lazy providers

[Kiwiology]

I'm gonna go for some sort of schwaking

[Mateo_1387]

Two things.

1. Start hiding refusal forms from that medic.

2. Make a department policy to carry a minimum of the first in bag, oxygen, monitor, and stretcher into the home. First person to disobey gets an automatic 3 days suspension.

Oh, and for the bad attitude, start spanking them. It supposedly works for children.

[Dustdevil]

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.

You have touched on the crux of the issue here. While there are certainly rogue medics out there who march to their own drummer, most of this kind of attitude comes from within the culture of the organisation itself. A FAILURE to provide proper management and supervision, policies and procedures, protocols and education results in an institutional apathy that is contagious. And since it is often the more experienced providers that it starts with, it quickly spreads to the younger medics who want to be like them. Everybody wants to fit in. It's not cool to care.

You can't change this without changing the culture of the organisation itself. If you have great faith in the intelligence and integrity of your partner, then you can go man-to-man and try to appeal to his character. You can simply say, "Come on, Man. You know this isn't right." You can try to talk medicine and re-awaken the sense of scientific curiosity that got him into EMS in the first place. You can tell him that his actions are unacceptable, and that you will report him before you allow him to get you in trouble with his laziness. But even if that works, it's a very small victory, because he's just one cog in the machine. I believe the proper approach is to approach it globally. Go to management and express your concerns and recommendations for changing the culture that encourages this attitude. Are there written policies requiring that certain equipment be carried in on calls? If not, there is the foundation of the problem. Are there written policies requiring that a certain level of patient evaluation be performed prior to a no-ride? Are there written policies about informed consent and witnesses to refusals? If no policy is written, then no policy is broken. And in order to fix the problem, you first have to identify it in writing. Then when you complain, it's not just that you don't agree with his personal style. He is violating policy, which makes it black and white.

And, of course, if management doesn't want to address it on an organisational level, they -- and your agency -- suck, so move on.

[tniuqs]

Two things.

1. Start hiding refusal forms from that medic.

2. Make a department policy to carry a minimum of the first in bag, oxygen, monitor, and stretcher into the home. First person to disobey gets an automatic 3 days suspension.

Oh, and for the bad attitude, start spanking them. It supposedly works for children.

I have to agree with the Culture of EMS that Dust refers as tolerance of this attitude acceptable without correction in this situation is deplorable. But the lets make a "policy" only idea I must disagree because I have observed this before one punishes all based on only one or two bad apples. I am for positive for peer pressure, one must ask the question just when did packing a refusal form around become acceptable or passing a comment "So just where is that crystal ball located in your truck" ?

On the lighter side: I wasn't born lazy I was just born tired ... j/k

cheers

[Mateo_1387]

I have to agree with the Culture of EMS that Dust refers as tolerance of this attitude acceptable without correction in this situation is deplorable. But the lets make a "policy" only idea I must disagree because I have observed this before one punishes all based on only one or two bad apples. I am for positive for peer pressure, one must ask the question just when did packing a refusal form around become acceptable or passing a comment "So just where is that crystal ball located in your truck" ?

On the lighter side: I wasn't born lazy I was just born tired ... j/k

cheers

Squeent....

The ol' punish all for a few bad apples' problems. I also disagree with that approach. If the rest of the system is full of crews doing the 'right thing', then implementing a policy for doing the 'right thing' should not be a problem. Also, when the people who already do the 'right thing' work with those who are used to being lazy, a policy will reinforce the correct decision and back up the EMT/Medic already doing the 'right thing'.

The alternative though is that if it is an organizational problem with crews not taking in necessary equipment, then a policy would be a start to fixing the problem. It is not truly punishing those who are already doing their job, it is rather going to affect those who are lazy.

[Just Plain Ruff]

Squeent....

The ol' punish all for a few bad apples' problems. I also disagree with that approach. If the rest of the system is full of crews doing the 'right thing', then implementing a policy for doing the 'right thing' should not be a problem. Also, when the people who already do the 'right thing' work with those who are used to being lazy, a policy will reinforce the correct decision and back up the EMT/Medic already doing the 'right thing'.

The alternative though is that if it is an organizational problem with crews not taking in necessary equipment, then a policy would be a start to fixing the problem. It is not truly punishing those who are already doing their job, it is rather going to affect those who are lazy.

