Supervisor's Instructions vs. Protocols

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Amber Lance

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An issue has come up where I work in which the supervisor issued a verbal directive that goes directly against our county's protocols. He hasn't put it in our service's protocols to my knowledge.

I don't want to say what the specific issue is, but it does involve a potentially life-saving procedure and could therefore be an issue of life or death on a scene.

Has this ever happened to anyone? I'm not asking for any type of legal advice, I'm just trying to wrap my head around this situation and get a feel for if it is a common occurrence.
 
Without knowing the specific issue, I can't say much. But my advice would be when in doubt follow your protocol, the one in writing. If it goes south his verbal directive can become non-existent very easily, leaving you out to dry.
But now I'm curious, what's the issue?
 
Never go against established protocol. If a supervisor wants you to do something that countermands protocol, get it in writing and involve OLMC if possible. You see, if your supervisor issues a verbal directive that countermands the protocol and YOU follow the directive and something "adverse" happens, guess whose license/certification is on the line? Yours. Not his. Why? Because YOU are responsible and accountable for what you do. If OLMC issues you a verbal order that's within your scope of practice, then that new order applies to that patient, and has likely been recorded "on tape" for future reference.

As someone else said... a verbal order by your supervisor can just "disappear" as soon as it was said, and denied just as easily unless someone somehow managed to get a recording of it and even then you're still not relieved of your obligation to follow medical orders given by the County's Medical Director (in the form of protocols), which your supervisor's verbal orders can't supersede or he'd be the Medical Director himself...
 
First, make sure you actualy heard what you think you heard.
Approach the supervisor and ask for clarification. Repeat what you think you heard and ask if this is correct. If you heard it wrong, easily cleared up.

Second, if you heard correctly and believe that it is in conflict with protocols, bring up the protocol and ask for further clarification. Maybe there are conditions that exist which align with the decision of the supervisor.

If the Supervisor is blatantly ignoring the protocol, it needs to get ramped up a notch. CYA

If this happens on-scene, things get trickier. If you find it contradictory, repeat it back and ask for clarification. If you misunderstand a protocol and dig in your heels and refuse to follow the direction of the one running the scene, you will be in a world of hurt. As a Basic, I'm not sure there is much you will be asked to do that could really make a call go south if it wasn't going there anyways. I'm curious what the issue is as well.
 
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Get a written instruction form the supervisor and an explanation; then refuse to do it if it is unsafe. Be civil. "I'm not comfortable with that".

Make sure it really is against protocols.

If you disagree with the protocols, make a civil and polite case for why you are uncomfortable with it, and be prepared to quit if you are still convinced and they will not change it. But be sure you understand it, take your time.
 
Amber Lance said:
An issue has come up where I work in which the supervisor issued a verbal directive that goes directly against our county's protocols. He hasn't put it in our service's protocols to my knowledge.

I don't want to say what the specific issue is, but it does involve a potentially life-saving procedure and could therefore be an issue of life or death on a scene.

Has this ever happened to anyone? I'm not asking for any type of legal advice, I'm just trying to wrap my head around this situation and get a feel for if it is a common occurrence.
Click to expand...

Are you referring to actual patient care protocols? Or Standard Operating Procedures? Patient care protocols fall under your medical control's license and you do not work under your supervisor's license. However, SOP? Get it in writing.
 
I would always go with protocols issued by county/state. If you get fired for not following an order, I guess that sucks. Break protocol and you can loose your cert and will get fired anyway.
 
Better to figure it out and quit before they fire you for insubordination.

When I was younger I used to ride bad jobs into the ground. Better to eject at a safe altitude.
 
I would never deviate from protocol if my supervisor told me so.

Like well say for example the protocol for cardiac arrest is CPR/AED and a BLS airway.

Your supervisor tells you don't apply the AED, because the pads are expensive and we rarely save people. Follow protocol and consider a new job.

However a SOP can supplement a protocol. or further restrict a protocol but not go beyond the practice of a protocol.

A good example is ours. Our protocol states that use of Light and Sirens is at the Crew Chiefs Discretion. Our service's SOP is all BLS calls are automatically a non emergent response. and all ALS calls are at Crew Chiefs Discretion.

So our protocol is further restrictive than the Regions protocol. which is acceptable. If our protocol stated "I don't care what the region says" you run hot to everything and exceed the speed limit" then we have a problem
 
Medical protocols have to be written and approved (or just approved) by medical control and IAW local EMSA, right? And a good thing if the receiving facilities have some say too at the writing stage. There is no such thing as a verbal protocol, verbal override, etc. If it is a doc (not a supervisor) and not unreasonable, and your protocol isn't working, go with it but document it; there usually is a protocol lurking about somewhere that says "If all else fails, do what seems right". HOWEVER, I have a multiple times in my career as EMT and nurse been told by a MD that they have a personal protocol, or their own set of SOP's, etc. Time to get those order in writing.

Not the same as EVOC and billing "how-to" 's.
 
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Thank you everyone for responding.

I took your advice and clarified the protocols as well as the supervisor's instructions. It does seem they are in conflict; however after reading your responses and talking it over with co-workers I agree that it is best to follow the protocols if that situation ever arises.

To those asking what the issue was, I just want to avoid being identified in case someone here recognizes the situation from my description of the issue it involves. :ph34r:

Anyway, thanks again for your input! It really helped sort things out :cool:
 
We'll send you the bill.
NOT.:cool:
 
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