The Code of Ethics sets out the basic ethical commitments that guide all regulated members of the paramedic profession in Alberta. Each regulated member is required to understand and comply with this Code, but how does this translate in the day-to-day work of EMRs, PCPs and ACPs?
In an effort to help regulated members understand and apply the Code of Ethics to real life situations, we will be sharing scenarios that give context to the Code and ideas on how to implement this into practice.
As you may know, the Code of Ethics sets out the basic ethical commitments that guide all regulated members of the paramedic profession in Alberta. Each regulated member is required to understand and comply with this Code, but how does this translate in the day-to-day work of EMRs, PCPs and ACPs?
The following scenario addresses responsibility to oneself – recognizing professional limitations and practising within one’s education, training, knowledge, skills and judgement.
Scenario:
A Primary Care Paramedic (PCP), Maya, has worked on a rural ambulance for two years. During an evening shift, Maya and her partner, Daniel, respond to a community recreation centre for a middle-aged patient with severe shortness of breath, low blood pressure and signs of worsening respiratory failure. Freezing rain has delayed the responding Advanced Care Paramedic (ACP) unit, and transport to the nearest emergency department will take approximately 35 minutes.
The patient’s condition continues to decline despite the care Maya is authorized and prepared to provide. A recreation-centre employee identifies a bag of advanced airway equipment kept onsite for special events. Daniel suggests that Maya use an endotracheal tube, noting that he has seen ACPs perform the procedure many times and that doing something may be better than waiting.
Maya recognizes the equipment from training demonstrations and has assisted an ACP with similar procedures. However, she has not been educated, assessed or authorized to independently perform this intervention. She also knows that observation and informal exposure do not establish the knowledge, technical skill or clinical judgement required to use it safely.
Maya feels pressure to act. The patient’s family is asking why more is not being done, Daniel appears increasingly concerned and the ACP unit remains delayed. Even so, Maya pauses and clearly identifies her limitation: the procedure falls outside the functions she is currently authorized and competent to perform independently.
Rather than attempting the advanced intervention endotracheal intubation, Maya continues the assessments and treatments that are within her scope, optimizes oxygenation and ventilation using the equipment she is trained to use, requests updated medical direction, asks dispatch to explore an alternate intercept point and prepares for rapid transport. She delegates appropriate tasks to Daniel and communicates the patient’s changing condition using clear, closed-loop updates.
The crews meet enroute. Maya gives the ACP a concise handover, including the patient’s response to treatment and the limits of the interventions available before intercept. The ACP assumes care and performs an advanced airway intervention. The patient is transported to hospital with improved ventilation.
After the call, Maya and Daniel debrief with their supervisor. Maya explains why she did not use the advanced device and reviews the clinical decisions she made within her authorized scope. Daniel acknowledges that urgency and familiarity with a procedure had influenced his suggestion, but neither replaced the education, training, assessment and judgement required to perform it safely.
By recognizing her professional limitations, declining to perform a function outside her competence and actively pursuing safe alternatives, Maya demonstrates accountability to the patient, her partner and the profession. Her response shows that remaining within scope is not inaction; it is the disciplined use of available knowledge, skills, judgement, consultation and resources to provide the safest possible care.
Recognizing professional limitations means:
- Knowing the functions permitted within your current scope of practice and any conditions or restrictions that apply.
- Honestly assessing whether you have the education, training, current knowledge, technical skill and clinical judgement required for a specific function.
- Understanding that having observed, assisted with or previously learned about a procedure does not automatically establish current competence to perform it independently.
- Not allowing urgency, peer pressure, patient or family expectations, or the absence of a higher-level practitioner to push you beyond your capabilities.
- Continuing to provide all appropriate care within your scope rather than treating a limitation as a reason to disengage.
- Seeking consultation, medical direction, additional resources, an intercept or transfer of care when the patient requires functions beyond your competence.
- Communicating limitations and escalating concerns clearly so that the team can make a safe and timely plan.
- Pursuing additional education and supervised practice when a recurring limitation identifies a learning need.
This scenario demonstrates that professional responsibility includes knowing when not to perform a function. A regulated member must consider both formal scope and personal competence in the circumstances. By naming her limitation, using the full range of care available to her, seeking support and transferring care appropriately, Maya protects the patient while maintaining professional accountability.
As you may know, the Code of Ethics sets out the basic ethical commitments that guide all regulated members of the paramedic profession in Alberta. Each regulated member is required to understand and comply with this Code, but how does this translate in the day-to-day work of EMRs, PCPs and ACPs?
The following scenario will attempt to address responsibility to oneself – maintaining mental and physical capacity.
Scenario:
An Advanced Care Paramedic (ACP), Jeremy, has been working as a paramedic for several years. A few months ago, Jeremy responded to a particularly traumatic call involving a critically injured child. Although he initially felt that he was coping well, he has started to notice changes in his mental and emotional wellbeing since the call.
Jeremy has started experiencing intrusive memories of the incident and occasionally finds himself thinking about the call while at work. He has begun having nightmares and wakes frequently throughout the night. He is increasingly irritable and finds himself becoming frustrated with his partner and other healthcare professionals over things that normally would not bother him.
Jeremy has also become more withdrawn outside of work. He avoids talking about the incident and has stopped participating in activities he previously enjoyed. He feels constantly “on edge” and is easily startled by unexpected noises. On some calls, particularly those involving children, Jeremy experiences a strong emotional response and has difficulty concentrating on the task in front of him.
