Need a debate, heres one.

[Ms.Medic]

I was recently written up for not taking a monitor (lifepack 11) into a call with us (a basic crew). We have lifepack 12s on all units except the backups, so as a basic crew, going into a medical facility, there was nothing I could have done with our 11. Our 12's, of course I could have used, no arguement there. FYI: I am taking my national exam for emtp next week, and this happend about 2 weeks ago. The supervisor said that I should have hooked them up to the monitor and had a strip ran for the paramedic when they got there because " I am so close to being a paramedic" and " I know how to do it". Now, I can completely see me doing this while they are there in front of me, but what if something was to show up on the monitor that was treatable, and the lvns/Rns are standing there looking at me like, "what are you going to do". Truth is, that as close as I may be, Im still not certified to put a monitor on a patient and run a strip,,,correct ???? Also, there is nothing in our policies and procedures that states what exactly we have to take in on a call. Can someone help me out in understanding why or how I can get in trouble for this. I certainly DO NOT want this in my file. So should I or should I not have ran a strip ?

 

[Aidey]

Depending on the state EMTs can hook up and print EKGs they just can't interpret them. If this is the case in your state, your Sup has a bit of a leg to stand on, but not much. Your supervisor really isn't being fair IMO, and I don't think it's worth a write up since it is a pretty ambiguious situation. Are you union?

 

[AJ Hidell]

You do not need a certification to perform a non-invasive diagnostic measure.

I believe what your supervisor was getting at is that they would expect a certain amount of intelligent initiative out of someone with your experience, so close to being a medic. I can understand that. If that is the case, take the incident as the clue it was meant to be, learn from it, and move forward with the better knowledge of what is expected of you. Yes, they apparently have not been clear with those expectations, and you can't read minds. But if you sit around and gripe about this, you are only going to hurt yourself. By smiling and accepting it and moving forward, you will leave a very positive and favorable impression with your management that will work in your favor in the future.

That said, I have to say I am completely confused by the scenario as you have presented it. If you are a basic crew, where is this medic coming from? Are you a first responder? Or is this one of those tiered systems, where you call for paramedic intercept when necessary? Neither of those explanations even make any sense since you talk of nurses being around. Sounds more like an IFT. What exactly was the situation here? That might make it easier to comment on the propriety of the discipline.

 

[Ms.Medic]

Depending on the state EMTs can hook up and print EKGs they just can't interpret them. If this is the case in your state, your Sup has a bit of a leg to stand on, but not much. Your supervisor really isn't being fair IMO, and I don't think it's worth a write up since it is a pretty ambiguious situation. Are you union?

No union here, and Ive never been written up before. I think he was maybe having a bad day ??? He was strictly using the fact that I have completed my paramedic program and I should know how to do it. Not to mention the other emt did not grab it as well, but nothing happened to him. No write up, no meeting, nothing. He was just as capable of bringing it in as I was. It all came down to me having more "knowledge" than the other member.

 

[AJ Hidell]

Seniority has it's privileges. But it also carries it's own set of responsibilities. As the senior crewmember, you are responsible for whatever happens. While I am certainly not defending the disciplinary action -- I agree it was not warranted -- I do understand what I believe the management was getting at with it. They expect more initiative out of you. You are at a point in your career where the minimum effort is no longer sufficient. Elevate your game and show them that they were wrong about you. If you do that, this incident will be rendered meaningless.

Unless, of course, they just don't like you. If you are whiner, that is entirely possible, so just beware.

 

[Ms.Medic]

You do not need a certification to perform a non-invasive diagnostic measure.

I believe what your supervisor was getting at is that they would expect a certain amount of intelligent initiative out of someone with your experience, so close to being a medic. I can understand that. If that is the case, take the incident as the clue it was meant to be, learn from it, and move forward with the better knowledge of what is expected of you. Yes, they apparently have not been clear with those expectations, and you can't read minds. But if you sit around and gripe about this, you are only going to hurt yourself. By smiling and accepting it and moving forward, you will leave a very positive and favorable impression with your management that will work in your favor in the future.

That said, I have to say I am completely confused by the scenario as you have presented it. If you are a basic crew, where is this medic coming from? Are you a first responder? Or is this one of those tiered systems, where you call for paramedic intercept when necessary? Neither of those explanations even make any sense since you talk of nurses being around. Sounds more like an IFT. What exactly was the situation here? That might make it easier to comment on the propriety of the discipline.

On our units, we have a basic riding solo on a unit, and a paramedic that responds in a squad. With the exception of our "training station" where there are restricted basics and restricted paramedics. I work at a station, by myself, in the middle of nowhere, thats 15 minutes from the next station where the paramedic is stationed. Sorry, the call was at a doctors office. Hope that makes more sense. We use the same method (tiered) as Houston Fire Department, if your familiar with that.

