So how would you handle a patient care situation where an EMT Enhanced Provider who is your Chief as well conducts him self in a very poor manner towards the patient has ETOH on board and potentially could have severe injuries from a Motor Vehicle Crash & you Chief/EMT Enhanced Provider is providing poor patient care yet wont let you as the Medic do what is in the best interest of the patient & when you do perform your patient care correctly he chimes with negative comments & then prolongs the transport time for an absolutely ridiculous reason but wont let you transport because he is the Chief and over rides you appropriate & correct decision? Im really looking for some input on this 1 guys and gals. Honestly I really need people to discuss this with so...Im asking for help please whether it be posts on this thread or a private email to my personal account!
Medic VS EMT Enhanced Provider Who Happens To Be Your Chief
- Thread starter FFMEDIC1
- Start date
JPINFV
Gadfly
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Does your service have a medical director?
Yes and the sad part is...I requested that the call be QA/QI by our peer review and the head of our peer review is good friends with the Chief and the OMD so the whole incident just got swept under the rug somehow...I also filed a 27 page complaint with the State and that somehow as well got swept under the rug...
Shishkabob
Forum Chief
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You have one of only two options.
Forget it ever happened and move on.
Stand up, grit your teeth, put your foot down and fight it. I have YET to find a single agency that allows a lower level provider to supersede a higher level one. The Paramedic is in charge of patient care, 100% of the time, regardless of the 'rank' of the other provider.
Forget it ever happened and move on.
Stand up, grit your teeth, put your foot down and fight it. I have YET to find a single agency that allows a lower level provider to supersede a higher level one. The Paramedic is in charge of patient care, 100% of the time, regardless of the 'rank' of the other provider.
Sounds like the volunteer rescue squad system...
The first question is the incident really as bad as you made it out to be in your mind? I only ask this because occasionally when I try to put myself in an objective role, things that I'm royally PO'd about don't seem quite as bad.
Second, have you directly contacted your medical director? If the peer review guy and your chief are friends, then the OMD may not even know it occurs. Even if the chief and the OMD are friends, most physicians take a dim view of this kind of behavior when the liability is partly on them.
Third, if this happened in the state I'm thinking of (from the terms your using) try contacting the OEMS representative and the EMS council for your area and ask about the status of your complaint.
The first question is the incident really as bad as you made it out to be in your mind? I only ask this because occasionally when I try to put myself in an objective role, things that I'm royally PO'd about don't seem quite as bad.
Second, have you directly contacted your medical director? If the peer review guy and your chief are friends, then the OMD may not even know it occurs. Even if the chief and the OMD are friends, most physicians take a dim view of this kind of behavior when the liability is partly on them.
Third, if this happened in the state I'm thinking of (from the terms your using) try contacting the OEMS representative and the EMS council for your area and ask about the status of your complaint.
Yup.
Quit and move to a different service.
It is not a battle that is worth fighting and even if you "win" you are likely looking at spending the rest of your time there wondering when they are going to sack you.
In my experience, people with the kind of mentality you describe are compensating for something. They cannot be reasoned with. They cannot be taught.
Even if the powers that be get rid of him, one of his buddies will step into his place. You will still be a target.
It is not a battle that is worth fighting and even if you "win" you are likely looking at spending the rest of your time there wondering when they are going to sack you.
In my experience, people with the kind of mentality you describe are compensating for something. They cannot be reasoned with. They cannot be taught.
Even if the powers that be get rid of him, one of his buddies will step into his place. You will still be a target.
jjesusfreak01
Forum Deputy Chief
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Can't picture working in a service where an EMT can override a Medic, and I'm an EMT. In an ALS case, the Medic is ultimately responsible for the patient, so the Medic should just do what they know is right for the patient, and deal with the fallout later. The MD will be on the Medic's side 9/10 times.
fast65
Doogie Howser FP-C
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I agree with veneficus, move onto a different service, because you will forever be a target if you fight this. IMO your chief needs to move on to a different career path because he obviously doesn't know how to leave his prejudices at the door.
Maybe we should all be leaving our prejudices at the door here? We don't have any idea what happened, other than a vague claim that a paramedic's judgment was questioned.
fast65
Doogie Howser FP-C
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I don't know if the problem is really that the paramedics judgement was being questioned, rather it was the fact that the EMT/chief allowed his care to be compromised by a prejudice he had against what the patient had done. At least that's the way I saw it.
For the 1 who asked if the situation was as bad as I made it out to be.....yes it was that bad, you tell me if you think it wasnt, MVC, multiple rollover with ejection, pt initially found by passerby"s face down in road unresponsive, face & head covered in blood. Ending result from a NeuroTrauma ICU stay was a Traumatic Brain Injury.
