The division of labor between partners.

[Aidey]

New thread, so we can let the other one stay on topic.

How do you and your partner divide up the work? What do you think is a "fair" division of labor?

 

[STXmedic]

On my truck, nobody is done until you're both done. If one is working, then you both are. I don't, however, consider the ePCR work. If it's my call, I help reset the truck before I finish up my report, if it's not already done.

 

[Aidey]

Why don't you consider the ePCR work? Arguably that is the second most time consuming thing after actual patient care. For me on some arrests, RSIs or nasty traumas the report takes significantly longer to write than the call did to run.

 

[Handsome Robb]

Good call! I like your style Aidey.

Where I work the job description for Paramedics and EMTs is very similar. With that said the way it usually works is the both partners are present for the handoff. Once that is finished the attendant writes the chart while the partner cleans the unit, stocks what they know needs to be replenished and gets it ready to be back in service.

If the attendant finishes charting most will help finish getting the unit ready to be back in service. If we need supplies that aren't in our stock room at the hospitals we call a supervisor or our VSTs to meet us at the ER or at a post to replenish supplies. If it's something critical we will stay out of service until we can meet the VST, if it's something we will go 10-8 and meet them when we can.

At EOS both partners clean the unit, usually we do it while we are getting fuel.

In my situation now working as a new per diem EMT I tend to do quite a bit of driving and cleaning since the medics have not been able to get to know me and my level of competency although the ones who know me let me attend my fair share of calls, especially if they are down on charts

 

[STXmedic]

Why don't you consider the ePCR work? Arguably that is the second most time consuming thing after actual patient care. On some nasty traumas the report takes significantly longer to write than the call did to run.

It doesn't usually take me very long to complete a PCR (and no, it's not thrown together with a lot of info left out; it's a thorough report). And if it's a major trauma or cardiac arrest, dispatch is usually pretty good about giving us extra time at the hospital, which I'll use to finish anything up. On the same level, resetting the unit takes nearly no time at all when two people do it. I made the mess, I'm not going to have somebody else clean it up for me all on their own.

Edit: The back especially doesn't take much time away from me, because my partner has already started clean-up while I'm transferring patient care. So I may not do 50% of the clean-up, but I help as much as I can.

 

[DesertMedic66]

My partner and I divide everything up. I drive every other call.

The person who is running the call (in the back with the patient) takes care of all the paperwork. The driver for that call cleans the ambulance and the gurney.

Whoever gets to the station in the morning gets the unit ready for the shift (filling the ice chest, getting the HT/computer/charger/unit keys/etc). Then the other person cleans the unit at the end of the night.

Everything is divided up equally and there are no issues as to "I work more then you do".

Our VSTs take care of all restock and our mechanics take care of checking oil/ changing bulbs etc.

 

[Aidey]

I'll throw myself to the wolves here. I work in a semi-busy mixed urban-rural EMS system. We work P/B and do all the 911 transports and 98% of the IFT calls for the county.

Myself and current partner (who has...issues)

My "duties"
-Advising my partner on driving, such as when to 3rd lane and whatnot.
-I take all patients, which means I do all the reports, which are ePCR.
-Compiling the paperwork at the end of the shift.
- All patient care that absolutely does not take 2 people to do. I take my own history, I set up my own IVs, draw up my own meds, do my own vitals, 12 leads etc etc etc. My partner used to do some of this, but over time has lost the "privilege" due to multiple issues.
-I do 95% of all the patient care interaction with facilities and fire.
-I am responsible for 75% of the routing, my partner is not very good at getting around on his own.
-I do about 80% of the "planning", such as we we should park, what to grab, what to do with the gurney, how to remove the patient from the house, etc.
-All non radio communication with dispatch, hospitals, and our supervisor. My partner does not carry a cell phone.
-Secondary stocking and inventory. (I have to double check my partner's work.)
-"Deep" cleaning the cab and back of amb. My partner's definition of this does not match mine by a long shot, so I end up doing it.
-Secondary decon after big calls (see above).
-Bring the computer to the back from the cab at the beginning of calls.


His "duties"
-Driving.
-Check the oil and washer fluid. (As previously mentioned I am too short to check the oil without a step stool)
- Change the main O2 (Again with the short thing. I also deliberately use the main as little as possible to reduce how often it has to be changed.)
-Put the gurney together after calls.
-Wash and vacuum the amb at the end of the shift.
-Primary stocking and inventory.
-Initial decon after "big" calls.
-Grabs the computer from the back and moves it up front after calls.


