Paramedic

1. Professional Conduct

a. Employees represent Mon EMS whenever they are on and off duty, in uniform, or otherwise identifiable as members of the organization.

b. Conduct themselves in a manner that reflects positively on the agency.

c. Avoid behavior that could damage the reputation, credibility, or public trust of Mon EMS.

d. Comply with all agency policies related to professional conduct, communications, and interactions with the public.

e. Interact respectfully with patients, coworkers, public safety agencies, hospital staff, and the public.

f. Comply with all Mon EMS policies, procedures, and standard operating guidelines.

2. Minimum Professional Standards and Licensure Requirements

a. The EMS clinician must maintain the professional standards required to successfully obtain and maintain certification and licensure as a Paramedic. It is soley the clinicians’ responsibility to maintain these. These requirements include, but are not limited to:

i. Maintaining National Registry of Emergency Medical Technicians (NREMT) registration as a Paramedic

ii. Maintaining West Virginia Paramedic licensure through the West Virginia Office of EMS.

iii. Maintaining eligibility for licensure under West Virginia law and regulations.

iv. Maintaining a valid driver’s license and driving record acceptable to the agency’s motor vehicle insurance carrier.

v. Maintaining all certifications and training necessary to function as a Paramedic by Mon EMS, the state of West Virginia, and the federal government.

3. Clinical Credentialing and Clinical Privileges

a. Paramedics employed by Monongalia EMS must be clinically credentialed by the agency and its Medical Director prior to independently performing patient care independently.

b. Possession of a state EMS certification or National Registry certification alone does not grant authorization to perform clinical skills within Monongalia EMS. Clinical privileges are granted only after successful completion of agency credentialing processes (Field Training and Evaluation Program).

c. The Medical Director or designee may restrict, modify, or delay clinical privileges until competency is demonstrated.

d. Paramedics may perform only those procedures and treatments that are:

i. Authorized by the West Virginia EMS Scope of Practice

ii. Permitted under West Virginia EMS Protocols

iii. Approved by the Mon EMS Medical Director

iv. Authorized through Mon EMS credentialing

e. To maintain clinical privileges, Paramedics must:

i. Maintain required NREMT and state licensure

ii. Maintain required continuing education

iii. Maintain required clinical certifications

iv. Successfully complete agency competency evaluations

v. Maintain compliance with protocol and documentation standards

f. Paramedics are also required to participate in:

i. Clinical review

ii. Quality assurance and quality improvement programs

iii. Skills verification

iv. Protocol updates

v. Continuing education programs

g. Clinical performance is continuously evaluated through:

i. Patient care report audits

ii. Quality assurance reviews

iii. Field performance evaluations

iv. Medical director case reviews

v. Skills competency evaluations

h. Clinical concerns may result in:

i. Remedial training

ii. Temporary restriction of clinical privileges

iii. Suspension of clinical privileges

iv. Reassignment of duties

v. Corrective action consistent with agency policy

i. The Mon EMS Medical Director has the authority to:

i. Grant clinical privileges

ii. Modify clinical privileges

iii. Restrict clinical privileges

iv. Require additional training

v. Suspend clinical privileges for patient safety concerns

vi. Clinical privilege decisions may occur independently of employment discipline and are intended to ensure patient safety and protocol compliance.

4. Patient Care and Clinical Operations

a. Provide Advanced Life Support (ALS) patient care consistent with the West Virginia Paramedic scope of practice and applicable EMS protocols.

b. Perform comprehensive patient assessments and formulate appropriate treatment plans.

c. Perform advanced airway management, pharmacological interventions, cardiac monitoring, defibrillation, pacing, and other ALS procedures authorized by protocol and credentialing.

d. Initiate and maintain appropriate medical treatments, including medication administration and advanced monitoring.

e. Provide medical care during 911 emergency responses, interfacility transports, and specialty transports consistent with agency credentialing and transport requirements.

f. Obtain medical direction when required by protocol or clinical judgment.

g. Continuously monitor patient condition and adjust care as appropriate.

h. Communicate patient condition and treatment information to receiving facilities.

5. Clinical Documentation

a. Complete accurate and timely electronic patient care reports (ePCRs) for all patient contacts. 

b. Ensure documentation meets agency, regulatory, and billing requirements. 

c. Accurately record patient assessment findings, treatments provided, and patient response to interventions. 

d. Participate in documentation audits and quality improvement initiatives as required. 

e. Maintain confidentiality of patient information and comply with all applicable HIPAA and privacy regulations.  

f. Complete documentation in accordance with the timelines established in Monongalia EMS policies.

