Going PB

[SliceOfLife]

So as a new medic I have been working medic/medic for my company and now I will be starting a medic/basic shift. My question is how do you divide work? I have heard of stories where a medic will make the basic do all the basic calls. I get the mentality that they can't do ALS calls so It's only fair, however our company does far more basic runs than ALS. I want to be fair and equatable but I also don't want to get taken advantage of because I'm to nice.

So how do you work it out on your P/B truck?

 

[Hunter]

So as a new medic I have been working medic/medic for my company and now I will be starting a medic/basic shift. My question is how do you divide work? I have heard of stories where a medic will make the basic do all the basic calls. I get the mentality that they can't do ALS calls so It's only fair, however our company does far more basic runs than ALS. I want to be fair and equatable but I also don't want to get taken advantage of because I'm to nice.

So how do you work it out on your P/B truck?

Basic runs the first call if it's BLS then you go 1 each. If you happen to get 2 ALS calls back to back then thr basic does next 2 BLS so that you each run as close to the same amount of calls each shift.

 

[Handsome Robb]

We run I/P not B/P but there's still a division. Generally most partners have the I run all the ILS/BLS calls and the medic runs the ALS calls. Sometimes the workload sucks for one person but that's the name of the game. I've had shifts where I write 8-10 charts and my partner writes none and visa versa. It generally tends to work itself out over time. With that said some medics will step in and take calls from the I if they are starting to get behind with charts but not all medics will do it. It's person dependent and I wish sometimes I could help my medic but I can't. You might be able to pull it off sometimes with good documentation but it's not worth getting in trouble over.

 

[medicdan]

So as a new medic I have been working medic/medic for my company and now I will be starting a medic/basic shift. My question is how do you divide work? I have heard of stories where a medic will make the basic do all the basic calls. I get the mentality that they can't do ALS calls so It's only fair, however our company does far more basic runs than ALS. I want to be fair and equatable but I also don't want to get taken advantage of because I'm to nice.

So how do you work it out on your P/B truck?

That's likely something best to work out with each individual partner, at the start of the shift, or long term partnership. You'll learn eachother's peeves, preferences and policies, and work from there.

As a fairly new medic do you feel comfortable working PB?

 

[abckidsmom]

Most of the basics in my system are firefighters. They are sometimes EMS-averse, and knowing such, I do almost all the calls except for the extreme frequent fliers and the hangnails.

Here's my theory: almost everyone who gets in the ambulance for an hour long transport is in pain, having difficulty breathing, or is nauseous. That's my job. I can do something for that, or they need to be monitored, whatever.

 

[Jon]

A great EMS blogger addressed this a while back. (I'm mobile, so I'm not going to find it and link it - it was Peter Canning). I follow his lead.

My partner gets to be "down" 2 to me. Then I start taking BLS calls, usually. Then again, I also have days where I'd rather tech than drive, so I'll take that option.

It also doesn't hurt to pick up recall/cancelled charts if you're already writing charts - half the time is logging in.

 

[Christopher]

So as a new medic I have been working medic/medic for my company and now I will be starting a medic/basic shift. My question is how do you divide work? I have heard of stories where a medic will make the basic do all the basic calls. I get the mentality that they can't do ALS calls so It's only fair, however our company does far more basic runs than ALS. I want to be fair and equatable but I also don't want to get taken advantage of because I'm to nice.

So how do you work it out on your P/B truck?

This is how I'm used to run, but it's even more lopsided as we run P/B plus a newbie/student.

My strategy is every patient needs an EMT-Basic and only a handful need a Paramedic. So initially their role on the call is to ensure everything with a B next to it in the book is handled, such as vitals, packaging, etc. If they're an intermediate, I'll expect they jump on starting a line too. I'll be directing them for the most part in order to build a desired workflow. At this stage I'm going to be handling most patients but they'll be expected to halve the paperwork.

Eventually they'll be experienced enough to be a near-medic-level provider in terms of their flow on a call. Their minds won't be concerned with acquiring a BP or how to package a patient because it'll be second nature. They'll start taking every other call, because 100% of EMS requires an EMT-Basic. On the worse patients I'll still run the show, but they'll be expected to automatically provide a high quality of BLS care autonomously.

I do like the 2-call policy of not letting your partner get too far behind, but usually I find this occurs because either the Paramedic or the Basic are not comfortable enough in their role.

 

[johnrsemt]

I was never afraid/too paragod to do BLS runs; so with most partners I had the basic do the 1st BLS run, then we would switch them.
I had days I didn't want to drive and I would tech everything.

I had Basic partners that insisted on doing the 1st 2 BLS runs; and for a year with 1 Basic partner she refused to ALLOW me to do BLS runs; except when I was too tired to drive safely.


When I was still a basic I had a medic partner that refused to do BLS runs. Weird 6 months, but I learned alot of how to be a EMT-B.

 

[Epi-do]

I will let my B partner do the first 2 or 3 BLS runs, and then I will offer to alternate with them. My old partner would always refuse, and take everything BLS, with the exception of babies. He just didn't like those runs. However, I can't stand mental/emotional runs, so the trade off was that he knew I would never offer to take one of those.

I just got a new partner, so we are working out the details of how things are going to go, long term. So far, we have mostly had BLS stuff, and he has taken everything. Just like my previous partner, he feels that there are plenty of days where everything is ALS, and he can't tech anything, so he doesn't mind the days we get hammered with BLS stuff. Like someone else already said, it all evens out over time.

We both check out the truck every shift, and whoever did the driving to the ED is the one that restocks the truck when we get back to station, if it is a run-of-the-mill type run. That's because the tech still has additional computer reports that have to be done on the station computer. If it's a big run where lots of stuff has been used, everyone helps restock.

We also take turns driving. One shift, I will do all the driving, with the exception of ALS transports. The next shift, my partner will do all the driving, with the exception of BLS transports.

 

[Ewok Jerky]

If we get all ALS calls, I cannot take any of them...so I think its only fair that if we get all BLS calls that I tech them all. Unless my partner insists, or doesn't want to drive or whatever, I will tech all BLS calls.

 

[NomadicMedic]

When I worked P/B, my partner took all of the BLS. He said, "I can't take yours, why would you take mine?" We both knew the pendulum would swing back and forth. Somedays we would be mostly ALS calls while other days would bring mostly BLS.

I thought it was a fair way to do it.

However, we split refusals.

 

[jemt]

I know its a little off topic but do any other states besides NJ run a two tier system? IE: BLS and ALS are always seperate?

 

[NomadicMedic]

I know its a little off topic but do any other states besides NJ run a two tier system? IE: BLS and ALS are always seperate?

Delaware. ALS chase trucks are third service county based. BLS ambulance is fire.

 

[TyBigz]

In my company every call is ran ALS unless downgraded by the Intermediate or Medic. My company is currently at the Intermediate level moving to medic. Its a very rare occurrence that a call is downgraded but it does happen. My company looks as it as if something goes wrong the ALS tech is more likely to help than the BLS. I have been downgraded 1 call from ALS to BLS. Keep in mind tho that this is for 911 calls. On the transfer crew as long as ALS isn't requested we alternate.