Ok, this is something that has been buging me for a while. I work for a company that says even though you are licc. in your state to practice at a certain level, they can tell you that you are not allowed to. We have a medic who is licc. by the state and is a NREMT-P and recerts every year, but the company we work for tells him he can only provide care up to a basic level and thats it. Can a company do that? Isnt there some legal liability? i mean if i knew a family member could have been saved if he had done what he was trained to but did'nt because the company said he can't just begs for a huge lawsuit. Any fealings on this issue?
What do you think?
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medic417
The Truth Provider
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Yes it is legal. If I hire you to work basic level and you go beyond you have practiced medicine w/o a license as you were not authorized to work at the higher level and would be subject to losing certification and possible other legal actions.
Perhaps the person you mention is a liability and should not even have their Paramedic certification, as not all that can pass the test should be allowed to work in the field. They may be doing them a favor by allowing them to keep a paycheck by keeping them at the basic level.
Perhaps the person you mention is a liability and should not even have their Paramedic certification, as not all that can pass the test should be allowed to work in the field. They may be doing them a favor by allowing them to keep a paycheck by keeping them at the basic level.
We've already seen a few examples of this just during the past year where an entire agency might have ALS privileges stripped from them by their Medical Director. In the eyes of the state, they still have a Paramedic patch but are not good enough to function at that level.
I applaud any company that values competency over a warm body with a patch.
By him still having his patch just means no one has pushed the issue far enough or he hasn't done grave harm to someone...yet.
Managers of companies don't want to ruin people's lives and if there is chance this person could develop the proper attitude, skills and knowledge to provide care, he will still have his license.
I applaud any company that values competency over a warm body with a patch.
By him still having his patch just means no one has pushed the issue far enough or he hasn't done grave harm to someone...yet.
Managers of companies don't want to ruin people's lives and if there is chance this person could develop the proper attitude, skills and knowledge to provide care, he will still have his license.
Sasha
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The company chose to have him function as an EMT, not a paramedic level. That is entirely within their right to do so, it's their butt on the line if/when he screws up. You think people just sue the medic involved in the call? Heck no, they go for the big money. It seems the company isn't comfortable with him as a paramedic.
medic417
The Truth Provider
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Actually most states are slow to remove except when drug abuse involved and some still slow then. But his license/certification only allows him to operate under a doctors license so if the service which hires the doctor says the paramedic must act as a basic that is all he/she can do.
akflightmedic
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It seems "HE" is not comfortable with being a paramedic or he would not tolerate this and have already moved on himself.
I would have unless there is more to the story eh?
Ped101
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Good point, if you were trained and confident to exert as a paramedic level and the company wouldn't allow you, then the person would naturally move on to another company where he/she could practice to the full extent of their capabilities
ResTech
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The real question is why are they not letting him function as a Paramedic? Im assuming it is an ALS service since you did not specifically specify. In PA, if your a Paramedic working for a BLS service, you are not allowed to portray yourself as a Paramedic... as in you cannot wear the patch or other insignia to indicate u are a Paramedic while working or volunteering for the BLS service. Not sure how it is in other States.
A service has the right to limit you. If he is a good Medic... he should have left himself long ago.
A service has the right to limit you. If he is a good Medic... he should have left himself long ago.
But if you do not demonstrate the competencies necessary to work as a Paramedic or have the attitude that you can play by your own rules, the company does not need to have you as a Paramedic.
Being granted the ability to function at a level requiring more responsibility is a privilege and not an entitlement because you have a pretty patch.
In Florida, you can work a BLS truck while wearing a Paramedic patch but you will only stay within the scope for that truck. You can do an "ALS" assessment and request for an ALS truck if you feel it warrants. In Florida, you can also go from Paramedic to EMT provided you meet the requirements to wear that patch. You may be asked to take the NREMT if you haven't in the recent past.
We have seen examples of were Paramedics that didn't meet their competencies go to the scope of an EMT in Washington, D.C. We have also seen a FD be stripped of their ALS privileges in Collier County until they could prove they were competent enough to be trusted with ALS medications and skills.
EMS has an opposite mentality of other medical professions. In EMS, the tech school mentality means every one is competent to perform certain technical skills and that patch gives them the right.
In other professions, they must demonstrate their abilities through knowledge, credentials, experience and initial competencies as well as expected level of competency to be maintained. Other professions also tell those that can not make the grade in their level of patient care to move on with some even being taken out of the patient care area totally. There are some in EMS that also place patient care as the priority. FF/Paramedics may go to being just EMTs as FFs. There have been Paramedics become just drivers for Specialty teams or inventory specialists.
I can also give you examples of people who hold two licenses that can not function at the level of the higher license in some situations. If I am working on CCT as a Paramedic that does not allow them to do IABPs but I have expertise at transporting IABPs as an RRT, an exception can not be made because I am not working as an RRT on that truck and it does not have the P&P from the medical director to back up his/her Paramedics doing IABPs.
If an RN who holds many years of experience in a high acuity ICU with the credentials of CCRN of many specialties, MICN and CEN became a FF/Paramedic with L.A. County in California, his/her scope of practice would be that of an L.A. County Fire Paramedic. The skills and advanced scope of practice he/she had as an RN would not be used on the Paramedic job but could still be used for a part time job.
We also had the problem with Paramedics who took the mail order nursing program Excelsior and passed the nursing board exam. They had the credential of RN but could not get licensed in their own state because their education was not recognized due to the lack of clinicals. If they could get licensed they found that the job market was not there for someone who could not pass competencies for basic nursing skills and a working knowledge of nursing theory. As well, a Flight Paramedic who becomes a licensed RN may not work as a Flight RN with the same company until all requirements are met such as 5 years of hospital ICU experience.
Another example, if you get hired for the position of ER Tech because your Paramedic cert showed proof of some medical training, that doesn't mean you will be functioning under the scope of a Paramedic and do what you were doing on an ambulance.
A lot of good points. The story is he didnt read a 12 lead right and it could have ended bad. The medical director wanted him to be "retrained" in cardiology but the company said no. his company ID says he is a paramedic for all to see. He hasnt left yet because of his senority and high level of pay. He has state dhe wants to move and work as a medic again. And in this state (NH) if your a medic and get on a bls truck, that truck then becomes a medic truck. This story btw really doesnt have to do with this person, i just use it as an example. i just upgraded to emt-i and i have to do a 40 hour ride time to upgrade and i am just worriod that the medic supervisor for some reason wont sign me off. Another question..do you as a medic tell an intermediate to give a dose of meds thats not within the scope of practice of an emt-i? Again thanks for you answers! 
So you are saying every ambulance in your state is licensed the same and carries all the ALS equipment and meds just in case a medic gets on your truck?
Tincanfireman
Airfield Operations
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The short answer is that the medic should be doing the administration. Do I think for a moment that some medics pass the syringe to their partner to administer? Probably. Do I think this would make a good topic for a unique thread? Yup...
Tincanfireman
Airfield Operations
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My agency keeps every truck at the ALS level, less the narcs. Unit drug bags are padlocked and sealed; only our -P's have keys. Narcs are carried by the -P supervisor in their QRV if they are needed to back up a -I unit. All the -P trucks have their own narcs.
I can see some companies licensing and equiping their trucks as all ALS. However, this might not be practical for every service. While Florida provides all ALS service to all of its residents, many ambulances are still licensed as BLS and a Paramedic can also work on a BLS truck. He/she may not have access to all the meds and equipment to perform ALS skills. We usually have two Paramedics on our ALS ambulances and since there is an abundance of Paramedics in Florida, some do find jobs with BLS IFT companies while waiting to get hired at the FD.
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