6. EMS Operations and Response

a. Ensure assigned ambulance and equipment are operational and properly stocked.

b. Conduct required equipment and vehicle inspections.

c. Respond promptly to emergency and non-emergency calls for service as assigned.

d. Operate safely within emergency scenes while maintaining awareness of environmental hazards, personal safety, and patient safety.

e. Assist with ambulance operations including preparation of the patient compartment, securing equipment, and preparing the vehicle for transport.

f. Participate in incident management activities consistent with the Incident Command System (ICS) when responding to multi-agency incidents or mass casualty incidents.

g. Identify and report equipment malfunctions, damaged supplies, or missing equipment to supervisory personnel.

h. Maintain cleanliness and operational readiness of ambulances, stations, and equipment.

i. Assist with restocking medical supplies and maintaining inventory levels necessary for operational readiness

7. Education, Training, and Competency

a. Successfully complete all required educational components of the Monongalia EMS New Hire Academy

b. Successfully complete the Field Training and Evaluation Program to become a credentialed clinician with Mon EMS

c. Participate in simulation training, classroom instruction, skills labs, clinical rotations, and field internship assignments.

d. Demonstrate competency in Paramedic skills and knowledge.

e. Complete assigned training, continuing education, and competency evaluations within required timeframes.

8. Quality Assurance and Quality Improvement

a. Participate in the organization’s Quality Assurance and Quality Improvement (QA/QI) programs to support continuous improvement in patient care, clinical performance, and operational readiness.

b. Responsibilities include

i. accurately completing patient care documentation

ii. participating in case reviews, skills verification, and educational feedback processes as assigned.

c. The EMS clinician will demonstrate a commitment to improving clinical knowledge, psychomotor skills, and professional performance through feedback, simulation training, remediation when necessary, and participation in agency educational and competency programs.

d. The EMS clinician must comply with all Monongalia EMS quality standards, documentation requirements, and clinical performance expectations, and decisions of the Medical Review Committee.

9. Safety Culture

a. The EMS clinician will lead by example to ensure that all activities performed while on duty at Mon EMS are done in a manner to ensure the safety of Mon EMS personnel, our patients, and the community.  This includes attitude toward safety such as, but not limited to: vehicle safety, OSHA compliance, scene management, routine facilities maintenance, etc.

b. Adhere to all safety practices including infection control procedures, personal protective equipment requirements, and bloodborne pathogen precautions. 

c. Promote a culture of safety for personnel, patients, and the community. 

10. Teamwork and Organizational Support

a. Work cooperatively with EMS personnel, healthcare providers, and other emergency responders.

b. Participate in routine station duties including cleaning, maintenance, and operational support tasks.

c. Assist with agency activities including public safety initiatives, training events, and community outreach when assigned.

d. Perform additional duties as assigned by supervisory personnel consistent with the training level and role of the EMS clinician

11. Work Environment and Exposure Conditions

a. The EMS clinician performs duties in a wide variety of environments typical of emergency medical services operations. These environments may include unpredictable and hazardous conditions.

b. The EMS clinician must be able to work effectively in environments that may include, but are not limited to:

i. Indoor and outdoor environments in all weather conditions, including extreme heat, cold, rain, snow, and ice

ii. Emergency scenes including roadways, highways, industrial locations, residential structures, commercial buildings, and remote or difficult-to-access locations.

iii. Exposure to infectious diseases, bloodborne pathogens, bodily fluids, and other potentially hazardous biological materials.

iv. Exposure to hazardous materials, chemicals, fumes, smoke, fire, dust, or gases.

v. Situations involving emotionally distressed patients, traumatic injuries, critically ill patients, or deceased individuals.

vi. Environments with loud noises including sirens, traffic, machinery, and emergency scenes.

vii. Situations involving combative or potentially violent patients or bystanders.

c. Employees are expected to follow all applicable infection control procedures, personal protective equipment (PPE) requirements, and safety policies established by Monongalia EMS.

d. Employees shall wear agency-issued ballistic protective vests during responses or operational activities when required by Mon EMS policy. Ballistic protective equipment will be provided by Monongalia EMS and must be worn in accordance with established policies and safety guidelines.

e. While Monongalia EMS is committed to maintaining a safe working and learning environment through training, supervision, and safety policies, employees must recognize that the nature of emergency medical services may expose them to situations where hazards cannot be completely eliminated. Employees are expected to actively participate in maintaining a culture of safety by:

i. Following all Monongalia EMS safety policies and procedures.

ii. Using appropriate personal protective equipment (PPE).

iii. Immediately reporting unsafe conditions, hazards, or injuries.

iv. Exercising sound judgment when operating in emergency environments.

