clarity in policy...

some of the times i have directly affected policy in our system.
.....1)no fire personel, even the ones who work part-time for us, cannot drive an ambulance in when on the clock at the fire dept. this was 'cleared up' in the summer of '07 when DC and i were riding together. we had just came out of paramedic school in Dec. and they had faith in us to ride together (this was so awesome because we didn't have to be embarassed as we 'worked things out' with pt's and could correct each other). we got called to a respiratory distress, 6D, and arrived on scene without first responders, we later learned they were accidently not dispatched. the pt was sitting in a chair, outside in the dark. as we approached him his wife stated he has congestive heart failure and we could hear the fluid in his lungs as we walked up to him. we quickly got him to the ambulance and his SPO2 was above 90% with a NRB at 15 liters so we weren't sweating it and i placed him on the monitor while DC looked for IV access. but once on the monitor things got a bit different, V-tach with a pulse, confirmed with a 12-Lead. by this time first responders were re-dispatched and coming to us. i worked the v-tach/cardiac issue and DC started running down the pulmonary edema protocol, they actually start out very similar. the pt was not able to talk in complete sentences but he was very calm and was actualy joking with us and we all were smiling as the fire dept arrived. both DC and i were dealing with v-tach with a pulse for the first time and when one of the firemen opened the door and said 'what's up' i didn't hesitate when i saw who it was. i said 'drive' and he jumped up in the front and took us in emergency traffic. the fireman was DM and he works part-time for us so i just assumed it was no big deal to have him take us in. it was very helpful for DC and i and the pt got great care (just an aside, the amiodorone didn't convert him and since he had a semi-good b/p and was c/a/o x4 i called med control. they advised to cardiovert him and after some sedation and electrical therapy he, needless to say, did not want to joke around with us anymore). but within a couple days a new, clear, written policy arrived to let us know that firemen who are responding with the city or a county fire dept. cannot drive us in anymore, and if needed we could call a QRV to drive.
.....2)this year i was driving with JM and we got a call to a child, like a month or 2 old who was very feverish. we got there and the child had something like a 102 fever axillary so we took him and mom out to the truck and slowly started some passive cooling and i thought 'how about some motrin'. so i looked it up quickly because of his age and it said nothing in our little policy/protocol book. JM's wife is a pharamacist and they have some kids, i don't have any. he said they have given their kids motrin at this approximate age, so i thought, no problem. but when we got to the peds ed the PA there said 'don't give kids under 6 months motrin'. ok. as per the norm in our pediatric ed she was snotty towards me, but hey, nothing new. listen, they deal with babies ok? ok!?!? so within a couple days an IM appeared to not give kids under 6 months motrin and a new 'fever' protocol form took the place of the old one.
.....3)this is a bit different but one day i came in and was told to go out a take 103. this is a lead medics area and it is a QRV. working alone, jumping only the serious calls, getting there first on scene, intercepting intermediate crews when they need an ALS intercept, etc....it's all gravy on a QRV. so i go out and in the morning the other shift comes in and i get a sour look when they see me out at 103. by the next night crap is hitting the fan because (in a whining little voice) 'he's not QRV qualified' whatever the fuck that means. i guess back in the day, good medics were rewarded by getting to go out on QRVs sometimes but only after becoming 'QRV qualified'. my supervisor has complete trust in me and is laid back anyway, so i got to go. i even got to be 102 for a couple nights and that really had the other shifts heads spinning. the sad thing was a lot of my fellow FTOs on the other shifts were talking shit, but it was just jealousy. so now CH, DC, LC and i go out to the QRVs whenever there is an opening and other FTOs have come to our shift to work QRVs (if we are all blue-dotting new employees) and no one says anything anymore. the lead medics in our system are a strange lot and i don't have the next 10 hours free to write about all that bullshit.