My partner is a moron.

[MrBrown]

Your partner is a moron .... disassociate yourself from his as fast as poss

Would you like some ketamine?

 

[DarkStarr]

didnt read the whole thread but 2 things came to mind.

1: we call the hospital en route either bls/als advisory with ETA via medcom.

2: if the other guy wants to do all the work, thats fine with me. if i think of something he didnt cover, i will.

 

[JPINFV]

@ SASHA:

So let me get this straight - you don't see anything wrong with him hitting up the ER, thus putting more prsesure on himself to get there when they were already notified of the emergency? You also don't mind him calling an ALS buddy of his for an opinion as opposed to asking his PARTNER first?

I've always given an ETA to receiving facilities, but I don't make them long drawn out if it's not life threatening. A quick "En route with a ___ y/o (male/female) with a c/c of atraumatic lower back pain starting approximately ___ long ago. The pain is ___/10 going to 10/10 on palpation. ETA ____. Any questions?" Add in any abnormal V/S or immediately pertinent history (e.g. cancer), and you should be done in 15 second and the hospital isn't surprised when you show up. If you're ETA is off, so be it. That's why it's an estimate. If you're partner is feeling pressure to get there faster because he gave an entry note, then he needs to get a lot more experience.


As far as what to do next, I have a problem calling a random paramedic for advice. Should he have asked you? Sure, even if he doesn't think you know the answer (I hope to God that he was looking for more than, "Stretcher. Transport," as an answer.)? Yes, because you might surprise him and it keeps you in the loop. Additionally, calling either a paramedic at your service or calling medical control would have been better options. However, there is no shame is asking for a consult.

 

[C.T.E.M.R.]

At my service we always do a radio patch to the destination hospital whether a basic day to day call, usually within the 5-10 minutes before arrival. Its a must on calls for geriatric and trauma patients so the ER can be prepared. as for your partner try to get to know him a little bit.

 

[JPINFV]

No, at the time I was getting the paperwork and the story from the nurse. I am not a cocky person. I'm new, I want to do things the right way but my partner likes to hog the spotlight and jumps on everything first and take all the credit (grabbing my paperwork to show the triage nurse and giving her the report, meanwhile I'm teching). Yes, you guys are right - next time i will communicate with him.

Who honestly gives a poop about who gives report? I agree, he's a douche if he's doing the entire, "I wanna give report and look super cool 'n awesome to the RN!" So what if he wants to give report? It's stupid, and petty, but there's much worse things than who gets to talk to Nurse Ratchet.

 

[JPINFV]

Yes/ The hopsital was 1 mile away from the assisted living home. Ok everyone maybe I was a little overzealous. I have jsut been stressed out by the work week. My apologies to everyone (even Sasha). I just thought when it comes to these emergencies, you work with your partner as a team to problem solve and if need be, call the medical director as opposed to one partner trying to solve everything himself and doing it his way.

I'm curious to know what the justification for emergency transport was.

 

[Bullets]

One partner get the chart, hx, rx allergens, ect, the whole story, the other gets vitals and physical info, trauma assesment and the like. Step up and take a role, be vocal, dont back down. your a team, demand he treat you like it

We NEVER call the hospital unless its code, trauma or something incredibly rare, like we called for a AAA last night, requested the cardiac surgeon be preped and ready, guy went straight to the cutters, sewed it all up and hes A-OK now

 

[jjesusfreak01]

We NEVER call the hospital unless its code, trauma or something incredibly rare, like we called for a AAA last night, requested the cardiac surgeon be preped and ready, guy went straight to the cutters, sewed it all up and hes A-OK now

We always call the hospital here, but its just to let them know we're coming. I think the nurses at stretcher triage probably appreciate it, even if they don't know they do.

 

[CAOX3]

but there's much worse things than who gets to talk to Nurse Ratchet.

Medication time!

 

[MRE]

Also -- he pulled over during a transport during an MVA -- there were two fire trucks there. What could we have done? We had a pt on board! He wanted to see if he could help...what could we have done? We had a friggin' pt on board! This guy is all show.

