So I got fired...

[TransportJockey]

Which brings up the whole BoN pushing their weight around to get things enacted that make THEM the only ones seen as "licensed" practitioners in the hospital setting when compared to other health professionals like Paramedics....

Linuss, most hospitals do not regard EMTs or medics as 'licensed' staff when their job title is not EMT or Paramedic. And a lot of time when you are working as a tech, your job title is the only thing that determines your scope of practice. The ED medical director is telling you what you are limited to, and could care less if you can do more somewhere else. Just the way a hospital works.

 

[dixie_flatline]

I have watched this thread and have held my tongue, but as a Registered Nurse, I feel it necessary to weigh in.


It is YOUR responsibility to know your scope of practice. You were already in trouble, don't try to blame everyone else for your actions. We see it here all the time on this forum, people come in with, "I hate my Partner" or "My Job sucks" when it is usually the individual in question that is the issue, but instead of looking at their own actions and asking if they are perhaps the problem, they choose to blame someone else.

When an MD orders something in an ER setting, it is up to the RN or another physician to delegate who does what. If the MD did not tell you specifically to start an IV, you wait until you are told or you ask someone if they would like you to start it. It seems to me like you were just itching to stick somebody, so instead of asking the RN (WHO YOU KNEW WOULD TELL YOU "NO"), you went ahead and "prepped" the patient. YOU ARE AT FAULT.

Also, your comment about, "As a nursing major, I couldn't stand working as a "dumbed down" tech who wasn't allowed to share and utilize what I knew."

Nursing major doesnt mean $h!t if you are working in the capacity of a tech. You are under the delusion that you being a nursing student actually means something with regard to your scope of practice. Son, you are not an RN until you take the NCLEX and you get your license. Don't get it twisted.

Don't start with the, "When Im on clinicals" BS either. The fact is at the time you were in the capacity as an "ER Tech", not an RN Student. I am a Nurse Practitioner student, but do you think I am going to try to write a prescription for my patient without a certificate of fitness?

I see your type in my practice every day. You think that because you are a nursing student that you are somehow better than the average tech or that you are magically given an extended scope of practice. Even when you finish your RN license, you are going to be under an RN for a year while being trained.

Bottom Line:

You were warned, you didn't listen. You got fired, and you deserved to be fired.

If you were a nursing student on clinical rotations with me in the trauma unit or the ICU, I would fail you for the day for that crap.

/Thread

This sums it up pretty well. It sounds a little harsh, but OP doesn't seem to be acknowledging any fault. The bottom line is that any extra knowledge you might have means nothing when you are hired to do a certain job. Going back to the example I posted about my only experience getting fired - they weren't interested in me being a self-starter or taking the initiative. Those are not always good qualities. Especially in a setting like an ED, the staff would much rather have a predictable, reliable cog who fits well into the madness and does what they are supposed to do, when they are supposed to do it. Some jobs applaud risk-taking, pushing boundaries, etc - but those are usually jobs measured in dollars, not deaths.

The only time you should be busting out skills you aren't licensed/delegated/paid to do is when the SHTF and it's either you or nothing. If you're hiking the Appalachian Trail and you come across a guy choking to death, if you think you can do it, go ahead and cric him - that's all on you. When you're in an ED full of other professionals who are responsible (liable) for the care administered, know your role and stick to it. I bet that horrible, nasty RN would be more likely to let you drop a line if he knew you could be counted on to stay within your role as a Tech when you weren't being actively supervised.

 

[Shishkabob]

Linuss, most hospitals do not regard EMTs or medics as 'licensed' staff when their job title is not EMT or Paramedic. And a lot of time when you are working as a tech, your job title is the only thing that determines your scope of practice. The ED medical director is telling you what you are limited to, and could care less if you can do more somewhere else. Just the way a hospital works.

Exactly... it's been the BoN pushing for that type of mentality... atleast here in Texas. It's getting to the point around here that while Paramedic techs can start IVs, they aren't even allowed to flush the line. A nurse has to be the one to push the plunger.


Because obviously a Paramedic loses all their education the moment they enter the door to an ER and leave the rig....