No way is this discussion of a policy on what equipment to take in will hold or even be set up. Our service prides itself in allowing our medics to work autonomously and every one of them sans one takes at least a med bag or all three pieces of equipment (bag, monitor and oxy) in on EVERY call. It's just this one person.

I'm not going to go any further into this discusion on the "lazy" because of several aspects which I cannot discuss.

Thanks for everyone's input.

[RFDMedic3D]

No way is this discussion of a policy on what equipment to take in will hold or even be set up. Our service prides itself in allowing our medics to work autonomously and every one of them sans one takes at least a med bag or all three pieces of equipment (bag, monitor and oxy) in on EVERY call. It's just this one person.

I'm not going to go any further into this discusion on the "lazy" because of several aspects which I cannot discuss.

Thanks for everyone's input.

Ruff,

These type of providers are everywhere. Here are some opinions of my own.

1. What does the Medical Director think of these acusations? What do the PCR's reflect? Does this provider "fudge" evaluations, or do they actually document what they find? Ultimately, you come down to what you can prove as apposed to what is documented.

2. If patient families have witnessed this poor attitude, have them submit a formal letter of complaint to the squad. This will back up any discilpine you may take. Documentation is not just good for PCR's you know. Other crew members that have witnessed this may also submit incident reports.

3. From the attitude you report, it sounds like this provider needs to take a break from patient care. This sounds like typical burn out symptoms. It may be time to have this person take some time off, or change thier primary duties, if that is possible. It's all well and good to say that someone should be let go, but remember, it could be you some day. While we all think it won't happen to us, burn out is real and should be dealt with fairly and justly. We don't give second thoughts to providing CISD for large incidents, but mostly fail to see the result of the accumulation of weeks, months, or years of dealing with our chosen profession. Some of us handle it well, others do not.

My final thought is this, there is a small percentage of providers in this industry, that are only here for the paycheck. While I admit, the paycheck makes it easier to do what we do, there should also be an eagerness to help your fellow man.

[Mateo_1387]

No way is this discussion of a policy on what equipment to take in will hold or even be set up. Our service prides itself in allowing our medics to work autonomously and every one of them sans one takes at least a med bag or all three pieces of equipment (bag, monitor and oxy) in on EVERY call. It's just this one person.

I'm not going to go any further into this discusion on the "lazy" because of several aspects which I cannot discuss.

Thanks for everyone's input.

A few things Ruff. You asked for ideas, I gave you a couple. What is the problem with the policy? Hard to be a paramedic in a house when all your equipment is in the ambulance. If the rest of your people are doing the right thing, then a policy should not affect them.

Also, I'm not sure what the word 'sans' is supposed to mean, but I am having some trouble reading what you typed.

[Just Plain Ruff]

A few things Ruff. You asked for ideas, I gave you a couple. What is the problem with the policy? Hard to be a paramedic in a house when all your equipment is in the ambulance. If the rest of your people are doing the right thing, then a policy should not affect them.

Also, I'm not sure what the word 'sans' is supposed to mean, but I am having some trouble reading what you typed.

Matt, that is hitting the nail on the head. Hard to be a medic in a house without equipment

The medical director was not so happy.

A policy will not cure this problem. As if the person goes in without equipment which common sense would say they should, what makes me think that they will go in with equipment after the policy is implemented. It's only them and their partner on alot of the calls. No accountability

Sans means "without" Like Sans Equipment "without equipment"

I let the medical director know of the issues I had, I will let them investigate and figure out the other stuff.

I've done my part.

I did tell the medical director that if I heard of this person not bringing in equipment and just bringing in a refusal then I was going to the state and he said for me to do that. He was on board with that. Our medical director is a great doc and I have become quite good friends with him. Not good enough friends to where he would hesitate to deal out discipline to me but I rarely do anything that would put my licensure or my self at risk. He's the kind of medical director that if you do it for the benefit of the patient and you can justify why you did it then he will back you unless it was illegal or immoral.

I'll keep all posted on what happens from here on out.

[Dustdevil]

I still call this an organisational failure if they refuse officially to sanction this kind of practice. Just picking someone to make an example out of, hoping others take a hint, is the very definition of laziness, and is an extremely poor reflection on management. The height of hypocrisy.