Needing Help!!!

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firerescue_emt19

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I would like to start off by saying Hi to all EMTLife forum members and fellow EMS Providers. Some back ground into my service is that im a 22 year old NREMT-I, I have been in Fire/EMS for 6 years and work for a private ambulance service for 4 years. I dont consider myself to be a "super squirrell", I have not seen it all, I train like theres no tomorrow and so does my fellow department members. My department, which I understand is not very liked, is a Fire department that runs ALS first response. My department was approached by the county one year ago about looking into the first responder due to the local Rescue Squad being "inadequately trained" in their words. Rescue Squads background:
3- Ambulances
52- EMT-B's
1- EMT-E
8- "Drivers" no EMS certs but CPR
1,500- Calls per year

With this being said, Our Fire Deparment that has:
7- NREMT-I's
2- EMT-E's

Of the NREMT-I's, 5 are testing for Medic in 3 weeks...
The county advised our department that due complaints from patients and Phyiscians that they would like to establish ALS first response in our department(Volley). This has been established for 8 month's, but there has been a issues arise that has really got me pissed off. To the point, on a call, Myself and a other member responded to a Chest pain call. When I arrived, obvioulsy patient care was established. O2, ASA, IV, 12- lead, Nitro, Morphine... this was all before the ambulances arrival (23 minutes later). At this time I ask dispatch the location of the ambulance, the EMT-B on the ambulances stated on the radio "were 10 out, If you want, you can go ahead and treat the patient, put him on 02 and stuff, we'll be there in a min", I literally about reached through the radio and strangled them. I know WTF is going on, I didnt need the reinsurance. This has been happening every call now. Another call, that is unbeleivable....... MVC, two patients upon arrival standing beside the car. Smoking cigerattes, and on there phones contacting their parents. Myself and another NREMT-I arrival first, after assessment, they both (early 20's) are laughing about how they were going to be in trouble for wrecking their Dads vehicle. Both patients stated the did not want to be transported. Refusals were obtained from both patient. At this time the ambulance arrives (17 minutes later), balls to the wall, 3 ambulances, 12 members roll out. We explain what was going on, VSP arrived, issued citations to the driver, etc. While waiting on the wrecker, I hear a HELICOPTER approaching. I took a look at the ambulance personel who are talking to the patients and their patients. I immediately walk over to the conversation. The EMT-B advised that the patients parents had talked the patients into going into the ED to be checked out for their insurance company. I hear this EMT-B contact a helicopter on a TAC channel and advised them that they had a patient just needing to be transported in. AGAIN, I lost it, I grabbed the radio and cancelled the helicopter, along with a second heliopter agency that the ambulance crew had en route. The patients were transported by ground. WTF!!!

Myself and other members have talked to our Chief, the EMS crews Captain (who thinks its funny), our county EMS supervisor, and Both agencies OMD's, all explained that there's really noting that can be done. I am lost for words at this point. You cant tell me constantly overriding the AIC in patient care is acceptable. We have tried everything, one on one conversations, joint trainings, meeting, even memos from the county and state about patient care and "Whos in charge".

CAN ANYONE PLEASE HELP ME????
 
I can't. Maybe.

The scenario is just too tangled for me. Let me see if I got it right: basically, no one is in charge and some members are unprofessional and offensive; you are sick and tired of it. If that is the case, it is up to far higher heads than yours to fix it, and probably it will entail firing some people. Maybe lots of people. Maybe nearly everyone when it is done.

I'd personally talk to the co-workers who are working well and see if there is a consensus, then do two things: each dedicate themselvs to keeping up good work despite the environment, AND then talk to your chief, either as a group or personally, about the issues. Then listen and either cooperate with her/him, or quit.

The mark of a professional, versus a technician, is the refusal to support actions detrimental to the profession, its clients, or its honorable practitioners. (Officers carried swords not only to enforce discipline, but to fall on if needed).
 
???

Get the medical director or the state ems office involved.
 
Thank you both for replying, I understand that this situation is very tangled. Basically its a complete clusterf**k, I have never heard of this happeing anywhere else. We keep our heads high, because Im there for one reason, the patient. In reguards to the OMD and state, our county advises that there "working it out with the state, but this has been almost a year. I dont want to be :censored::censored::censored::censored::censored::censored::censored:, but push come to shove I will have them removed from the scene, which is what our county advises.
 
Completely unrelated to your inter-agency issues:

*months not month's

*EMTs not EMT's

Apostrophe indicated ownership or "is" after the article. Such as "It's cold outside" (It's=It is). Month's=month is

Sorry, pet peeve.
 
bstone said:
Completely unrelated to your inter-agency issues:

*months not month's

*EMTs not EMT's

Apostrophe indicated ownership or "is" after the article. Such as "It's cold outside" (It's=It is). Month's=month is

Sorry, pet peeve.
Click to expand...

peeple correctin' other peoples grammer anoise me.

