Paramedic - Taney County Ambulance District

Reports To: Captain

Status: Non-exempt

Professional member of the pre-hospital staff who works as authorized and directed by physician. Performs basic and advanced life support treatment and transport to sick or injured patients in accordance with federal, state, and local laws, regulations and statutes as well as TCAD by-laws, guidelines, and procedures, and protocols as provided.

Essential Functions

Essential Duties and Responsibilities include the following. These are intended only as illustrations of the various types of work performed. The omission of specific duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position.

• Responds to emergency and non-emergency calls and routine and long distance transfers; performing basic and advanced life support procedures as stated in protocols, understanding these guidelines may not be appropriate for each circumstance. Leads, directs and participates in the delivery of emergency and routine patient care. Gives direction to and has authority over any crew member or other responding agency personnel, holding lesser certification on patient care regarding medical issues.
• Assesses nature and extent of illness or injury to establish and prioritize medical procedures to be followed, or need for additional assistance.
• Administers prescribed treatment at site of emergency, or in specially equipped vehicle, performing such activities as application of splints; takes and records patient's vital signs; administration of oxygen; injections of medications and drugs; treatment of wounds or abrasions; initiates intravenous fluids to administer medication or drugs, or to replace fluids lacking in body; performs endotracheal intubation to open airways and ventilate patient; administration of artificial resuscitation; restores and stabilizes heart rhythm on pulseless, non-breathing patient; monitors cardiac patient.
• Assists in extricating trapped victims and transports sick and injured persons to treatment center.
• Observes, records, and reports to physician patient's condition and reaction to drugs, treatments, and significant incidents.
• Communicates with professional medical personnel at emergency treatment facility to obtain instructions regarding further treatment and to arrange for reception of victims at treatment facility.
• Assists professional medical personnel in emergency treatment administered at medical facility.
• Obtains and records all information related to victims' vital statistics and circumstances of emergency according to current incident documentation procedures.
• Monitors communication equipment to maintain contact with dispatcher. Operates handheld and mobile radios in accordance with TCAD guidelines. Maintains a professional attitude and uses appropriate language and tone while using radio equipment for district traffic.
• Responds to instructions from emergency medical dispatcher and drives specially equipped emergency vehicle to specified location, according to TCAD procedures.
• Efficient knowledge of all service area boundaries, primary roadways, and prominent county landmarks.
• Keeps current on treatment techniques, protocol changes, and application of new drugs and equipment.
• Prepares required reports and maintains records of activities.
• Requisitions and restocks supplies, material, and equipment.
• Cleans, sanitizes, and performs minor maintenance to assigned emergency vehicle. Reports vehicle and equipment malfunctions to Captain.
• Performs daily cleaning duties at assigned station.
• Maintains a professional appearance, ensuring uniforms are properly fitted, cleaned, and pressed, boots are polished, hair and beards are neatly groomed.

Job Responsibilities Related to Patient Privacy

• The employee is expected to protect the privacy of all patient information in accordance with TCAD's privacy policies, procedures, and practices, as required by federal [and state] law, and in accordance with general principles of professionalism as a health care provider. Failure to comply with TCAD's policies and procedures on patient privacy may result in disciplinary action up to and including termination of employment with TCAD.
• Employee may access protected health information and other patient information only to the extent necessary to complete your job duties. The employee may only share such information with those who have a need to know specific patient information you have in your possession to complete their job responsibilities related to treatment, payment or other TCAD operations.
• The employee is encouraged and expected to report, without the threat of retaliation, any concerns regarding the TCAD's policies and procedures on patient privacy and any observed practices in violation of that policy to the designated Privacy Officer.
• The employee is expected to actively participate in TCAD privacy training and is required to communicate privacy policy information to coworkers, students, patients and others in accordance with TCAD policy.

Key Competencies 

Job Knowledge - Competent in required job skills and knowledge; Adapts to new technologies; Exhibits ability to learn and apply new skills; Keeps technical skills up to date; Strives to continuously build knowledge and skills; Shares expertise with others.

Customer Service - Manages difficult or emotional customer situations; Displays courtesy, sensitivity, respect; Responds promptly to customer needs or requests for assistance.

