Overruling captain!

[u/Ok_Assistance69]

Just getting opinions here. Other night we had a well known psych patient who’s not only know to verbally accost medics/hospital staff, but can get aggressive. Delt with her multiple times where our local PD had her cuffed, hands on a taser. On scene for the THIRD time that week same patient, different captain (not mine, was working OT) and I told this captain “we’re going to need PD” Captain replied back “THIS IS NOT A PD ISSUE” very loud and aggressively I might add. I stated “she can get aggressive” he replied back “SHES NOT AGGRESSIVE”and he denied calling PD. Once she was loaded on the stretcher, she started to become verbally hostile, then and only then did the captain call PD. Then I was instructed to go to my patient. She started getting verbally hostile with me. I was told to get in the engine at this point and the other medics would run the call. PD followed the medic unit to our local ER.

Now, we all learned “BSI/scene safety” right? I always thought it was a medics discretion if it came to safety. KC firefighter died over a psychiatric patient after being stabbed by her. Another psych call, patient flew out the back doors and ended up being killed by a semi truck.

Does anyone think this needs to go up the chain? I feel mine AND my crews safety was compromised by a captain with a superiority complex and this captain has been known for his temper. His behavior was unprofessional, unacceptable and unbecoming an officer.

Opinions???

[u/RJM_50]

Ugh, I thought we were past this "old generation" bullshit where they didn't run medical as a rookie. The Medic in charge of that runs patient care runs the show, it's their license. What "Captain Licence" did he have to outrank you in patient care?

Your crew screwed you over taking patient care, they should have all looked around and told the Captain if he wants to change patient care, he's the Medic in change now!😒😂 Are you a rookie or was the replacement Medic a rookie? I wouldn't have played hot potato, especially from the Engine, if you're assigned to the rig that shift he can't move personal unless it's multi victim incident that involves more patients than rigs. Moving on/off the Engine usually has a change in pay or counts towards how many days you've worked in on EMS, depending on your Union contract. Some guys work longer in their career on the Ambulance because it pays more with seniority, and they haven't lost their sanity (yet)!

Generally the few large City Fire Departments that run EMS all have to be trained; AND Paramedic if they want that juicy pay, EMTs are generally flunkies that don't last! So everyone on the Engine and that Captain should know the etiquette rules. Or departments like Detroit have separate Unions and training for Fire & EMS, they can't swap from the Engine like that.

But if you're asking us, then your Union sucks, or you don't have enough friends and/or years of experience at this Department to get the advice you really need.

[u/Ok_Assistance69 → u/RJM_50]

5 years in, just biased admin

[u/RJM_50 → u/Ok_Assistance69]

Sorry to treat you this way, but I(we) need more information to give correct detailed advice; I've been a Rookie, the Commanding Officer, and Medical Training Officer for Rooks (including working for the local community college Paramedic Academy throughout my career).  Please answer the following to the best of your ability without disclosing too much personal information, but don't be vague with the important details! If you want us to we need some important details.  Sorry but I'm going to treat this just like I would if I was reviewing this call as the Fire Department Medical Supervisor (I've held that position 😂 ) I need an accurate history of the events:

**1) Was this Captain also a Licenced Paramedic?

2) Is this Captain newly promoted or close to retirement? Or any career change coming soon?

3) Was this Captain dispatched to other medical calls during your shift? 

4) Does your department dispatch an Engine with each Ambulance medical call?  (Likely because more Engines are available than rigs more likely stuck finishing up at the hospital before being dispatched to the next call). Or is it not common for an engine to go out on medical calls?

5) Are you allowed to Radio dispatch or is that all handled by the superior officer on the Engine?

6) Is there no situation where you can radio dispatch for Leo backup? Without getting approval from the officer on the Engine?

7) How much experience did the replacement Medic have?

8) This is a large(r) metropolitan Fire Department and you're an IAFF Union member, correct?

9) You're not like Detroit Fire and EMS separated; with a different IAFF contract, different chain of Command, and low chance somebody on the Engine is up to date with their Paramedic training and licensure, correct?

10) Did you get back on the Ambulance after this call, back in service for the next call away from this Captain, or stayed on the Engine?

11) Does your Department track EMS days differently than Fire days; for your Union commitment before you can step away from EMS and work on Fire career advancement?

12) How did this psych run get documented? The replacement Medic must have done all the documentation under their name, yes? How much information did you volunteer for them to complete the beginning of this run? How many times did this replacement Medic use your name in the report?  Or was this report extremely vague with all of the "drama" redacted (per the Captain's pressure to exclude any & all "drama")?

13) Did you ever speak with the responding LEO at the hospital about the "drama" without anyone looking over your shoulder?

14) Did you ever speak with the replacement Medic about the "drama" at any point after this run? (IMO that's the #1 individual you should be talking to about this!)

15) How is "the Administration biased?"

