Looking for a little input about what happened.

[ironguy321]

Let me start from the beginning. I have a friend who was an EMT-B for a local ambulance service. He told me they were hiring so I showed up and applied. I filled out the application and talked to the guy and he said I was hired as long as I didn’t have anything on my driving record, no formal interview or entrance test or anything. So I showed up my first day and the field training officer wasn’t there so I went along with the most seasoned medic at the time… which was one month. We transported a pt. from a retirement home to the hospital by strencher and backboard. He was slow to start an IV because everything was tagged in the back and things weren’t where he expected them to be [ex. Alcohol pads were under all the syringes]. We dropped off the pt. and departed from the hospital. As we posted up, we realized we had no back up straps for the backboard [plan was to pick a backboard up later]. The EMT-B [driver] was on his phone almost every time we were enroute or departing from a facuility[no pt. tho although we almost were the way he drove]. Documentation was poor and no one could give me a set way to write a report. Once I got back to base, the FTO went over a few things with me but stopped because he had a call to run. He wrote on my paper that the medic I was with probably went over everything but didn’t sign it. I quit the next day because honestly, I didn’t want to be apart of a company that ran this way. I hate feeling like a “QUITTER” but I have mixed emotions for it. I heard a story previous about a cardic pt. that was on a BLS truck enroute back home when they had a heart attack. All the EMT-B could do was put the pt. on oxygen and head back to the hospital. If that was my mom in the back, I’d want them to do a lot more than that.

What would you have done in my shoes? Should I have stayed hoping things would get better? Are all places ran this way?

 

[reaper]

You did the right thing. Get out before you are in to deep. If you have a bad feeling, then it is most likely a bad situation!

Stick to your morals and find a different job! Good Luck.

 

[mikeylikesit]

Let me start from the beginning. I have a friend who was an EMT-B for a local ambulance service. He told me they were hiring so I showed up and applied. I filled out the application and talked to the guy and he said I was hired as long as I didn’t have anything on my driving record, no formal interview or entrance test or anything. So I showed up my first day and the field training officer wasn’t there so I went along with the most seasoned medic at the time… which was one month. We transported a pt. from a retirement home to the hospital by strencher and backboard. He was slow to start an IV because everything was tagged in the back and things weren’t where he expected them to be [ex. Alcohol pads were under all the syringes]. We dropped off the pt. and departed from the hospital. As we posted up, we realized we had no back up straps for the backboard [plan was to pick a backboard up later]. The EMT-B [driver] was on his phone almost every time we were enroute or departing from a facuility[no pt. tho although we almost were the way he drove]. Documentation was poor and no one could give me a set way to write a report. Once I got back to base, the FTO went over a few things with me but stopped because he had a call to run. He wrote on my paper that the medic I was with probably went over everything but didn’t sign it. I quit the next day because honestly, I didn’t want to be apart of a company that ran this way. I hate feeling like a “QUITTER” but I have mixed emotions for it. I heard a story previous about a cardic pt. that was on a BLS truck enroute back home when they had a heart attack. All the EMT-B could do was put the pt. on oxygen and head back to the hospital. If that was my mom in the back, I’d want them to do a lot more than that.

What would you have done in my shoes? Should I have stayed hoping things would get better? Are all places ran this way?

you had a great reason to quit and are very smart for doing so. this is not the time to pick up bad habits or they will stick with you your entire career. most new basics wouldn't have because they want a job and by all means that one sounded too easy to get, i would wait to return to the company in a few months WHEN they get revamped with better management because they will be under investigation in the next few days guaranteed. you should feel grateful that you will not be around when that place gets checked on, i have a feeling most of the people there now won't be in a few months. next one will hopefully be better, you without a doubt did the right thing since you probably wouldn't have been able to change the way things were going on your own. i feel bad for the patients though.

 

[Katie]

if you're uncomfortable with it then you shouldn't stay. when you're in charge of pt care then it's your responsibility to see that things are done right. i think it was the right choice

 

[Hastings]

To be fair, there isn't really much more a Basic can do for someone suffering a heart attack than put them on oxygen and turn around. In fact, a Basic can't even verify a heart attack. I don't think Basics can even give ASA. So that's not a problem with the Basics or the company. That's a problem with the system.

