What is dangerous?
How about looking at a clearly sick patient and saying You aren’t sick enough to get a ride in my ambulance based on I don’t know.
“He came in and said, ‘This is another attention-grabber; she’s faking it; there’s nothing wrong with her,’ ” Chavez said. After Tate continued to balk at authorizing her transport to the hospital, despite her vomiting and other symptoms, she said her family used a car with bad brakes to drive her themselves. She was hospitalized for the next seven days.
This does not appear to be a good example of assessment skills.
This may be an example of a lack of assessment, but we do not know what was done, assessment-wise.
Her treatment by Tate became part of the Albuquerque Fire Department’s basis for firing the 10-year paramedic lieutenant last January. A five-month internal investigation of Tate’s conduct turned up so many serious instances of misconduct that AFD Chief James Breen testified this week that he didn’t consider rehabilitation, suspensions or other type of lesser discipline.
He has been doing such a bad job that management considers him to be irredeemable?
It seems that the problem is a lack of oversight.
He has been a medic for ten years.
He is a lieutenant.
As an officer, he is in a position where he is supposed to have demonstrated more than the usual amount of responsibility. After ten years, the officers above him should already have an idea of what kind of assessment and treatment he provides, or fails to provide. If this is a sudden departure from the assessment and treatment he has been providing, then there should be a consideration of possible causes, such as PTSD (Post-Traumatic Stress Disorder).
The AFD undertook an investigation that included a review of 18 months of 911 calls that involved Tate.
Of the 300 or so reports Tate filed on those calls, about two-thirds raised red flags or showed some type of problems, according to testimony from now-retired fire department EMS commander Jon Sigurdson.
I would expect to hear about problems the same week I wrote the charts, especially if this involved most of my calls. If I could write 200 problem charts without negative feedback, then that would suggest that the problems were not detected by the QA/QI/CYA department until after a specific complaint.
One call was labeled cancelled by Tate in a report, even though the patient showed abnormal heart rhythms at the scene and wasn’t transported.
Maybe they have different rules there, but a cancel is a call where I never even begin to assess the patient, never mind hooking up the heart monitor (or was the patient on some other heart monitor?).
Some 911 calls appeared to be dismissed as “anxiety attacks,” even though paramedics aren’t supposed to diagnose patients, testimony showed.
We do diagnose.
I have had plenty of patients who were hyperventilating, but were able to be calmed to the point where they no longer wanted to go to the hospital. All of these patients were advised to call 911 again if their symptoms returned. If a patient wants to go to the hospital for anxiety symptoms, I take them.
Many of Tate’s reports “were so grossly inadequate it was virtually negligence,” Sigurdson said.
I see that as a failure of oversight.
This appears to be a response to a complaint that resulted in recognition of serious problems that had not previously been seen as serious.
Remediation is almost always the first step, but recognition of the problem before it becomes overwhelming is important.
He also said his report writing improved after the records management section notified him about incomplete reports.
What message does management seem to have been sending?
You are doing a good enough job to be one of our officers, even though some of your charts are not complete. Were other problems mentioned?
Testimony showed that Tate’s “bedside manner” provoked complaints from patients and their families in the past, but not until another AFD lieutenant complained about Tate’s treatment of his 16-year-old daughter last year did AFD officials look at his standard of medical care to patients.
And there are other examples of complaints.
Why has it taken so long to address these? Has remediation already been attempted several times?
There is an article from 2012 that describes several other problems over the past decade for a Brad Tate that works for Albuquerque Fire Department.
He does look intimidating in this picture, so maybe management
is was intimidated by him.