Standard of Care Advice for Paramedic

Paramedic150

Paramedic150

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Ok here is the situation. I am a paramedic at a private ambulance company. The frequently take EMT-I's and EMT-P's and place them on BLS rigs with no ALS equipment or even place them in Wheelchair trucks. I know this isn't suppose to be but when I tell supervisor they blow it off. The standard of care for the state of Ohio states you must provide service at your certification level. I know this can get into all kinds of legal issues but what I am really looking for is concrete evidence that I can print out in black and white to show that this is illegal. Thanks for all the help in advance and this is all takes place it the state of Ohio.
 
I know this isn't suppose to be but when I tell supervisor they blow it off.
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Really? Ever thought the reason for that is because you're mistaken?

The standard of care for the state of Ohio states you must provide service at your certification level.
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Usually, it's you can't go above your certification level but you can work down. If it worked the way you think it did, theoretically every patient a medic touched would have to be given an IV, blood sugar, etc. It would also hinder ALS providers from volunteering at a BLS service which is something no state discourages actively.

I know this can get into all kinds of legal issues but what I am really looking for is concrete evidence that I can print out in black and white to show that this is illegal.
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You need to review the difference between the words 'know', 'believe', 'think' and the phrase 'I was told'. That's going to be much more productive for you than looking for some mystical piece of regulation that likely does not exist.
 
So its perfectly ok for a paramedic serve on a BLS ambulance without ALS equipment? Ok so say pt codes in back of ambulance then you as a paramedic do not have ALS equipment to provide what you have been trained to do. Pretty sure that is negligence. You are not providing the appropriate level of care which you are trained to do and are being paid to do. As far as every pt getting an IV meds whatever that's not the point. As a paramedic you evaluate the pt and provide appropriate treatment. If you don't have the appropriate equipment to provide the treatment then what?
 
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So its perfectly ok for a paramedic serve on a BLS ambulance without ALS equipment? Ok so say pt codes in back of ambulance then you as a paramedic do not have ALS equipment to provide what you have been trained to do. Pretty sure that is negligence. You are not providing the appropriate level of care which you are trained to do and are being paid to do.
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Because they are working as an EMT and not as a medic in that setting. It's just like how I can do a lot of things as a respiratory therapist that you can't do as a medic but if I go out and work as an EMS provider- at whatever level- my status as a respiratory therapist is completely secondary since I am not functioning as such. The standard of care depends on the level at which you are being paid to function not on what your card says. If you're an ALS provider at one service and a BLS provider at the other, there's nothing that says the BLS provider has to start running an ALS truck just because they have someone whose day job is providing the broader scope of care. If you need to me to slow down and use smaller words for you so you can grasp this, let me know because I'm more than willing to do so.
 
Same company same rate of pay just one day they can say ok today you are a medic but tomorrow you will be a basic? No change in status no change in pay just because the company you work for decided for you that you have to be a basic that day.
(A) A person issued a certificate to practice shall provide professional services that conform to minimal standards of care for the person’s certification level under similar circumstances.
Straight from Ohio Revised Code 4765-0-01
If i am functioning as a Basic EMT that is not to the minimal standards of care for my certification level.\
Plus and RT is only reconized in Ohio anyway on a critcal care level of transport such as AIR or MICU. There is a scope of practice for medics statewide for ALS ambulance services
 
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If the units they're working on are not designated as ALS units then there is no legal precedent that they are violating to the best of my knowledge. Like USAF said, they are only required to operate in the capacity that they are being paid or assigned to operate in.

Let me ask you this. Since my medical director rides with us on occasion and doesn't have all of the equipment he is trained to use, is that illegal? If we have someone with a hemothorax and he doesn't have a chest tube available, is he breaking the law? No, because our units are only designated as paramedic units.

We have plenty of paramedics or intermediates that will pick up an extra shift on the wheelchair van, but when they do that they are operating strictly as a BLS provider.


Sent from my iPhone using Tapatalk
 
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Is it legal for a Paramedic to work as an EMT and be held to the EMT level of protocols? Yes.



Do I and most Paramedics sign up for EMT shifts to get held to that level and be put in that situation? No.
 
You notice that little line about "in similar circumstances?"

That's something that's important.
 
