medics with attitudes

[Trip]

I'm out. Think what you will. The issue was Paragod syndrome, not ALS vs BLS.

Sorry, didn't mean ALS vs BLS, meant "The issue was Paragod syndrome, not when should BLS call for a CC or Paramedic."

And NY volunteers don't need CPR/AED cert to drive as long as one person that is with the pt is certified, ie an EMT-D or higher.

 

[Madmedic780]

Luckily with my dept, theres only one paramedic that I routinely work with that has the P-Patch Pathology. He's fairly new to EMS, (Went from basic to Paramedic school in under a year) so I deal with it. The hilarious part is the other medics who won't hesitate to rip him a new one if they see him ragging on our Basics and FRs.

But as it was pointed out, in a P/B team the paramedic is ultimately responsible for the care rendered by us, it will be their clinical judgement that is examined in court. The best thing to do IMHO is to talk to the medic and try to establish a mutual agreement about what they expect and how you want to treat each other. Some of the best crews and teams I've seen act like a old married couple.

 

[kbrodie694]

seems like those people are the ones who always make mistakes and don't learn from them so you try and teach them to step back and listen to others around them, sometimes it is a matter of letting them get chewed on by the chief after a screw up!

 

[46Young]

I didn't read much of this thread, but I felt the need to point out that such saying as "BLS before ALS" and "EMT's save medics" make no sense. The medic's title is EMT-P. We know how to do BLS; it was required to learn BLS before we moved up to medic. My medic partner can do all the BLS that an EMT can, in addition to the ALS assessment and skills. In the NYC 911 system, it's often just the two medics on the scene by themselves. No one's saving them, and the BLS gets done before we drop a lock and push meds. What's the issue? EMT's are useful, they have their place, but their scope is limited. It doesn't give the medic the right to s*** on them, but the EMT needs to know their boundaries. In many medic/EMT txp systems, the EMT is basically performing tasks for the medic. It's not to belittle the EMT, but they lack the education and skills to have much of a say in pt care, unless the medic is weak and is neglect in performing a basic diagnostic or intervention before moving on.

It's like when you test for your medical or trauma scenario - you have a few partners, be they imaginary or real for the evaluation. You're ordering vitals, C-spine, bleeding control, assisted vents, a NRB, etc. That's kind of how the medic runs the scene. They need various tasks and assessments completed, not someone of a lower cert level offering opinions as to the pt's treatment course. When managing the scene, that doesn't give the medic the right to belittle the EMT's, however. If you run your scenes like that, you'll lose confidence from your crew (or other responders), you'll lose respect, and they'll look to help you as little as possible, and maybe even try to jam you up.

Edit: At the EMT-P level, I don't really see pt care as "BLS" or "ALS." There's no division. It's all pt care. Some assessments and interventions are always going to come before others. I only use "ALS" to define the point where the EMT-B's scope and abilities end.

 

[Jon]

As has been said - the issue is Paragods and EMT-Heros.

I'm a paramedic. I went to school for it. I passed my tests. I maintain my merit badge certs, pursue con-Ed, maintain medical command status with multiple services, and try to keep learning.

Just because I don't do things exactly the same as another medic doesn't mean I'm not a good medic. And *****ing and belittling me behind my back because you don't understand the whole picture - that's not teamwork. If I say I want a 12/15 lead - I've got reason for it. Yup. I know the patient isn't having chest pain.

It goes the other way too. I still volunteer on a BLS truck. When I get a Paragod as my ALS provider, it's frustrating.

 

[Veneficus]

I would just like to share an anecdote that happened the otherday that I think ties into this.

We started our day with grand rounds as usual. One of my classmates noticed a crucifix in the ward.

Next we went to the out pt clinic where again we saw a crucifix on the wall.

Another in the hall and 2 in the ICU.

But it was then noticed there was not one in the operating theatre. To which it was remarked in jest that in C/T surg, God stands at the table, not on the wall.

Now on to the OP.

In medicine, the earlier and more simple one's education, the more absolute things are presented. Providers are trained there is only one right thing to do and only one proper way to do it.

