Date: |
August 25, 2002 |
To: |
All DCs, ACs, BCs, Captains |
From: |
T. J. Kiesewetter, Battalion Chief, Director of Training |
Subject: |
FEEDBACK FOR PROBATIONARY FIREFIGHTER MONTHLY EVALUATIONS #4 |
A discrepancy is a difference between what is and what should be. The focus of this portion of this feedback memo is on Probationary Firefighter performance discrepancies, those differences between what they are actually doing (or not doing) and what they should be doing. The difference defines “what needs to be improved”.
If the discrepancy is large enough or serious enough it warrants the formal approach described in the Introductory Chapter of the Recruit Fire Training Manual:
“Upon notification that a Probationary Firefighter is experiencing performance problems in the field, the Director of Training will notify the District Assistant Chief and meet with the Probationary Firefighter, assigned Captain(s), and Battalion Chief. A plan of improvement will be formulated that addresses the deficiencies noted to date. Failure of the Probationary Firefighter to show significant improvement in the noted areas within the stated time frame will result in a recommendation for termination.”
The perceived performance discrepancy should be described in terms of (a) what is actually happening and (b) the desired performance.
The following example, although not immediately life threatening, indicates the need for a formal plan:
“(Recruit Firefighter’s name) fails to perform an organized PQRST on chief complaints dealing with pain. This failure comes after numerous Patient assessments drills at the station and was seen on Inc #12345 on August xx. On August xx, Inc #12345 a “victim of a fall,” failed to perform a total body check. This failure comes after a critique on August xx #12345, “needs to perform a total body check”.
Ask these questions:
Why do I (or someone else) think there’s a problem?
What is the actual performance at issue?
What is the desired performance?
In the case of the PQRST
This Captain believes (and we would all agree) there is a problem because the acronym is a universally taught tool used by EMTs to gather information in a systematic fashion so an accurate assessment and informed decision can be made about a patient’s condition.
The desired performance is to ask questions relating to each letter of the acronym when gathering assessment information on a patient with pain.
From the description above, the actual performance appears to indicate one or more of the letters of the acronym are passed over during assessments.
Depending on the severity, a plan to improve can be developed that might range from flash cards drills, to station simulations, to EMS educator involvement at a local triage desk.
If the consequences (e.g., death) of the discrepancy (e.g., airway management skills) are significant, a formal plan for improvement must be initiated as soon as the discrepancy is identified.
If the consequences (sad kids) of the discrepancy (forgot to put “stickers” in shirt pocket) are not significant, a simple verbal plan is appropriate. (e.g., “Keep 10 stickers in your pocket at all times”).
A formal plan for improvement should include:
1. A concise description of the discrepancy
2. A starting point for the plan
3. Who (the recruit firefighter, the crew, the EMS Educators)
4. Does What (read 20 pages, throw ladders, staff the triage desk)
5. How well it should be done
6. Any parameters (time, money, equipment)
7. A finish point to assess results
Consider this very good example of a “tie back” to a previous month:
“For the month of June, one of (Probationary Firefighter’s name) plan for improvement was to show more initiative when conducting station drills. This month (July) he/she demonstrated in a positive fashion his/her effort to improve by presenting three excellent station drills (Hurst equipment, chain saw, and forcible entry).
Finally, when a Probationary Firefighter is graded in multiple areas as needing improvement, the “plan for improvement” area at the end of the evaluation should clearly address the areas needing improvement. Frequently we see probationary firefighters who are graded as needing improvement in EMS. Unfortunately, the plan for improvement at the end of the evaluation reflects up coming tool drills and no EMS components.
A method of organization that one Captain is using in the field is to start a MS Word document for the next month while completing the previous months report. On the left hand side of the document he places each date he will work. The file is saved as the Probationary Firefighters name and Month.
During a duty day he frequently accesses the document and under the date types some notes. An example follows:
9-6-02
Inc #12345 Male chest pain
Good primary and followed PQRST
Good teamwork in the back of the rescue and also 4-person gurney carry
At the end of the month he prints out the notes, uses them to write his comments and attaches the document to the evaluation.
Consider the following examples from “Tools & Equipment”
Probationary Firefighter A “needed prompting and had to refer to written material to respond to questions on drills. The affected drills covered ropes, air bags and ram fan.”
Probationary Firefighter B “Familiar with every tool on the engine when questioned. Can be relied upon to locate and use appropriate tool in given situation”.
It is evident that (Probationary Firefighter’s name) has had much experience with leading drills and speaking in front of a group.
To “fine tune” a written statement, try to describe the behaviors that make you say, “it is evident”. Do they always start with a motivational statement? Do they always end with a single sentence summary? Do they move around the room fielding questions?
A comment from a Captain last month allows me the opportunity to demonstrate how the categories can help in evaluating probationary firefighters at various levels. In the category of:
EMS – Recognizes patients that need further medical attention. Determines appropriate mode of transport (ALS or BLS ambulance, private car, etc.) and transports at appropriate point in run.
A Captain wrote:
“We don’t expect (Probationary Firefighter’s name) to make decisions regarding when to transport patients.”