Massachusetts actually has a policy on doing this. If the patient you are transporting is stable and you maintain their standard of care (an EMT stays with them in the ambulance) then you can stop at another scene and assist. Never done it or had the opportunity/need to, but it is allowed here.

We also call in to the hospital for every person we bring in, regardless of their condition or injuries/illness.

 

[redbull]

spoke with my company today

A note to an ER is only necessary if its major trauma, pt's status is declining, etc.

as far as taking advice and carrying out advice from ALS or someone else other than working the company, well, its a POTENTIAL liability.

spoke to my partner today, he understands and is ok with my concerns.

 

[firemedic07]

Standing protocalls in my area advise us to call the ER every time we bring a patient in. no matter what the condition.

 

[DrParasite]

Medics, on the other hand, are currently required by state regulation to call medical control for a mother may I on /every/ call. Even a M&T within their standing orders. And preferably before any interventions (even an IV start). The latter tends to be more honored in the breach than the observance, but... yeah.

ummmm no, sorry buddy, not required in New Jersey before anything is done.. Medical control is required to be contacted on all ALS patients, but that also doesn't mean the receiving hospital gets a notification.

and M/C is supposed to be contacted AFTER your standing orders are followed, not before. if your ALS are doing it before, than it's an agency requirement, not a dept of health requirement. or maybe your medics need their hands held more than other ALS providers in the state, i don't know.

we only give notifications on sick patients (traumas, sick patients with no ALS, anything where we need a bed waiting for us when we get there).

and considering I have hear horror stories about crews waiting 20 mins to 4 hours to get a bed in the ER, I am assuming that all these notifications for non-sick patients don't really do anything important.

spoke with my company today

which is probably the second thing you should have done in the first place

A note to an ER is only necessary if its major trauma, pt's status is declining, etc.

ehhh, probably. doesn't mean I don't call the charge nurse while on my way there, especially since it makes her life easier so she can figure out where I am going

as far as taking advice and carrying out advice from ALS or someone else other than working the company, well, its a POTENTIAL liability.

hey newbie, i know this might shock you, but EVERYTHING is a potential liability. listening to the SNF, using L&S, not administering oxygen, not getting enough sleep before the shift, not writing clear enough, not charting good enough, not getting to the SNF fast enough, driving too fast to get to the SNF, it's all POTENTIALLY a liability. And, not calling for ALS for the patient, along with a helicopter to transfer them to a trauma center is definitely a potential liability. But potential liability and actual liability are completely different things.

spoke to my partner today, he understands and is ok with my concerns.

and that was the first thing you should have done.

 

[akflightmedic]

and while we are on the job, we're not supposed to be talking on the phone, especially when we're around doctors, nurses, etc, or hitting on any aides. Professionalism. I'm looking at it from a third-party perspective.

And since the topic has been addressed, I thought I would point out the interesting sentence structure and/or comma placement.


I read the above quote to mean your company regulates your phone chatting even to the point that you can't chat on phone while hitting on aides...harsh.

 

[18G]

It sounds like your partner is cocky and not a team player. A partner is supposed to work with you and not go off on their own especially when their driving on the call. I hate it when I am the lead person on the call yet someone else feels inclined to start assessing my patient, asking questions and what not. It messes up my train of thought and takes me longer to go down the path that I am desiring to go down after having to wait for the patient to stop answering the other persons questions.

I think it is very tacky for an EMT to be calling a Paramedic to ask for advice on a seemingly minor call. Yet alone sharing the patients medical information with someone who is not a part of your company. This is a piss poor practice in my opinion. If this EMT partner was all that than why is he calling to ask a Paramedic why a patient is having hip pain?

And don't mind Sasha... she is just being her usual rude self.

 

[reaper]

It should not matter who's call it is. You listen to the pt for all questions asked. You build your assessment off the information you are hearing. If you lose focus, just because your rhythm is disrupted. Then that is something to work on. You have to be able to adapt to any situation. When I have a new partner, I do an assessment off everything then ask or find. If they miss something, then I ask more questions. You don't need to start at the beginning to make your assessments.

