As you may know, the Standards of Practice set out the minimum standards in paramedic services. Each regulated member is required to understand and comply with these Standards, 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 Standards to real life situations, we will be sharing scenarios that give context to the Standards and ideas on how to implement this into practice.
The following scenario will attempt to address defining restrictions.
4.0.2 Restriction
Despite any authorization to perform restricted activities, regulated members must restrict themselves to performing only the restricted activities that they are competent to perform. Additionally, members must only perform activities that are appropriate to the clinical circumstance.
Scenario:
Kevin is an Advanced Care Paramedic who has recently returned from parental leave where he was away from the workplace for nine months and not practicing in the field. Kevin is on a gradual return to work where he is riding as a third paramedic on the ambulance for three tours so that he has the ability to regain some confidence in his skills and to ensure that he is comfortable on his own. Kevin is paired with another ACP by the name of Josh, as well as a PCP named Cherie to help with his return.
It is Kevin’s second day of his return to work when he, Josh and Cherie are called for an emergent transfer out of their local community hospital. When Kevin and the crew arrive on scene, the physician and nurses are actively caring for a 50-year-old male patient that had received a life-threatening gunshot wound to the abdomen. As Kevin, Josh and Cherie arrive, the hospital staff ask Kevin to initiate an additional IV line and administer a bag of packed red blood cells while Josh and Cherie start to package the patient for transfer to a surgical facility.
As Kevin is initiating the IV line, he is finding it difficult to concentrate as his thoughts are being consumed by how to administer blood and blood products. He begins racking his brain and trying to remember his training from many years prior and begins to worry that he is not feeling confident in his competence and skill to be able to administer blood safely.
Kevin decides to call Josh over to let him know that he is not feeling comfortable performing this restricted activity (even though he is authorized to perform it) as he doesn’t feel competent to perform the skill in that moment. Kevin also recognizes that this administration of blood is appropriate to the clinical circumstance of this patient.
Recognizing the strength and professionalism that Kevin just demonstrated, Josh reassures Kevin that he will take over the administration of blood for this patient. Josh also lets Kevin know that they can review this skill after the call so that he can feel comfortable next time there is an opportunity to administer blood or blood products. Kevin breathes a sigh of relief and begins to help Cherie prepare and package this patient for transport.
In this example, Kevin and Josh both demonstrate their knowledge and adherence to the Standard 4.0.2 Restriction, where despite any authorization to perform restricted activities, regulated members must restrict themselves to performing only the restricted activities that they are competent to perform. Additionally, members must only perform activities that are appropriate to the clinical circumstance.
Kevin did a good job recognizing that, while he had authorization to perform the administration of blood, he had not done it in several months and didn’t feel comfortable in his level of competency in doing so. By letting his partner Josh know that he didn’t feel competent, Josh was able to step in and administer the blood to the patient in need. Josh did a good job of offering to help Kevin review the administration of blood and blood products after the call so that for the next patient encounter, Kevin could feel confident and competent.