Partner help

[rhan101277]

I know there are many threads out there about this. I have an EMT partner who has several years more experience than I do. Sometimes he suggests doing things or not doing things and it is not appropriate for the care of the patient. I always correct him about it but he continues to do so on occasion. I have to physically go ahead and proceed with whatever procedure he disagrees before he will start helping me. He is a good partner and I realize he has more experience as an EMT and all I have to go on is my 5 months experience, clinical experience and paramedic education.

Sometimes when I ask him to do things on scene he will say, I don't think that is necessary and I have him do it anyhow. After the call he says he has been at this for some years and tries to explain his reasoning. The things I ask are appropriate and sometimes I think that he just wants to cut corners and I am not going to tolerate that.

I don't want to bring up that, oh well I am a paramedic and what I say goes. I want to get along and some of his suggestions are good but some are just plain idiotic and where I work I am ultimately responsible for patient care but he still tries to push the envelope.

Any ideas on how to approach without coming off as a paragod or know it all which I certainly am not.

Thanks

 

[8jimi8]

Explain to him that you will no longer tolerate his questioning of your judgement in front of the patient. If he has a suggestion to improve efficiency or care, he can bring it up after the call, where it can be discussed /s compromising patient care or the integrity of the patient / paramedic relationship. If he continues to question your orders, or disregard your orders while in the process of caring for a patient, you will have to move forward /c a formal complaint to the chain of command.

 

[rhan101277]

Explain to him that you will no longer tolerate his questioning of your judgement in front of the patient. If he has a suggestion to improve efficiency or care, he can bring it up after the call, where it can be discussed /s compromising patient care or the integrity of the patient / paramedic relationship. If he continues to question your orders, or disregard your orders while in the process of caring for a patient, you will have to move forward /c a formal complaint to the chain of command.

Yeah him disagreeing about anything compromises my rapport with the patient and effects patient care. If I am doing something absolutely unreasonable then I don't mind him speaking up. He did not want to c-collar a pt one time after I asked him to go ahead and do so.

 

[medicstudent101]

Ugh.
It's a toughie and I think we've all been there at one point in time whether it's just a temp partner or something a bit more permanent. First and foremost, experience is truly invaluable as it pertains to EMS. BUT, in saying that you also have to understand that YOU are the paramedic. Although he may have more experience under his belt, it's ultimately your call when it comes to any sort of pt. care. You've been to paramedic school and have a much deeper knowledge base as well as understanding than he does.

As long as you aren't doing anything harmful to the pt, then there's NO reason he shouldn't be helping you with procedures you deem necessary for Tx of your pt. Of course there are tricks to every trade that you'll continually pick up as you go & as I'm sure you did with your clinical experiences for you paramedic. By no means am I saying you shouldn't listen to what he says, I'm sure he's got a great deal of little tidbits that would be quite useful. Though saying that, there's NO reason he should question your choice of Tx unless it's going to harm the pt in any way.

It's an all around tough situation but a partnership like the ones we share in EMS are different than most. A lot of times we're less than an arms length away from each other a good majority of the day. We spend more time with each other than we do our own families or friends. Communication is vital for our special partnerships we have. Of course there'll be days that we fight like cats & dogs. Days we won't agree about much. Days we wish each other would've called off. But those days should be few, far, & in between.

Sounds like you really enjoy having him as your partner but on the same note there's a certain amount of trust that needs to be maintained. My best advice would be to have a sit down with him and communicate the issues that you feel are present. Explain to him that although he may not understand why you're doing what you're doing, you have no problem explaining it to him after the run. But when you're caring for your pt, he doesn't need to question what you're doing unless he feels that it'll adversely effect the pt. Go on to say his 'experience' is very welcomed but also has it's time and place.

If the problem still occurs down the road, then go to your supervisor and explain the situation with him. Most companies are very understanding when it comes to situations like this. Just don't go the petty route and talk behind your partner's back. Leave, if you must, on a good note. I'm 22yo and about done with paramedic school myself. I'm hoping to not run into this problem anymore than I already have.

Best of luck!! B)

PS. Sorry for the long rant!

 

[usafmedic45]

"Relying on experience alone simply means you make the same stupid mistakes with an ever increasing level of confidence". Put him in his place but only do so if you're ABSOLUTELY certain you are correct. Basically, if you can't cite the evidence to back up your stance (something beyond "I was told this....") off the top of your head, tread lightly young Padawan.

 

[ebass30920]

How much paramedic experience does he have? none.... My point is made.

 

[usafmedic45]

How much paramedic experience does he have? none.... My point is made.

....and makes you sound like a self-righteous douche.

Keep in mind that just because you have a higher credential doesn't mean you automatically have more clinically relevant knowledge. I've got 15 years in EMS, have worked all over the place and still would 99 times out of a 100 take the word of one of the first responders I originally worked with. The man was an amazing talent.

 

[JPINFV]

How much paramedic experience does he have? none.... My point is made.

Actually, no... no actual point relevant to the OP was made by your post. I award you no points, and may God have mercy on your soul.

 

[firetender]

Diplomacy with limits and boundaries

If you are the high man on the totem pole, then technically AND legally, you call the shots. You are not immune from missing something, however, and experience DOES count for something.

This is about respecting your partner and treating him as an asset WITHOUT jeopardizing the patient. So why not lay down some ground rules, while you make room for his inclusion as well.

I am the senior medic on the scene, that means I'm ultimately responsible for any decisions made about the handling or treatment of our patients. At the same time, I have no intentions of excluding you. We may disagree in some areas based on differing styles. I just want to make sure we can work through stuff.

