I don't trust him

Sassafras

Sassafras

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I realize the anser may only be "suck it up and deal", but here is my issue...

My volly unit only runs as BLS. We have a transplant from another state who hasn't run as a paramedic in a few years, but was assisted in gaining reciprocity here and went through all the steps and recertifications to do such.

He likes to take over calls refusing to allow EMT-B's to tech. On one level I understand this. He feels ultimately responsible as the highest trained provider. On the other hand, I've gotten into many an argument with him over things where he refuses to admit he's wrong, even when I pull out the text books showing him that yes in fact you can not give D-50 to a hypERglycemic patient and expect good results. He pawns it off as "such and such unit would" and I've rolled my eyes and thought "no, you just said you'd provide this treatment". We've had multiple discussions such as this, and frankly, I know my training is lower than his, but I think my college level biology class educated me more in anatomy than his paramedic course did.

The fact is, as a provider, I don't know if I could trust this guy and I'm not sure how to deal with this fact. If I'm stuck up front driving because he's pulled the "higher trained" card and jumps in back, I am afraid of not being able to advocate for a patient if he pulls one of these stunts on call. Luckily our arguments have been off the clock, and I've not run a single call with him yet, but it's only a matter of time and I need to figure out what to do with my personal feelings about this guy before it happens.
 
Sassafras said:
On the other hand, I've gotten into many an argument with him over things where he refuses to admit he's wrong, even when I pull out the text books showing him that yes in fact you can not give D-50 to a hypERglycemic patient and expect good results. He pawns it off as "such and such unit would" and I've rolled my eyes and thought "no, you just said you'd provide this treatment". We've had multiple discussions such as this, and frankly, I know my training is lower than his, but I think my college level biology class educated me more in anatomy than his paramedic course did.
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[sarcasm]Well, you see, the problem is that the dextrose isn't dilute enough for a homeopathic treatment. [/sarcasm]
 
I should have added my anatomy comment was in reference to other arguments we've had over where specific areas were in the body as he reprimanded me to go back to anatomy class (only to pull the A/P book I have on my bookshelf and point out that I was again correct).
 
It's time to chat with your boss/supervisor/mentor, letting them know what's going on, and taking their recommendation and moving forward.
 
If you don't trust him, don't go out on calls with him. Let your supervisor know that you refuse to work with him.
 
Is it really as simple as that? I'm not being snarkey. It just seems as though it could create a lot of waves within the politics of volley service. Know what I mean? How do you even approach the cheif about that when this person goes on a good portion of calls?
 
Do you not have direct evidence that he is a subpar provider who is often wrong about FACTUAL knowledge.

I don't understand how ANYONE can earn their Paramedic if they don't understand such a simple concept as not administering dextrose to someone with hyperglycemia.

Pull your supervisor to the side and tell him that this guy is dangerous.

Maybe everyone else is also intimidated by this charlatan, but not strong enough to stand up and say something.

What if you two get on a bad scene and he tells you to do something contra-indicated, and you hurt someone?

Sure the vollies all have terrible politics, but that isn't an excuse that should permit bad medicine to be practiced.

Tell you supervisor that you do not trust his clinical judgement and you don't feel comfortable with his as your team lead on calls.
 
Your lucky. If the Medic ever gets in the back of the truck at my agency its a good day lol.
 
I think the real question is does someone with more training get to pull rank on scene if the service only runs BLS? It's a good question and I think you need to look at the bylaws of your unit. It may be a situation where you can say "I was first on scene, we are BLS, I'm running this." But better to have the leadership of your organization spell it out.
 
Talk to your supervisor, clinical standards officer, medical director or PADOH
 
Back in the day, in NYC, we would give the unresponsive cocktail. It was D50, 2 mg of narcan, and 100 mg of thiamine. It mattered not if the pt's BGL was over 70, 400, or whatever. The reasoning was that the glucometer could be malfunctioning, and that if their sugar is already high, a little more isn't going to make much of a difference in the short term. We all knew this protocol was flat out stupid, but we had to follow it anyway.