Precisely correct, ultimately the Medic is in charge of anything that goes on with patient care....period...and I did, for the record, do everything that I needed to do for my patient, all of my patients receive the same quality of care regardless of the situation or any other factor, a 24 ETOH driver from an MVC will receive the same quality patient care that a sweet 90 year old lady would receive. As far as the transport of the patient, my EMT driver was not allowed to pull away per our Chief, Sheriffs Dept, & State Police, trust me we tried, even to the point of hitting the chief with the ambulance because he would not move out the way. I know it sounds like an easy situation to correct, however, you would have to understand the small minds of such a small, countrified, good ole boys club type place this 1 is. To the 1's who say just let it go, walk away, & move onto to a different agency/service, I say the following....if someone could just walk away from a patient neglect issue as such, then truly what kind of provider does that make you? What if your family was traveling through an area and received such care from PreHospital Care Providers, then how would you feel? Moving on to another agency/service is an option, however, if you always run from your problems, what kind of individual does that make you? With that being said, another agency has been appropriated for me, however, I still am at the agency where this occured. Some of you may say Im crazy for stayin & yes you are right I am probably the #1 target for the wahoo's whom I have lodged complaints on, but I was never taught to run from my problems, therefore I will see this through till the end, & ultimately that individual will be the 1 who suffers when he kills someone & is taken for everything that he is worth as well the agency he is in charge of.
Precisely correct, ultimately the Medic is in charge of anything that goes on with patient care....period...and I did, for the record, do everything that I needed to do for my patient, all of my patients receive the same quality of care regardless of the situation or any other factor, a 24 ETOH driver from an MVC will receive the same quality patient care that a sweet 90 year old lady would receive. As far as the transport of the patient, my EMT driver was not allowed to pull away per our Chief, Sheriffs Dept, & State Police, trust me we tried, even to the point of hitting the chief with the ambulance because he would not move out the way. I know it sounds like an easy situation to correct, however, you would have to understand the small minds of such a small, countrified, good ole boys club type place this 1 is. To the 1's who say just let it go, walk away, & move onto to a different agency/service, I say the following....if someone could just walk away from a patient neglect issue as such, then truly what kind of provider does that make you? What if your family was traveling through an area and received such care from PreHospital Care Providers, then how would you feel? Moving on to another agency/service is an option, however, if you always run from your problems, what kind of individual does that make you? With that being said, another agency has been appropriated for me, however, I still am at the agency where this occured. Some of you may say Im crazy for stayin & yes you are right I am probably the #1 target for the wahoo's whom I have lodged complaints on, but I was never taught to run from my problems, therefore I will see this through till the end, & ultimately that individual will be the 1 who suffers when he kills someone & is taken for everything that he is worth as well the agency he is in charge of.
You asked for advice and I offered it.
Right or wrong, if you keep butting heads with the establishment in the fire service your exit is inevitable. The only questions are on what terms and when?
Your conviction reminds me of a story about the mighty oak and the reeds.
You cannot say for certain that the decision of yor chief made any difference in the outcome. You cannot say if he had follwed your direction it would have made any difference.
With all the wonderful fantasy aside, you may fight this and suffer for it and still not make any difference except in your own mind. I don't know where you are from, but many states and organizations have some crazy artificial seperation between in charge of patient care and in charge of the scene. If his decision was to let your vehicle move or not, it was not a patient decison, it was a logistical one, which he is in charge of. Whether he was trying to show off his horns or legitimately making a command decision could never be determined with accuracy. You got nothing.
First learn to choose your battles. Then learn how to fight them.
Did it ever occur to you that if this chief is such a poor care provider there is a history of it as well as a high likelyhood it will continue in the future?
People are rarely fired for one mistake. The level and volume of competence is also a bit subjective. You didn't present a pattern, you presented one side of one incident.
Did it occur to you that we all have bad days and that people do occasionally make mistakes?
From your description, it sounds like you have nothing but a perception of wrong doing. If you are bothered that much by it, I stand by my original advice, move on.
rescue_356
Forum Ride Along
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patient care is first
I'm sorry to hear of your chiefs ignorance but I find this a lot in the area where I practice and although I am not an als provider it is all too often that you will find a lower level provider as the head of a department . My suggestion to you is either fight him or take your service elsewhere. I am aware that this may be hard for you to do . If this is an issue I would deffinitely discuss the matter with your medical director. I am sure he/she would want the best care for their patients. And it very well may cause problems at your agency if you do this but hopefully your omd will see your side of things and the problem will ultimately be resolved
I'm sorry to hear of your chiefs ignorance but I find this a lot in the area where I practice and although I am not an als provider it is all too often that you will find a lower level provider as the head of a department . My suggestion to you is either fight him or take your service elsewhere. I am aware that this may be hard for you to do . If this is an issue I would deffinitely discuss the matter with your medical director. I am sure he/she would want the best care for their patients. And it very well may cause problems at your agency if you do this but hopefully your omd will see your side of things and the problem will ultimately be resolved
Hockey
Quackers
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Grow a backbone and stand up to him. It is YOUR license in the end, not his. If he fires you, its just a job. If you lose your license because of him, its your career