Professionalism - Displays positive outlook and pleasant manner; Treats others with tact, respect, and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments; Works with integrity and ethically; Upholds organizational values; Focuses on solving conflict, not blaming; Keeps emotions under control; Exhibits objectivity and remains open to others' ideas and views; Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Participates in meetings.

Diversity - Shows respect and sensitivity for cultural differences; promotes a harassment free environment.

Safety - Observes safety and security procedures; Determines appropriate action beyond guidelines; Reports potentially unsafe conditions; Uses equipment and materials properly.

Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.

Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Follows instructions, responds to management direction; Displays commitment to excellence; Requires minimal supervision; Uses resources effectively; Assesses own strengths and weaknesses; Completes work in timely manner; Works quickly.

Initiative - Actively seeks out new projects, and is eager to assist others achieve their goals; Volunteers readily; Seeks increased responsibilities; Asks for and offers help when needed.

Adaptability - Shows adaptability in a changing work environment with competing demands. Accepts criticism & feedback and remains open to other’s ideas. Able to deal with frequent change, delays, or unexpected events and changes approach or method to best fit the situation.

Attendance - Is consistently at work and on time; Ensures work responsibilities are covered when absent; Arrives at meetings and appointments on time; Schedules time off in advance.

Position Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience 

• High school diploma or general education degree (GED); College degree encouraged.
• It is the responsibility of the employee to acquire and maintain the following licenses and certifications and to meet insurance company requirements:
  • State issued Driver’s License with acceptable driving record
  • Missouri EMT-P License
  • Advanced Cardiac Life Support
  • BLS for Health Care Provider CPR card
  • Hazardous Materials Incident Awareness
  • NIMS/ICS 100, 200, 700, 800

Language Skills

• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. 
• Ability to write routine reports and correspondence.           

Mathematical Skills

• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. 
• Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.                                 

Reasoning Ability                                                    

• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
• Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
• Ability to multi task, manage multiple priorities.
• Ability to manage effective interpersonal skills in often stressful or conflict situations.

Computer Skills                                                      

• To perform this job successfully, an individual should have knowledge of basic computer operations.

Physical Demands

This position requires significant physical strength and dexterity and the ability to function in very adverse environments with exposure to numerous safety risks typically found at emergency scenes. The following guidelines are used to describe the frequency of activities in this position: Occasionally equals 1%-33%; frequently equals 34%-66%; and continuously equals 67%-100% of a typical work day.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Standing/Walking

• Frequently too continuously when responding to calls. Standing or walking is optional while at rest at the facility. This usually includes: going to and from the emergency vehicle, getting patients from their locations, and rendering treatment. Most walking would be for short distances, as emergency vehicles are allowed to get as close to the location as possible. However, the incumbent must also be able to run these same distances, in case of an emergency where time is of the essence. Walking and running may vary, however, as the patient may be located inside a large, multi-floored facility. Standing, walking and running could be on all types of surfaces, including but not limited to: asphalt, cement, concrete, soft/ packed dirt, linoleum, wood, hardwood floors, etc. The individual must be able to go up and down slight inclines or declines that may be found at roadsides, agricultural areas, etc. At a location, standing would occur more often than walking or running. Standing would occur on the wide variety of surfaces mentioned above. Standing could last from a few minutes to hours, depending on the situation. Standing could occur in the standard erect position, the kneeling or squatting position, etc.

Sitting

• Frequently when responding to a location, the individual will sit in the emergency vehicle. The emergency vehicles are equipped with a standard installed vehicle seat. The time performing the sitting activity on a call would depend upon the specific situation.

Lifting and Carrying

• Frequently required to lift and carry weights ranging from a few pounds to 10 pounds and above. Occasionally required to lift and carry weights scaled at above 100 pounds or more. Incumbents will need to lift and carry, with one team member, adult patients, lifting them from various positions (such as the floor, a bed or a chair) onto various patient movement devices, such as an ambulance cot, a stair chair, long back boards, scoop stretcher, etc., and then efficiently move them into an ambulance. The medical equipment and supplies can weigh approximately 70 pounds or more.