It is true that a probationary firefighter may not be responsible to make decisions regarding patient disposition, but it is an EMT skill. It is also a frequent opportunity to evaluate the probationary firefighters ability. If they consistently make correct decisions in controlled situations, confidence can be transferred to their ability to act independently and successfully when necessary. Consider the following comments from a month-end evaluation:
“I have confidence in (Probationary Firefighter’s name) ability to perform at EMS runs. Especially at incidents that are spread over large areas such as multi-vehicle accidents. He/she has demonstrated, thru drills at the station and on runs, the capability of making sound judgments. At incident #12345, I assigned him/her to perform a primary and secondary assessment on a patient involved in a vehicle vs. pole ITA. This person was located some distance away from the rest of incident and crew and required (Probationary Firefighter’s name) to operate on his/her own for several minutes. He/she was able to not only gather the information needed but to accurately record it as well.”
Also consider the following comments under the same category that represents a good plan for a skilled Probationary Firefighter who is apparently ready for more responsibility.
“In order to improve EMS decision making ability, during the next month, (Recruit Firefighter’s name) will apply LA County Ref 808 to determine and verbalize an “unofficial” patient transport mode for the Captain to verify as appropriate.”
Another good example of a plan for a Probationary Firefighter who is performing satisfactorily:
“(Recruit Firefighter’s name) recognizes the appropriate level of transport. Starting next month, I will have him/her focus on determining level of distress and communicating his/her opinion to me.”
A plan for someone who is struggling with patient assessments:
“I am not having him/her make transport or downgrade decisions. He/she needs work on clarifying the patient’s chief complaint and processing the patient’s answers. Our area of focus is assessment, passing information to paramedics and giving supportive care. The plan is to continue with assessment practice and move onto to pt. disposition decisions.”
Competent with the use of our R-1 filing system and the yellow cards. He/she does not need to be prompted to gather the updated data for the cards when conducting inspections.
He has also learned how to forward the inspection form to the responsible person via US mail through Code Enforcement Division of the Fire Prevention Bureau
(Probationary Firefighter’s name) performed flawlessly while giving equipment drills to the crew on July xx and July xx. Entirely by memory without any prompting from notes.
(Probationary Firefighter’s name) secondary surveys are consistent and adequate for his level of experience. Examples are; July xx #12345 , July xx (The Captain attached a separate sheet with detailed notes).
#3 rating for tool specifications, #4 rating for tool use and application.
(Probationary Firefighter’s name) decisiveness has been demonstrated on a couple of drills he/she has given to the crew this month. When questioned as to the accuracy of his/her information he/she has been able to stand his/her ground by saying, “based on my training that is what I know.” At the same time, he/she is able to see where practical experience may supercede his/her information
(Probationary Firefighter’s name) conducted a forcible entry drill on July xx for the crew of Station xx. His/her drill consisted of a walk-thru of an alley in the area. He/she described procedures to use for opening bars on windows, security gates cylinder locks padlocks and garage doors. His/her drill was informative, thorough and well presented. He/she was able to describe in detail at least a couple of methods for each type of security problem encountered starting from the least complex to the progressively more involved. Even when presented with “what if” type situations he/she was able to provide good answers consistent with his/her training.
(Probationary Firefighter’s name) continues to impress me with his/her history interviewing skills. At incident #12345 is an example. The patient was not only elderly but a Spanish speaker as well. He/she was able to identify this right away and utilize the patient’s daughter as the interpreter. Rarely am I required to intervene for clarification at virtually any type of run.
I have confidence in (Probationary Firefighter’s name) ability to perform at EMS runs. Especially at incidents that are spread over large areas such as multi-vehicle accidents. He/she has demonstrated, thru drills at the station and on runs, the capability of making sound judgments. At incident #12345, I assigned him/her to perform a primary and secondary assessment on a patient involved in a vehicle vs. pole ITA. This person was situated some distance away from the rest of incident and crew and required (Probationary Firefighter’s name) to operate on his/her own for several minutes. He/she was able to not only gather the information needed but to accurately record it as well.
I am pleased with the time and effort that (Probationary Firefighter’s name) has spent preparing for his/her station drills. They are presented in a well-organized and thorough fashion. His/her handouts are very well prepared with digital pictures.
(Probationary Firefighter’s name) works hard to keep a positive image of the fire service. I always see him handing out stickers to the kids and spending time talking to civilians.
(Probationary Firefighter’s name) … saw that we were going to lay the supply line across a busy street and grabbed a few cones and redirected traffic. Good initiative and forward thinking.
On July xx and on July xx, (Probationary Firefighter’s name) performed well while drilling with the 35’ ladder. He/she called out all commands appropriately and performed according to the grade sheet with no deficiencies.
While doing a knot drill and tying off tools, (Probationary Firefighter’s name) was able to correctly identify and perform the correct knot according to the 1.1 Manual. In addition he/she showed alternative knots that could be used in similar situations.
Had drills on Hi-lift jack, cable come-along, and air bags this month. Showed competent knowledge in specs and usages.
No trouble noted during this period regarding his/her application, retention and ability to learn information. Specifically, he/she handled 2 R-1 inspections with little advice from me.