 

[dudemanguy]

They dont say nurses eat their young for nothing. Hospitals can be a pretty cut throat sink or swim environment, long term care facilities too. I work as a CNA and if a Nurse needs to tell a CNA something they should already know, its not a good thing, and if they need to do it more than once they will remember that.

I dont understand why the OP felt the urge to continually push the envelope of their scope of practice, just do what you are allowed to the best of your ability and leave the other stuff to people who are paid to do those things. I remember when I was doing my ER clinicals during EMT school, a patient once asked if I was a doctor in front of a nurse. The nurse, without looking up or even pausing just said 'no, hes.....nothing' lol. I think that kind of summed up the typical nurse opinion of EMTs, so it possibly annoyed this nurse to no end he caught you doing something he felt you arent qualified to do.

 

[aewin90]

They dont say nurses eat their young for nothing. Hospitals can be a pretty cut throat sink or swim environment, long term care facilities too. I work as a CNA and if a Nurse needs to tell a CNA something they should already know, its not a good thing, and if they need to do it more than once they will remember that.

I dont understand why the OP felt the urge to continually push the envelope of their scope of practice, just do what you are allowed to the best of your ability and leave the other stuff to people who are paid to do those things. I remember when I was doing my ER clinicals during EMT school, a patient once asked if I was a doctor in front of a nurse. The nurse, without looking up or even pausing just said 'no, hes.....nothing' lol. I think that kind of summed up the typical nurse opinion of EMTs, so it possibly annoyed this nurse to no end he caught you doing something he felt you arent qualified to do.

As a (thankfully former) CNA I can attest to this. Pushing the envelope with nurses, especially when you're an "ambulance driver," is a bad idea.

 

[TransportJockey]

They dont say nurses eat their young for nothing. Hospitals can be a pretty cut throat sink or swim environment, long term care facilities too. I work as a CNA and if a Nurse needs to tell a CNA something they should already know, its not a good thing, and if they need to do it more than once they will remember that.

I dont understand why the OP felt the urge to continually push the envelope of their scope of practice, just do what you are allowed to the best of your ability and leave the other stuff to people who are paid to do those things. I remember when I was doing my ER clinicals during EMT school, a patient once asked if I was a doctor in front of a nurse. The nurse, without looking up or even pausing just said 'no, hes.....nothing' lol. I think that kind of summed up the typical nurse opinion of EMTs, so it possibly annoyed this nurse to no end he caught you doing something he felt you arent qualified to do.

Actually that's a nurses opinion of most students. And that was my opinion of some nursing students when I was a floor tech

 

[jjesusfreak01]

The nurse, without looking up or even pausing just said 'no, hes.....nothing' lol.

Would have responded, "don't worry about her, she's just a nurse" then promptly walked to HR and tendered my resignation. Its not worth working with people who won't give you respect, regardless of your level.

 

[medicRob]

Would have responded, "don't worry about her, she's just a nurse" then promptly walked to HR and tendered my resignation. Its not worth working with people who won't give you respect, regardless of your level.

Yes, I believe that nurse definitely took it too far. I try to be respectful with everyone I work with and work together with them as a team. Calling a co-worker, a "Nothing" isn't in the best interest of the team and is just down right bad manners, especially in front of a patient. That nurse was out of line. You did not deserve that.

 

[dudemanguy]

I'll add something more to this. I wasnt trying to bash or whine about nurses, so much as point out the hospital environment is different than EMS. EMS seems to have a little bit of commaraderie. You wont find that in hospitals(or LTC facilities). You will find a lot of bickering and back stabbing and gossiping. I've seen good CNAs get fired out of the blue in order to "make an example" of them, or because of personality clashes.

The long term care facility I work at part time is even worse than the hospital, since there is not nearly enough time to get everything done exactly the way it is supposed to be, you are forced to cut some corners. Every so often Ive seen a CNA get crucified for doing what basically everyone else is doing. Usually its because they ran afoul of the wrong nurse, or even fellow CNA who has some pull.

The OP may have very well been perfectly good at their job, but maybe just gave the wrong person some rope to hang em with, and they used it.

