this and not discussing the situation with those involved in the management of his company. This is NOT an issue for some anonymous forum members to decide the outcome. However, it is a good scenario for some to see what not to do.

In his first post he said he was a seasoned Paramedic but he seems to not see how his actions can affect patient care and the reputation of his company. Or, maybe he just thinks that working in some small little town the people don't care or need "ALS" or he can always come up with some way to justify "BLS" to prevent any hard feelings or tears between him and his partner.

I don't know what some think holding a medical license means. It is not something you can sometimes take responsibility and sometimes not for your actions. When patients are involved, you must do what is right by the license you are holding.

Medical Directors and managers of companies expect professionalism or at least they should. One should understand the responsibilities that their licenses and directors have given them. There must be a trust that the professionals working for them will do the right thing since they will also pay the price for granting these privileges to the wrong person. If an employee is more concerned about hurting his wife's girlfriend's feelings, then maybe their judgement on patient issues might also need to be questioned. Is this person capable of making sound decisions for patient care? I also don't think the other Paramedics and EMTs working for that company who do work within their license level would be too happy if their service was busted down to BLS level for failure to comply with certain regulations or have a competitor come in wanting to take over the C.C. IFTs.

One's actions may have serious consequences for many and then there may be a need for tears. My posts should be taken as a reality check and not necessarily as a scolding. But then, this person would probably no longer be employed if this occured at other agencies for covering up things and not disclosing information that could affect patient care or the company.

Again, holding a medical license means accepting responsibilites and the reality that someone might hold you accountable for your actions.

 

[medic417]

Huh???? I am confused, did she actually say this? I am not sure where this comment came from. :wacko:

I put a smiley. Does that answer the question?

 

[Melclin]

When you post on an anonymous forum, what expectations do you have?

Correct me if I'm wrong, but weren't reprimanding people recently for their language and the way they were talking on this public forum because it reflected badly on EMS? Besides, just because its anonymous doesn't mean you can't at least try to extend people the same professional courtesy you would if you were in person.

Maybe you don't understand the difference between an EMT and a Paramedic or ALS and BLS in this country. They are two very different certs and licenses.

That is undoubtedly true, and that may make his actions worse than I see them. But my original point was that he was just asking for help (how wrong he was is irrelevant). Maybe its obvious, maybe he shouldn't have to come to a forum to know what he should have done, but I don't see why that doesn't mean you can't just point him in the right direction.

However, it is a good scenario for some to see what not to do.

You expect such constant perfection and the minute people ask for help you pounce. Zero tolerance with the highest standards, militantly enforced, is not an effective teaching mechanism with which to spread the gospel of professionalism. I have a thing about professionalism, and how its taught, so I could see us butting heads like this often, if I allowed myself, still I suspect we are just on different pages of the same book (and we come from different worlds, I was shocked when you told me about those EMS shootings). Its a subject of some considerable research at my university at the moment, and the luminaries in the field are all unassuming, quiet teachers, with a tolerance for mistakes and learning, a process which continues throughout your career and from all different sources, including anonymous forums, and should be positive. I can't help but feel that the brand of professionalism you expect is a bit.. officious. You (I'm not attacking you personally, I'm just saying how the brand of professionalism you seem to adhere to appears to me) seem more concerned with telling people how wrong they are, rather than being a friendly helper, on the road to professional improvement.

As for that comment about him maybe thinking rural areas don't need ALS, that's just plain unfair. He never said anything to suggest he felt that way. Address his arguments, by all means, but don't use rhetoric to demonize his position.

 

[djmedic913]

Correct me if I'm wrong, but weren't reprimanding people recently for their language and the way they were talking on this public forum because it reflected badly on EMS? Besides, just because its anonymous doesn't mean you can't at least try to extend people the same professional courtesy you would if you were in person.

Um, actually the way most of have posted here is more than likely how we would have said to him face to face.

You have to remember in EMS we eat our young. As the OP stated, he is a seasoned medic. Which automatically states he knows better. and if you read what he wrote, he knows he knows better.