Not listed is the difference in knowledge base when it comes to operations. What fire rigs are ALS and BLS. What parts of town are covered by what stations, that sort of thing. This also includes things like when it is necessary to use bleach in the amb, when we should hose off the gurney, change the straps etc etc etc.

My partners feeling on cleaning is that if he can't tell it is dirty it doesn't need to be cleaned. He is concerned with over sanitizing our environment and all that. I finally read him the riot act and explained that it isn't about us, or even most of our patients, it is about the 5% of people we transport that are immunocompromised and at risk. After that he stopped making comments about my cleaning, but he still doesn't do it himself unless told. Which is generally how everything is with him. He doesn't like making decisions himself, has no intuition and very little (if any) judgement.

 

[Epi-do]

We alternate who does the majority of the driving each shift. Since we work in a B/P system, we then split the calls BLS/ALS. If my partner is getting hammered and I haven't had to take anything, I offer to take BLS runs, but he typically tells me he's got them, since he knows there are days where everything is ALS and he can't do those for me. (The only exception is babies, which I always take since he doesn't feel comfortable with them. Also, he knows I won't offer to do a BLS psych call, because that is my least favorite type of run.)

Once we get to the ER and the pt is off our cot, the tech does their PCR, and the driver puts the truck back together. We also have an additional program that we have to enter run information into on the computer at the firehouse. Because of that, when we get back to station, the tech completes the additional report, and the driver restocks anything that needs put back on the truck. If we have a really big run, everyone pitches in and helps restock once we are back on station.

 

[Sasha]

My Job:

Clean and stock truck at the start of shift

90% of patient care. (vitals, assesment, any treatments. Exception to vitals is when I have partners I trust not to make crap up)

Communicating with dispatch via phone 90% of the time while on scene or drop off

Help move patients

Get and give all reports.

ALL run reports including incident reports.

Either fuel up or empty trash at the end of shift. Either or. Not both.

Turn in paper work, sign equipment back in, restock if extremely low on something.

Partners job:

Check fluids and exterior lights.

Wipe down and remake stretcher

Drive

Get room and patient ready for stretcher, including removing Tele. (hate when I go for lung sounds and find the Damn box. I'm gonna start selling them back to nurses.)

Help move patients

Empty trash or fuel up

Wash truck.

Sent from LuLu using Tapatalk

 

[mycrofft]

Depended upon the type of job.

Three man truck: driver did the cab and the engine, rescue man did the compartments, crew chief was responsible for everything. Crew chief did the paperwork, which back then did not include a PCR since the med techs did all the transport and we did basically first aid and very little EMT.
Two man ambulance: driver was crew chief, did internal paperwork. Attendant did PCR and pt care once we were enroute. On-scene, everyone did care. Again, driver was responsible for the rolling stock being on shape, and the attendant was responsible for medical end to be ready to go.

Once I was past being the lowest totem on the pole, I made two rules, one for me and one for the rig; I made sure everything was good (after the other guy had finished his or her checks and gone in to clean up), and no run was over until the rig was ready to go again. If my co-worker didn't like that, they got paired with someone else; my partners (I had three total) never had a problem and we would frequently surprise each other by having gotten the job done already.

 

[Sodapop]

The last unit I worked on I was the EMT with a Paramedic partner. He liked to drive so when we did not have a patient he drove. If he did not feel like driving (which was rare) then I drove. He handled most patient care and as such the report, although if we had a BLS patient I would handle the patient and report.

Whoever drove to the hospital would clean the back of the unit and equipment and make up the gurney. Usually this was me but he was good about keeping things pretty well in order in the back with his patients and there was not much to do in many cases I was done before his PCR was completed.

As for the split of station duties I would handle washing the truck and cleaning the bay and ramp and he handled cleaning the inside of the station. vacuuming, bathrooms, etc and everyone washed their own dishes (if any were used). I also generally restocked the supplies throughout the day but there were times if the truck was really dirty or something that he would restock.

It really worked out well for both of us and we never had issues of one feeling like they were doing more of the work. If something was taking longer the other would jump in and help so we were both done at the same time. These were days of hand written PCR's and trauma reports so there were times when I would assist with paperwork when I had the rig cleaned and he was still buried in silly forms.

