FDNY EMTs do not let Private Medics help with choking child

[Richard B the EMT]

I always had a problem with EMT's supervising medics, but where the system is largely BLS they feel it is OK to have some EMT bosses. They even have some that are Capt. and D/C's

So I take the Lieutenant's exam 4 times, finally pass the test, and place on the promotion list. There never was any mention of requiring lieutenants to be ALS, but just to be in the service, obviously, you have to be, minimum, BLS.

I am not qualified to start an IV line, as that is ALS, but I am 34 years overall as a BLS provider, 22 of them with the agency I took the promotion exam at.

Are you implying that just because I am not allowed to do ALS protocols, I am not qualified to be a leader, even with input from those who I would be supervising?

Sounds to me that you ARE implying that.

[DwayneEMTP]

So I take the Lieutenant's exam 4 times, finally pass the test, and place on the promotion list. There never was any mention of requiring lieutenants to be ALS, but just to be in the service, obviously, you have to be, minimum, BLS.

I am not qualified to start an IV line, as that is ALS, but I am 34 years overall as a BLS provider, 22 of them with the agency I took the promotion exam at.

Are you implying that just because I am not allowed to do ALS protocols, I am not qualified to be a leader, even with input from those who I would be supervising?

Sounds to me that you ARE implying that.

We're not saying you can't do it because your BLS, we're saying you can't do it because your goofy...and funny looking.

Just sayin'....

Dwayne

[Richard B the EMT]

We're not saying you can't do it because your BLS, we're saying you can't do it because your goofy...and funny looking.

Just sayin'....

Dwayne

Dwayne, how can you say that?

It never stopped YOU!

[JPINFV]

So I take the Lieutenant's exam 4 times, finally pass the test, and place on the promotion list. There never was any mention of requiring lieutenants to be ALS, but just to be in the service, obviously, you have to be, minimum, BLS.

I am not qualified to start an IV line, as that is ALS, but I am 34 years overall as a BLS provider, 22 of them with the agency I took the promotion exam at.

Are you implying that just because I am not allowed to do ALS protocols, I am not qualified to be a leader, even with input from those who I would be supervising?

Sounds to me that you ARE implying that.

Here's the problem. If a basic with a higher "rank" (I've said this before, I'll say it again. Any system who needs a ranking system to delineate authority in a team of 2-3 people, frankly, sucks) and a paramedic disagree about any treatment decision (transport priority, treatments, destination, etc), the paramedic is the one with the higher medical education and the one responsible for care. I don't care if the chief of FDNY (provided that he isn't an active paramedic) is on scene for a medical call, the paramedic is still the one responsible for patient care, and as such, the person ultimately in charge. Chevrons, collar brass, and funny hats do not change this.

This would be like having a nurse supervising physicians, LVNs supervising RNs, etc.

So, it is not the fact that you can't provide [insert random skill that paramedics perform that basics can't], but that you, as a basic, lack the educational and training background to adequately supervise, train, and advise paramedics on the practice of paramedicine.

Now if the entire purpose of ranks is to determine who gets to be the one who sets shifts, assigns station chores, and who gets the shiny new unit with zero input on training, patient care, and QA, then sure. Of course once you get to that point you don't even need a basic to be able to perform those duties. Any average Joe off the street can do those.

[Richard B the EMT]

Figure the FDNY EMS Lieutenants to be field managers for several teams of both EMTs and Paramedics, both for getting the crews out at the beginning of the shift, handling problems cropping up during the tour, or first due Emergency Managers for a Multiple Casualty Incident.

Someone has to fill out the paperwork when someone on the crews gets hurt, or professionally misbehaves, or doesn't fill in all those damnable boxes on the "ePCRs". They also have to process the paperwork so the crews get paid!

Does a military sargent in the infantry need to know how a tank and tank crew functions when he orders a tank crew to fire at a target? Or the same sargent, when he orders up a "Warthog" to take out an enemy position firing on his guys? Hey, he's in the Army, not the USAF.

(Everyone either knows, or should respect the fact, while the generals and admirals give the orders, it is always the non-coms who actually run the show, and "git 'er done!"

[Dustdevil]

This would be like having ... LVNs supervising RNs...

Been there. Wasn't so bad in that situation, as it was an intelligent LVN who knew her limitations and wasn't on a power trip. But yeah, certainly not an ideal situation.

But back to the FDNY thing, Richard, you're mixing "leadership" and supervision, and they are not the same concepts. A basic may well be qualified to lead, and should be encouraged to do so. But s/he is not qualified to supervise an ALS operation. I would say they're not even qualified to supervise a BLS operation. I suppose this could be contingent upon the duties of the "supervisor". If all of his responsibilities add up to no more than making out the schedule and signing time cards, then sure... integrity and reliability are the important factors. But if it involves any measure of medical or operational oversight, then no. Not only is s/he not qualified, but her/his FAILURE to make a professional effort to advance her/himself for ten, twenty, or thirty years would be evidence to me of an lack of the necessary qualities to supervise or lead.

[JPINFV]

Does a military sargent in the infantry need to know how a tank and tank crew functions when he orders a tank crew to fire at a target? Or the same sargent, when he orders up a "Warthog" to take out an enemy position firing on his guys? Hey, he's in the Army, not the USAF.

Apples to oranges. Fire control would be more akin to dispatch than oversight since it involves telling a party what to do, not how to do it. That Warthog pilot still has the final say on releasing his ordinance and isn't being told how to fly his airplane. On the other hand, people involved with training and QA (operational oversight) not only tell people to take care of patients, but how to take care of the patients.

[JakeEMTP]

Sometime I can't believe the GALL of some people

I can't believe I missed this.

Was the pun intentional? If it was, good show old man!

[DwayneEMTP]

Dwayne, how can you say that?

It never stopped YOU!

Yeah, but I'm to dumb to know better. We expect more from you!

Dwayne

[Timmy]

So, let me get this straight. The emergency ambulance didn’t have something as simple as a laryngoscope and magills? Why were they dispatched to a situation like this so ill equipped and under trained?