Many of us have ended up in these type situations before and if you noticed there was a lot of advise for what he should do...I am choosing not to use the word constructive criticism because it was blunt advise, but still an attempt at being helpful.

But also as we all know, EMS is not black and white. not professionalism or even patient care. EMS is a GIANT gray area. We all learned early in our EMS careers that there is the classroom/textbook world and then there is the real world which rarely ever fits into the classroom/textbook world.

 

[VentMedic]

Address his arguments, by all means, but don't use rhetoric to demonize his position.

Okay, I'll just address the personal issue.

The female partner is playing him for being a fool to get her way. His wife probably thinks the same but has him pretty whipped also by her stance on the issue.

Issue addressed.

You have to remember in EMS we eat our young.

Eat our young? No, we actually allow too much and too many to continue down the wrong path by making excuses for bad behavior.

Some also use the words accountability and professionalism when referring to "eating our young".

But also as we all know, EMS is not black and white. not professionalism or even patient care. EMS is a GIANT gray area. We all learned early in our EMS careers that there is the classroom/textbook world and then there is the real world which rarely ever fits into the classroom/textbook world.

There is that for every area of medicine. It is just that in other medical professions they don't have constant fights that a CNA is better than an RN, an O2 tech is better than an RRT and a Physicians Assistant is better than an MD when it comes to licensure and responsibility. You also have probably not been around these professionals very much to understand what eating their young is all about. EMS providers are the ones who continuously want to blur the lines between the EMT and the Paramedic. But of course this is only until something bad happens to the patient and then it is on the Paramedic's shoulders in court. It is time the OP stops with the excuses. This also goes for others in EMS who continue to justify bad behavior when it comes to patient care. I am an advocate of quality patient care. If you are not able to understand your responsibilities to the patient or make excuses for justisfying only providing BLS care on an ALS truck because it'll make your EMT cry or you'll have to rat on her for being afraid to drive, then maybe one should examine what they are doing on that ambulance. Covering up incidents involving patients is just not good enough.

 

[Sasha]

I for one feel its understandable how these things just happen.

Once, maybe. Not all the time. Then the problem is with the one allowing it to happen.

 

[medic417]

Okay, I'll just address the personal issue.

The female partner is playing him for being a fool to get her way. His wife probably thinks the same but has him pretty whipped also by her stance on the issue.

Issue addressed.




Eat our young? No, we actually allow too much and too many to continue down the wrong path by making excuses for bad behavior.

Some also use the words accountability and professionalism when referring to "eating our young".



There is that for every area of medicine. It is just that in other medical professions they don't have constant fights that a CNA is better than an RN, an O2 tech is better than an RRT and a Physicians Assistant is better than an MD when it comes to licensure and responsibility. You also have probably not been around these professionals very much to understand what eating their young is all about. EMS providers are the ones who continuously want to blur the lines between the EMT and the Paramedic. But of course this is only until something bad happens to the patient and then it is on the Paramedic's shoulders in court. It is time the OP stops with the excuses. This also goes for others in EMS who continue to justify bad behavior when it comes to patient care. I am an advocate of quality patient care. If you are not able to understand your responsibilities to the patient or make excuses for justisfying only providing BLS care on an ALS truck because it'll make your EMT cry or you'll have to rat on her for being afraid to drive, then maybe one should examine what they are doing on that ambulance. Covering up incidents involving patients is just not good enough.

:beerchug: Very good honest blunt post.

 

[Melclin]

Um, actually the way most of have posted here is more than likely how we would have said to him face to face.

You have to remember in EMS we eat our young.

Mmm yes I'm quite aware of the traditional approaches to learning in EMS. And its entirely counter productive. That whole eating the young thing is what they're trying to change here. It gets rid of perfectly good medics who just can't put up with what is essentially bullying and leaves the rest working in unpleasant, stressful environments. Anyway, I digress, what I've just said there doesn't really apply to this thread very much.

I agree that alot (but not all) of people were, blunt, but still helpful. I don't really have a problem with that, and, like I said, I might be overreacting peoples tones, because you Americans do have a decidedly different way of talking to each other, that's can seem quite rude to some of us Aussies who don't understand you, when really there was no rudeness.