It has really motivated me to get my paramedic patch and get the hell out of a hospital setting.

 

[EMS49393]

I'll add something more to this. I wasnt trying to bash or whine about nurses, so much as point out the hospital environment is different than EMS. EMS seems to have a little bit of commaraderie. You wont find that in hospitals(or LTC facilities). You will find a lot of bickering and back stabbing and gossiping. I've seen good CNAs get fired out of the blue in order to "make an example" of them, or because of personality clashes.

The long term care facility I work at part time is even worse than the hospital, since there is not nearly enough time to get everything done exactly the way it is supposed to be, you are forced to cut some corners. Every so often Ive seen a CNA get crucified for doing what basically everyone else is doing. Usually its because they ran afoul of the wrong nurse, or even fellow CNA who has some pull.

The OP may have very well been perfectly good at their job, but maybe just gave the wrong person some rope to hang em with, and they used it.

It has really motivated me to get my paramedic patch and get the hell out of a hospital setting.

Yeah, I don't know about that EMS comradeship thing. The last few EMS jobs I've worked have been cut throat and back stabbing. Some of the worst I've seen since working in the hospital. I thought it was just me, but most of the old timers agree with me. It's not what it was 15 or even 5 years ago. You can't sling a dead cat in most areas without hitting and EMT or a paramedic. When you have that many people all looking for jobs, they're going to start stepping all over people to get up the ladder.

The days of "what happens on the truck, stays on the truck" are over. What a shame, not being able to trust your partners anymore.

 

[akflightmedic]

The days of "what happens on the truck, stays on the truck" are over. What a shame, not being able to trust your partners anymore.

This is about the most asinine statement regarding EMS and you are not the only person to repeat it.

The only reason this type of mentality ever develops is a lack of professionalism. DO your job and do it well and you never have to worry about stuff :staying inside the truck". Act like a mature, professional adult.

Why do "WE" think we are any different from any other profession. Why do we "NEED" loyalty from a partner in a truck? Just do your job and follow the rules, quite simple.

I wonder if cooks fight and argue and say "Hey man, what happens in the kitchen stays in the kitchen"...or do teachers say "what happens in the classroom, stays in the classroom".

See how idiotic it sounds when you extrapolate it to every other profession? See how stupid "WE" are being by saying such dribble?

 

[medicRob]

This is about the most asinine statement regarding EMS and you are not the only person to repeat it.

The only reason this type of mentality ever develops is a lack of professionalism. DO your job and do it well and you never have to worry about stuff :staying inside the truck". Act like a mature, professional adult

I couldn't agree more. It's also time to get rid of this, "Good Ole Boy" system of EMS where "Who you know" is valued more than "What you know".
I see it every day. Paramedics who could care less about learning something new or about evidence based medicine and all they do is sit
around and complain about, "Im sick of working this job". News flash, if you are sick of working EMS, get the hell out.

As for this little, "What happens on the truck stays on the truck" mentality, that is down right ignorant. So are you saying if a Paramedic on your truck
pushed a wrong med and caused further harm to a patient, that you would just cover it up? That's what I'm hearing.

So how far exactly does this "What happens on the truck, stays on the truck" mentality go? Would you falsify a chart in this situation? After all,
that happened on the truck and we wouldn't want to get our partner in trouble.

If you want to be accepted as a professional, act like one.

 

[Emtpbill]

This is about the most asinine statement regarding EMS and you are not the only person to repeat it.

The only reason this type of mentality ever develops is a lack of professionalism. DO your job and do it well and you never have to worry about stuff :staying inside the truck". Act like a mature, professional adult.

Why do "WE" think we are any different from any other profession. Why do we "NEED" loyalty from a partner in a truck? Just do your job and follow the rules, quite simple.

I wonder if cooks fight and argue and say "Hey man, what happens in the kitchen stays in the kitchen"...or do teachers say "what happens in the classroom, stays in the classroom".

See how idiotic it sounds when you extrapolate it to every other profession? See how stupid "WE" are being by saying such dribble?