It is presented that way to dissuade people from taking shortcuts that may be harmful or defeat the original purpose.

I am not interested in the quality of education except to say they is a very disproportionate difference between EMT and medic material. Not respecting that difference is where the problems come from the EMT end. They only see skills, they cannot see thought process, so they are usually oblivious to it. Eventually they see the skills so often they believe they could do it themselves. Their criticism is from their perspective of absolute right and wrong, what and how things "should be done."

From the medic perspective, it is important to continue the education of the EMTs and always remember to take an active role in that by explaining the thought process as soon and as often as practically possible. Empty criticism does get very old no matter what your title or role.

If you notice, a vast majority of providers of all titles are eager to learn why as well as teach their perspective. It is only with this collaboration that the art of patient care is advanced.

It took me a few years to figure out that all healthcare providers are teachers by default. No matter what your position, talk before you criticize.

 

[RiverpirateEMT]

Luckly Ive never had to run with a paramedic with an attitude. Although I do know a few. Best way for a EMT-B to deal with them? Ignore them. If they have the attitude that a EMT-B is just a ambulance driver then be just a ambulance driver to them. I have no problem going to work and just driving. Im not paid much to begin with , lol. A medic that wants my help will show respect to get my help, otherwise he can bring it up to the supervisor and let the supervisor deal with it. A paramedic that complains about multiple EMT-B's not wanting to help him/her obviously shows who is the problem.
I know my limit when it comes to knowledge ( I am in nursing school right now ) but as with any job, it takes respect to get respect. The medics I run with are all great. They are willing to teach and willing to answer questions, they also are willing to step back and let me do my job sometimes because they know without EMT-B's their job is much harder.

 

[reaper]

Luckly Ive never had to run with a paramedic with an attitude. Although I do know a few. Best way for a EMT-B to deal with them? Ignore them. If they have the attitude that a EMT-B is just a ambulance driver then be just a ambulance driver to them. I have no problem going to work and just driving. Im not paid much to begin with , lol. A medic that wants my help will show respect to get my help, otherwise he can bring it up to the supervisor and let the supervisor deal with it. A paramedic that complains about multiple EMT-B's not wanting to help him/her obviously shows who is the problem.
I know my limit when it comes to knowledge ( I am in nursing school right now ) but as with any job, it takes respect to get respect. The medics I run with are all great. They are willing to teach and willing to answer questions, they also are willing to step back and let me do my job sometimes because they know without EMT-B's their job is much harder.

Well you had a great post, right up until the last sentence!

 

[RiverpirateEMT]

Well you had a great post, right up until the last sentence!

In all truthfullness Medics need EMT-B's. Who does their grunt work? Who drives them ? Who gets them the things they need? Who does the lifting for them? Who carries all their bags? A medic can not do it on their own period. They either need an EMT or a Fire fighter. My job is to make their job easier. Sometimes a medic just needs to step back and let us EMT-B's do our job. Get the patient in the rig , get them set up for the medic and let us get them to the hospital. Face it a medic can not do it alone no matter how much some ( and I mean some not all ) think they can.
I dont claim to know a 10th of what a medic does , but I know what I need to do serve my patient and that is to get them to the hospital no matter what.

 

[46Young]

Luckly Ive never had to run with a paramedic with an attitude. Although I do know a few. Best way for a EMT-B to deal with them? Ignore them. If they have the attitude that a EMT-B is just a ambulance driver then be just a ambulance driver to them. I have no problem going to work and just driving. Im not paid much to begin with , lol. A medic that wants my help will show respect to get my help, otherwise he can bring it up to the supervisor and let the supervisor deal with it. A paramedic that complains about multiple EMT-B's not wanting to help him/her obviously shows who is the problem.
I know my limit when it comes to knowledge ( I am in nursing school right now ) but as with any job, it takes respect to get respect. The medics I run with are all great. They are willing to teach and willing to answer questions, they also are willing to step back and let me do my job sometimes because they know without EMT-B's their job is much harder.