16) thanks for answering these questions!** 🍻

There are few remaining large City Fire & EMS together, which are better trained because everyone is the same level of Medic (generally). They all have the better medical training, and get days on both sides. And they usually offer an option to exit EMS rotation after X number of years (or actually X days worked per the Union contract), it's not a standard number for all departments or even employees depending on how often the Union contract is negotiated, different groups hired in would be under a revised contract based on when they hired in and seniority.  This started in the 1990's for most departments, that ended the days of a Fire Command officer giving orders to EMS with no clue of patient treatment or the severity of the situation, we were just little trucks in their way. But a decade later and all of Fire Dept Officers now had Paramedic Academy training by 2005 all the old Fire only Officers had retired. I retired in 2022 from a Fire & EMS IAFF larger municipality.  After the "old guys" retired I never heard of anyone having a situation like this. Only it a Rook was (their opinion) putting the patients like in danger, but then the commanding Officer was a mediocre Paramedic (like myself) and would assume control of patient care and it was documented; so then the Rook would get the appropriate corrective training; and the commanding Officer would be questioned on their rational for those actions.  Whomever reviews medical runs should be coming to that: replacement Medic, the Captain in command, and yourself (unless this drama was intentional left out of the run).🤔😒🫤

[u/Ok_Assistance69 → u/RJM_50]

1. NO, not a Paramedic.

2. Has been in the position 2 yrs

3. Yes he was, but he chose not to go on those even though it’s in our response posture. Don’t know why he chose this one.

4. Very VERY small paid dept so yes, they are “supposed” to go on most calls.

5. Yes, we are allowed to radio dispatch at anytime needed as long as it’s articulate to some degree

6. We have no official “policy” on that. My shift captain stated I was in the right and if I feel I need resources it’s not up to him to tell me no.

7. I’ve been there longer than both replacement medics by at least 4 years. Both medics are “baby medics”

8. Yes, IAFF (just a small dept)

9. No we are EMS/Fire integrated

10. No, he told me to “attend to my patient, she started screaming, I told him “SEE” and then he pulled me. I stayed away from him. Called MY captain and then my EMS captain, was told to write a statement. My taking up the chain would be the city/HR if my admin avoids this.

11. Not sure I understand the question

12. I have no idea. I have not been communicated to in regard to this or what the other medics documented. I do know they stated he handled it incorrectly

13. I did not go to the hospital. I was instructed to get on the engine and I would be driven back to the station

14. Only that the whole ordeal was not handled correctly by the captain (his hostility)

15. Good ol boys club. Everyone in current leadership is friends or friends of friends. Hired on/promoted because admin knew them, not because they could perform the job. Honestly they’re all free masons.

16. You’re welcome!

I will say this particular captain has been the talk of many at the dept. Known for his explosive temper and hostility. What I found cowardly is he didn’t even ride in the call since he wanted to make the decision so badly. He made two others do it. He’s honestly one of the worst captains I’ve seen. Sure, is he great on fire, yup! Is he a peoples captain?? NO! He also has a huge distain for women in the field.

One of the medics that took the call is a good guy, but not sure he would document that for fear of retaliation. The other medic is aspiring to be a captain, so either he will play the game to get the job, OR watch everything this guy does to get him out. Not sure though.

Thanks for your time! Let me know what you think

[u/RJM_50 → u/Ok_Assistance69]

1) Captain wasn't a paramedic!🤯 That's absolutely unacceptable this needs to be escalated to your local Medical Control Authority (MCA)

2) 2 Years is not enough in his position to have 

3) Absolutely unacceptable he skipped out on the psych patient after making medical care decisions!

4) What do you consider small, how many Union members? Ambulance on call? Trucks in service? I don't want to assume "Small" and give the wrong advice.

5) Okay, any reason why you didn't just radio dispatch for an Officer to your location? Before this Captain gave bad opinions.

6) Again if you're not obligated by a policy on contacting dispatch; I'm not sure why you didn't just make that (radio) call?

7) I suspected there was some rookie bullshit!  You need to talk to that replacement Medic and so they understand a legal patient care transfer, and "Duty to Act" you were already obligated unless replaced by somebody with a higher medical license.

8) I would talk to your regional MCA is likely the most important organization that will stop this Captain from overstepping ever again. They will contact your Fire Department administration about this continual problem.

9) If your department is Fire & EMS integrated; why is this Captain not licensed accordingly?

10) That's why I would contact the MCA, it would avoid the HR/City Hall potential waste of time.

11) This might be why the Captain is no (longer a) Medic...  Here once you work ~600 days on the Ambulance or the equivalent of 6 years, we have the option to stop running shifts on the Ambulance, but there is a pay decrease, however that's usually the time when we'd get promoted to a Captain and get that pay increase. Some colleagues decide to keep going for the pay and they enjoy the ambulance. While others are willing to skip the pay for the reduced stress. Does that make sense?

12) That's not acceptable, I'd mention the rookie didn't document the beginning of the call to your MCA. Or they faked that initial documentation?

13) WOW! This sounds like you were officially reprimanded and should ask HR about what happened, not making a complaint at first, just asking why you were sent to "timeout" by a Commanding Officer who doesn't have a Medic license!

14) Depending on how "small" your department is, you should start to speak up to the rookies at this point, it's obvious they don't know how to deal with this Captain and aren't making good medical decisions.

15) Depending on the size of your department and how old this "Good old boys club" is, they might be close to retiring out and then it's over. That happens to us in the late 80s/90s when they didn't understand the importance of the ambulance to the community.