Friday, September 3, 2010

As the Cretin Thinks (or not) Episode 3

If you haven't been keeping up with the ongoing saga of the developments at my non-Fire/EMS employer, read the first installment HERE and the second installment yesterday is HERE. You really need to read these in order if you are just catching up. I don't want to bore anyone with repetition.
 I will also summarize the positions of each of the players to spare you the blow by blow. To type it all  out is too painful right now (I am still pretty angry) and would use too much space. Frankly, it's not funny anymore. The company has put me in a very difficult position and I am spending the weekend deciding if I can remain there with the parameters they have established, or if my ethics require that I move on.
 So let me introduce you to the players: First, coming on as the local EHS specialist we have the Environmental Health and Safety Wienie [EHSW], you all met her in the last installment. She is the gal who is charged with making all the programs work at our plant. Next we have the EHS Mangler [EHSM], she is the Manager at our plant that makes the hard decisions and really makes things happen. She is EHSW's boss. Rounding out the brain trust we have the Corporate Occupational Hygiene Consulting Occupational Health Nurse [COHCOHN].
 OK so what follows is the bottom line stance of each of the players after we had a phone conference today which was clearly crafted to ambush me, put me in 'my place' and make it clear that what I or the Law said made no difference. It had been decided, and I was to pay attention. What I was told, on the other hand was that this was my opportunity to have my concerns heard and find a workable solution. I came prepared with both the public health law of our state and the documented standards of our Corporation which we had used to establish our procedures.
 Here are the closing arguments. no further discussion will be considered:

 [EHSW] I am just a pion here and do whatever they tell me, I just want everyone to get along. I don't like all this talking and debate, it makes my head hurt. Whatever they say, goes. I will do what they tell me whether I understand it or not.

[COHCOHN] I understand your concerns because I used to work in an Emergency Room. I appreciate that you want to help your co-workers when they need you. However we have concluded through a super secret  method (that is so secret, even we don't know what it is) that your facility does not require the services of an EMT and we will therefore not support that level of care. Yes I know you have made it clear that you need no support and offer the assistance freely, but we don't want you doing it anymore. You will remove any tools, appliances, or devices from the building which require training above the level a a Red Cross Basic First Aider. You may not use a stethoscope, B/P cuff, Splint, BVM, oral or nasal airway adjunct. You may stop bleeding, take a pulse, count respirations, apply band-aids, and perform CPR on adults with the minimal tools we provide and no more. I have covered my ass, that's all that matters to me. So I have spoken, so you will do.

[EHSM] I have tried to find a compromise between the ridiculous requirements set forth by the COHCOHN and our EMT who has demonstrated his value to our employees beyond doubt. However, I really like my job so I have to do what Corporate dictates and I cannot put anything in writing that is against policy, so I won't. Besides, this is a holiday weekend and it's almost noon so I need to get out of here and begin partying. Let's all be polite and say goodbye on the phone call, and you and I can go talk in my Office......... OK, now that it's just you and me and you have no witnesses I am going to tell you what I really think we need to do. Let's just put this process in place and document it the way the COHCOHN wants it. We will remove all those dangerous things from the building and make her happy. When somebody has an issue, you do whatever you have to do, just like you have before and we'll worry about it later. Don't worry, we'll figure something out, we just won't tell anybody. I do not want to have somebody die because we told you that you can't do certain things, even though we have told you that you cannot do certain things. I also have to insist that you never tell anybody that we have told you to withhold care, even though we are telling you do do just that. That would look really bad.  In other words, I am trying to cover my ass, make sure our employees are protected, and put the whole responsibility on you to do what you know is right even though we have told you not to do it in an official/unofficial kind of way. That's pretty simple and should work for you right? Good! I have to go to my hide-away cabin in the mountains and start drinking now...BYE! OH, and have a NICE holiday!

[ME]: I have been prohibited from performing basic assessment skills. The jackass that the corporation has hired to advise them is going to advise them right into a lawsuit of major proportions that could be successfully waged by any paralegal. The Company has taken away the tools I need to provide a complete basic assessment to the responding Medic hereby delaying transport. That's in the best case, in the worst case, with no airway adjuncts, no BVM, and no O2, I could very well lose a patient before the medic arrives (6-25 minute response time, as recorded). The "Company" says "NO", but the Mangler says "Yes, sort of" with a wink.
 My bottom line is this: can I live with this very undefined set of rules? I asked: "what if I 'did what I had to do for a critical patient', would I get fired?" I got no answer, just "we 'll worry about that later". I know already what that means, even if she doesn't. If the patient dies, I get fired, and if he lives, we'll let it go, this time. I am having a hard time with this because I am a very honest and ethical person. I don't lie to others or to myself. The pressures of patient care are tough enough without worrying about the rules you are working under.

I am going to have to take this weekend and decide if I am staying in this job or not. I really don't enjoy working with people who have no ethics or spines. They want my help, but they don't want to say that out loud. As long as I stay in the closet and take it on my own chin, they are ok with it. As soon as they need to put some skin in the game, they run for their mountain cabins and liquor cabinets.

This is a tough one for me. ANY advice out there? How about the big boys? Justin, Mark.. are you guys listening? This is my version of EMS 2.0, "The war of the Cretins" industrial style.



  1. That sounds like the biggest load of bullshit I have ever HEARD!!!


    The back-ass talking is so stupid. I would (yet I am not office politically correct in any means) tell them flat out "If I have a paitent that requires my attention- for what ever reason- I will use my full skill set to aid that person. If you don't like it. Fire me. Make a decision like someone's life depends on it because it does! if not, then shut up and let me do my job!"

    Anyway that's just me, blunt and to the point with minimal bullshit! I hope you get this sorted!


  2. It's unfortunate, but there's no way to get your way in this situation. The employer decides what level of care they want to provide to their employees.

    Its noble that you're offering more and can provide more, but I really would play the game exactly as COHCOHN wants it.

    "I know already what that means, even if she doesn't. If the patient dies, I get fired, and if he lives, we'll let it go, this time."

    Wrong. EHSM will never in a million years cover your ass over his/her own, and you have no proof that the coversation ever happened. The second COHCOHN finds out you acted out of the defined scop of practice, you're history- regardless of the patient outcome. You could sue, but your chances of winning are slim. I garuntee they can pay a lawyer for longer than you can.