Talking about mistakes and failure isn’t something we do often enough. As humans, we naturally appreciate being recognized for what we do well, but let’s be honest, no one enjoys having their flaws or errors pointed out. The truth is simple: everyone makes mistakes. Yes, everyone.

This topic is not meant to intimidate, assign blame, or act as a scare tactic. Its purpose is to create clarity, encourage honest reflection, and support growth. The framework focuses on professionalism, ethical practice, documentation integrity, patient advocacy, and accountability because learning from mistakes is how we strengthen ourselves, our practice, and the trust placed in us.

Objective:
By the end of this tip, paramedics will have a clearer understanding of ethical and professional standards, gain insight into accountability and documentation practices, strengthen patient advocacy and escalation of care, and reflect on expectations that support positive and meaningful practice change.

Key Content:
Professionalism
Professionalism is reflected in how you act when things don’t go as planned. It includes honesty, respect, humility, and a willingness to acknowledge mistakes. Owning your actions especially during challenging calls demonstrates integrity and reinforces trust within your teams and with the public.

Ethical Practice
Ethical practice requires you to place patient safety and well-being at the center of every decision. When errors or near misses occur, ethics guide you to be transparent, reflective, and committed to improvement rather than avoidance or defensiveness.

Documentation Integrity
Accurate, timely, and truthful documentation is essential. Ambulance Call Reports (ACRs) tell the story of your clinical decision-making and are critical for continuity of care, quality improvement, and legal accountability. Documentation should always reflect what actually occurred and not what you wish had happened.

Patient Advocacy
Advocating for patients means speaking up when something doesn’t feel right, reassessing when conditions change, and escalating care when needed. Advocacy is not about questioning competence, it’s about ensuring patients receive the safest and most appropriate care possible.

Accountability
Accountability is not about punishment, it is about responsibility. Taking ownership of your actions, learning from mistakes, and making changes when needed. This strengthens both individual practice and the profession as a whole. Accountability helps maintain public trust and supports a culture of safety and learning.

Scenario:
A 78-year-old patient with a head injury and on blood thinners refuses transport after a fall. Pressured by family, short on time, and facing a busy system, the crew accepts a quick refusal with minimal risk explanation and limited documentation. Hours later, the patient deteriorates and dies from an intracranial bleed. The crew is later subpoenaed.

Patient refusals are not just about assessing orientation, quantifying vitals and obtaining signatures. High-risk patients require a clear capacity assessment, thorough explanation of risks in plain language, freedom from outside influence, and strong documentation. Rushed decisions and “checkbox refusals” can turn ethical shortcuts into legal consequences.

Remember, if you wouldn’t feel comfortable reading your ACR out loud in court, it’s not finished.

In paramedicine, ethical care isn’t just about getting it right, it’s about what you do when things go wrong. Failure can sting, especially in a profession shaped by legal accountability and public trust. But reflective practice asks you to look squarely at your decisions: the pressures you faced, the information you had, the biases you carried, and the systems around you. Owning mistakes doesn’t weaken professionalism, it strengthens it by turning accountability into learning, protecting patients, and safeguarding your future practice.

Challenge: Think of a recent call that didn’t sit right. What would you do differently next time, and what support or system change would help you do it?