Well said! "It takes respect to get respect." Like I said, as a crew leader, you have to gain the confidence of your crew. Respect comes with that. If you're a d-bag, your crew will just underperform, or even look to sabotage you. If you forget to order the BLS to resume compressions after a pulse check or shock, they'll just sit there. They may apply a mask, and "forget" to turn on the O2. They may hand you the wrong med. They may stand around and do nothing unless you explain in detail what they should do. A good crew will start getting your vitals, hook up the monitor, opening then O2 and asking how you want to give it, they may already be getting the stair chair, without you having to say anything. If you treat them badly, they'll just stand around with their hands in their pockets. The station's a very lonely place if everyone ignores you.

Edit: Yes, medics ahould teach EMT's whenever possible. If I'm asked a question on the scene, I tell them that we're busy now, but I'd be happy to explain everything after we drop the pt off. We hold regular drills at the station and try and up the EMT's knowledge with every session.

 

[reaper]

In all truthfullness Medics need EMT-B's. Who does their grunt work? Who drives them ? Who gets them the things they need? Who does the lifting for them? Who carries all their bags? A medic can not do it on their own period. They either need an EMT or a Fire fighter. My job is to make their job easier. Sometimes a medic just needs to step back and let us EMT-B's do our job. Get the patient in the rig , get them set up for the medic and let us get them to the hospital. Face it a medic can not do it alone no matter how much some ( and I mean some not all ) think they can.
I dont claim to know a 10th of what a medic does , but I know what I need to do serve my patient and that is to get them to the hospital no matter what.

Well, this is the thinking that gets you in trouble. I carry my own equipment. Double medic trucks work just fine. I work a QRV. I am by myself on scene for long periods of time, all alone. I do just fine by myself.

A good EMT is nice to have as a partner and we should always respect them as a partner. But, when you think that EMS cannot work without you, then you get in trouble. Do the job, hold mutual respect for each other and learn all you can. That is what will make you stand out above the rest!

 

[46Young]

In all truthfullness Medics need EMT-B's. Who does their grunt work? Who drives them ? Who gets them the things they need? Who does the lifting for them? Who carries all their bags? A medic can not do it on their own period. They either need an EMT or a Fire fighter. My job is to make their job easier. Sometimes a medic just needs to step back and let us EMT-B's do our job. Get the patient in the rig , get them set up for the medic and let us get them to the hospital. Face it a medic can not do it alone no matter how much some ( and I mean some not all ) think they can.
I dont claim to know a 10th of what a medic does , but I know what I need to do serve my patient and that is to get them to the hospital no matter what.

Every medic needs a partner. In NYC it was another medic. In Charleston SC it was an EMT. Where I am now, it's usually another medic and 3-4 BLS. Unless the pt is crashing, the one medic will talk with the family, the other medic will get L/S and ask questions, and the BLS pretty much know what to do otherwise. For most pts, they'll ask if I want O2 and how, when and how to move them, and that's about it. I don't have to manage them otherwise. They introduce themselves appropriately, explain what we're doing and what to expect, get vitals, BGL if appropriate, monitor, proper positioning, and generally make them as comfortable as possible and try to put them at ease. In the bus, they're hooking the pt back up to the monior, pulse ox, ETCO2, BP cuff, O2, asking if I want a bag spiked, or maybe preparing my IV materials and a chuck pad for under the arm in case I blow the tamponade. My job is eay thanks to the BLS crew that I have.

 

[RiverpirateEMT]

Well, this is the thinking that gets you in trouble. I carry my own equipment. Double medic trucks work just fine. I work a QRV. I am by myself on scene for long periods of time, all alone. I do just fine by myself.

A good EMT is nice to have as a partner and we should always respect them as a partner. But, when you think that EMS cannot work without you, then you get in trouble. Do the job, hold mutual respect for each other and learn all you can. That is what will make you stand out above the rest!

Doesnt happen like that in my state. Your either a MICU or in a chase truck by yourself. Our medics carry two heavy bags plus a monitor. They "can" carry it by themselves but not likely to. Again Id like to see a medic load a 300lb person in the back of a ambulance by themself.
Just remember no one person is any better than another. One may be better learned , but that does not make them a better person.