Sorry, pet peeve.
 
To the OP, grammar and spelling notwithstanding...

Welcome to Politics.

I smell a Good Ol' Boy's Network involving some sort of favoritism, entrenched procedures, or a culture of casualness, if not neglect.

Maybe it's time for you to keep your mouth shut as much as possible and learn about the realities of the system you're in.

Find out who listens to reason or who carries the biggest club. You're in over your head unless you take the time to prepare properly.

If you'd keep your head about you you could find it fun to be an investigator and then bust up the ring...but you have to be aware of the consequences, esp. to your career. If you'll end up a sacrificial lamb, go bye-bye!
 
firerescue_emt19 said:
Thank you both for replying, I understand that this situation is very tangled. Basically its a complete clusterf**k, I have never heard of this happeing anywhere else. We keep our heads high, because Im there for one reason, the patient. In reguards to the OMD and state, our county advises that there "working it out with the state, but this has been almost a year. I dont want to be :censored::censored::censored::censored::censored::censored::censored:, but push come to shove I will have them removed from the scene, which is what our county advises.
Click to expand...

Really? You're going to have the transporting agency removed from the scene? I highly doubt that will happen. In most states and or agencys, they have the overall authority over the patient. If you do attempt this you may be attempting to intefer with their duty to act.
 
As with anything when there is a new system put in place the participating services usually go through some communication issues and growing pains. I don't see these instances you presented as insurmountable, explain to them we are not looking for patient care instructions over the radio, and please check with the on scene providers before launching a helicopter assault.

Sit down with them either officially or unofficially, by taking this to management you have made this adversarial, with the egos in EMS your more likely to make the situation worse, that should have been a last resort tactic.

In my experience the best way to resolve issues is face to face with all acting parties involved not by having a couple managers sending emails back and forth.

I have seen a lot worse, your not there yet, and with a little effort you should be running smoothly, it takes time, nothing good is going to happen overnight, goods systems evolve to to overcome their limitations. Once everyone is on the same page you will see things improve.
 
Wow, I really hope that I don't have to work with people like that. I can't believe they called in the birds for that mvc when both patients were ambulatory. It sounds like they need to brush up on proper use of resources. You just keep being the great dedicated EMT that you are! Good luck with your situation.
 
firerescue_emt19 said:
The county advised our department that due complaints from patients and Phyiscians that they would like to establish ALS first response in our department(Volley). This has been established for 8 month's, but there has been a issues arise that has really got me pissed off. To the point, on a call, Myself and a other member responded to a Chest pain call. When I arrived, obvioulsy patient care was established. O2, ASA, IV, 12- lead, Nitro, Morphine... this was all before the ambulances arrival (23 minutes later). At this time I ask dispatch the location of the ambulance, the EMT-B on the ambulances stated on the radio "were 10 out, If you want, you can go ahead and treat the patient, put him on 02 and stuff, we'll be there in a min", I literally about reached through the radio and strangled them. I know WTF is going on, I didnt need the reinsurance. This has been happening every call now.
Click to expand...

I'm a little confused here. You said you work private ambulance, but for this thread you're talking about your work as a volunteer in a fire dept, right? One that has ALS providers but no transport units? I'm assuming on the call above you were riding on a medic engine or something, first on scene? And you handed the patient off to a BLS ambo from the Rescue Squad?

It was a little hard for me to follow. I don't really understand some of the phrases like "My department was approached by the county one year ago about looking into the first responder". What does that mean?
 
OP, I just want to clarify facts here... please correct me if i'm wrong
-- You work for a private, paid service, (ILS or ALS), and provide ALS first response services to the given community.
-- Once you arrive it sometimes takes 20+ minutes before a transport unit arrives
-- The transport for the community is handled by the volunteer fire/ambulance service... and they have no paid staff.
-- Despite the fact you outrank the town's service personnel re: training (you are ILS or ALS, they BLS), they do things behind your back and without your permission.

My best advice for you is to work with your counterparts on the street, and informally let them know your expectations. Get to know them socially, but make it clear that on scene, you are in charge.
 
Again, Thank everyone for responding.... The part abouting having them removed from the scene, I was referring to having a provider removed that seems to be a constant problem, not the ambulance. And I work for a private ambulance service, that has nothing to do with the problem. Im on the fire department (volley) and the rescue squad is seperate (volley). Sorry for the confusing statements. Myself and other have talked once again about this problem this am in a private meeting with a state rep... we will see what happens...
 
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