medics with attitudes

[rhan101277]

A good EMT means everything though. It effects scene time, if they fumble around and don't know where stuff is and we gotta do it, it sucks.

 

[abckidsmom]

Are there medics with attitudes? Hell yes. Hate them.


But at the same time you need to view it from our perspective. We (generally) have way more education (atleast 10x the amount of an EMT if you want to be specific). We (generally) have a bigger clinical and knowledge base, with a longer looking perspective at what we're doing now and how it will effect the patient in the long run, not just 10 minutes from now. We have to deal with the thought process of a lot more drugs than you, a lot more treatment modalities, and a lot more complications in our differential diagnosis. We DO have a bigger legal responsibility-- We're held to a higher standard than EMTs. Something goes wrong, we have a helluva lot more to lose than you.

And we are expected to take control of the scene and patient care from the moment of contact until we drop the patient off at the ED. Part of that means being assertive... and some people view being assertive as being an ***. They aren't the same.



Most medics I know aren't purposefully trying to be jerks to EMTs, but when you're trying to get a lot of things done quickly, someones feelings might be hurt. I know I'll be seen as crass with some EMTs at times while trying to get stuff done on a call, but I always try to apologize afterwards, among other things to show that you're not "just the driver" and I'm not "just the medic", but that we're partners.



But even still, it IS my patient, and it IS my call. If I piss a "lower" provider off because they don't agree with me while I provide competent medical care, oh well, tough noogies, deal with it.

Not to be all maternal or anything, but this comes down to manners. I think I've experienced maybe a dozen times over the course of my career where time and a critical incident took away the luxury of communicating with please and thank you, respectful requests and not barking orders.

Adults in a work environment don't get the luxury of saying tough noogies, deal with it. I bet that your words got ahead of you and maybe you didn't mean to say that out loud, but the fact remains that the thought is there.

I've got a new partner these days, a brand new, 50 year old female EMT. She can't lift, she has no EMS experience, and she can't read a map. Every day we spend together is frustrating beyond words, when we're on a call. Off the call, she's awesome- an Air Force wife who lived all over the world and has had such a varied life experience that there's always something to talk about.

I can't let my frustration with her performance on the calls take away the rest of her that deserves and inspires respect. EMS can be learned, but polite society requires that ALL people treat ALL people respectfully and kindly ALL the time.

There's no "get over it" in kind, respectful behavior. It's lazy to fall back to that instead of educating people to see it your way or communicating with them until you can see it their way.

 

[cmetalbend]

I don't think Linuss' post was about glory or credit. No matter how much teamwork happens, there is always one person that is ultimately held responsible. In most places that is the paramedic. I don't give a rats tail about who gets credit for what, but I do care what I'm going to be held responsible for. I work in a system with EMTB/FFs and Paramedic/FFs, and my partner is usually a basic. It doesn't matter if it is an EMT or a Paramedic, I'm not keen on being held responsible for what anyone else did, no matter their certification level.

I agree, it's not really about the glory or credit. But again responability is upon everybody. Not just the medics. I would hate to see a good medic loose his lic. or job for a another responder of any type. In my opnion, "What happens on the truck, stays on the truck". Nobodys perfect, we all make mistakes, the only difference is how and if we learn from them.B)

 

[Aidey]

It isn't about how you view responsibility, it is about how managment and state law view it. The fact is that one person is ultimately deemed to be most responsible, and it is usually a paramedic.

 

[CAOX3]

I have a simple rule, I respect you, you respect me, if you want to act like a five year expect to be treated like one. This rule applies to everyone on the ladder from the top to the bottom.

 

[EMS49393]

I have a personal rule in addition to the treat me with respect and I'll return the same and be professional rules. If you do not know, ask. I love to teach and do not mind answering questions or showing you how to do something. That said, please know when to ask your questions. There are times when your question may be perceived by the patient as personally questioning my treatments thereby killing my credibility. The best worded questions usually start with "can you explain why...?"

I've never been one of those medics that throws a fit with a new EMT or medic. I can handle about any level of partner, I just like to know what I'm dealing with before hand. If you're green, it's cool, we'll get through it. If you're green and act like you've been in EMS for 40 years because your Daddy's a paramedic at such and such service but you don't know an oxygen wrench from a spider strap, be prepared to get schooled real quickly. I rarely ever have to pull rank, but I will if I have to because I have several thousand hours and several thousand dollars invested in my license that I'm only giving up when I decide it's my time, and not before.

