Sounds like some of the gears in your department's training program need some grease. Whenever somebody tells me questionable applicants have slipped through the cracks, it usually means the cracks are really large crevices.
The screening phase for new applicants is the prime time to weed out the losers from the thinning herd of applicants. If you allow people with lousy attitudes, backgrounds or skills to get by this level and enter your system, you'll get stuck with them for months, years-even an entire career. And don't think you can always identify and terminate poor performers during their probationary period. I've watched some masquerading medics hide behind the skills of others and avoid difficult patients throughout their entire probationary period. Their true skill level later surfaces like a creature from The Black Lagoon, and they provide horrible care on the street.
In my experience, if you allow an incompetent provider to perform EMS in your department and handle patients, you end up with marginal care, poor decisions and, often, dead patients. I don't mean these dolts purposely allow patients to die. But they're so poor at patient assessment they can't distinguish between an airway obstruction and a pulmonary embolism.
They rely on what I call a box-to-box knowledge base. All they know is the protocols they've memorized. They don't understand the concept behind the patient condition they're called on to treat. They get by with limited knowledge and work like a bunch of Star Wars droids. When they see V-fib, they shock it. When that doesn't work, they pull out the epinephrine box and dump in some epi. If that fails, they reach for the red box. They fail to realize grandpa's in V-fib because he has a hunk of hamburger stuck in his trachea and his heart's fed up waiting around for oxygen to arrive, so it throws V-fib at them as the ultimate warning sign. You get my drift.
Let's face it, once the training staff accepts a student and puts them on payroll, they'll do almost anything to make them pass. The reason: If your training staff bounces out rookies because of weak BLS skills, they indict themselves for missing the weaknesses up front. They don't want to admit they made a mistake, so they pass them on to operations to weed out on the street. It's a lousy way to run a circus.
However, it sounds like-even though you're frustrated-you love your job and your city. Don't throw in the towel and leave town just yet. Do your homework. Call around to respected cities and ask for a copy of their screening, training and evaluation processes. I've done it and found most happily share their stuff.
You'll find plenty of solid ideas to help you fill in the cracks in your department's educational foundation. These departments have had their own share of Gomer Pyles get by their original screening and educational systems and revised their processes to stop the flaws in their system from reoccurring.
Outline your department's shortcomings, identify solutions implemented by other agencies, then put together a brief-but accurate-report. List your recommendations for improvement and cite departments that use each recommended process. Present the report to key training officials for their review.
You've now armed them with a list of recommendations for improvement. If they fail to correct their problems now, you've done two things: 1) Put them on notice and 2) created a written document that will haunt them if they ignore it.
If they blow you off and trash your report, then it's time to print new copies and submit them to your peers, department officials and union reps.
