What makes someone a "bad" paramedic?

KingCountyMedic said:
Not recognizing the value of BLS providers would make you a bad Paramedic all day, every day. Public, Private, or Fire.

Listening to opinions of coworkers who have bad attitudes and then making those your opinions would make you a bad Paramedic.
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Slow down, Cochise. While I don’t disagree with most of your post, we’ve all had growing pains.

Many of us have had a paragod/ EMT moment or 10. This doesn’t make the OP a “bad” paramedic. Least the guy recognizes the need for input outside of his own work place.

Honestly, I think the biggest takeaway is try and avoid most, if not all water cooler talk buy in. Don’t worry about the what the “cool kids” think, do the damn job, do it well, and everything else will eventually fall into place for you individually.*

*The caveat being you may feel like an outlier. But then you wouldn’t be the first or only provider to feel like one at their agency either.
 
I've been an EMT doing everything actually. 911 on bls, als , a sprinkling of ift and also in the e.r. as a tech with an advanced scope and also a military medic... so I consider myself fairly well rounded.

Fire doesn't have a REASON to act like our bls crews are a hindrance. They act that way simply because it's a bls crew arriving to scene. To clarify.... Als ambulances aren't treated this way and neither am I.
 
My first EMS job was with a private 911 agency that covered numerous municipalities. One of them was a very small (few thousand residents) city with a non-transporting BLS fire department that responded to every medical call in a squad truck.

Per our contract with the city, we couldn't respond to any call until the FD requested us. Didn't matter the nature or urgency of the call, or even whether we were closer, or that we went to every call they went to anyway because we transported every one of their patients. We'd hear them get toned out by the county for an obvious ALS complaint (asthma attack, chest pain, etc) and have to sit on our thumbs until the FD EMT-B's got on scene, assessed the patient, confirmed whether ALS was actually needed, and then requested an "ALS transport" or "BLS transport" as well as the response mode. They would tell the patient which hospital they were going to and what interventions, if any, they would have performed enroute.

There were many times that ALS interventions were needlessly delayed by these guys arriving first and playing on scene (er, I mean, "assessing the patient") for 5 or 10 minutes before requesting us. Predictably, our paramedics often disagreed with the diagnosis and treatment plan decided on by these EMT-B's, and it was a constant source of friction between the two agencies. Things only got worse when the agency went "EMT-I", because now these guys REALLY thought they knew what they were doing, and the delay between them arriving and them requesting us got much longer because now every patient was "ALS" and they pretty much refused to allow us on scene until they had an IV started.

It was a terrible approach to EMS which put the well-being of the patient exactly last, and unfortunately it wasn't an uncommon set up in this region. I also worked a fly car for the same agency in a very rural area covering multiple rural municipalities with whom we had similar arrangements.

Point is, I wouldn't assume that just because a new paramedic says he's having trouble with a BLS fire department, that it's necessarily because of his attitude.
 
Like point in case...Just showed up to a call......Here was my report:

"Yeah this is mary, she's having troubling breathing. We couldnt get a pulse ox reading.
If its respiratory she needs to get going to the hospital right now"

And then cleared themselves which is against policy.

And mind you this pt was completely stable,a nd had no difficulty breathing, Chest pain, Clear airway, SP02 @ 98% first attempt, Skins pink/warm/dry with her only complaint being a productive cough X6 months with clear sputum.

And i just smiled and thanked them for all their hard work and continued on with my pt.
 
Well, if they are clearing themselves which is against their policy, that's something for their admin to handle (and if you feel that strongly about it, ask your admin take it up with their admin). to be honest, if that's all the report you are getting, than it doesn't seem like they would be all that useful, provided they were on scene for more than 2 minutes. There are some departments that are known for not being good EMS providers, and some that provide amazing care.

I used to work in a county where one particular career FD would clear themselves after 10 or 15 minutes. It could get a cardiac arrest, CHF, or the sniffles, but after their 10 or 15 minutes of being on scene, they were leaving, even if we were just walking in the door.

Honestly, at least they gave you the patient's name, tried something, and transitioned the provider/patient relationship over to you. that is more than what some departments would do.
 
The simplest answer to how to be a bad anything is forgetting where you came from, failing to remain teachable, and letting your pride get in the way of making rational logical decisions.

That goes for firemen, paramedics, and pretty much every other profession out there.
 
I used to be a pretty good paramedic, but I fear I’ve lost some of the sharpness due to my stint in Transfer Heck and the Wheelchair Chariot.
 
On a serious note, you really can’t “win” an inter-agency spat or fix much, so the best answer is to do what you’re doing...be polite and just roll with the punches. Me personally, I let them do them and don’t worry about it unless it’s clearly dangerous, in which case I just politely assume command. I find a decent answer is to let the fire captain run his show and I run mine.
Also, it can be very easy to make competency assumptions. To the average 911 medic like I used to be and wish I was, the dudes on the wheelchair van looked like failures...but now that I’ve been humiliated and find myself at a job where I go from 911 to CCT to BLS to wheelchair in literally the same shift I have a different perspective. It’s really really hard to quantify what “good” means because there isn’t really an adequate or appropriate definition of “good”.
There are good jobs, good clinicians, good employees, good friends, good coworkers, good paramedics, etc. There are bad ones. And good ones can have bad days and bad ones can have good days. Even attitude isn’t a constant.
 
mrhunt said:
So Bit of specifics here.... i work in a county where private EMS is first in and County fire is Just BLS and assisting us.