 

[AlphaButch]

Almost every partner I've worked with it;

One of us would do inventory count, other would pull items for restock.
IFT - One would get vitals, while other handled the handoff.
911 - One would manage scene safety and do gear prep, while other did assessment.
Both would do the patient load and stretcher.
Both would clean the rig after the run and prep for the next call.

I preferred my last system where my partners did all the driving and I did all the paperwork, as it enabled us to have everything complete at the end of the shift. I would finish paperwork while he fueled and washed the rig.

Some systems were alternating (I do one, they do one). In alternating systems, we would be catching up on paperwork at the end of the shift because we would have to trade off the computer (neither leaves until it's done).

 

[Aidey]

Some systems were alternating (I do one, they do one). In alternating systems, we would be catching up on paperwork at the end of the shift because we would have to trade off the computer (neither leaves until it's done).

There are several paramedics in my system that take all of the calls, BLS IFT or not becuase of this. They found it made things go much smoother for those exact reasons.

 

[Handsome Robb]

I bet the partner was stoked that they ended up being an over-glorified chauffeur, just sayin'.

I get so bored if I drive all day. Sure I start lines on scene and do other things for the medic I'm working with but if they ALS calls that should be ILS/BLS I start to get irritated, personally. I know most of the EMTs I work with feel the same way too.

It's a running joke that the EMT runs the truck in our system not the Medic being as we are all I's and can attend most calls per protocol.

 

[Aprz]

I do BLS IFT. Depending on who gets there first, the first person to get there usually does a rig check: make sure everything is in the rig, write down notes that we are required to report like milage, and clean the inside and outside of the rig. Usually while they are in the middle of cleaning the rig, the other partner gets there and starts helping out with cleaning. If the other person gets there around the same time, they'll divide up the cabinets and verbalize the info that needs to be recorded e.g. person in front will say the milage and person in back will say the gurney, main O2 tank psi, and the medical air psi. Whoever has the clip board will write down what was verbalize.

We'll ask "Do you want to tech or drive the first call?" Every call after that, we'll trade off UNLESS it's beneficial for the person to the tech/drive the call instead e.g. if the patient is a Spanish-only speaker and the person is suppose to drive speaks Spanish/person that is teching can only speak English. We'll trade off then since it's better for the patient.

When we go into the hospital, clinic, or home to transport the patient, the person that techs the call grabs the paperwork, reviews the chart, and gets a report from the nurse. The driver is gonna take the gurney to the patient room, introduce himself and the partner/person that's gonna tech "Hey, my name is Andrew. I'm the driver. My partner name is Dahif, he's gonna be in the back with you today." He'll assess how oriented the patient is (ask AO questions), get baseline set of VS, and if possible, do an assessment of the patient (ask if there are any complaints, S/S, ask about when was the last time they ate, if they have any belongings, etc). If the partner isn't done with the paperwork, the driver will return to the tech, and report all of his findings. If the patient is able to ambulance on his own or with the assistant of one person, he'll get the person onto the gurney, strapped, and ready to go (5150 calls are usually like this).

After the patient is tranfered to the receiving facility, the tech is gonna get signatures/report to a nurse, and the driver is gonna take the gurney back to the rig, clean the gurney, rig, make sure everything is ready for the next call. If the tech returns to the rig after finishing the report, he will usually help the driver prep the rig for the next call, and either finish his PCR during down time after the call, or if there is another call/it's busy, finish his PCR on the way to the next call. Sometimes the driver will relieve the tech of helping with cleaning and ask the tech to finish his paperwork while he cleans.

At the end of the day, both people will make sure that the rig is full of gas, stocked, clean, and ready for the next crew. Sometimes we'll prefill the paperwork for the next crew regarding milage, O2 tank, etc. The next crew is still responsible for all of this though/it would be risky if they didn't double check if something wasn't missing or a number was off. Some of it can be handy like we have to write the VIN, license plate, etc, so that can definitely make things easier for them.

Unfortunately it doesn't work like that with all crews, and some of my partners haven't done it this way, but I try to go by the above format usually. Sometimes I'll get an ambulance that's totally trashed, gas isn't full, isn't stocked, work with partners who doesn't want to hear the driver assessment, doesn't help clean the rig after a call, etc. This is just the format that I've mostly gone by, and try to go by.

 

[WuLabsWuTecH]

We try and do 3 man trucks, but once in awhile do 2.

3 man trucks:
In charge and second attendant go in to transver patient. Driver will help if necessary.
After patient is handed off, in charge goes to write up the report. Attendant grabs replacement supplies, driver goes out to clean the rig.