 

[johnmedic]

It seems to me that the Medics are saying two medics on a team are better than a medic and an emt. Meanwhile the Basics's are saying a medic and an emt is better than just a medic.

Both are correct.

Are we done now?

 

[JPINFV]

In all truthfullness Medics need EMT-B's. Who does their grunt work? Who drives them ? Who gets them the things they need? Who does the lifting for them? Who carries all their bags? A medic can not do it on their own period. They either need an EMT or a Fire fighter.

...or, they could be partnered with another medic...

 

[usalsfyre]

It seems to me that the Medics are saying two medics on a team are better than a medic and an emt. Meanwhile the Basics's are saying a medic and an emt is better than just a medic.

Both are correct.

Are we done now?

Two well rounded medics where one is the clear lead probably makes the most effective crew configuration.

Barring that, a well rounded medic and an EMT is probably a better combination than two "parathinktheyares" (thanks Brown) where no one is in charge.

 

[EMS49393]

In all truthfullness Medics need EMT-B's. Who does their grunt work? Who drives them ? Who gets them the things they need? Who does the lifting for them? Who carries all their bags? A medic can not do it on their own period. They either need an EMT or a Fire fighter. My job is to make their job easier. Sometimes a medic just needs to step back and let us EMT-B's do our job. Get the patient in the rig , get them set up for the medic and let us get them to the hospital. Face it a medic can not do it alone no matter how much some ( and I mean some not all ) think they can.
I dont claim to know a 10th of what a medic does , but I know what I need to do serve my patient and that is to get them to the hospital no matter what.

Wow! Apparently paramedics are not the only ones with bad attitudes. You might want to check yours at the door.

 

[Shishkabob]

Again Id like to see a medic load a 300lb person in the back of a ambulance by themself.

I can, have, and do.

In all truthfullness Medics need EMT-B's. Who does their grunt work? Who drives them ? Who gets them the things they need? Who does the lifting for them? Who carries all their bags? A medic can not do it on their own period.

I carry my own bag. I carry my own monitor. I clean up my own mess in the ambulance.


When I first work with an EMT, I tell them they have their own certification and that they can do any and everything that their protocols allow without worrying about asking me... though I make the exception about giving drugs for the fact that it might change what I do.

Sometimes a medic just needs to step back and let us EMT-B's do our job. Get the patient in the rig , get them set up for the medic and let us get them to the hospital.

What if the patient doesn't need to go to the rig, get set up, or go to the hospital? What's the EMTs job then, in your eyes?

 

[CAOX3]

How about putting attitudes and ego aside and working together towards the ultimate goal?

I have an eighteen-month old, if you choose to act like her you will be treated accordingly, I dont care what level you are.

Attitude and egos have nothing to do with certificatin level, its a personality flaw, respect is earned and goes both ways.

 

[usalsfyre]

It's entirely possible for me to take care of a patient that requires advanced care (with in the realms of EMS, none of the care we provide is really advanced in the grander scheme) by myself with the exception of lifting help. I've done it with some of the more booger-eating partners I've had. That said, it's massively easier to do my job with a strong partner I don't have to worry about. This is the reason I try like hell to take care of my current partner.

Taking care of a patient that requires advanced care is not something a Basic can do by themselves. THAT said, I know of basics that have to hold their medics hand to ensure the proper care gets done. Neither one is anything close to ideal.

Both sides usually have something to offer. However, as I mentioned earlier, at the end of the day I answer for what goes on. So if I correct a basic, it's not because I think they're stupid, it's because I have to answer for it (not to mention I've probably got a reason for doing it the way I do, based on problems in the past). Both sides should approach the issue with mutual respect in mind as it will make the day go much smoother. However, the medic is the defacto supervisor.

Another example would be although a physician may not appear in a nurses organizational chart, at the end of the day the physician is responsible. Doesn't mean the nurse is dumb, can't operate independently based on orders, or has no insights to patient care. Just means there's someone in charge. Just like medics, some physicians are bigger jack@sses than others. It's worked well for the rest of medicine for a long time, why not here?