I'll probably make the initial decisions. As time goes on I hope we'll both automatically know what to do. If you have questions about what I want, bring them up AWAY from the patient WITHOUT interrupting our flow.

I will listen to what you have to say and consider it and then say, "Let's do it!" or, "I'd prefer to stick with my plan."

Unless it is a life and death situation, please hold off on saying anything or pressing the point any more until AFTER the call. Then we can talk about it.

If I'm I'm not sure of something, I'll ask your opinion. I hope you'll do the same with me.

There are certainly things we can learn from working with each other. I just want to make sure the patient doesn't get compromised while we work stuff out.

How does that sound to you?

I'm not writing you a script so much as offering an approach that will build bridges instead of drawing a line in the sand. I suspect you may have something to work with, but you WILL have to gain his respect. That means you start by respecting him.

 

[mgr22]

Unless one of you is doing something that is clearly and immediately dangerous, you shouldn't be discussing it on scene. Maybe you could indicate your willingness to consider feedback after, but not during calls.

You did say some of his suggestions are good, right? There's a middle ground where you can listen, but still be in charge. No matter how much experience or what certification you have, sometimes you'll be wrong -- or at least not as right.

 

[Icenine]

After each and every call my partner and I run through the whole thing and ask "what could we have done differently?"

We've been together now for well over a year and this is still status quo. Netflix can wait, absorbing new information and correcting issues shouldn't have to.

Before we go back into service the rig is cleaned and refit. On the way back to the station the report is written. On arrival we transmit the reports, and debrief. If there are questions about the clinical presentation or proper procedure we look them up. We leave no questions unanswered. There have been more than a few times we take notes and talk to a doc on our next tx.

It's been a huge help and I think is helping us become a better team and building knowledge all around.

 

[boingo]

How much paramedic experience does he have? none.... My point is made.

Education w/o experience is just education. If I had a dollar for everytime I saw a new EM resident in July completely fail at whatever procedure or tx plan they were attempting I would have several dollars I can't count how many times a nurse had to bail them out, even though the education was there, the experience was not.

 

[ebass30920]

USAF how is this any different than a chain of command. Ultimately its the paramedic that takes the fall if he chooses to listen to the guy then thats his decision if not still his decision. If the partner wants to make the decisions he should put in the work. I am quite pleased you pointed out the fact that I AM a self righteous douche. JPINFV I need no one to bless my soul. I think its hysterical you know nothing of me but a simple comment and have so much insight into my character. A lot of maturity here I see.

 

[ffemt8978]

Play nice...

 

[usafmedic45]

USAF how is this any different than a chain of command.

In a chain of command, at least a good unit's chain, the commander or senior person present will listen to the guys serving with him (or her) especially those with more experience. It's a very stupid military officer who does not listen to his first sergeant.

Ultimately its the paramedic that takes the fall if he chooses to listen to the guy then thats his decision if not still his decision.

Listening to someone and doing as they say are two separate things. Maybe the other person realizes something the medic does not.

 

[usalsfyre]

The "I'm the paramedic, what I say goes" is absolutely the last card you should ever play. It's a big gun, and God help you if your wrong...

Tough situation. I'm lucky to have been a medic long enough now I'm rarely questioned. If he ask why your doing whatever, consider it a teachable moment. Explain to him why your doing what you are. If he presses the issue, tell him you'll discuss it later. If you can't explain, with good reasoning, why your doing something he's questioning you on, consider doing it his way.

Experience and education go hand in hand. However "experience" as a basic does not ever equal a paramedic education, no matter hom many people think it does.

 

[Shishkabob]

My partner and I have the same kind of "issue", him with 14 years of EMT experience and me with 1 of Paramedic and 1 of EMT. Does he have more experience? Yes. Am I still ultimately responsible for the patient? Yup, and he knows it. He'll ask if certain things want to be done, instead of flat out going "We should do this". He understands and respects that it ends up being my call.


The issue I primarily have with him is he butts in on my assessment, and butts in on my report to the hospital. But those really are minor issues.




But he is a decent EMT and actually tries to better himself asking me advice on previous calls and such.

 

[ebass30920]

When did I say he shouldn't listen? The OP it sounds to me like the guy is trying to do the right thing and his partner is still trying to walk on him.
bottom line is experience is great but it also isn't the end all be all. Is everyone aware the OP states this guy is trying to cut corners then pressure his partner into excepting? Are you saying he should blindly follow the bad habits and experience? I get tired of people that have X number years of experience, have done nothing to further themselves and then try and make everyone feel inferior.

 

[JPINFV]

Education w/o experience is just education. If I had a dollar for everytime I saw a new EM resident in July completely fail at whatever procedure or tx plan they were attempting I would have several dollars I can't count how many times a nurse had to bail them out, even though the education was there, the experience was not.

Wait, you mean a physician that isn't even fully licensed yet might still be learning? Say it isn't so!

 

[JPINFV]

If the partner wants to make the decisions he should put in the work.

Damn. I thought medicine was supposed to be a team support. Sure, the highest level is the team captain and coach with the ultimate final say, but I would hesitate to just shut down anyone else's opinion. The question should not be whether or not an EMT should question the care provided by the paramedic they're partnered with, but when is the proper time and place to do so. That, however, is dependent on the specifics of each case.

JPINFV I need no one to bless my soul.

In case you missed it, it's a Billy Madison reference.

I think its hysterical you know nothing of me but a simple comment and have so much insight into my character. A lot of maturity here I see.

I find it hilarious that you think that the only thing that matters is experience as a paramedic. Do you ever question the care provided by a nurse at a nursing home?