lazy providers

[Just Plain Ruff]

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.

Dust, are you saying the sanction comment is that referred to the policy that they won't put in effect?

I'm sure you are correct but this is something that has never been a problem in the past.

I don't think that they will make an example out of someone because there is only one person that I know of that does not bring equipment into the scene.

If there's only one person doing it wrong is it wrong to make an example of that person? If there is only one person who's care sucks is it wrong to deal with that person one on one?

If only one person does something wrong, for example gives 500mg lidocaine versus just 100mg and no-one else does then by your example we not make an example of them.

I don't see it as picking someone out to make an example of them. I'm saying that that person needs to be sat down and discussed the ramifications of their not doing something that everyone of us in this organization is doing correctly. Not saying fire them but I'm saying to get them on the same page. I have an idea as to why this person is doing what they are doing and it stems from past employment but I can't make a case that that is the true reason. Maybe they are lazy but I think there is something more to it.

[Lone Star]

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.

Isn't that kind of what you do when you hammer the hell out of someone? Make an example out of them and hope that others will take the hint and not do the same thing again?

[Dustdevil]

Ruff, I guess I am possibly making an incorrect assumption about the prevalence of the practice. Unless this is a three ambulance operation, in my experience it seems unlikely that it's just one person. In an organisation of any size, this is usually a cultural thing that spreads like a virus. If not -- if this is truly just one rogue arsehole -- then I agree with you. It's time for a 'come to Jesus' meeting with the guy. But no, I don't think it's time to blindside him with harsh punishment without first an educated chance to correct the problem. Sometimes, all it takes is a word to the wise. But otherwise, he's got the very same argument that you do, which is 'it's never been a problem before'.

[Dar_USAF-Lifeguard]

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.

That's morally wrong. Who are they to make the decision without even seeing the patient? I expect people who sign up for the job to take their profession of saving people's lives very seriously. Does your employer have a procedure to follow like writing them up?

[tniuqs]

That's morally wrong. Who are they to make the decision without even seeing the patient? I expect people who sign up for the job to take their profession of saving people's lives very seriously. Does your employer have a procedure to follow like writing them up?

I am an advocate of peer pressure in this scenario the decent now patented "Gibbs Head Slap" technique applied

Quote Gibbs: It worked for Dinozzo and Magee ! You got to love NCIS !

Thats just an OPEN handed slap to start with.

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.

Slap required, in front of the family.

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.

Slap required again, unless Paramedic carries a Mood ring and a Crystal Ball on her belt !

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

A 5 second remote evaluation .... Major Slap.

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

Good Grief thats just stupid.

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.

Major Bitch Slapping heard if it was my Child.

Seriously a wee fireside chat from elders with the offender (if its an isolated event) and later in hospital bay/ hall does wonders in for attitude adjustment.

cheers

Edited August 27, 2009 by tniuqs

[Sputtervalve]

I think some village is missing their resident idiot very much right now.

[cosgrojo]

Squint- Never have watched NCIS, so the reference is lost on me... but the commentary was hilarious regardless... good work!

Ruff - I agree with Dust to a certain extent. The old adage "one bad apple to ruin the bunch," comes to mind. If this guy gets away with this type of activity without some sort of meeting with your local EMS Lords, then you set a nasty sub-conscious precedent. The rest of your crew members may start to think to themselves... if this guy can do it... then so can I. Or more problematic, if you get any new employees that don't have the experience or work ethic of your other crews, you run the risk of this guy infecting them. So it's not quite an organisational failure yet... but it has potential.

And as a career street guy who has never graced the Ivory offices, these types of behaviors are usually more prevalent than they think. So be careful about throwing out absolutes about the rest of your crews... it's better not to be so surprised when the "S" hits the "F."

[Just Plain Ruff]

Squint- Never have watched NCIS, so the reference is lost on me... but the commentary was hilarious regardless... good work!

Ruff - I agree with Dust to a certain extent. The old adage "one bad apple to ruin the bunch," comes to mind. If this guy gets away with this type of activity without some sort of meeting with your local EMS Lords, then you set a nasty sub-conscious precedent. The rest of your crew members may start to think to themselves... if this guy can do it... then so can I. Or more problematic, if you get any new employees that don't have the experience or work ethic of your other crews, you run the risk of this guy infecting them. So it's not quite an organisational failure yet... but it has potential.

And as a career street guy who has never graced the Ivory offices, these types of behaviors are usually more prevalent than they think. So be careful about throwing out absolutes about the rest of your crews... it's better not to be so surprised when the "S" hits the "F."

Cosgrojo, you are correct about absolutes - But I'm relatively certain that only one of our providers goes into scenes with nothing but their body. But I cannot be 100% certain of that.

I can be certain 100% that the policy would more than likely never happen. Am I 100% completely well maybe not but there have been other incidents over the past 15 years or so where a policy would be a fine idea but it doesn't happen.

heck I submitted a hypertensive crisis protocol and it was approved by our medical director 6 or so months ago and it has yet to be implemented.

If I listen and harkin back to the presidential election rhetoric the words "Change, something we can believe in" just never made it into my organization.

[cosgrojo]

Cosgrojo, you are correct about absolutes - But I'm relatively certain that only one of our providers goes into scenes with nothing but their body. But I cannot be 100% certain of that.

I can be certain 100% that the policy would more than likely never happen. Am I 100% completely well maybe not but there have been other incidents over the past 15 years or so where a policy would be a fine idea but it doesn't happen.

heck I submitted a hypertensive crisis protocol and it was approved by our medical director 6 or so months ago and it has yet to be implemented.

If I listen and harkin back to the presidential election rhetoric the words "Change, something we can believe in" just never made it into my organization.

I am not advocating a policy as much as some re-education for your one derelict employee. Make sure he knows what is expected of him... and I would frighten him more with what he says and does on scene that is reported by the family and the patients, rather than the equipment issue. I'm sure that there is a policy about professionalism and courtesy to tax-payers and town's people, and that is where I would reprimand him the most.

[Lone Star]

Squint- Never have watched NCIS, so the reference is lost on me...

cosgrojo,

Here's a 'classic' example of the patented 'Gibbs NCIS head slap' being properly applied: