Calling all Paramedics…

I need some help.  I am looking at creating some content with my mate Tim from ki-docs about starting out as a paramedic.  Not about the clinical stuff but more about the human factors, what to expect, what is important to know; all that sort of stuff.

Sadly it has been a very long time since I started out in the field the world of paramedicine has changed a lot since then.  The things that may have been important to me (even if I could remember them) are perhaps not as important to new paramedics/ambulance officers now.

So with that in mind, I would love to get some feedback.  I would love to hear from all paramedics, volunteers or paramedics to be.  Let me know what is important for a new paramedic to know: how to deal with shiftwork, with people, with partners, with toilet breaks, whatever.  Nothing is off limits, any comments or questions gratefully accepted.  For people training or about to start as paramedics, what is it you would like to ask about the career you are about to embark upon?  I will attempt to answer any questions I can and hunt down the answers to those I can’t.  If you don’t want to put it out there for all the world to see, email me at angryambulancedriver(at)gmail.com and I’ll make sure you keep your anonymity.

The intention is to make a podcast about this and if there are any specific issues that appear to predominate we can perhaps explore those further in the future.

So please, don’t be shy, let me know what you wish someone had told you or what you would like to be told about before you start.

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12 Responses to Calling all Paramedics…

  1. James Marshall says:

    I have the exact same discussion with new grads at Brady st. I think we should discuss this, I have lots of ideas.

  2. Evan says:

    I read Stuart Gray’s “The Street Medics Survival Guide” before starting my paramedic training in London. It has some good tips for those about to start or considering a career in paramedicine but is UK-centric.

  3. Jeannie says:

    I’m currently a student with VU, and currently working with non-emergency transport.

    Some of the questions I’d like to ask, or advice I like to collect and such silly beginner-like things are:

    1) How do you deal with the partner who won’t compromise?
    I’m sure that most paramedics are on the same page and are working together as a team, but I’m also aware that a small percentage of paramedics are stubborn and bull-headed (nothing wrong with it, I’ll probably be like that one day, lol!) So I’d like to know how do you deal with someone who is senior to you, who is treating the patient, but is doing something that you don’t think is in the patient’s best interest, even after you’ve made your view known, and they don’t want a bar of it? Have you ever been in that position where if you were louder, or more forceful, an adverse outcome could have been prevented?

    2) How likely is the paramedics career going to get me overseas and into front line emergency aid? Long term that is where I want to be, but I don’t see the options of nursing or becoming a doctor an excellent way to deal with emergency situations where I need to be in an outdoor environment with minimal equipment and medications to use. There has been talk of standardizing paramedicine, but is it something that is happening, or just gossip to give us false hope?

    3) Who gives training on dealing with family members witnessing their family dying in front of them?
    I don’t think VU trains us on that, and I’ve heard a rumour that AV just put you out there to deal with it as respectfully as you can…

    4) Has anyone done a night shift and slept through the pager and radio?
    (Just out of interest. XD)

    5) Are paramedics in general highly supportive and team players, or are they one man teams — if you stuff up, you’re on your own?

    And other questions are silly and I’ll figure them out once in the job. 🙂
    Thanks!

    • Those are some fantastic questions Jeannie, thanks for asking.
      So the issues I see there are:
      Interpersonal/professional relationships.
      Portability of qualification and maybe longevity in the job.
      Managing the difficult scene (and probably some debrief stuff as well)
      and Fatigue management.

      These are exactly the sorts of things I was looking for, so if anyone else out there has anything to ask, please feel free. I’ll take these on board and have a chat to some other people about developing a resource for the starting paramedic.
      Keep an eye on the site Jeannie and I’ll get something up as soon as I can. Thanks for stopping by, please spread the word to your colleagues.

      Robbie

  4. caps says:

    I am a student paramedic at uni at the moment and walk out sometimes really worried about things they say are really important but then talking to qualified paramedics they say not to worry about that so much, so one thing I would like to know is what is really important to become a good paramedic, clinical approach? communication? patho? etc etc?

    how do most paramedics find work life balance and what they do to relax/de stress?

    there is many more questions I have but these are two main ones!

    Thanks for the blog its great.

    caps

  5. meditude says:

    I did a 1 year EMT to paramedic foundation degree. I was stuffed to the top with paramedic magic. I went to a really poorly head injury, no idea what had happened to him. I didn’t know where to start.

    An EMT turned up and inserted an airway.

    Remember, start with the basics. Paramedic magic can come any time after that.

    @meditude

  6. GAP1 says:

    Having just started on road some good topics might include: Roles of the driver at a case (setting up the bed, sitreps etc)?, how to manage really negative paramedics towards the job?, how long should you be on road before its acceptable to do overtime?, how to get the most out of your CI….just to think of a few.

  7. drew1387 says:

    gday Rob,

    I’m a new GAP in my first month. For me, it’d be nice to get a better sense what I – as brand new to this job – should really be prioritising at a scene, especially when there’s others on scene and things are a little busy.