 

[AJ Hidell]

Weird! I have spent a lot of time in Houston, although not recently. They never used that system when I was there. How very sad. Sounds like they have gone from worst to worser. Glad the only family I have left there are people I don't like.

Anyhow, I would agree then, that you very definitely should have carried the monitor in. It was a common sense move that someone of your experience should have known.

 

[Ms.Medic]

Seniority has it's privileges. But it also carries it's own set of responsibilities. As the senior crewmember, you are responsible for whatever happens. While I am certainly not defending the disciplinary action -- I agree it was not warranted -- I do understand what I believe the management was getting at with it. They expect more initiative out of you. You are at a point in your career where the minimum effort is no longer sufficient. Elevate your game and show them that they were wrong about you. If you do that, this incident will be rendered meaningless.

Unless, of course, they just don't like you. If you are whiner, that is entirely possible, so just beware.

I am by no means "whinning", but is it legal, or in better terms "safe" for me to do this when there is nothing in written form whether we can or cant ?

 

[AJ Hidell]

There is no legal restriction on a non-invasive diagnostic technique in the field. The only restriction would be on the interpretation of the results. And in Texas, whatever your medical director (read: protocols) say is legal is legal. There is no state law governing it.

A 12-lead EKG is a time consuming task. Personally, it is not one that I trust an EMT partner to perform for me, unless I am present and observing the procedure. But you are not just an EMT anymore. You cost this patient several minutes of assessment time by delaying something that was within both your scope and your capabilities. Now that you know this, I'm sure you won't have the same problem in the future, and will go on to help other EMTs to understand these expectations.

 

[Ms.Medic]

So legally, what would you consider me then if Im "not just an emt anymore" ??? If you read the emt wearing a paramedic patch thread, it seems like things are very contradicting. Im not arguing, just trying to understand. And Im a little confused when you say its not a task you would trust an emt to do for you, but then you say I should have? And, I cant exactly go anywhere until the paramedic gets there to do his assessment also, so why not load them up after Ive done what I can do, and if time allows before he gets there, then have it done ? But thanks for the info.

 

[Ms.Medic]

Weird! I have spent a lot of time in Houston, although not recently. They never used that system when I was there. How very sad. Sounds like they have gone from worst to worser. Glad the only family I have left there are people I don't like.

Anyhow, I would agree then, that you very definitely should have carried the monitor in. It was a common sense move that someone of your experience should have known.

As far as HFD goes, 85% of our employees work for HFD as well, so they felt that it would be easier on them, not only that, but it works well. Can you imagine trying to pay that many paramedics vs emts ??? My SO also is a ff/paramedic for HFD, and has been for 6 years now. They've had that in place for at least that long I know for a fact. Although Im sure longer.

 

[daedalus]

There is no legal restriction on a non-invasive diagnostic technique in the field. The only restriction would be on the interpretation of the results. And in Texas, whatever your medical director (read: protocols) say is legal is legal. There is no state law governing it.

A 12-lead EKG is a time consuming task. Personally, it is not one that I trust an EMT partner to perform for me, unless I am present and observing the procedure. But you are not just an EMT anymore. You cost this patient several minutes of assessment time by delaying something that was within both your scope and your capabilities. Now that you know this, I'm sure you won't have the same problem in the future, and will go on to help other EMTs to understand these expectations.

Whoa thats a huge negative! She, as an EMT (and she is an EMT until she passes the registry, gets a state license) cannot preform a 12 lead without her Medic present. No way, no how. She should have started BLS interventions and assessments, like getting a history, applying oxygen, and getting vital signs until the paramedic got there. After the paramedic gets there, they can direct the EMT to apply the 12 lead electrodes.

This would be a huge breach in scope of practice where I work. What is a basic going to do with a 12 lead? They cannot act on any arrhythmia, or any ST elevation. Its waisted time that could be spent doing vital BLS interventions.

 

[reaper]

I agree that you should know how to do it, since you have completed medic school. It would have been in the best intrest of your pt's care.

Now that said, Does your protocols state that an EMT in your service can apply a monitor? If it does, then you should have.

If it is not in your protocols, then you have no legal right to preform the task and should not be expected to, just because you know how.

Until you have your medic card, you are an EMT just like all the other EMT's in your service.

 

[Ms.Medic]

I agree that you should know how to do it, since you have completed medic school. It would have been in the best intrest of your pt's care.

Now that said, Does your protocols state that an EMT in your service can apply a monitor? If it does, then you should have.

If it is not in your protocols, then you have no legal right to preform the task and should not be expected to, just because you know how.

Until you have your medic card, you are an EMT just like all the other EMT's in your service.

