What do you do when first responders and paramedics don't respect what you do?

I am both a volunteer EMT and I work for a private service at a resort that staffs EMTs around the clock. I have a two part problem: one is when we have a medic run at the resort and have a patient to transport the local department shows up even when they're signal 9. I'm not disrespecting what they do because as a volunteer I'm on a first responder department and its a great service, But we don't generally need them as we already have EMTs on scene and most of the time we are just waiting on the ambulance for transport. It wouldn't be so bad but they just do it for the money ( The resort has paid out thousands of dollars just this year alone when all they do is disrupt the care we're giving our patients.) The second problem is with a para(GOD)medic on the county ambulance who I'm starting to have doubts about turning patient care over to as she doesn't bring equipment to the scene and then tries to talk our patients into signing SOR's. My last two patients that she responded to was a bee sting that was a heartbeat away from dying and she didn't even bring an epi down when she arrived, and I made sure the county notified her of the situation when they were dispatched. The second was chest pains and vitals going thru the roof and she didn't bring a cot to load the patient on, we were lucky enough to have a wheelchair close by so we took the patient out to the ambulance and loaded him on board while she was still trying to figure out what was going on.

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As for the first problem Of the first responders showing upon stable Pt's. I think alot of that might be the department padding the run volume. It is alot easier to get money from the powers that be when you are making for example 20,000 runs a year rather then 200 runs a year. The City I work for we run first responce on everything from a heart attack to a stubbed toe for this very reason.

As far as the Medic problem. I belive this is happening everywhere not just in your area. I belive the major reason for this is what we call burn out they just don't care anymore. They have been doing the job for so long and do so many BS runs they treat every run as a BS run. As long as you continue to treat the Pt. to the best of your ability that is really all you can do. You can pull the medic to the side and talk to her and if that does not work file a complaint. I am a true beliver of haandling at the lowest level but if that does not work you cant afford to be offering substandard pt. care continue.
First-Not sure what signal 9 means for your area, but the department I run with that does qrs for the transporting agencies, we get dispatched to all calls that 911 center deems a life threat regardless of where it is and who is on scene. That includes drs office and medical clinics where they have more equipment and higher training than we do. But since we are dispatched we have to go or risk losing our certification if the department misses a certain percantage of calls. Mostly what we do is write down info to give to ambuance and generally try to stay out of the way.
As for the second problem do what scott said and try to talk to her off to the side where no one else is around and find out what her problem is, sometimes thats all it takes
We too have some problems with para-gods. I see both sides of the coin here as I work for EMS and also volunteer for county fire. We have so many new EMT's & medics working at EMS that I don't know most of them, and they don't know me, so if I respond to a call with FD and try to give someone a pt report when they arrive they tend to blow me off too. It's very infuriating!!! I have had our guys complain about certain medics doing the same thing to them. Alot of our guys aren't EMT's, but they are all trained as first responders, and they know how to get vitals and an assesment and give a good pt report to arriving EMS. The medics they complain about are always the same ones and they definately have the God syndrome, & you can't tell them anything! They know it all, and it's sad because they really don't know squat!
Marc said they write down the info then just stay out of the way. I have told our guys that if they are treated like crap, and just pushed out of the way, to just leave. Make sure the EMS crew has the pt and go. That's what I do. If a medic shows up and wants to be that way I just tell my partner "Let's go" Of course, anymore I'm just as liable to tell them exactly what I think about them, away from the pt and family, as it seems the older I get the more vocal I am about that sort of stuff! LOL
From the EMS side of the coin, I know most all of the guys in FD and I know who I can trust with their assesments and who I can't, as does my partner. There are some who are just there to collect their pay per call, and don't do squat before we arrive, but most of the guys are great, and we have to do very little upon arrival as far as vitals and such. Some of the guys even put our unit back together for us after a call if it's a refusal, just as well or better than we do!
Sometimes you just have to tread a thin line and do what you have to do to treat the pts. right and try not to let the idiots get to you.
A few years ago we (vol. FD BLS ambulance) went on an ALS criteria call. The ALS tech took a look (visual) at the patient and said she didn't need to ride with the pt. Well, during transport the pt went sour and we wound up calling another ALS agency to intercept and provide higher level care.