Alot of them dont like it. they're all EMT certified but just show up to open doors, maybe take vitals and carry our bags...Despite this, easily 50% think they're better than us an that they run the show. alot of Them like to loudly complain about staff members saying that were "incompetent" or something...

Mind you this hasnt happened to me YET but plenty of my co-workers who definitely are NOT incompetent. None of these guys are paramedics and hate running on medical calls anyways, Who are they to judge us? Takes one to know one. I dont show up to their Fire calls judging them cause im not a fire fighter!


So got me to thinking.....As a new medic.......What makes someone "bad" or incompetent or just like a "watch out for that guy" sorta thing?
Post your words of wisdom for me.
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Before I begin please understand that I freely admit that I am not the sharpest tool in the shed. I am not God. I am not a god. I do not walk on water. I make mistakes, I have been wrong, and I will continue to do both. And like everyone I strive to do both with decreasing frequency. And being someone who is in his third decade of providing prehospital care I am still striving.

Now that's out of the way.

There are two different kinds of "bad" paramedics. The least common "bad medic" I'll mention first.

First one: Some people just aren't cut out for EMS. Try as they might, they just simply keep making the wrong decisions utilizing the wrong algorithms in their patient care. If you read their charts then it may seem that they are treating their patients just fine... until to also happen to be on scene and witness the fiasco first hand and you realize that what they might be saying what is going on with the patient is not what you are seeing is wrong with the patient. These are the paramedics that are by far the worst ones and they probably don't realize just how dangerous they are.

The second and most common type of "bad medic" are the ones with delusions of grandeur who have forgotten that their sh@t still stinks. These are the ones that emit the culture that can lead a new medic down the wrong type of personal path in their new career. They tend to be apathetic, judgmental, and self serving.

News flash. I, myself, have seen the aforementioned character traits staring back at me in the mirror more times than I care to admit. Do not let these descriptions become your descriptions. Find you a mentor(s). Those who have earned the respect of everyone around them. Not just in knowledge and skills, but also in personal integrity. Learn from them. Learn how to own your career from them. When I say "own your career", I mean own it: the good, the bad, and the ugly. The good: when everything is going great. The bad: when everything is going wrong. And the ugly: when it's all your fault.
 
@mrhunt One glaring little problem is it sounds like team effort is lacking. Out on scene every person can play a vital role in making the job safer, easier, and more effective.
Where I was for quite some time we would periodically have meetings with all responders including S.O. and police, the focus usually being how can we better coordinate on scene.
One outstanding lecture given by a fire chief of, no BS, 60 years in the FD delineated jobs by level of training. The weakest, most vulnerable persons were those of the highest level. They were total patient focus, handicapped to all else, unable to even get supplies very often. Then periphrial of the patient, foreseeing what the top level would need/require, then on down to situation then scene management and safety. Thus a trained EMT 1 was a critical component of an ACLS operation and the like. A non medical FD was a critical component in access, safety, watching walking wounded and on down the ladder. In a proper team operation, everyone is valuable.

So maybe some meeting are in order, hashing out how to work as a team most effectively?
 
That would be an excellent idea. but unfortunately our company was just bought out and we've been in the midst of MASSIVE transitions for months now and this is the least of the issue on managements hands unfortunately.

Theres also the fact that it often falls down to certain crews only.....Some are EXCELLENT. Some show up and do literally nothing, and then i show up and They weakly say some excuse like "oh we just got here too" which i know is a lie..... Some crews dont want to be there and view medical aids as a hinderance that they HAVE to do and dont really want to.

Its obvious in their apathetic attitude and leads to me usually just clearing them pretty early and Working with my partner and thats it....
 
@mrhunt Not good. Especially thinking of having a partner that may not be reliable. Just always remember the rule: CYA
 
i know.....I know trust me. Luckily its a small enough company that i know exactly what partner i can rely on and who i cant. But regardless......I wish things were different but it'll just take time for now.
 
mrhunt said:
So Bit of specifics here.... i work in a county where private EMS is first in and County fire is Just BLS and assisting us.

Alot of them dont like it. they're all EMT certified but just show up to open doors, maybe take vitals and carry our bags...Despite this, easily 50% think they're better than us an that they run the show. alot of Them like to loudly complain about staff members saying that were "incompetent" or something...

Mind you this hasnt happened to me YET but plenty of my co-workers who definitely are NOT incompetent. None of these guys are paramedics and hate running on medical calls anyways, Who are they to judge us? Takes one to know one. I dont show up to their Fire calls judging them cause im not a fire fighter!


So got me to thinking.....As a new medic.......What makes someone "bad" or incompetent or just like a "watch out for that guy" sorta thing?
Post your words of wisdom for me.
Click to expand...
Perception of the wannabes, nothing more.
 
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