Bending and Stooping

• Frequently throughout a work shift the incumbent will be required to bend in a range of 1 to 90 degrees. The average situation will require the individual to work in a range of 35 to 65 degree bends. This would involve: lifting a patient, lifting equipment, treating a patient at ground level, sitting on a bench located in the ambulance. This activity may be prolonged and last up to 30 minutes or more. During any given call, the provider may bend and/or stoop 1 to 15 times per incident.

Crouching and kneeling

• Frequently, crouching and kneeling may be performed when on the scene picking up equipment or assisting patients. The actual number of times this is done depends on the particular incident but may be up to 15 times for a duration up to 30 minutes or greater.

Climbing

• Occasionally, this is required when climbing steps up and down with a patient on a stretcher or other device, and when entering or exiting the emergency vehicle. Generally, the climbing would require that the incumbent be lifting and carrying heavy objects such as a stretcher or other device with a patient on it. Balancing may be required when backing down staircases.

Reaching

• Frequently to continuously throughout the work shift in order to review monitoring equipment, operate communication equipment, administer oxygen and operate equipment. The incumbent may also be required to reach in precarious positions, such as in a vehicle, which has been crushed in an accident, or in other confined spaces. If working inside the ambulance enroute to a medical facility, the incumbent will need to reach to access the patient and supplies. Reaching will involve partial to full extension of the arms.

Pushing and Pulling

• Frequently the activities that would require the most force in pushing and pulling is when removing or returning the ambulance cot to the emergency vehicle with and without a patient on it. The weight required to push/pull will vary, depending on the weight on the cot. Slight pushing will be required if the incumbent is performing CPR, which can require repetitive pushing and may range from a few minutes to hours. Pushing and pulling is required when operating and closing vehicle doors.

Handling or Grasping

• Continuously, while working at any given location, continual bilateral gross manipulation is performed in this position. This may be involved when: opening/closing doors, grasping hand holds in the ambulance; and using, handling, carrying and/or operating medical equipment that may weigh approximately 70 pounds or more, such as stretchers, cot rails, various handles attached to equipment, and tools. The arm and hand must be able to perform all types of positions, including supination and pronation. Hyperextension, extension and flexion of the fingers will be involved, ulnar and radial deviation, abduction and adduction of the hand and wrist will be required. A wide variety of grasping will be required, such as cylindrical grasping, palmer grasping, hook grasping, tip grasping and lateral and spherical grasping.

Hazards

• The incumbent, when responding to emergencies, can be exposed to dust, fumes, gases, fire, smoke, adverse weather conditions, and chemicals. There is potential for bodily harm or death from violent patients, bystanders, or other dangers. At all times the incumbent is expected to adhere to all applicable policies and procedures concerning safety and the prevention of contamination and infection due to bloodborne pathogens.

Other Physical Requirements

• Personnel must complete Physical Ability Testing and Fit Testing for Respiratory Protection before being accepted for employment; and as required annually or anytime deemed necessary thereafter. 
• Ability to effectively use all tools, devices, equipment, computer systems required to fulfill essential functions of the position.
• Maintain balance and strength in awkward positions; Respond physically with speed; Speak at proper volumes for appropriate situations; close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

Mental Requirements of the Position

• Handle a significant number of stressful situations, and be able to function calmly, coolly and collectedly under all types of stressful situations; Get along well with diverse personalities; Communicate with patients and others with empathy and respect; Create and maintain a positive and cooperative working environment in stressful situations; Work independently with minimal supervision for assigned tasks; Establish and maintain effective working relationships with all levels of personnel within the medical community, TCAD, outside agencies, patients, and members of the community; Understand and follow federal, state and local laws, and TCAD policies, procedures and rules; and Appropriately deal with stress and maintain composure when encountering serious injuries or illnesses.

Work Environment

• While performing the duties of this Job, the employee is frequently exposed to outside weather conditions. The noise level in the work environment is usually moderate.
• Occasionally:  Extreme heat and cold, wet and/or humid conditions, vibration, pressurized equipment, burning materials, moving objects, high places, fumes/odors/mists, gases, toxic conditions.
• Frequently:  Extended days, inside, outside, temperature changes, mechanical & electrical equipment, confined areas, noise, dirt/dust, other hazardous conditions, human excrement, blood, urine, mucous, tissue.