    Also, It’d be good to know if there’s CPD-type courses out there that are available for GAPs to take part in? I think clinical decision making and prioritisation of treatment modalities depending on the type of patients would be something I’d at least be keen to hear more about.

    cheers

    Drew

  8. Graeme Dalziel says:

    Hi Robbie

    Interesting question. As mentioned, life as a paramedic has changed and is continuing to change. Our workload has markedly changed from high acuity to low acuity, with frequent calls to the worried well, the concerned and patients with multiple comorbidities. In order to evolve, I feel that we need to change our default. I graduated in the “fix it” era, with the panacea being high flow oxygen, lots of fluids or some other cure, pulled from the kit and administered with zeal. Life was exciting with frequent STEMI’s, lots of road trauma, severe asthmatics in extremis, acute cardiogenic pulmonary oedema patients every second night shift, etc. Nowadays life as an ambo is somewhat different. Low acuity workload has increased and high acuity workload has decreased, yet many of the ambulance education curriculums have not changed. Paramedics need to know how to deal with high acuity problems, however they also need to learn the soft skills that are now essential in our day to day interactions with everyone. I feel that the key to success as an ambo these days is cognitive empathy. I recently watched a really good presentation on this across at RSA animate. Here is the link.

    http://www.thersa.org/events/rsaanimate/animate/power-of-outrospection

    From time to time, we all experience an epiphany. I had one of those life changing experiences after listening to a great podcast on the EMS Leadership podcast back in 2009. Thom Dick was being interviewed about his book “People Cares”. I’d encourage you to have a listen to his thoughts on emotional intelligence, making a connection and cognitive empathy. Here is the link

    http://www.emsleadership.com/?p=150

    Food for thought

    Graeme

  9. Oneday says:

    Hi Rob I’m starting my gap2 phase, if I could go back and leave a note to help myself just starting from day one it would say the following:

    • Is the patient dead/sick(stable)/dying. If sick sit back get a good history then VSS. If dying go in for VSS (after primary). If obviously deceased the family are now your pt. treat as such.
    • Introduce yourself and take a physical step back and observe. Observe your surroundings, look at they way a person lives, look for clues, meds on the bedside table ect, also really look at your pt, you will have a brief medical history before you have even begun assessment.
    • Make evidenced based decisions. Even if you are wrong it’s important to learn to make the decision and understand why you made that decision, your ci won’t let you screw up.
    • learn from everyone, not just other paramedics, but also nurses and doctors at any oppurtunity
    • Get through your student phase by flying under the radar
    • Wee at any oppurtunity you get
    • People like happy people, so be happy, but not over the top.
    • Work and study hard so you can be quietly confident. “Walk the walk not talk the talk.”
    • Basics first!
    • Prioritise the tasks at hand and act.

  10. Dano says:

    Jeannie,
    It’s a cliche but there are no stupid question!
    I am a paramedic and have been for the past 8 years. I love my job and am not burnt out yet but I attribute this to my attitude and also the locations I have chosen to work in. At the end of the day, there is a lot of grumbling in ambulance services (as there are in every other job) but also a lot of positivity. You can choose your attitude and the way you conduct yourself at work. If you are in the job for flashing lights and action all day you will be dissapointed as the majority of ambulance work is low acuity and mundane. However, if you get satisfaction out of helping people, this may not bother you. There are also opportunities to work further in these low acuity areas constantly developing (extended care paramedics in SA and NSW and low acuity response trials in QLD).

    1) How do you deal with the partner who won’t compromise?
    This can be a tricky one, especially when starting out however, you owe a duty of care to patient’s and if things go bad you are considered a crew and questions will be raised as to why you did not intervene. I have worked with some tough offsiders and at the end of the day, it is how you communicate with them. If all else fails, offer to take over as patient care officer!

    2) How likely is the paramedics career going to get me overseas and into front line emergency aid? Long term that is where I want to be, but I don’t see the options of nursing or becoming a doctor an excellent way to deal with emergency situations where I need to be in an outdoor environment with minimal equipment and medications to use. There has been talk of standardizing paramedicine, but is it something that is happening, or just gossip to give us false hope?

    The profession is currently in a state of evolution though current overseas opportunities are limited and largely restricted to ICP’s ( Intensive care paramedics). Registration may change this. See the paragraph above regarding ’emergency situations’ .

    3) Who gives training on dealing with family members witnessing their family dying in front of them?

    This is a hard thing to ‘train’ somebody for. Emotional intelligence, communication skills and empathy help but there are no ‘workshops’ covering this (to the best of my knowledge). I cannot remember how I learned except though experience and consultation with peers and I find it one of the hardest parts of my job. I would be interested if anyone else can provide more info to this question.

    4) Has anyone done a night shift and slept through the pager and radio?
    (Just out of interest. XD)
    Yes!

    5) Are paramedics in general highly supportive and team players, or are they one man teams — if you stuff up, you’re on your own?
    In my experience I have been fortunate to work with some excellent people and had found most paras to be supportive and team players. There are rotten eggs and you will know them, probably before you even speak to them! Some people in management can be a little less than supportive but I have found if you have been doing your job properly, you will be supported. Be positive, work hard, smile, put down your phone and converse with people, don’t participate in gossip, treat your patients well, do some exercise, learn when to listen and take every opportunity for professional development offered to you and hopefully you can enjoy a long and fullfilling career!

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