The OP's partner may be overzealous, but is not a moron. He provided adequate care and took care of the pt. Nothing wrong with calling a medic for advice on something and hipaa was not violated, unless he gave the Medic personal info on the pt.

 

[Level1pedstech]

From the ER side of the fence may I offer the following on the subject of pre arrival reports. A pre arrival report should be SOP for any private or transport agency. Its not only good customer service for all involved but helps us to best prepare for your patients. I know there is waiting involved sometimes but you are triaged during that initial report and put into our system. The acuity level of your patient is what determines your wait time if any when you reach our facility.

Just because your an ambulance crew do you think you should be able to come in and displace all the other patients in the ER. There is a common misconception especially among our frequent flyer's that an ambulance ride will get you into a room and help to your bed side in a more timely manner,this at least at our level one facility could not be further from the the truth. Acuity is the number one factor in determining what fate awaits your patient once you hit our doors.

We handle level one and two traumas through a different system and of course these as high acuity patients get priority treatment. Most patients will be given a bed on arrival it may be in a room or in the hallway but its a bed and a release of care for the transport crew. This is what we are contemplating while we await your arrival. Even if you are less than a minute out it still lets us at least know we will be seeing your smiling faces and wont be surprised.

We don't like surprises but we are always fair and your patients care and comfort comes first no matter what. Worse case scenarios are a wait in the hall without a bed or a trip out to wait behind all the rest in triage,once again your patients acuity level is the determining factor not whether are not we like you or your agency. Once again its all about customer service,the thing to keep in mind is that we are all each others customers and should always strive to give the best level of service starting with that first radio report.

A little about what makes a good radio report at least from our point of view in the ER. Having taking many radio reports over the years and having listened to many more being taken I can tell you exactly what we at our level one like to come away with after your initial radio report. Your unit number,your en route code,ETA,patients stats,BRIEF description of what your bringing us,a full set of vitals including GCS and pulse ox if you think it will help us better prepare,BRIEF details of any interventions followed by asking if we have any questions. At this point we will let you know what other information we might like to have saving all of us time. Its a pretty simple deal no need for long drawn stories or you trying to impress us,you may well be gods gift to field EMS and may be on your way to bigger and better things which is great but frankly we don't really care and we are usually to busy to care even if we wanted to. Just try and picture all of us within ear shot of the radio that your going to annoy with your ten minute report and please have mercy.

 

[18G]

Reaper... everyone has their preference... mine is when I am the crew chief then I will interview and assess the patient with my partner assisting me and doing any specifics I assign. It's not that I can't "adapt" and follow, it just makes it more convoluted and harder on the patient when they have multiple people asking them questions. The patient needs to know who the main provider is that is in charge of their care.

I like to think of it as team directed care and not a free for all.

 

[sarweim]

We call in to ED on every call, too, from MVA, to cardiac, to stubbed toe. Usually on the radio in the back of the rig, giving ED a more accurate time for them to be prepped, and the most up-to-date report on patient condition. I don't see how that's a bad thing.

As for the partner not talking to you, I think that's bogus. You, theoretically, have the same training. And while he may have more experience (multiple agencies over just a few years, hmmm... I've seen people like that, and there's usually a reason!), he should still get your input, too. And if NEITHER of you can come up with an answer, call someone up the line in your OWN agency with more experience, or medical direction, not his buddy. I feel like there's a little HIPAA issue here, too.

Sounds like a significant communication problem all the way around. There may be no I in TEAM, but there's no TEAM without communication. And that's a two way street, so you've gotta talk to him, too, and express your concerns.

 

[Madmedic780]

Overall I would suggest to establish better communication with your partner. I see no real reason for getting upset about the consult he did what he thought was most appropriate for the situation at hand.

I'm not sure what area you are providing service but in my neck of the woods we have a large selection in regards to what hospital to transport to. That being said we sometimes will call a hospital just to make sure they can take the patient we want to bring them. If not we bounce em up the line to a larger facility. It would be well worth the patient's interest who is in pain, to call ahead and be sure rather than being told to take them to the other place across town.