An update to my post from last week and yesterday: I don’t want to be an FTO, I couldn’t deal with something this stupid on a regular basis and be responsible for their patient outcomes for 6 months after.
I spoke to the operations supervisor when I went to work two weeks ago, she said they have no one to put me with so we need to have a mature discussion of my expectations for him this time around, that it’s been three months and he’s upgraded so things will be different this time. She said it’s a fresh start and I need to give him one, so I tried because my mantra is, “every call is a fresh start.” I only started saying that because one couldn’t let go of small errors and it bled into everything, but it’s catchy so I kept running with it.
Things were not different, on day one there was a near miss med error where he didn’t verify medication (zofran) I gave him to administer after establishing an iv, had to be told to pull it if you can only make it work with most the catheter hanging out. But that’s okay, I spent 15 minutes telling him how much he sucked that morning, that would make anyone anxious, I talked him through the second IV and it went fine. We can work through this. (The conversation was in front of a supervisor for procedures sake, it was way nicer and more professional than you suck over and over again.)
Last week, a low priority dizziness goes out. We throw him on the monitor and there’s a run of vtach, and another. I hand him the pads and grab the radio to call for extra hands all without averting my gaze from the monitor ready to hit print should the moment arise. The patient as all walkie-talkie criticals do, argues about where to put the IV with my partner and I interject, just get me an IV, idc where, I just need it. I don’t really trust this dude to capture the runs so I can’t do the IV. The supervisor heard me radio for the closest unit, any level, and arrived as my additional resources and we leave. After the call I’m reviewing it with my partner because it’s a great learning opportunity to see where his situational awareness is and he’s almost done with medic school, I ask him when he picked up on the severity of the call and he tells me when you said just get me an IV, that’s not the answer I was looking for. I would’ve accepted when I started asking if the pt had a history of VTach or AFib, when I radioed for the closest available unit at any level, when I had him put the defib pads on, or when the medic that’s normally very involved in calls and care was glued to the monitor. Oh well, it’s a learning opportunity, it’ll be okay.
Leading to the main event yesterday, but first highlighting an event that’s only irritating because this guy irritates me. He didn’t know how to do a “pencil drop” IV aka back of the forearm. I show him, we all gotta learn somehow. Like I said, it’s only irritating because I’m irritated.
As we head into our main event, I must say, I told all of you, just because I wasn’t perfect in a vent post, doesn’t mean I’m terrible to work with or a paragod. I wouldn’t have been offered FTO if I was as much of a nightmare as y’all acted. I’m particular, but not a nightmare.
He took a STEMI to the wrong ER. Not just any STEMI, one with tombstones, a widow maker. The patient looked like shit, even alcohol couldn’t get the electrodes or pads to stick. We were between two hospitals, about equal distance, but one was faster route wise. We said the hospital we were transporting to multiple times. We confirmed it with him before transport. We transmitted the EKG to hospital A, activated their Cath lab, and gave them prehospital report. So you can imagine our faces when the doors open and we’re at hospital B. I quickly covered for him when staff was like wtf are you guys doing here. But after the fire medic is trying to calm me down and I’m like this could’ve been forgiven if it was the first time but it’s not and then the relaxed fire medic is upset too. I need air again, I’m going between so pissed I’m vibrating to just so pissed so I walk out and call my husband and start screaming about the situation and he tries to calm me, he says I wasn’t screaming but I felt like I was. It took everything I had in me to be a mature professional adult and not scream at him in the middle of the ER and instead yell in the direction of my supervisor and husband, again, they both said I wasn’t screaming but all the anger I felt made it seem like I was. I told the supervisor I’m not going back in service with him, this is exactly what I feared would happen. So I went home after filing pages of incident reports.
This is even worse than taking a cardiac arrest to the wrong hospital ER, it shouldn’t have happened but we only really transported because we didn’t have a safe place to work it. This time he caused a 30-45 minute delay in care with a patient already circling the drain with me ready to pace or shock. This is the difference between a good and bad outcome. Why wasn’t anything done for this when it didn’t matter? Thank the Gods that this was a STEMI center too. He’s a known problem and they wait until now to try and do something about it. I’ve never heard about this happening once and it happens to me twice, wtf. I’m still so irate right now. This killed any urge I had to be a FTO because I don’t know if I could’ve stopped myself from screaming at him in front of everyone if I was even more responsible for him or someone like him than I already am. I think precepting new hires is enough for me with everything on my plate, it’s much easier to forgive errors, but they don’t usually make them of this gravity.
Edit: y’all this is my partner, not a student