I read your post to the new emts that were riding with me. While I agree 1000% with your statement the only thing that keeps coming to mind is the partner from hell. The one who operates on the edge. That treats their patients like it is a privledge that they get treated by him.
And then the old feeling of " man, he did this and that wrong. Do I notify the superiors and be labeled a rat. Or handle it myself( keeping it in the truck).
This moral dilema has faced people in all careers. But when you are working a 12 or 24 hour shift with only one other person. Can make for a long tour.

 

[Level1pedstech]

I have watched this thread and have held my tongue, but as a Registered Nurse, I feel it necessary to weigh in.


It is YOUR responsibility to know your scope of practice. You were already in trouble, don't try to blame everyone else for your actions. We see it here all the time on this forum, people come in with, "I hate my Partner" or "My Job sucks" when it is usually the individual in question that is the issue, but instead of looking at their own actions and asking if they are perhaps the problem, they choose to blame someone else.

When an MD orders something in an ER setting, it is up to the RN or another physician to delegate who does what. If the MD did not tell you specifically to start an IV, you wait until you are told or you ask someone if they would like you to start it. It seems to me like you were just itching to stick somebody, so instead of asking the RN (WHO YOU KNEW WOULD TELL YOU "NO"), you went ahead and "prepped" the patient. YOU ARE AT FAULT.

Also, your comment about, "As a nursing major, I couldn't stand working as a "dumbed down" tech who wasn't allowed to share and utilize what I knew."

Nursing major doesnt mean $h!t if you are working in the capacity of a tech. You are under the delusion that you being a nursing student actually means something with regard to your scope of practice. Son, you are not an RN until you take the NCLEX and you get your license. Don't get it twisted.

Don't start with the, "When Im on clinicals" BS either. The fact is at the time you were in the capacity as an "ER Tech", not an RN Student. I am a Nurse Practitioner student, but do you think I am going to try to write a prescription for my patient without a certificate of fitness?

I see your type in my practice every day. You think that because you are a nursing student that you are somehow better than the average tech or that you are magically given an extended scope of practice. Even when you finish your RN license, you are going to be under an RN for a year while being trained.

Bottom Line:

You were warned, you didn't listen. You got fired, and you deserved to be fired.

If you were a nursing student on clinical rotations with me in the trauma unit or the ICU, I would fail you for the day for that crap.

/Thread

Thank you for jumping in,we need all the RN's to get involved more often in some these discussions. Like you I see this behavior way to much in students moving thru the ER on clinicals and sometimes even in people who make it on to the floor as techs.

 

[EMS49393]

This constant bashing and bickering is a large reason why I want out of this profession. All people do is beat each other up. It's no wonder there isn't any trust anymore.

As for the truck statement, it has nothing to do with policies and rules. I follow them quite fine. My point is that I hear other people bash providers, bosses, etc., and judging from how they talk about them, I wonder what they say about me when I'm not around. Almost all of what they say about other people I don't see myself and have a hard time believing. It used to be different. I didn't hear people talk so poorly about their partners. I remember when we all got along well at work.

You can't trust anyone in this job. You probably can't trust anyone in any job. If I can't trust a partner not to make up a bunch of tales about me or any other paramedic then I can't trust them to be there on a call when I need them.

 

[Level1pedstech]

This is about the most asinine statement regarding EMS and you are not the only person to repeat it.

The only reason this type of mentality ever develops is a lack of professionalism. DO your job and do it well and you never have to worry about stuff :staying inside the truck". Act like a mature, professional adult.

Why do "WE" think we are any different from any other profession. Why do we "NEED" loyalty from a partner in a truck? Just do your job and follow the rules, quite simple.

I wonder if cooks fight and argue and say "Hey man, what happens in the kitchen stays in the kitchen"...or do teachers say "what happens in the classroom, stays in the classroom".

See how idiotic it sounds when you extrapolate it to every other profession? See how stupid "WE" are being by saying such dribble?

I remember hearing "what happens on the engine stays on the engine" but it
was never in an attempt to cover up or hide unprofessional conduct. Usually chit chat on the engine was much like any other work place and of course included a bit of harmless gossip here and there. I don't think we will ever totally remove gossip from the work place I think its just human nature. I agree that we should never excuse poor conduct by keeping it on the engine or rig.