 

[rhan101277]

I have a personal rule in addition to the treat me with respect and I'll return the same and be professional rules. If you do not know, ask. I love to teach and do not mind answering questions or showing you how to do something. That said, please know when to ask your questions. There are times when your question may be perceived by the patient as personally questioning my treatments thereby killing my credibility. The best worded questions usually start with "can you explain why...?"

I've never been one of those medics that throws a fit with a new EMT or medic. I can handle about any level of partner, I just like to know what I'm dealing with before hand. If you're green, it's cool, we'll get through it. If you're green and act like you've been in EMS for 40 years because your Daddy's a paramedic at such and such service but you don't know an oxygen wrench from a spider strap, be prepared to get schooled real quickly. I rarely ever have to pull rank, but I will if I have to because I have several thousand hours and several thousand dollars invested in my license that I'm only giving up when I decide it's my time, and not before.

LOL "my daddy is a paramedic"

 

[Shishkabob]

Not to be all maternal or anything, but this comes down to manners. I think I've experienced maybe a dozen times over the course of my career where time and a critical incident took away the luxury of communicating with please and thank you, respectful requests and not barking orders.

Oh, agreed. I tend to say please/thanks/would you mind, etc etc, 99.9% of the time. However, don't fault me every time if I don't, as I have other things on my mind.

I don't see anyone ****** when a doctor says "Let's go ahead and put them on the monitor" etc etc without always saying please.

Adults in a work environment don't get the luxury of saying tough noogies, deal with it. I bet that your words got ahead of you and maybe you didn't mean to say that out loud, but the fact remains that the thought is there.

Nope, I meant what I said and I said what I meant.

There's no "get over it" in kind, respectful behavior. It's lazy to fall back to that instead of educating people to see it your way or communicating with them until you can see it their way.

The "get over it" was aimed more at "If you don't like how I run a call, oh well", and I stand by that.


I will be one of the FIRST to educate my partners on why I did or did not do something on a call as I LOVED it when I was an EMT and my medic took the time and did the same, but if my treatment decision offends you, it's a competent decision, and it's not yours to make, then that's your problem to deal with.



Let's be clear here: I don't treat my partner, be it an EMT, Intermediate or another Paramedic, as an idiot. They are their own certified or licensed professional, and they get treated as an equal, and as a partner, not as a lowly servant. However, my patient is my patient, and my call is my call. That cannot be argued.

 

[CAOX3]

I have a personal rule in addition to the treat me with respect and I'll return the same and be professional rules. If you do not know, ask. I love to teach and do not mind answering questions or showing you how to do something. That said, please know when to ask your questions. There are times when your question may be perceived by the patient as personally questioning my treatments thereby killing my credibility. The best worded questions usually start with "can you explain why...?"

I've never been one of those medics that throws a fit with a new EMT or medic. I can handle about any level of partner, I just like to know what I'm dealing with before hand. If you're green, it's cool, we'll get through it. If you're green and act like you've been in EMS for 40 years because your Daddy's a paramedic at such and such service but you don't know an oxygen wrench from a spider strap, be prepared to get schooled real quickly. I rarely ever have to pull rank, but I will if I have to because I have several thousand hours and several thousand dollars invested in my license that I'm only giving up when I decide it's my time, and not before.

First your investment is no more important them mine, this is my career also. So the entire premise of that comment is condescending.

And since I keep hearing over and over how a incompetent lower level provider can somehow cost a medic their certification can anyone provde some evidence maybe a link where this has occured?

 

[ffemt8978]

I agree, it's not really about the glory or credit. But again responability is upon everybody. Not just the medics. I would hate to see a good medic loose his lic. or job for a another responder of any type. In my opnion, "What happens on the truck, stays on the truck". Nobodys perfect, we all make mistakes, the only difference is how and if we learn from them.B)

No it doesn't, nor should it. What happens on the truck can affect the patient's final outcome. If somebody screws up on scene or "in the truck" it needs to be appropriately documented so that it can be dealt with correctly.