12. Cultural Competence and Community Awareness

a. Provide patient care in a manner that demonstrates respect for cultural, religious, and social differences within the community served by Monongalia EMS. 

b. Interact professionally and respectfully with patients, families, coworkers, and members of the public from diverse cultural, ethnic, and socioeconomic backgrounds. 

c. Demonstrate awareness of the communities served by Monongalia EMS, including the general geographic layout of the service area and factors that may influence access to care. 

d. Provide care that respects patient beliefs and preferences when clinically appropriate while maintaining adherence to medical protocols, applicable laws, and organizational policies. 

e. Compliance with applicable federal, state, and local laws and Monongalia EMS policies is required in all aspects of patient care and operational duties.

PHYSICAL REQUIREMENTS: 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.

The 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.

1. STANDING/WALKING: Continuously. This usually includes: going to and from the emergency vehicle, and 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 employee 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.

2. 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. Frequently in station, as the facility is equipped with a small lounge area that is furnished.

3. LIFTING AND CARRYING: Frequently. Required to lift and carry weights ranging from a few pounds to ten pounds and above. Occasionally required to lift and carry weights in excess of 100 pounds or more. Employees will need to lift and carry with one team member adult patients, lifting them from various positions (such as a bed or a chair) onto various patient movement devices, such as an ambulance stretcher, a stair chair, long back boards, etc., and then efficiently move them into an ambulance. Other heavier objects in the high range category would be 5-foot tall, 10 inch diameter oxygen cylinders, and medical equipment boxes. The oxygen cylinders can be made of quarter-inch steel and weigh up to 120 pounds. The medical equipment boxes can weigh approximately fifty pounds or more.

4. BENDING AND STOOPING: Frequently. Throughout a work shift the individual 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 any number of times per incident.

5. 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.

6. CLIMBING: Occasionally. This is required when climbing steps up and down with a patient on a cot or other device, and when entering or exiting the emergency vehicle. Generally, the climbing would require that the employee be lifting and carrying heavy objects such as a cot or other device with a patient on it. Balancing may be required when backing down staircases.

7. REACHING: Frequently. Throughout the work shift in order to review monitoring equipment, operate communication equipment, administer oxygen, and operate equipment. The employee 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 en route to a medical facility, the employee will need to reach to access the patient and supplies. Reaching will involve partial to full extension of the arms.

8. PUSHING AND PULLING: Frequently. The activities that would require the most force in pushing and pulling is when removing or returning a gurney to the emergency vehicle, with and without a patient on the gurney. The weight required to push/pull will vary, depending on the weight on the gurney. Slight pushing will be required if the employee 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.

9. 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; using, handling, carrying and operating medical equipment that may weigh approximately fifty pounds or more, stretcher 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, lateral and spherical grasping.

10. HAZARDS: Occasionally. The employee, when responding to emergency situations, may be exposed to dust, fumes, gases, fire, smoke, adverse weather conditions, and chemicals. There is also exposure to body substances that may contain infectious materials that could cause illness or death. There is potential for bodily harm or death from violent patients, bystanders, or other dangers. At all times the employee is expected to adhere to all applicable Policies and Procedures concerning safety and the prevention of contamination and infection due to bloodborne pathogens.

11. OTHER PHYSICAL REQUIREMENTS: Maintain balance and strength in awkward positions; Speak clearly under stressful circumstances;

Respond physically with speed; Accurately communicate ideas orally and in writing in English; Operate effectively in loud environments;

Get along well with others.

12. 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 smoothly and professionally in an environment where teamwork is essential; Analyze and interpret difficult and complex patient care and personnel situations; Work independently with minimum supervision for assigned tasks; Exercise sound independent judgment within general Policy and procedural guidelines; Anticipate and identify problems and take initiative to prevent or correct them; Establish and maintain effective working relationships with all levels of personnel within the medical community, the Squad, outside agencies, patients, and members of the community; Understand and follow federal, state and local laws, and Squad policies, procedures, and rules; Establish and maintain effective working relationships with others; Follow orders; Remember and apply concepts, knowledge and principles; Analyze and interpret situations; and Appropriately deal with stress and maintain composure when encountering serious injuries or illnesses.