Ratting on your employer...

[RanchoEMT]

BACKGROUND: My company has been out of Procainamide(1 Month), Zofran(1month), Mag Sulfate(8 months) Nitro Spray(2 months). All are part of our protocols and all we are without. No "Supplier Shortages" have been reported, and surrounding services(ALS Fire Dept's, Hospitals) are still with ample supply of these drugs. I will mention, it is very common for my company to be "Out" of something for upwards of a week. Tournaquetts for example(last week)...
When asked, supervisors/managers say nothing with regard to why there are no drugs and we are told to make due with what we have... It should be noted here that it is regular for this type of no explanations "just keep working" attitude to take place as my company is very "stand-off-ish". If we refuse to go into service without the drugs we are supposed to have but were not provided with, we get a write-up.

My company is very well known for spending the minimum possible to achieve functionality. Stations are dissapearing(a previously bought out company had set in place prior), shifts are sometimes "browned-out" and crews who show up to work are sent home without pay. Ambulances are ran into the ground, AC systems dont work, etc etc. Is it as common for any of your coverage systems(unit levels) to be as badly managed as to have only 1 or 2 ambulances present at a given time??? It is very common to be "level 1" as we call it. Take into account we cover Montclair, ca to Yucaipa, ca(excluding Rialto city). Take even further into account that my company division is the highest grossing of all the company's southern california divisions. ( we have money)

A union was recently voted in, but No contract has yet been agreed upon so no help on that front..

QUESTION: Is there a "Higher-Up" so to speak, that my company can be reported to? I find it morally irresponsible and ethically inexcusable to provide such shotty-911 services to communities we been contracted to properlly service. Wether or not one must bite the hand that feeds....

Thank You Pre-Empt and sorry for any errors as I am txting from a phone...

 

[bstone]

Laws get passed when people don't naturally do the right thing. There may be laws (or regulations) that your state has but your service isn't adhering to. You might want to place an anonymous call (or letter) with the details you described to your state's EMS office.

 

[Aprz]

He works in California so it would be your county EMS agency. You could probably easily contact them by e-mail.

 

[Aidey]

Just FYI there are confirmed shortages of Zofran, Mag Sulfate, and procainamide, along with about 200 other drugs. The zofran shortage is especially bad, with some hospitals running out. My employer along with the local FDs are currently completley out of zofran, ativan, and etomidate. Our supplies of fentanyl and Mag sulfate are limited.

 

[usalsfyre]

Rancho, to be blunt your living in puppy dog and unicorn land. I haven't been able to get a multitude of drugs for months and am being forced to make treatment decisions based of logistics more than patient presentation. "Brownouts" or being "low censused" off is very common in healthcare. Stations are uncommon in systems who work 12 hour shifts (not saying it's right) and I've been in as many ambulances with 250k+ on the clock than without (although A/C for the patient compartment is usually mandated). Every system I've ever been in has dropped to level 2 daily, and level one a couple of times a week, even the FDs.

I'm not sure what you expected healthcare to be, but you seem monumentally unsatisfied with what you've found. I suggest rather than reporting what is basically normal, you ask yourself how to rectify your view of what should be with what the actual norm is.

 

[RocketMedic]

Same here as usalsfyre. At my hospital-based system, we often ration our short drugs by distance. Zofram, morphine, fentanyl are short.

We've got loads of thiamine...yey?

Should your care ever come under fire due to a shortage, my personal advice is to busthrow the company. As a paramedic working with shortages, if my truck ever drops below the authorized minimum, I note it and notify the on duty supervisor with signature from him. Its not bulletproof, but I'd rather they be on the hook than me should Johnny Cochran sue.

 

[Sandog]

Let me ask you this, you rat out your employer, will you still have a job?

 

[mycrofft]

Anonymous but detailed US mail letter to your local EMSA. Decide if you will try to keep your job. I'd get working on another one.

 

[usalsfyre]

With the exception of the A/C in the trucks and excepting local contract requirements I have still yet to see a legit reportable issue.

 

[Aidey]

With the exception of the A/C in the trucks and excepting local contract requirements I have still yet to see a legit reportable issue.

I agree. People getting sent home due to brown outs or low census happen at my agency and at the local hospitals. The hospitals also float staff between departments. So if things are super slow in the ED they might send a few ED nurses upstairs to floors that are really busy or vice versa.

 

[RanchoEMT]

With the exception of the A/C in the trucks and excepting local contract requirements I have still yet to see a legit reportable issue.

Forget the AC, the discussion here is how to take corrective action to an employer who is insufficient at the job it (the company) has been contracted to perform. Within my County Protocols are minimum requirements for an ALS rig to be in service. My company does not meet these requirements and should be fined or disbannded as a 911 service all together. If I went to a call In-Service and didn't stock up Nitro, ASA, or whatever drug the patient required would I be discaplined? Would I be fired? Was there loss of life? Did I not do what I said I would do and perform my full duties and treatments? Did I continue on throughout the day as if I had? Omission anyone?

I dont know where you have been educated, employed or where you provide service but you present a subservient attitude and ethical permissiveness I do not wish to aquire. Call it my unicorn-esc personal attitude towards patient care but I would not want you nor your below minimum ambulance providing service to my family. Im not interested in your submissive subpar make-do attitude. So unless you have thoughts on how to Change what is wrong I don't wish to further entertain discussion with you on why you feel not enough is enough. Good Day.

With regard to finding another job, It won't take too long to find another minimum wage job...

 

[usalsfyre]

So you want to disband anyone who can't get medications that there's a well documented shortage of? That HOSPITALS (much larger purchasers of meds than EMS and preferentially supplied to) can't get? You'd be disbanding an unholy amount of ambulances....

I'm involved in setting stock levels at my service. I've sat in regional and state level meetings about drug shortages. One 70+ ambulance 911 service for a city of >1mil can't find morphine, fentanyl or Ativan right now. Anesthesia departments don't have opiates for surgeries. It may seem to the ED they have plenty of meds, I'll bet if you talk to the pharmacy it's a different story.

If you go to an EMS authority with these complaints you'll likely be laughed out of the office, and out of a job to boot. It would behoove you to start living in the real world vs what is "right and moral" in your own head.

 

[ShannahQuilts]

OK, I looked at the list Aidey posted, and it's extensive, and very scary, frankly. I don't understand why so many drug makers are having problems all of a sudden. Does anyone know what started this lack of production? The notations about having to calibrate their equipment I can understand, but a lot of the entries seem to be giving no real reason for why they can't distribute enough medication.

 

[usalsfyre]

OK, I looked at the list Aidey posted, and it's extensive, and very scary, frankly. I don't understand why so many drug makers are having problems all of a sudden. Does anyone know what started this lack of production? The notations about having to calibrate their equipment I can understand, but a lot of the entries seem to be giving no real reason for why they can't distribute enough medication.

If you'll notice they're mostly injectable generics, there's a (very plausible) theory that manufacturers are purposely holding production on low margin products to drive demand and therefore prices.

 

[DesertMedic66]

You would to call or send an E-mail to ICEMA (the San bernardino county EMS agency).

However I doubt that will do anything. Drug shortages are extensive right now. You have to make due with what drug you do have. With the company you are talking about I doubt anything will change/happen due to the size of the company.

 

[Aidey]

In some cases only a couple of companies make the medication. If one company shuts down production due to financial or quality issues it doesn't take long for the other companies to run short. Increased demand is frequently cited on that list.

 

[RanchoEMT]

Just spoke to fire, they are stocked. Just asked er charge nurse at 2 ED's, they're stocked... Just phoned a friend at a 'same company different division' they are with drugs....

Anywho...

 

[exodus]

If he wants to stay 911 he has to stay at his company, he can't go anywhere else. Are you a medic or EMT?

 

[usalsfyre]

Just spoke to fire, they are stocked. Just asked er charge nurse at 2 ED's, they're stocked... Just phoned a friend at a 'same company different division' they are with drugs....

Anywho...

Don't ask the end user, ask the supply source. All the end user will know about is what's in their box, not how much is available.

I promise it's not as simple as you want to make it. Certain employees have accused my company of being to cheap to order drugs. I on the other hand, have listened to the supply manager literally beg our suppliers and heard our medical director state he can't get meds to treat patients in the ED.

But ya know, if it doesn't fit your own morals, than it must not be true...

 

[JakeEMTP]

You don't have much of a case. The drug suppliers have published the shortages in headlines everywhere including the EMS news sources.

FDs aren't going to release information unless it is through their PIOs and then only what is necessary. Who ever you talked to may not know how much supply is left or how much was bought up before. Nurses working in isolated areas of the hospital like the ER are not going to know what the PHarmacist in charge of purchasing is doing to cover one area and short another. This information is not going to be given to just anyone on the telephone.