 

[akflightmedic]

This constant bashing and bickering is a large reason why I want out of this profession. All people do is beat each other up. It's no wonder there isn't any trust anymore.

As for the truck statement, it has nothing to do with policies and rules. I follow them quite fine. My point is that I hear other people bash providers, bosses, etc., and judging from how they talk about them, I wonder what they say about me when I'm not around. Almost all of what they say about other people I don't see myself and have a hard time believing. It used to be different. I didn't hear people talk so poorly about their partners. I remember when we all got along well at work.

You can't trust anyone in this job. You probably can't trust anyone in any job. If I can't trust a partner not to make up a bunch of tales about me or any other paramedic then I can't trust them to be there on a call when I need them.

And when you "hear" these things, do you end the conversation or walk away from it? DO you make it known that you do NOT want to hear it?

This was a very difficult skill for me to learn and practice but what I have learned is people will eventually stop saying things about others in front of you and then when other people know that is how you are...they will do the same when they hear people talk about you or they will simply disregard anything they hear.

Sounds simple I know, but it isn't. The first thing that needs to change is yourself and very few of us ever admit we need to fix ourselves or expend the effort to change.

 

[EMS49393]

And when you "hear" these things, do you end the conversation or walk away from it? DO you make it known that you do NOT want to hear it?

This was a very difficult skill for me to learn and practice but what I have learned is people will eventually stop saying things about others in front of you and then when other people know that is how you are...they will do the same when they hear people talk about you or they will simply disregard anything they hear.

Sounds simple I know, but it isn't. The first thing that needs to change is yourself and very few of us ever admit we need to fix ourselves or expend the effort to change.

Actually I do which has done little but cause me more grief because I'm not a member of the bash everyone misery club. One of my favorite things to say at work is "Really? I never seem to have that problem with them." I usually walk away from it after that. It seems as though this job is not maturing in any way and in fact I find it growing more juvenile with every shift.

 

[Veneficus]

Has it occured to anyone not to take the "bashing" too personally?

Complaining about long term partners, like spouses, EMS partners, coworkers, etc. Is a coping mechanism.

People who spend a lot of time together will do things that gets on each others' nerves. By complaining to a third party or even outloud, at work, etc, it allows the stress to be vented without causing a conflict between those people.

The trouble i smost in this profession want to "help" people, so instead of just writing it off as venting and not giving it attention ever again it turns into "guess what who said about whom" and rhumors, and then retailiations, etc.

As everyone here is well aware, we can give ten answers to one scenario and no two will agree. It doesn't mean any of us are idiots or suck. It simply means we have a different perspective.

as always, the other person's perspective is never related or pobably even considered before judgement passed.

In the past I have worked with people who one day told me: "I was really worried about the way you did things from what I heard, but there is a lot of logic in the way you do things when I see it."

Who among us has never heard "guess what person X did on a call?"

Let the people vent. Then let it go. Don't take it as gospel, accurate, or even something that needs fixed.

I once attended a class about the psychology of women. Which was really about the difference in the psychology of men and women.

It was described in Westenr society women look for consensus. Several examples were given. Men are raised in an almost paramilitary culture. From the games we all play to the perspective we all see, we are inundated and reinforced to this dispositions.

as an obvious disclaimer there are always outliers or crossovers, but knowing if somebody is "stupid, dangerous, or whatever" because they didn't follow the ascribed orders from the "usual" channels, or whether they want you to agree to support their decision as the right one will save you much grief in both the workplace and at home.

 

[LonghornMedic]

The days of "what happens on the truck, stays on the truck" are over. What a shame, not being able to trust your partners anymore.

The only time I tell anyone that is to students or new hires getting precepted. And it has nothing to do with treatment, treating patients rudely, etc. It mostly has to do with them hearing anything we may talk about and to not go babbling to others about it. When they are on a truck with us for anywhere from 12-24 hours, they are bound to hear us say things as we normally do as partners. They are expected to respect "what happens on the truck, stays on the truck" as a courtesy to being a guest on our truck.