An update to my post from last week and yesterday: I donāt want to be an FTO, I couldnāt 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 itās been three months and heās upgraded so things will be different this time. She said itās a fresh start and I need to give him one, so I tried because my mantra is, āevery call is a fresh start.ā I only started saying that because one couldnāt let go of small errors and it bled into everything, but itās catchy so I kept running with it.
Things were not different, on day one there was a near miss med error where he didnāt 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 thatās 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 thereās 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 donāt really trust this dude to capture the runs so I canāt 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 Iām reviewing it with my partner because itās a great learning opportunity to see where his situational awareness is and heās 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, thatās not the answer I was looking for. I wouldāve 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 thatās normally very involved in calls and care was glued to the monitor. Oh well, itās a learning opportunity, itāll be okay.
Leading to the main event yesterday, but first highlighting an event thatās only irritating because this guy irritates me. He didnāt know how to do a āpencil dropā IV aka back of the forearm. I show him, we all gotta learn somehow. Like I said, itās only irritating because Iām irritated.
As we head into our main event, I must say, I told all of you, just because I wasnāt perfect in a vent post, doesnāt mean Iām terrible to work with or a paragod. I wouldnāt have been offered FTO if I was as much of a nightmare as yāall acted. Iām 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 couldnāt 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 weāre 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 Iām like this couldāve been forgiven if it was the first time but itās not and then the relaxed fire medic is upset too. I need air again, Iām going between so pissed Iām 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 wasnāt 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 wasnāt screaming but all the anger I felt made it seem like I was. I told the supervisor Iām 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 shouldnāt have happened but we only really transported because we didnāt 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 wasnāt anything done for this when it didnāt matter? Thank the Gods that this was a STEMI center too. Heās a known problem and they wait until now to try and do something about it. Iāve never heard about this happening once and it happens to me twice, wtf. Iām still so irate right now. This killed any urge I had to be a FTO because I donāt know if I couldāve 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, itās much easier to forgive errors, but they donāt usually make them of this gravity.
Edit: yāall this is my partner, not a student