It does NOT state anywhere in there that emts can or should if they know how, place leads or run strips. Of course I know how, but theres soooooooooooooooooooooooooooooooooooooo many legal issues with medics these days, I dont want to risk my future patch, or current job for anything foolish.

 

[triemal04]

It does NOT state anywhere in there that emts can or should if they know how, place leads or run strips. Of course I know how, but theres soooooooooooooooooooooooooooooooooooooo many legal issues with medics these days, I dont want to risk my future patch, or current job for anything foolish.

If that's the case, (and you need to be really sure that it is) and your protocols and scope don't allow you to run an ekg, then you should be taking this up with your supe as you where written up unfairly and innapropriately.

Saying that you are almost something for justification isn't right. You are not a paramedic yet, and aren't working as one for them. And as far as doing it because you know how which supposedly makes it ok...I know how to do a lot of things that would get me in a lot of trouble if I ever did them. What you know how to do, and what you are allowed and EXPECTED to due under your job requirements are 2 very different things.

Bottom line: sit down and have a chat with the supe.

 

[MMiz]

I'm going to have to disagree with everyone else here. While I may be trained and knowledgeable in how to assist a Paramedic/ALS unit, I would be roasted if I were to hook up an EKG to a patient. Our Paramedics would sometimes be downgraded to BLS units due to short staffing of Paramedics, and while they had all of the goodies of the ALS trucks, they still operated within the BLS scope of practice.

Heck, our Paramedics operating as first responders, with all of their ALS gear in a SUV, couldn't switch the button on their LifePak 12s to manual mode until another Paramedic arrived and they are officially an ALS unit. Those units operate and function as BLS units until another ALS unit arrives on scene. Sure, they have the advantage of having the ALS gear (LifePak 12, advanced airway, etc) set up and ready to go when ALS arrives, but it sure isn't used until the unit is upgraded to ALS.

What I or anyone else says really doesn't matter though, and I think it's time you sit down with your supervisor and talk this one out.

 

[firecoins]

If you are not hired to do ALS, than you should not be expected to do it. Does not matter if your almost a medic. Either you are working as a medic or you are not. As you lack a certification, you should not be required to do it.

 

[AJ Hidell]

Whoa thats a huge negative! She, as an EMT (and she is an EMT until she passes the registry, gets a state license) cannot preform a 12 lead without her Medic present. No way, no how

It is quite obvious that you have zero knowledge or experience with Texas EMS. Everything you just stated is completely false. Texas and California EMS could not possibly be any more different.

Ms. Medic, legal definitions are not relevant to this scenario. Anyone is legally able to attach an EKG in Texas. Whether or not you actually do it is a matter of local policy. Your management writing you up for not doing it is a pretty clear sign that they consider it policy, is it not? End of story. You failed a test of your initiative and confidence. That will probably end up setting you back from being cut loose as a solo medic after graduation.

I have already stated that I do not completely agree with management's position on this. Obviously, they are unclear in their policies and inconsistent in their discipline. But regardless, the facts stand as above. Take it as a lesson and move forward.

We constantly hear all the absurd nonsense about how indisposable EMTs are, and how they are "saving paramedics", yet when they are asked to actually do something to help us -- and the patient -- all we get is argument. See why that silly t-shirt slogan just doesn't carry any weight? If your department were sending out dual medics, this issue would never have come up. So tell me again how EMT's "save" paramedics.

 

[artman17847]

in Pa. the USE of a monitor by an EMT is behond thier scope of practice...so here you would not be permitted to use the machine until you are a certified paramedic.

 

[Ms.Medic]

It is quite obvious that you have zero knowledge or experience with Texas EMS. Everything you just stated is completely false. Texas and California EMS could not possibly be any more different.

Ms. Medic, legal definitions are not relevant to this scenario. Anyone is legally able to attach an EKG in Texas. Whether or not you actually do it is a matter of local policy. Your management writing you up for not doing it is a pretty clear sign that they consider it policy, is it not? End of story. You failed a test of your initiative and confidence. That will probably end up setting you back from being cut loose as a solo medic after graduation.

I have already stated that I do not completely agree with management's position on this. Obviously, they are unclear in their policies and inconsistent in their discipline. But regardless, the facts stand as above. Take it as a lesson and move forward.

We constantly hear all the absurd nonsense about how indisposable EMTs are, and how they are "saving paramedics", yet when they are asked to actually do something to help us -- and the patient -- all we get is argument. See why that silly t-shirt slogan just doesn't carry any weight? If your department were sending out dual medics, this issue would never have come up. So tell me again how EMT's "save" paramedics.

Why the heck do you seem so hostile about the situation toward me, I NEVER said emts save paramedics, so get off your hype about that, and I think Im quite confident, I only wrote this to get advice for my own self, to see where they were coming from. AND as far as the legal aspect of it, I was simply just curious about it. CHILL.