Need Help With A FF

[HERBIE1]

Yes Herbie CC = Crew Chief

On my rigs we are the same way everyone is interchangeable but the CC is usually the most experienced person. Just lately that seems to be me

As an update the patient is still in the hospital and no further information given.

In many systems- especially fire departments- you are dealing with paramilitary organizations. I understand the need for hierarchy and someone needs to be in charge or you would have absolute chaos. The problem is, in medicine and the fire service, the real life situations often become collaborative efforts, with everyone doing their assigned parts, but usually all are allowed input. Yes, there is a time and place for discussion or thinking through a problem- ie on an extrication, but there are also times when you simply listen to your superiors and do your job. The hard part of course is understanding the proper time and place for those "discussions". One of the reasons I became an officer was because many of the "old timers" I worked with when I was new were poor medics, had poor interpersonal skills, and often times I feared for my license and/or my safety. I figured if I was going to get in trouble, it would be due to my own mistakes, not those of someone else.

Our problems arise when the person in charge is not the most experienced provider, but someone who simply enjoys the title, and the small increase in pay. They may be working with someone who has many years more experience than their "superior", and it's still up to that subordinate to ensure things are done the right way- regardless of their rank or status. Obviously in a medical setting, those decisions are vital- morally, ethically, and legally.

As you say, being in charge is a good thing. Scary at first, but as you gain confidence and experience, the decisions you make become easier. If you are a quality provider, when you are in charge it's reassuring to know that the best possible care will be provided for your patient. Yes, much of our job is "cookbook" and routine, and anyone with a basic knowledge can handle it most of the time. You really earn your money(or title) when things are dicey, it's a strange situation, or all hell is breaking loose.

Sounds like you have your head screwed on straight, Ugly. Good luck.

[uglyEMT]

Thanks for that Herbie! Yes it is scary at first being "the one in charge". Normally my CC is around and we have a great working relationship. She is more of a guide then a boss. Usually lets me do my thing and observes and steps in if I am straying (which isn't often) and also between runs has me review past calls (not ours) and see what, if anything, I would do differently.

I think it is just lack of experience when it comes to the Docs. Being we run the same EDs all the time the nurses and Docs have gotten used to certain folks as being the go to person and sometimes walk right past me to get the info. I understand and sometimes like observing and listening to the way she gives her report, helps me understand what key points I need to hit. Writting the PCR is one thing its that face to face that is work LOL Sometimes though I wish they wouldn't just walk right past me. I'll get there one day though. Just like I got there being comfortable in the back, will just take time.

Now I have a probie on my rig so the CC has tasked me with teaching him so I am getting there with respect to being a CC.

Thanks again for the pointers, I will definatly be adding them to my memory.

[HERBIE1]

Thanks for that Herbie! Yes it is scary at first being "the one in charge". Normally my CC is around and we have a great working relationship. She is more of a guide then a boss. Usually lets me do my thing and observes and steps in if I am straying (which isn't often) and also between runs has me review past calls (not ours) and see what, if anything, I would do differently.

I think it is just lack of experience when it comes to the Docs. Being we run the same EDs all the time the nurses and Docs have gotten used to certain folks as being the go to person and sometimes walk right past me to get the info. I understand and sometimes like observing and listening to the way she gives her report, helps me understand what key points I need to hit. Writting the PCR is one thing its that face to face that is work LOL Sometimes though I wish they wouldn't just walk right past me. I'll get there one day though. Just like I got there being comfortable in the back, will just take time.

Now I have a probie on my rig so the CC has tasked me with teaching him so I am getting there with respect to being a CC.

Thanks again for the pointers, I will definatly be adding them to my memory.

Maybe ask your CC to step back when someone asks for information and you can provide the answers. It can be intimidating to talk with the docs sometimes- especially if they are the holier than thou, MD (me doctor) type. LOL

I've also found that younger/newer providers problems are generally due to 2 issues- the deer in the headlights fear, or the cocky, arrogant types. Most docs can handle the fear- especially since they are used to dealing with brand new med students. They certainly do not like the arrogant, know it all's and are more than happy to cut them down to size as needed.

Will you find the occasional a'holes? Yep. Minimize your interaction with them because regardless of what they are, it's still their show and you will never win a confrontation with them. Stand your ground if you are right, but remember, ultimately their decision and opinion is the one that counts.

It's just about practice, confidence, and being assertive. As long as you know your stuff and have done the right thing, you have nothing to fear. You may be surprised- many of the more aloof docs adopt this persona, when in reality they are just as goofy, twisted, and down to earth as we are. They especially appreciate information they may not get from the patient or their family- interpersonal family issues you experienced, condition of a home if pertinent, contradictions in the patient's story vs the family, etc. After working with docs in ER's for many years and having many as personal friends, I no longer have the intimidation factor to worry about.

Just realize these docs are being pulled in a million directions- especially in a busy ER. Lab reports, consults, Xray results, contacting primary doctors, monitoring medical students and residents in a teaching hospital, listening to their reports, answering the radio, giving reports to an admitting service, clerks and nurses asking questions, and of course, patient care. Don't take it personally if they appear brusque. Be succinct with the report or question, and try to pick an appropriate time and place for the interaction. Always be professional, and always use proper terminology. Most of the docs are more than willing to answer questions, they appreciate getting information- especially when it can help determine how to proceed with a patient, and they always appreciate the fact you take more than just a passing interest in the patient.