Once the attendant gets the supplies and drugs, he goes out to hand off supplies to the driver to restock and depending on the crew, he'll either stay out there and restock and clean while the driver comes in to make the cot or he'll give the supplies to the driver to restock and he'll go back in and clean the cot.

The timing works out that generally as cleaning is being finished, the run report is finished and needs to be printed. In that five minutes the driver and second attendant grab snacks/drinks, and take a break while the in-charge prints the reports. (The in charge was already writing reports in the snack/break room so already got his food.) Once the report is handed off we pile back in for the (long) drive back to station (we're in a rural area). Driver and attendant change if desired.

On the runs where more goes on and are less straightforward, the in-charge will often write the report in the hallway or the back of the rig while we work around him so he cna get input from the second attendant if necessary.

Most people here just kinda help each other out until the work is done, but this is how it usually ends up going. A lot of the older guys around here don't like being second attendant (and aren't cleared to ride as in charge) so they'll usually drive. I prefer patient care, so if it's a basic run I'll take in-charge, and on a medic run I'll usually take second attendant, but transports nonwithstanding, I'll usually drive every now and again just to make sure I keep up those skills.

On a 2 man rig, the driver just does as much as possible until the in-charge is done with the ePCR and helps out. The times for these runs are noticibly longer as they generally go over 2 hours where as runs with 3 man crews generally fall under the 2 hour mark. (1:40 to 1:50 is normal).

-Wu

 

[DV_EMT]

My partner is currently going through some tough medical stuff... so I try to do most of the lifting and shifting I can for him so he doesn't have to exert too much.

Driving:

Check onboard equipment to make sure it's in good working order
Make sure we have gas
Make sure we have a trashbag
Park it and map out directions
Usually load and unload pt
Ask partner to see if Code is needed based on need

Attending:

Assist with gurney functions
Vitals
Paperwork
Radio/Telephone comm
Report to staff
Yell at driver to slow down and stop taking corners to fast ^_^
Yell at driver to go Code

 

[the_negro_puppy]

We work Paramedic/paramedic or paramedic/student

we take turns job by job of driving and doing patient care.


We both help check and stock the vehicle at the start of shift and clean it at the end.

The person who drove on the call, is responsible for prepping the truck and gear for the next call while the attending does the report.

 

[DrParasite]

We work B/B or P/P. everything is split 50/50.

we both clean, we rotate charts, we rotate driving. we both check the truck. when one of us screws up, we both take the hit, especially if we are full time partners. If there is a documentation problem, we both take the hit, since we are equally responsible (I don't agree with this, but it's how policy is, and I have been written up because of my partners poor charting).

after a call, one person speaks to the nurse and works on the chart, the other makes the cot and puts the truck back in order. once report is given and chart is done, both will continue cleanup. everything is done together, since we are partners. I typically will handle the EDPs, while my partner typically handle OB calls. Everything else is the luck of the draw and depends on whose turn it is to chart.

whomever is writing the chart is responsible for getting demographics and meds/history/allergies, and carrying the bags in. usually the driver brings in the carrying device (typically the stairchair, but it can be a reeves or backboard/cot depending on the nature of the call), and performs the assessment.

One thing that is different in our systems than in others, once a unit gets to the hospital, they get 10 minutes before they can be dispatched for another job. We can ask for 15, or go out of service for cleanup, but most of the time we try not to.

At my former job, once we called out at the hospital, we were available for the next 911 job. This was for ALS and BLS assignments. that means as we are backing into a spot we can be dispatched for another assignment (and yes, I have been).

 

[McGoo]

Wow. We run a completely different system over here. We have either two paramedics or paramedic/ambulance officer. (AO is training to be paramedic). We do two days and two nights, and you drive one day and night, and attend the others.

Driver checks the van itself, O2, swaps the defib batteries, checks the oxyviva, and makes sure the right gloves are in.

Attendant checks the drug pouch, which can take just as long.

Both people check the interior for stock, but you usually use the same van for your shifts so there shouldn't be much to check.

At jobs the attendant is primarily responsible for patient care, the driver manages extrication as well as being a second pair of eyes and ears in case the attendant misses something. Attendant does all paperwork, driver cleans and makes the stretcher after each patient, and cleans the van.

End of the day the driver cleans the inside of the van, and puts it away. The attendant puts the drugs away.

All used items are replaced by whoever remembers to do it first, and are usually done as soon as you get back to the depot.