The "blue wall" mentality is detrimental to the patient, and ultimately EMS is all about the patient. If your patient's final outcome is less of a concern to you than keeping your license or job, then maybe you should be looking at a different career option.

But I am curious as to how the statement "What happens on the truck, stays on the truck" enables the last statement in your post "Nobodys perfect, we all make mistakes, the only difference is how and if we learn from them". If you're keeping a mistake on the truck, how can you learn anything from it and how can anybody else?

Maybe I misunderstood your post, and if I did I apologize.

 

[Aidey]

I can't provide a link because it wasn't the sort of thing that would make the news, but I know of one case. A Medic was fired after an IV line an EMT I started infiltrated and the Medic pushed meds through it, causing permenent damage. Even though the emt had started the line the medic was held responsible because they should have known the line was bad.

 

[EMS49393]

First your investment is no more important them mine, this is my career also. So the entire premise of that comment is condescending.

And since I keep hearing over and over how a incompetent lower level provider can somehow cost a medic their certification can anyone provde some evidence maybe a link where this has occured?

I never said my investment was more important than yours, however it is much more time consuming and expensive. 120 hours compared to 3000 hours of paramedic didactic and clinical hours? $400 plus books (unless you got yours for free at the local FD) versus over $8000? I'm only counting my science related courses and paramedic program. I didn't even count any of my humanities or English courses because I can apply them toward my current degree track as well. I have substantially more time and money invested in my career then I care to lose.

We have IV techs and EMT-I's in Maryland. I am ultimately responsible for their actions. If they do something that causes harm to a patient, MIEMSS is going to knock on my door and ask why I didn't stop them seeing as how I was the highest level provider. If they start an IV, I HAVE to check it before I use it. Several medications cause tissue necrosis. As was stated before, I could be liable for their mistake because I did not recognize and correct the mistake.

I can not use the phrase "um, well, you see, I didn't know" if I get questioned about patient care. It's my job to know any and everything that is being done to a patient because I am ultimately responsible for the outcome. Because I am responsible, I have to be able to intervene if someone is doing something incorrectly or something that would potentially harm a patient. If I idly stand by and let an EMT-I give a patient complaining of toe pain 10 mg of valium just because it's his first day and he wanted to see how the drug affected a person, I will be held accountable because I knowingly and willingly stood by and watched a lower level provider (or even another paramedic provider) deviate from the standard of care and potentially harm the patient.

This is the same reason I always check my ambulance personally. I will never "blame" an EMT for something not being on the truck when it was my responsibility to insure all the equipment was in place and operable.

 

[traumahawk]

I can't provide a link because it wasn't the sort of thing that would make the news, but I know of one case. A Medic was fired after an IV line an EMT I started infiltrated and the Medic pushed meds through it, causing permenent damage. Even though the emt had started the line the medic was held responsible because they should have known the line was bad.

Yes because they. Key word they should have known. So it is the medic fault to. But could a fellow medic made the same mistake? Yes. Nobody is perfect. Your post is arrogant.

 

[usafmedic45]

No it doesn't, nor should it. What happens on the truck can affect the patient's final outcome. If somebody screws up on scene or "in the truck" it needs to be appropriately documented so that it can be dealt with correctly.

The "blue wall" mentality is detrimental to the patient, and ultimately EMS is all about the patient. If your patient's final outcome is less of a concern to you than keeping your license or job, then maybe you should be looking at a different career option.

But I am curious as to how the statement "What happens on the truck, stays on the truck" enables the last statement in your post "Nobodys perfect, we all make mistakes, the only difference is how and if we learn from them". If you're keeping a mistake on the truck, how can you learn anything from it and how can anybody else?

Maybe I misunderstood your post, and if I did I apologize.

You're officially my favorite moderator now.

 

[CAOX3]

I never said my investment was more important than yours, however it is much more time consuming and expensive. 120 hours compared to 3000 hours of paramedic didactic and clinical hours? $400 plus books (unless you got yours for free at the local FD) versus over $8000? I'm only counting my science related courses and paramedic program. I didn't even count any of my humanities or English courses because I can apply them toward my current degree track as well. I have substantially more time and money invested in my career then I care to lose.