Despite these changes, Jeremy continues to report for work. He tells himself that he should be able to handle what he has experienced because he is a paramedic and does not want his colleagues to think that he cannot do his job. He is also concerned about being taken off the road if he tells anyone what he has been experiencing.
During a call involving a pediatric patient, Jeremy notices that he is struggling to focus. He catches himself repeatedly thinking about the previous traumatic incident and realizes that he has missed part of the information his partner is providing. His partner notices that Jeremy seems unusually distracted and asks if everything is okay.
After the call, Jeremy reflects on what has been happening. He recognizes that his symptoms are no longer limited to his personal life and may be affecting his ability to remain focused, make sound clinical decisions and provide safe and competent patient care.
Jeremy decides that continuing to practice while experiencing these symptoms could put both himself and his patients at risk. He speaks with his supervisor and arranges to stop working. He also seeks appropriate professional assessment and treatment to address what he has been experiencing.
By recognizing that his mental health symptoms may be affecting his ability to provide safe and competent care, Jeremy takes action before an incident occurs. His decision to seek treatment, refrain from practicing, and notify the College demonstrates professional accountability and prioritizes patient safety.
Maintaining mental and physical capacity means:
- Recognizing changes in your mental, behavioural, or physical health that may affect your ability to practice safely.
- Paying attention to symptoms such as intrusive memories, nightmares, heightened alertness, emotional distress, avoidance, irritability or difficulty concentrating.
- Recognizing when symptoms begin to affect clinical judgment, concentration, communication, decision-making or interactions with patients and colleagues.
- Seeking appropriate assessment, treatment and support when a condition may affect your ability to practice.
- Refraining from practicing when your ability to provide appropriate and competent care is compromised.
- Contacting the College when a leave from practice may be appropriate and understanding the requirements associated with a self-declared leave.
- Understanding that seeking help and stepping away from practice is part of professional responsibility and does not represent a failure or weakness.
- Taking action early, before a condition contributes to an error, patient harm or unsafe practice.
This scenario demonstrates that maintaining mental and physical capacity is not simply about being physically capable of completing a shift. Regulated members have a responsibility to recognize when their mental or behavioural health may affect their ability to practice safely and competently. By seeking help and formally stepping away from practice, Jeremy demonstrates accountability to himself, his patients, his colleagues, and the profession.
Self-Declared Leave from Practice
Note: Regulated members who are taking a physical or psychological medical leave from practice, where they do not have the capacity to complete CC requirements, can submit a request to the College to have an adjustment made to their CC credit requirements during their time away from practice.
As you may know, the Code of Ethics sets out the basic ethical commitments that guide all regulated members of the paramedic profession in Alberta. Each regulated member is required to understand and comply with this Code, but how does this translate in the day-to-day work of EMRs, PCPs and ACPs?
In an effort to help regulated members understand and apply the Code of Ethics to real life situations, we will be sharing scenarios that give context to the Code and ideas on how to implement this into practice.
The following scenario will attempt to address responsibility to the profession – respecting professional relationships.
Scenario:
An Advanced Care Paramedic (ACP), Sarah, has been assigned as a preceptor to a Primary Care Paramedic (PCP) student, Jake, during his clinical practicum. Over the course of several shifts, Sarah notices that she feels a personal attraction toward Jake. She recognizes that while these feelings may be natural, her role as a preceptor places her in a position of authority and influence over his learning, evaluation and overall success in the program.
Jake, who has also developed an attraction to Sarah, approaches her at the end of a shift and asks if she would like to spend time together outside of work. He suggests that since they get along well, it could be a chance to get to know each other better in a more personal setting.
Sarah pauses and reflects on her professional responsibilities. She recognizes that engaging in a personal or romantic relationship with a student she is directly supervising would create a clear power imbalance and could compromise both the integrity of the learning environment and the fairness of Jake’s evaluation. Even if the relationship appears consensual, the inherent authority she holds as a preceptor makes it ethically inappropriate.
Sarah responds by thanking Jake for his honesty, but clearly and respectfully sets a boundary. She explains that, as his preceptor, it is her responsibility to maintain a professional relationship and ensure a safe and unbiased learning environment. She emphasizes that this boundary is in place to protect both of them and uphold professional standards.
She also acknowledges that the situation could feel uncomfortable and offers to speak with leadership about arranging a different preceptor if that would better support his learning experience. Jake appreciates her transparency and professionalism and indicates that he is comfortable continuing the practicum under her supervision.
Jake further reflects on the situation and agrees that maintaining professionalism is the priority. He shares that he is happy to complete the practicum as planned and suggests that, once the educational relationship has formally ended and there is no longer a power imbalance, they could revisit the conversation if mutual interest remains. Sarah agrees that any future discussion would need to occur entirely outside of the professional, educational and evaluative context.
Sarah considers informing her supervisor or educator about the interaction and documents it according to organizational policy. She continues to treat Jake with respect and professionalism, ensuring that his learning experience remains fair, supportive and focused on clinical competence.
This scenario highlights the importance of maintaining professional boundaries, particularly where there is a power imbalance. Even when mutual attraction exists, regulated members must prioritize their ethical obligations over personal interests.
Respecting professional relationships means:
- Recognizing and managing power differentials
- Avoiding dual relationships that could impair objectivity
- Maintaining clear, professional boundaries with students and colleagues
- Acting in a way that upholds trust in the profession
By choosing to set clear boundaries while also supporting the learner’s comfort and autonomy, Sarah demonstrates her commitment to the Code of Ethics 4.5 and to fostering a respectful, safe and professional environment for learners and colleagues alike.