Partner Preferance?

[Novisen]

I prefer to work with another nurse :wink:

[Richard B the EMT]

Due to scheduling complications, usually not the supervisor's fault, I have, at FDNY EMS, been partnered for a tour, or a part of a tour, with a paramedic. By radio designations, we know who are normally BLS or ALS, but when you have a BLS assigned with an ALS personnel, the unit is usually a BLS designation, with the team doing BLS skills.

If the mixed crew responds on a dual level call, with a full ALS crew also responding, the Paramedic from the BLS team can and will operate at ALS level, the EMT stays within BLS level treatments, assisting the 3 paramedics as if he were a part of a regular BLS team.

I have used the occasions to ask a lot of medical questions of my Paramedic partners, between calls.

[AnthonyM83]

Yup, it's definitely good for, us, the EMTs.

But really, I wouldn't take the results of that questionnaire personally. It didn't say medics disliked EMTs, it just said they would prefer other medics, since a medic can offset the workload by doing all the things an EMT can, plus more.

[CBEMT]

So how is my load lightened?

By recognizing that on average, 80% of your call volume (if you were practicing) could be handled by your EMT. They're only a "driver/helper" if that's what you force them to be.

Not that I'd be surprised in the least.

[akflightmedic]

By recognizing that on average, 80% of your call volume (if you were practicing) could be handled by your EMT. They're only a "driver/helper" if that's what you force them to be.

Not that I'd be surprised in the least.

Unfortunately, your statement is correct, however a lot of times not recognized so, until a medic has done an assessment and determined it to be be.

Our system is mucked up by the fact that an ALS assessment should be given first and then handed off to a BLS crew, not a BLS crew doing an assessment and handing it up if need be.

Dust as usual has made many valid points. I started off in a Medic/EMT system, was the greatest EMT in the world, so valuable and so very needed. I was so good, I always had everything ready for my medic too. After all, the only difference was just a few drugs and skills, so we were equals.

How little did I know until I actually became a medic. The day I got my patch I was on a truck by myself with a fairly new EMT. Yes that was a fault of my agency at that time, but it was a huge eye opener. I had the run of EMT partners that never understood why I was stressing over this or that. They were quite nonchalant or ignorant at times not being able to recognize the severity of the call, despite the patient appearing to be presenting quite normally.

I had no outlet to take a break. It is mentally draining, especially on 24 hours shifts and those early morning ALS calls.

I agree a medic partner is most preferred. I do enjoy EMT partners on occassion as it presents a teaching opportunity, howver those people are usually medic students or soon to be anyways, so its a great pleasure.

Once I moved to FL and went to work in an all ALS system, I was so amazed at how nice it was. I reflected back on my medic/emt years and said "I really never want to be in that configuration again". There was actually less ego in an all ALS system. You took every other call regardless of what it was. This was very fair and balanced. If you were having a bad day, your partnr could assist. If you had a bad hour or a bad call, they could take 2 or 3 calls in a row just to help you out.

The knowledge base is similar and it is nice to bounce ideas off someone if needed. Do not give me the whole call med control or your supervisor spill as sometimes there is no time for such matters.

On some patients, your partner may develop better rapport with the patient, so it is nice to not have to take over when it can be detrimental to the patients mental well being. There are so many reasons for wanting a medic partner, the list is endless. However, none of these are paragod syndrome or ego trips.

If I have a choice, I will always take a medic over an EMT. I am not saying there are no competent basics out there, nor am I saying there is no use for them. However, the question was, which do I prefer.

[lonewolf_6491]

we run a strictly 2 medic system here, and I can tell ya, there is no better way,,, I spent 26 years working with either a basic or intermediate partner and doing 90% of the work, and now it's 50/50

[Dustdevil]

Unfortunately, your statement is correct, however a lot of times not recognized so, until a medic has done an assessment and determined it to be be.

Exactly. Until I have assessed that patient, my EMT cannot take over. There is no patient that I can simply sit back and drive on. And everytime I hand off a BLS patient to him, I am still ultimately on the hook for the care he receives. Consequently, no... my load is not lightened in the least bit by an EMT partner. Again, if you were a paramedic, you would realise this. Ignorance is bliss.

I would also reiterate what AK said. None of this is a slam against any EMT. I have worked with many good ones, and some truly great ones. It's just that the best one on his best day still isn't as helpful to me as a minimally competent paramedic.

[Happiness]

Well I have to admit that this was a very good question. I have to agree with they guys that I perfer to work with someone at my level. Sadley but true. I use to think I could work with any level but in the last 3 months I have had to work with the new trainees that were trained at a lower level that myself. These past months have been very stressful as I now have the the role of trainer and I have to think for both of us. When the pager goes off I hope its just a transfer, if its code 3 I just cringe.

But the one thing I disagree with the guys about is handing over a stable pt to the EMT. If you have a competent partner then use them when your having a bad day as at least you will get a bit of a break and your partner will keep up the skills they have. If you keep them as drivers only the only thing they become good at is driving.

Paramedic = pair of medics

[CBEMT]

I will admit that a large part of my aversion to medic/medic systems is an issue we have discussed here before- ALS over-saturation as being detrimental to patient care.

I'm willing to accept the supposed increased paramedic workload if it means that the actual ALS patients are being treated by a provider whose skills are exceptional because he doesn't have to fight 6 other medics for the chance.

The other part, probably, is because my service considers itself a "teaching service." Our student volunteers are here to learn. There's only so much they can learn from me doing all the assessments. Unless on approach the patient is blatantly someone I should be dealing with, the patient is theirs. If something gets left out, I make sure it's covered before a treatment plan is formulated or a transport decision made. If they decide they'd rather the patient go ALS, I'm there to step in.

It's like a tiered system where the ALS is already there (for those of you who have to have that element).

[Dustdevil]

I'm willing to accept the supposed increased paramedic workload if it means that the actual ALS patients are being treated by a provider whose skills are exceptional because he doesn't have to fight 6 other medics for the chance.

Certainly a valid point to consider. I agree this is a factor. It is an unfortunate fact that there are slow systems where skills retention becomes a problem, even if they aren't dual medic. There's really nothing that can be done about that in a practical sense. I wish there was. But those systems are simply going to have to make a bigger commitment to continuing education than others in order to compensate for the lack of exposure. Unfortunately, those are usually the systems with the least commitment to continuing education. It's a Catch 22.