Same company same rate of pay just one day they can say ok today you are a medic but tomorrow you will be a basic? No change in status no change in pay just because the company you work for decided for you that you have to be a basic that day.
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So you're actually complaining about being paid as a medic but asked to do less work on less complicated patients? You're not going to get much sympathy on here I don't think.

(A) A person issued a certificate to practice shall provide professional services that conform to minimal standards of care for the person’s certification level under similar circumstances.
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OK....you see the modifier at the end of that sentence? I even italicized it (you know, letters that aren't standing up straight) to make it easy to identify. Being assigned to a BLS truck is not "similar circumstances" to being assigned to an ALS truck. So is it a problem with recognizing dissimilar situations, the use of words with more than three syllables or just non-linear thinking thinking which gives you problems and sends you into a self-righteous foaming at the mouth fit of indignation?

If i am functioning as a Basic EMT that is not to the minimal standards of care for my certification level.
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Go google "circular reasoning" and then come back and we will talk.
 
I understand what both of you are saying and honestly didn't know that it is legal for me to receive the same amount of pay to be a medic one day and work on a wheelchair van the next. My company has ALS and BLS trucks so even though my certification level is Paramedic and there is a statewide protocol for paramedics in a pre-hospital setting I can function as a basic and receive the same pay.
 
From what I can tell, this thread boils down to 150's lack of understanding of a hierarchical job structure.
Let's say that, hypothetically, you're a level 4 Lion Shaver out of a total of 6 levels. Each level has its own duties. You're able to perform the duties of levels 1, 2, 3 and 4, not 5 or 6. Sounds kind of like the situation you're in.

Also...be glad you have a job! I'd love to get paid as much as my manager does to do less than I do now! Haha....
 
Yep, there's a chance it's actually illegal for them to change your pay rate based on what truck your on.

If the truck has no ALS equipment, you can't be expected to perform
at that level can you?

Word of advice, be very, very selective of who you take your information from. There's a gaggle of morons in this field.
 
Yep, there's a chance it's actually illegal for them to change your pay rate based on what truck your on.
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I believe he said the pay scale is staying the same. Besides, if he signed the paperwork to agree to variable pay scales based on assignment when he hired on, that's fairly solid legal grounds if that were the case being discussed here.
 
Thanks for explaining it and I don't care to get paid to do less of a job my only concern was I didn't want to get stuck holding the bag if something bad happened. Just seems illogical and a waste of resource to place a medic on a bls rig but not my call. Thanks again everyone. No sliding scale same pay rate no matter what truck
 
Redacted... already covered.
 
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JPINFV said:
[citation needed]

Is there an actual source for this, or is this the "Someone once told me a while back that I can't work below my level"?
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I'll go find it here in a second (I work in Ohio). It does say you have to operate at the level of certification WITH AVAILABLE RESOURCES.

Thus, if you're a medic on a BLS ambulance then the resources available only allow that level of care.
 
Paramedic150 said:
...and receive the same pay.
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Depends, does the state set your wages or the service set your wages? What's stopping your service from paying EMTs double what the paramedics make (outside things like economics)?
 
Dwindlin said:
I'll go find it here in a second (I work in Ohio). It does say you have to operate at the level of certification WITH AVAILABLE RESOURCES.

Thus, if you're a medic on a BLS ambulance then the resources available only allow that level of care.
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I pulled that post as it was already covered. The important words being "similar circumstances."
 
Service sets wages. Just making sure do to standard of care laws and the whole neglagence thing.
 
Remember that the level of care that you provide is determined by your service administration and ultimately the medical director under who's license you work. There's a long precedent for medics working BLS when limited by service design or medical control.

I know several companies that require new hire/newly minted medics (who were never EMTs) to work BLS for a period of time-- to gain proficiency with ambulance operations and the stretcher, basic paperwork, facilities, etc. They have a state credential as Paramedics, but their scope of practice is limited to BLS. If they happen to intercept with an ALS truck, they can work to their level of training (with another paramedic/ALS equipment), but otherwise, they are ALS.

OP, perhaps a relevant question for your supervisors would be of your scope of practice when working with other medics (ALS intercept with BLS). Also consider what your responsibility is if you disagree with your Basic partner on the management of a BLS patient-- and whether you must tech emergency patients, or whether you can overrule your partner in that case.

Good Luck!

D
 
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