lazy providers

[Just Plain Ruff]

How do you deal with Lazy providers? Those who walk into houses with no equipment and a refusal in hand?

Late calls that the medic doesn't want to run and they already have a refusal of service in mind for the patient?

For example -

Call to a person who choked on formula. On arrival medic on ambulance tells the medic first responder "why didn't you cancel me, I get off at 7am" call came in at around 6am.

Crew begins to go in the house with no equipment. Medic sends emt back to truck to get monitor and refusal form. No other equipment was brought in. No drug bag, no oxygen. Originally no equipment but the medic decided to bring the monitor for a pulse ox.

First thing out of the medics mouth before she even saw the patient was "baby's ok"

Family heard the cancel statement outside the house. (uncle heard this)

Medic got a refusal and I'm not saying that a refusal was wrong in this case but from the first responders on scene her decision to get a refusal was already made even before she got out of the ambulance.

How do you break someone of this type of mindset or do you????

if this scenario sounds familiar to someone on this board then maybe it should and you should take it to heart and change your ways.

Edited August 21, 2009 by Ruffems

[GhostMedic29]

How do you deal with Lazy providers? Those who walk into houses with no equipment and a refusal in hand?

Late calls that the medic doesn't want to run and they already have a refusal of service in mind for the patient?

For example -

Call to a person who choked on formula. On arrival medic on ambulance tells the medic first responder "why didn't you cancel me, I get off at 7am" call came in at around 6am.

Crew begins to go in the house with no equipment. Medic sends emt back to truck to get monitor and refusal form. No other equipment was brought in. No drug bag, no oxygen. Originally no equipment but the medic decided to bring the monitor for a pulse ox.

First thing out of the medics mouth before she even saw the patient was "baby's ok"

Family heard the cancel statement outside the house. (uncle heard this)

Medic got a refusal and I'm not saying that a refusal was wrong in this case but from the first responders on scene her decision to get a refusal was already made even before she got out of the ambulance.

How do you break someone of this type of mindset or do you????

if this scenario sounds familiar to someone on this board then maybe it should and you should take it to heart and change your ways.

I don't think there is anyway you can break this mind set. So many medics have this type of attitude. I work with several medics who have this exact same attitude. Medics deciding before they ever get on scene that they are "not gonna haul" this patient.

[Chief1C]

I tell them if you don't want to do it right.. Drive. Because that's all they're good for. I hate it, down right hate it; when people take short cuts on patient care. I'm a very thorough person, and it's a sure as shit way to piss me off. I have no problem telling someone that they're breaking the No. 1 rule - do no harm. Then, I guilt trip them; and don't let them forget about it. Take it to a sit down, line out exactly how the fucked up, and what should have been done.. and suggest they get up and leave, if that's the kind of provider they want to be. Usually cures their lazy ass syndrome.

[Just Plain Ruff]

I don't think there is anyway you can break this mind set. So many medics have this type of attitude. I work with several medics who have this exact same attitude. Medics deciding before they ever get on scene that they are "not gonna haul" this patient.

So what would it take to break them of it? Is it something that requires one of those Holy Shite moments like entering a house on a chest pain or back pain and the patient being in cardiac arrest? Having to go back to the rig to get your equipment because you were too lazy to bring it in and the patient is critical?

Or does a patient need to file a ethics complaint or some type of complaint with the state for negligence?

I'm just curious how some have broken attitudes like this?

[GhostMedic29]

So what would it take to break them of it? Is it something that requires one of those Holy Shite moments like entering a house on a chest pain or back pain and the patient being in cardiac arrest? Having to go back to the rig to get your equipment because you were too lazy to bring it in and the patient is critical?

Or does a patient need to file a ethics complaint or some type of complaint with the state for negligence?

I'm just curious how some have broken attitudes like this?

As an attorney once told me, it's hard as hell to prove negligence. But then again I think this attorney is plain out full of shit. As for the ethics complaint, that's a very distinct possibility.

Me personally I would take the peer approach and have a sit down just the two of us and discuss the situtation at hand. If that didn't solve the situtation, then I would involve a supervisor or member of management. If that doesn't work, then I suggest time off (unpaid of course) and remedial education. Worst case is where you have to terminate the employee.

Personally I would only suggest termination as a last resort. Usually a write up and time off get's the attention of the individual who is "lazy" and doesn't want to do their job.

[spenac]

I'm sorry Ruff I will not do that again.

Actually that is just sad. I bet they are the kind of medic that when they do transport says just drive and we'll let the hospital do everything.

As they say you can't fix stupid.

Edited August 21, 2009 by spenac

[JakeEMTP]

Actually that is just sad. I bet they are the kind of medic that when they do transport says just drive and we'll let the hospital do everything.

Unfortunately, that is the norm for the FD here. Their claim is the were to close to do any interventions, unless of course it is the "cool"stuff.

I had a partner who was similar to the one Micheal summed up. This individual would get out of the ambulance and walk towards the location of the pt. w/o bringing anything with them. I would bring the bag, monitor and O2 which I thought might be required and the stretcher. Enough times of hearing "how about giving me a hand?" I guess eventually shamed them into doing there part. This individual is no longer my partner, however I recently spoke with the person who is now partnered with them and was told they were an outstanding partner.

Badgering your partner until they eventually shape up doesn't always work and can be hard on you, but it can be done.

[Lone Star]

Personally, I've had the 'sit down chats', and I've also had the 'come to Jesus' blow outs. I've also filed ethics violation charges with the state.

We're not in the field to see how many 'refusals' we can get, and its not 'all about us'!

We're there to provide emergency interventions for the patient, because it's "all about them"!

Granted, to some, I'm just a 'lowly Basic', but hey, I'm still part of the thinnest part of that fine line between the patient and DEAD!

If this job is 'too much of a hassle', or is 'too inconvenient' for you, it's time for you to turn in your credentials and try to find a job at the local Wally World, where you can make up 'important meetings' to avoid dealing with the customers.

EMS is a profession struggling for the recognition that it deserves, and people like this are one of many reasons that we keep taking 3 steps backwards for every step forward.

[medic82942003]

Talk to them, politely tell them what you think-tell them the truth. Sounds like burn-out.

Also talk to your supervisor. Document everything, do you have incident reports. Maybee change partners. Also in some states they allow the medic to drive and the basic to tech the call. That is if it is a basic call.

Or tell him you would like to help and tech all the basic calls. That is if its allowed. I have been

partnered with the partner from hell, and another I called Queen of the sign-offs. Or SNR Sign and refusal. I mean this girl (I was a emt-I at the time) would leap at a chance to get a sign off.

Just my 2 cents. I always have problems with the crispy nurses who make you wait to 30-60

minutes to give report. instead of getting mad, I would hook them up to the hospital moniter,

start another IV, do paperwork ect when the nurse showed up I would kill her with kindness.

Be safe.

[under-dreaming]

Great topic, and a lot of great things said so far.

I'm with rural combination paid/volunteer fire department where there is at least one person on shift at any time and we are responsible for EMS and Fire response. We have a couple of EMTs that are employed here who are apparently only interested in fire calls, and their lack of interest in running ambulance calls is, in my opinion, bringing our reputation down. The frequent flyers and common call types have some of our guys locked into a track that can easily become dangerous for the patient. I also found that these personalities are often infectious. I just hope I can keep myself from one day realizing that I have began going down that path of carelessness. Fortunately, when I am on shift I run the calls, so the ball is in my court and I can make sure I do what needs to be done on behalf of all parties involved in the incident.

Honestly, it is these types of forums that keeps my perspective in the right place. It's good to know I am not alone in my endeavors.