Glad we hurried

We drove almost 15 miles. A little less than 25 minutes. At 5 o’clock in the morning. In a torrential downpour.

For a grown man with abdominal pain for about 8 hours.

Because he’s lactose intolerant.

And ate a Wendy’s Frosty for dessert.

Then we took him to the hospital.

And his wife followed all the way in her car.

With her emergency flashers on.


“You’re gonna be here tomorrow, right?”

That’s become the mantra where I work. It doesn’t matter how bad you screw up, or whether or not you are actually competent at your job. As long as you show up on time, you’ll have a place to work.

They won’t fire you if you give the wrong dose of the right drug to a patient, and cause serious complications. No, they won’t fire you, as long as you can make it to a meeting where we can slap your wrist.

Oh, you gave the wrong drug to the wrong patient at the wrong time and the patient died? Don’t worry, that pink slip isn’t your termination notice, it’s your transfer notice. That’s right, they’ll just ship you to another division.

What? You sexually harass your employees and got arrested for beating your spouse? Geez, now they’re going to have to transfer that harassed employee! Don’t worry, though, they won’t fire you. You’ll get a new job title out of the deal, though.

You did what? You called a STEMI because the monitor doesn’t know how to recognize a right bundle branch block, and you activated the cath lab and cost the hospital thousands of dollars? They won’t fire you. Heck, they won’t even give you any remedial training. They’ll just make you transmit all your EKGs to the hospital.

Oh my goodness, you called a patient deceased in a motor vehicle crash without actually touching the patient? And that patient wasn’t actually dead? And another ambulance had to take that patient to the hospital? And you told the patient’s wife that her husband was dead? Don’t worry, they’ll somehow blame it on the fire department, even though the ambulance service is responsible for all patient care.

Yeah, you’re gonna be here tomorrow, right?

Imagine this

Imagine if you will, an ambulance service decides to make every “patient contact” require either a refusal signature, or a transport. Imagine there is no more “false call,” or “no patient found,” or “no EMS needed” options for call disposition, only a patient refusal or a transport to an emergency room.

Imagine that the service ignored their definition of a patient, which used to be “a person who is ill or injured who requests, or would request, emergency medical attention.” Imagine if that new definition included:

  • People sleeping in cars
  • Accidental medical alarm activations
  • People in car crashes who didn’t request EMS
  • A guy changing a flat tire
  • Passengers on a school bus which struck a mailbox

Imagine being told by dispatch to chase down a guy in a grocery store who was sleeping in his car, waiting for the store to open.

Now, imagine if you will, the ambulance service issues “report cards” to their employees, and one of the categories in which they are evaluated is their “Transport/Refusal Rate.”

Imagine that your yearly raise is directly tied to your “Transport/Refusal Rate.”

Imagine how angry you might be.

Dispatching Wolf

“Med four, call radio please.”

Sigh. I hate when they want us to call on the radio.

We have radios. They are called ‘radio’ (or dispatch, depending where you are, whatever) for crying out loud. We have multiple channels that we can talk on, and they have the ability to contact us directly through our radios.

They can even send messages to us through our MDTs.

But they want us to call them on the phone. I hate talking on the phone.

And it’s never for anything important that couldn’t be handled some other way. It’s always crap like “hey, you guys have a call coming out soon,” or “do you have a phone number from that lady from that wreck six hours ago?” or “did you guys see a purse/license/keys/stuffed animal in the back of the truck? A patient from two days ago is missing it.”

  • I don’t care. Just dispatch me when it’s time to go.
  • What lady? No, I don’t have her number. It’s on the PCR.
  • Yes, I found it, and I sold it on eBay.

I cannot stand talking to radio on the phone. Well, frankly, I don’t like talking to them on the radio either. Shaq and I came up with a new strategy:

“Medic four, can you call radio?”

“No, ma’am, we can’t. Neither one of us have a cellphone. But we can switch over to private.”

Lame excuses

My employer runs a paramedic program. When I say that the company runs a paramedic program, what I want you to take away from that is that the company supplies a physical location for a paramedic program, and students to fill the chairs.

But, they attached the words “EMS Academy” to it, so maybe it is sorta-kinda-official.

Whatever. It’s a moot point.

My employer runs a paramedic program.

Being one of the company’s Field Training Officers, I get to see the aftermath of the paramedic program, when the newly graduated paramedics spend several shifts riding with me. Some of them aren’t prepared, but most are.

I was having a talk with another FTO, Tony, while at the hospital a few days ago. This must have been early in a shift, because I actually cared about the topic.

Tony mentioned that he rarely sees the same paramedic student more than twice, and that each student does at least twenty rides at our company. He thought it would be wise for a student in our paramedic program to be ‘assigned’ to an FTO for the duration of their preceptor rides.

While we’re on the subject…our program is putting paramedic students on ambulances for their preceptor rides after three months of school. They don’t know how to read a monitor, and they aren’t allowed to perform any ALS interventions. What the hell is the point of riding for twelve hours on an ambulance if you can’t do anything?


Tony made a good point. After ten rides or so, there should be a pretty good rapport between an FTO and a student. They should be able to communicate openly with each other, so the student can get the most out of their classroom time, and their ambulance time. After twenty rides, any bad habits should be corrected, and the FTO can feel confident in his evaluation of the student. Alongside the FTO’s confidence in his evaluation, the course director can feel confident in the evaluations he gets from the FTO.

But instead, the students just ride whenever, and wherever. Rarely more than once with the same paramedic, or even with an FTO.

So Tony and I brought it up to the director of the program.

“Assign each student to an individual FTO. We have twenty-five students, and eighteen FTOs. Surely we can come up with a list of seven competent medics to fill the roster of needed FTOs. Once a student is assigned to an FTO, that student does all of their rides with that FTO. It only makes sense.”

We got a reply:

“Well, that would just be too hard, and we don’t want to make it any harder on the students.”

This is why I don’t care.

Lame-ass excuses.