We have IV techs and EMT-I's in Maryland. I am ultimately responsible for their actions. If they do something that causes harm to a patient, MIEMSS is going to knock on my door and ask why I didn't stop them seeing as how I was the highest level provider. If they start an IV, I HAVE to check it before I use it. Several medications cause tissue necrosis. As was stated before, I could be liable for their mistake because I did not recognize and correct the mistake.

I can not use the phrase "um, well, you see, I didn't know" if I get questioned about patient care. It's my job to know any and everything that is being done to a patient because I am ultimately responsible for the outcome. Because I am responsible, I have to be able to intervene if someone is doing something incorrectly or something that would potentially harm a patient. If I idly stand by and let an EMT-I give a patient complaining of toe pain 10 mg of valium just because it's his first day and he wanted to see how the drug affected a person, I will be held accountable because I knowingly and willingly stood by and watched a lower level provider (or even another paramedic provider) deviate from the standard of care and potentially harm the patient.This is the same reason I always check my ambulance personally. I will never "blame" an EMT for something not being on the truck when it was my responsibility to insure all the equipment was in place and operable.

This is the key, if you didnt know how could you be held responsible and that was my whole point. We are all providers allowed to work autonomously, you being present shouldnt relieve me of my responsibility to act as a competent provider within my scope.

 

[usafmedic45]

This is the key, if you didnt know how could you be held responsible and that was my whole point. We are all providers allowed to work autonomously, you being present shouldnt relieve me of my responsibility to act as a competent provider within my scope.

No, but a reasonable person would still hold the person guilty for the act of omission as much as the other person guilty of comission. You have a professional and moral expectation to intervene and protect your patient if you know what is about to happen is going to likely be harmful to the patient.

 

[ffemt8978]

You're officially my favorite moderator now.

It only took 6 years for that to happen.

/threadjack

 

[usalsfyre]

I'm gonna go with an unpopular opinion here...

What I say goes, period. You as any other level of provider are certainly more than welcome to offer ideas and suggestions, which I will take under advisement. If it's good/appropriate we'll go with it. If not, don't get your feelings hurt. I'll be more than happy to explain my reasoning, but unless I'm about to kill someone, don't argue in front of the patient. If I AM about to kill someone, then by all means object loud, pround and often (I ran into that as the objector recently, thankfully my advice was listened to and it turned out ok). The only people who can ultimately trump me though are my med control physicians and sending physicians (and even the latter is pretty flexible).

Don't like how I do things, go to school and be a medic. I try not to be an ***, but some providers have a VASTLY overestimated view of where they fit in the system. Paramedics included, so it's not just a bag on basics, but there seem to be more "I save lives" basics than medics. These are the people I have found get upset when I don't recognize their brilliance.

 

[CAOX3]

Don't like how I do things, go to school and be a medic. I try not to be an ***, but some providers have a VASTLY overestimated view of where they fit in the system. Paramedics included, so it's not just a bag on basics, but there seem to be more "I save lives" basics than medics. These are the people I have found get upset when I don't recognize their brilliance.

You dont say.. I also think anyone who has spent any time isn this field recognises if a life is saved it will take a team of players not just the lead off hitters.

 

[traumahawk]

I'm gonna go with an unpopular opinion here...

What I say goes, period. You as any other level of provider are certainly more than welcome to offer ideas and suggestions, which I will take under advisement. If it's good/appropriate we'll go with it. If not, don't get your feelings hurt. I'll be more than happy to explain my reasoning, but unless I'm about to kill someone, don't argue in front of the patient. If I AM about to kill someone, then by all means object loud, pround and often (I ran into that as the objector recently, thankfully my advice was listened to and it turned out ok). The only people who can ultimately trump me though are my med control physicians and sending physicians (and even the latter is pretty flexible).

Don't like how I do things, go to school and be a medic. I try not to be an ***, but some providers have a VASTLY overestimated view of where they fit in the system. Paramedics included, so it's not just a bag on basics, but there seem to be more "I save lives" basics than medics. These are the people I have found get upset when I don't recognize their brilliance.

What u say does go. U r the higher medical authority. But that is the attitude that make this rivalry. And yes I am in medic school and I have a minor in nursing. But I don't like medics who walk in push me aside. Its not about PT care, its about the medic god complex.