 

[Melclin]

Eat our young? No, we actually allow too much and too many to continue down the wrong path by making excuses for bad behavior.

Some also use the words accountability and professionalism when referring to "eating our young".

Yes I don't think the young part applies here. The way it seems to work from my admittedly short time taking notice of such things, is that when you are young and inexperienced, people are way too tough on you and tough in an unhelpful way. Then when you qualify, or reach higher levels, all of sudden you can get away with murder. Once you've joined the club.

Thankfully this is changing and, from what I hear, has changed alot from the way it used to be here.

 

[djmedic913]

because you Americans do have a decidedly different way of talking to each other, that's can seem quite rude to some of us Aussies who don't understand you, when really there was no rudeness.

Don't try and figure Americans out...we never have a clue what we are saying anyway...LOL

 

[Melclin]

Ah bugger it its not letting me edit my posts. I was just ganna add that your point, VENT, about the MD/RNs, RRT/ 02 techs helped me understand the issue better. It would be ridiculous for a RN to usurp the authority of the MD, and if there was a doc here saying "help my nurse thinks shes a doc" then I would understand people saying things like they have. I didn't realise the differences were as great as RN/MDs. Cheers.

 

[VentMedic]

Ah bugger it its not letting me edit my posts. I was just ganna add that your point, VENT, about the MD/RNs, RRT/ 02 techs helped me understand the issue better. It would be ridiculous for a RN to usurp the authority of the MD, and if there was a doc here saying "help my nurse thinks shes a doc" then I would understand people saying things like they have. I didn't realise the differences were as great as RN/MDs. Cheers.

I didn't use RN to MD.

I used:

CNA is better than an RN, an O2 tech is better than an RRT and a Physicians Assistant is better than an MD

EMT-B is usually just 120 hours with no prerequisites of any type much like a CNA. It is also a certification and the Paramedic is a license although some states do use the word certification. Granted, in some states the Paramedic training can be as little as only 500 hours more than the EMT-B it still has advanced invasive procedures and meds that can be done within the scope of practice. The EMT-B can splint and apply O2.

 

[Melclin]

My bad, little tired when I wrote that last one. But, yeah, my point was I get the difference better now with the examples.

 

[FF-EMT Diver]

Been a while since I've been on board. Had a chance to poke around today.

Paragod I am assuming you are over toward Savannah?

I will say that I think a lot of the problem is with managment and not with the employee per se, Here are some points I see and I'm sorry if there not laid out great.

You are critical care unit then every employee should be CCEMT-P as a service.

No one should be allowed to go home for dinner this is a job and a profession lets keep it that. ( I realize some people work in the sticks and that may be difficult but IMHO you're asking for a can of worms eventually.)

Managment should have clear quidelines on call taking there should be no call jumping it should be one truck then the other unless one is in terittory and can catch the call faster. ( I also can see that this call would not have been taken by unqualified personnel if you and your wife (the only Paramedics on shift) had been at the office and not home on dinner.

So I would say the young lady may have problems or she may not it seems to me that a lot of this would have been avoided had you been straight with her from the start and managment needs to make it plain that the SENIOR medic is in charge of the truck.(BTW I hate paramedics that try to make B's and I's ride all BLS) again maybe she wanted to and communicated that to you..I dont know. I will say that maybe she is a qualified knowledable I and is confident to handle a bad call, that needs to be channeld in the right direction ( Like paramedic school) I personlly am just now in paramedic school and I was confident when I got out... And I have proved that competence over and over to the medics I work with ( I'm not trying to sound like I'm all that I just take my Patient care seriously and in doing so I wouldnt take anything beyond my scope of practice.

Welcome aboard this is a good place to hang out and get info....

Dont take Vent wrong He and RR are very outspoken on Ems proffesionalism and should be there is not enough of it. Your post was kinda confusing and contains a lot of proffesional blemishes from managment to the ground so stick around and learn from people that have walked the walk from running high call volume to attending class after class.