I called the manager of the first ALS service and spoke to him about the situation, and he took the guilty party out of service then and there. I didn't intend for that to happen, but that's what he did - and in hind sight I think it was a good move.

Back to Ray's situation, if she is doing this on other calls she is doing this on others as well and may need "remedial training" or perhaps a different type of job.

By the way - in our area "routine medical care" includes bringing the equipment to the patient ALWAYS and never the reverse. Transporting agencies with advanced life support techs carry said equipment on the stretcher/cot/gurney (whatever you folks may call it) so they have it with them when they establish patient contact.
Try talking to the paramedic in question.
If that doesn't work, then take it to the Medical Director.
If the MD is not receptive, then there is a department of professional standards, I would guess.
However; if you have a natural disdain for paramedics in general, get over it.
Remember; you're there for the patient.
Never lose sight of why you do it and who you do it for.
Art
To the first problem. If the FD doesnt have a lot of runs, they might be dealing with a bit of the itchy feet syndrome. I've seen it happen on one of the departments i was on.Whenever the call volume would get low, the ambulance would start complaining cuz there were too many FFs on scene. Someone would stub their toe, and you'd have five guys there to assist. It's just the nature of it, and finding a way to foster a friendly relationship helps. At least they are there and they want to help. If they are in the way, send them to keep an eye for the ambulance or simply tell them you have it under control. We are all here to work together, and support one another. If you start griping because they are showing up too much, then when you really need them they may not be there.

As for the second issue. I have seen some many EMT B,I,or P that have the know it all attitude. Specifically, I think what happens often with the paramedic is that they have a lot of pressure to perform above and beyond what is currently going on in the scene, so they try and maintain a level of confidence that often comes across as "God -like" as for your Paramedic, it sounds like there are standards that are not being met, and clearly need to be addressed. Maybe they need to attend some refresher classes, or maybe there is burn out, whatever the case, if you dont address the issue then you are equally as responsible for the patient care. If you see someone who is not performing to the standards then you must approach them and or their supervisor and get it resolved, or you are, in a sense, endorsing that behavior by allowing it to continue, and can be held liable. Good luck! It is never easy to deal with these situations and at least you have the guts to take note and seek advice.
Marc Hanson, Here when a dept is signal 9 that means we stop the run and return to quarters. Like I said, I wouldn't complain if they wasn't disrupting patient care. The main one on that dept thats causing the trouble has even hit me in the face with a door to keep me out of my own med room. There have been 2 complaints filed and now he's trying to sue one of our EMTs because she filed a charge with state for him not allowing her access to the patient. He claims that filing the complaint was slander and he needs $5,000. to feel better, this was after he told the Casino he would drop everything if they fired her.
As far as the Medic she's new to the field. I will try again to talk to her boss and see if we can fix it before it gets to bad. The other Medics we work with generally plop down beside us and start working as we give report and start by assisting what we're already doing till they have the info then we reverse and assist with what they need and ask for.
Well, I can see why you would be sore. It sounds like it has more to do with individuals than the entire crew so hopefully can be resolved without too much damage to the rest of your team. If more than one or two of you have filed complaint against said individual, then they surely will have to do something about it, if for no other reason then to avoid the string of lawsuits. Good luck
Ray if you get along good with other medics from the same service try talking to one of them see if they cant sorta steer her in the right direction. This might work better coming from a peer rather than a supervisor
The first problem is either burn out or inexperience. I have seen cases of both. The second problem the only thing that I can say is start with the person, and then work up the chain of command. Hopfully you will get some results.
sounds familiar, i used to work at a factory that had an arraingement with a service that has a MONOPOLY in the city and has been featured rendering care on national tv at a couple of football games any way we would call them in as a emergent private transport and it took 45 min to arrive for a diabetic with a hx of htn and an unstable tib / fib fx that was bleeding out when they decided to show up my boss ( also an EMT ) was holding pressure @ the femoral artery the medic asked why were we using the pressure point after i told her the pt's hx. there is more just ask
The lawsuit went to court and the Judge through it out. We even have it on record of the Responder saying that he wont accept our being higher level of care just cause we're a private EMS company. The Judge did order a moderator from State EMS commision to settle this. The Chief of the complaints division is coming down, seems she's not to happy about what was said in court.

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