 

[ironguy321]

To be fair, there isn't really much more a Basic can do for someone suffering a heart attack than put them on oxygen and turn around. In fact, a Basic can't even verify a heart attack. I don't think Basics can even give ASA. So that's not a problem with the Basics or the company. That's a problem with the system.

I agree with you 100% but what bugged me was the fact that this pt. was placed on BLS instead of ALS.

Thank you guys for your input by the way. I've been feeling pretty bummed out about this but after seeing that people are behind me on my choice, I'm feeling better. My plan is to go to a bigger, well known company that I know for sure is run better [did my ride outs there but I havn't reached minimum age]. ^_^

 

[jazminestar]

wow, there's some companys around here that work like that and there's no way in h-e double hockey sticks that i would work there......good thing you got out early before anything 'bad' happened while u were working.....

 

[KEVD18]

im with you right up to the heart attack bit. that sounds like a very poorly run company. however it could also just be a very poor crew so dont let it completely sour you towards ems. there are bad companies and bad employees everywhere.

as for the suspected heartattack situation: bls protocols in ma are:

activate als
high flow o2 nrb
asa 162-324mg chewable po
transports to closest appropriate facility.

thats it. nothing more that you can do. oh, assist them with their pre-prescribed ntg if they are so equipped. thats the whole shooting match for a basic. well, maybe a line in some states. and maybe some places that can apply(but not officially interpret) an ekg.

 

[rhan101277]

This is why I want to be a paramedic. I would feel terrible to be in a ambulance with basics, and have someone have a heart attack. I don't think B's can even hook a pt up to a monitor. But as long as they are breathing and blood is pumping they are still alive. If someone was to die though, because I couldn't give the drug I know they needed, it would be rough.

 

[KEVD18]

I agree with you 100% but what bugged me was the fact that this pt. was placed on BLS instead of ALS.QUOTE]


they were discharged from the H to home right? and at home, were they going to have a full ccu setup? i doubt it. they were d/c'd by bls ambulance because they didnt need any medical care enroute. they needed a taxi, but medicare wont pay for a taxi so they took an ambulance. the occurrence of the mi was either unfortunate coincidence or a big oopsie by the discharging md. the fact that it happened in the back of the bus has nothing to do with the how much of a freak show that company was. just bad luck.

 

[MMiz]

This is why I want to be a paramedic. I would feel terrible to be in a ambulance with basics, and have someone have a heart attack. I don't think B's can even hook a pt up to a monitor. But as long as they are breathing and blood is pumping they are still alive. If someone was to die though, because I couldn't give the drug I know they needed, it would be rough.

You need to learn to walk before you can run.

I agree with most of what has been said. No interview? No test? No formal FTP/orientation process? I'd run.

 

[Airwaygoddess]

You did the right thing.... You will learn from this experience. -_-

 

[johnrsemt]

depending on the circumstances on the BLS crew with the patient who had a heart attack. It sounds like they were taking the pt from a hospital back to an ECF or to home. in that case, it is most definitely a BLS run.
If the pt has a heart attack, or even goes into cardiac arrest, they SHOULD turn around and go back to the ED, what else would you want them to do?
and depending how far out they are, they may have been too close to call for a medic.

I have had BLS crews, that could see the hospital, and refused to transport the pt because they thought it should be an ALS run. If you are that close everything is BLS.'

 

[johnrsemt]

besides those comments: I would run from that company also.

 

[BirdtheEMTB]

I am a basic in Pa we are able to admin nitro subling under medic command. But I also run with a ALS crew at all times..at least 1 medic on board. That does not mean I cannot read some of what is going on, on the LifePack, and place a 4 and a 12 lead, but monitoring a sinus rhythm is out of my scope of practice. Good job on leaving that place, seems very like a very badly run systemll!
sorry about my spelling its late and I just got off a 16 hour shift

 

[MSDeltaFlt]