You said that this medic was from another state, and that they hadn't practiced as an ALS provider for a few years? It sounds like he had a lousy, quickie mill type of education, is stuck on doing things the old school way, and hasn't bothered to supplement his original knowledge base from back when pterodactyls were flying. I see this problem where I work now. We have a mix of old timers who were originally certified around 1985-1990 or so, and us younger medics, a good number of which actually hold EMS degrees (degrees help with promotion in the fire service; some figured out that they might as well get their P-card through a degree program, and kill two birds with one stone). It seems to me that some of these old timers think they're still back in 1990, and their pt care decisions and knowledge base reflect that. They have no clue how to read a 12 lead, and you have to force them to use CPAP, since they don't understand it, and just think it's a PITA, much like cracking open the narc pouch for pain management.

Anyway, how about you just give him rope and let him hang himself? If he's a tool, and consistently disrespects you, just throw him under the bus when he inevitably commits a serious pt care error.
 
Sassafras said:
... and I've not run a single call with him yet, but it's only a matter of time and I need to figure out what to do with my personal feelings about this guy before it happens.
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You're condemning the guy before you have any real experience with him. YOUR suspicion could be the most toxic thing here as right now, all this is in your head.

In this moment, YES your personal feelings could interfere with good patient care. He apparently didn't pass muster with you in conversation. Maybe he's resistant some. But you DON'T know how he responds during calls and wouldn't it be fair to be the best EMT with him you can be without being his watchdog? Start there first, that's your job.

Then come back and talk to us!

Your job right now is to not let your personal feelings impinge on your job right now.
 
Sounds like the critical care medic we just hired that gave me a pt from a BAD accident placed on the backboard on her stomach. And couldnt give me a reason why she put her like that.
 
In a vollie situation, I wouldn't ride with him. As a volunteer, I reserve the right to only ride with people who make the job fun. You'll need to pay me to deal with people who in any way make the situation more difficult.

At my vollie agency:

  • I will not ride with people who scare me with their driving
  • I will not ride with people who mouth off to the patients
  • I will not ride with people who embarass me in the hospitals
  • I will not ride with people who are resistant to learning new things

I love to teach, and I love to help people become a better provider, but if they chose to wallow in ignorance, I don't want to be around them.
 
firetender said:
Your job right now is to not let your personal feelings impinge on your job right now.
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You're right. I'm trying here. Really. I've had way too many off the clock convos with this guy (and a personal run in that Brown can attest had me upset for days since he got to hear me rant about it in chat for a while). It may just be tainting my impression of him as a provider. I may simply just not want to be alone with this guy at all. But I have to figure it all out in my brain. Mayhaps deal with things as they come. I suspected someone may give this opinion. Part of me holds the same. I think I'm really just trying to talk myself down and thinking the entire process aloud.
 
In your vollie on a rig is someone designated crew chief ?

In my vollie, there are working medics, RNs, and a few PA's. There is an indisputed chain of command. Someone on every crew is designated crew chief and he or she has the final say. Even if someone on the crew is a medic or an officer in another organization.

Of course, an on duty medic from another organization can take over the scene and our crew chief is outranked, but it is his or her position in the other organization as a medic that gives them the authority, not their education, training or experience alone.

IMHO, you said you have never riden with him but argue about patient care? Do you have a position of authority to question what goes on at calls you were not at ? Q/A, and officer or board member? If not , IMHO, better to be silent.
 
:blink:
tazman7 said:
Sounds like the critical care medic we just hired that gave me a pt from a BAD accident placed on the backboard on her stomach. And couldnt give me a reason why she put her like that.
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:blink: confuzzled...very, very confuzzled.
 
"...I am afraid of not being able to advocate for a patient if he pulls one of these stunts on call"


Frankly, in my opinion that pretty much raps it up. If you're in any way accountable for his actions on a ride, and you're afraid you can't legitimize his actions should you ever face court you shouldn't ride with him and explain that to your supervisor. EMT providers are susceptible to law suits even when they do their best, so you should have the right to minimize damage as much as you can.
 
Talk to your EMS Director for a "surprise" protocol test?
 
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