Let me start from the beginning. I have a friend who was an EMT-B for a local ambulance service. He told me they were hiring so I showed up and applied. I filled out the application and talked to the guy and he said I was hired as long as I didn’t have anything on my driving record, no formal interview or entrance test or anything. So I showed up my first day and the field training officer wasn’t there so I went along with the most seasoned medic at the time… which was one month. We transported a pt. from a retirement home to the hospital by strencher and backboard. He was slow to start an IV because everything was tagged in the back and things weren’t where he expected them to be [ex. Alcohol pads were under all the syringes]. We dropped off the pt. and departed from the hospital. As we posted up, we realized we had no back up straps for the backboard [plan was to pick a backboard up later]. The EMT-B [driver] was on his phone almost every time we were enroute or departing from a facuility[no pt. tho although we almost were the way he drove]. Documentation was poor and no one could give me a set way to write a report. Once I got back to base, the FTO went over a few things with me but stopped because he had a call to run. He wrote on my paper that the medic I was with probably went over everything but didn’t sign it. I quit the next day because honestly, I didn’t want to be apart of a company that ran this way. I hate feeling like a “QUITTER” but I have mixed emotions for it. I heard a story previous about a cardic pt. that was on a BLS truck enroute back home when they had a heart attack. All the EMT-B could do was put the pt. on oxygen and head back to the hospital. If that was my mom in the back, I’d want them to do a lot more than that.

What would you have done in my shoes? Should I have stayed hoping things would get better? Are all places ran this way?

I would not have quit after one day without having a serious sit down talk with the manager. Here's why; in order of the bold prints.

1. Why were you riding with a medic who was "Greener 'n' goose sh*t in August"? If the FTO wasn't there then you should have waited for him to come back.

2. Not one of the three of you guys, medic, basic, and yourself, checked off the truck? It takes time finding things if you don't already know where they are. You guys need to work together.

3. No backup straps?!? I prefer tape anyway. If you tape all the way around the pt on the LSB, they'll NEVER move, and are a hell of a lot better than any straps.

4. Quit the next day, huh? Did you at least tell them why?

I sincerely hope you didn't burn any bridges. Maybe I'm wrong. I wasn't there.

Good luck.

 

[Hastings]

I am a basic in Pa we are able to admin nitro subling under medic command. But I also run with a ALS crew at all times..at least 1 medic on board. That does not mean I cannot read some of what is going on, on the LifePack, and place a 4 and a 12 lead, but monitoring a sinus rhythm is out of my scope of practice. Good job on leaving that place, seems very like a very badly run systemll!
sorry about my spelling its late and I just got off a 16 hour shift

A Basic giving a drug that can not only put a patient in a hypotensive crisis but also make an inferior MI a million times worse? And furthermore, being unable to take any steps to fix either problem? If it were my family member, I'd personally prefer all they did WAS take them back to the ED.

 

[teehehe]

A Basic giving a drug that can not only put a patient in a hypotensive crisis but also make an inferior MI a million times worse? And furthermore, being unable to take any steps to fix either problem? If it were my family member, I'd personally prefer all they did WAS take them back to the ED.

Umm, he said "medic command" so I think he means, if the paramedic sitting in the truck gives him the order to give nitro to the pt, he can carry it out. Not on his own initiative.

 

[KEVD18]

Umm, he said "medic command" so I think he means, if the paramedic sitting in the truck gives him the order to give nitro to the pt, he can carry it out. Not on his own initiative.

incorrect sir. what he meant(i have to assume) was medical control, meaning the doc at the hospital. you call the doc, say the pt is having cp sob diaphoresis left arm pain with a pressure over 100 etc and the doc say ok give him ntg sl q5m x3. the problem here is if his pressure bottoms out, you cant do anything about it except the super effective trendelenburg. you also cant do an ekg to determine the location of the mi which is *****HUGE***** in determining whether or not to give them the nitro.

 

[teehehe]

incorrect sir. what he meant(i have to assume) was medical control, meaning the doc at the hospital. you call the doc, say the pt is having cp sob diaphoresis left arm pain with a pressure over 100 etc and the doc say ok give him ntg sl q5m x3. the problem here is if his pressure bottoms out, you cant do anything about it except the super effective trendelenburg. you also cant do an ekg to determine the location of the mi which is *****HUGE***** in determining whether or not to give them the nitro.

ah, I was confused by the mention of the ALS crew. :blush: