Food, exercise and other stuff
- Eat sensible food.
You know what’s sensible, you don’t need me to tell you that the 3am burger is probably a bad idea. Ambulance shifts are long and you can’t survive on biscuits and chewing gum. Eat real food, preferably food you made yourself. If you’re having trouble getting organised, set aside one evening a week to make a big batch of something that reheats well, then freeze five or six servings. Bang, that’s next week’s meals. I do this every week – it’s not exciting but it means that I never have to try to work out what eating. I just grab something out of the freezer and find out what it is when lunchtime rolls around. Also, buy a slow cooker. They can cure cancer.
I have no proof of this but my experience is that during, and on either side of my night shifts, I do better if I eat low-carbohydrate food. I don’t know the mechanism but eating lots of sweet or starchy things seems to make me really sleepy, and then I hanker for more soon afterwards. Eating a meat and veg meal seems to last me through the shift and I snack on dried fruit and nuts as required.
Above all else, try to avoid the sweets that seem to linger around most stations. For some reason I get a powerful craving for sugar during night shifts, and I’m pretty sure it’s because my body is physiologically stressed and looking for easy energy. Resist.
You need to organise a regular program of exercise. You know that already but you may have some reluctance in implementing it due to chronic CBF. The time to change is now. Ambulance work is hard on the body at times and the best way to minimise the chance of injury is by being used to physical exertion. I personally recommend weightlifting of some kind because it’s highly applicable to the work we do (when was the last time you ran a half marathon on duty?), but whatever works for you. Physical exercise is also excellent for managing mood, inadvertent weight gain, and for shaking out the cobwebs after a night shift. If you can add a social aspect (riding with mates, boxing with mates, climbing with mates) that’s even better because it is highly motivating and increases compliance.
More about training here.
- Your social life.
You need one. Over time you may find that many of your friends are paramedics, nurses or other healthcare folk, and that’s fine. But make sure that you set aside some time to catch up with your non-medical friends to quickly work out how weird and awesome our job is – expect to tell the same war stories dozens of times.
That said, it can be tricky to catch up with people between shift work and study time. If you throw family obligations into the mix it can be downright treacherous. The solution, as always, is to get organised. You may not have as many 12-hour sessions in the pub as you might have had while you were at university but a dinner out with mates is very doable. Try to work something in during your set of shifts on, such as meeting someone for coffee before your night shift or going out for dinner after a day shift. This will help to stop you getting too isolated and never seeing anyone who isn’t in uniform.
It’s important. If you don’t know this already it’s likely you’ll learn. But don’t overdo it, caffeine is no substitute for sleep and it’s horrendous for exacerbating anxiety. If your caffeine use is moving from pleasure to pharmacology you may need to reassess.
- Social media.
Use your brain. If you’re a heavy user of social media like me you need to be very aware of what you’re putting out there. Your employer likely has rules and policies about social media but I feel that you should take it a step further and not discuss your job in any vaguely public forum. You never know who’s reading and you never can guess what the consequences would be. Jobs have been lost over this kind of thing.
When the crusty old paramedics at your branch whine that there isn’t any good work out there any more, they’re right. The widespread changes to healthcare over the last generation, the development of asthma care plans and cardiac catheterisation laboratories, the strong emphasis on public health issues from government, improved car design and road law enforcement; these all add up to fewer patients who are extremely sick. That’s good for them but bad for our clinical practice. Compared to twenty or thirty years ago we spend much more time attending minor illnesses or transporting nursing home patients than in the past. You may not get the exposure to an acute workload that you were hoping for, particularly in rural areas.
Accept it. Move on.
In the past paramedics became good operators by having lots of exposure to very sick people and having to heal them with a GTN tablet and two bits of string. Those days are happily behind us because we now have the benefit of much better knowledge and a much wider array of drugs and equipment. As a point of comparison, when I started work in 2005 I was only allowed to use five drugs and a fully-qualified paramedic only had access to eleven. It seems that we have more gear to help fewer sick people – how is a junior paramedic meant to learn the job?
I understand it’s frustrating but you need to find the silver lining. As one of my first instructors said to me, the minor cases are practice for the major ones. If you get really really good at assessing, treating and transporting nursing home patients the habits you’ve formed will be extremely useful when the Big One happens. Certainly when I’ve worked with people who dismiss the minor cases as “dunny jobs” they are usually incapable of handling the major cases, despite what they may think. Under pressure you don’t rise to the occasion, you sink to the level of your training.
- Being systematic.
If I could give one piece of clinical advice to new recruits it would be to get used to being systematic in your assessment. The people who are poor paramedics and struggle through their first year are always lacking a good systematic approach. And once bad habits have been ingrained it can be very tricky indeed to scrub them out.
Don’t be that guy. Your ambulance service has a prescribed way of going about assessing a patient. Use it. Learn it backwards. Apply it even when it doesn’t seem relevant. Or don’t. Come up with your own system that covers the main points but is easier for you to apply. But don’t try to wing it and do what seems like a good idea at the time. I can promise you that any system is better than no system at all. A good-quality, automatic clinical approach will save your bacon every time.
More about clinical approaches here:
This is something I lacked when I was studying, for various reasons including my own pride. A good mentor can be extremely helpful while you’re learning to navigate your new life and find your place. You want someone who has been there and done that but who is still interested in your well-being and wants to share their knowledge. This may be one of your instructors, or a senior colleague, or even someone just a few years ahead of you. Mentors help to prevent you reinventing the wheel in terms of your learning and can be a valuable perspective check when you’re firmly embedded in your own fundament. Just remember that you can’t demand that someone mentor you – it’s a two way street that needs to provide benefit to both parties.
- Keep learning
Even after you’ve qualified the learning never stops. It usually becomes less formal (unless you choose to do another degree) but it’s an ongoing process throughout your career. I’d advise you not to pay attention to those who insist that all study be done in work time and on the work coin – there may be an argument for it but it’s a great way to learn nothing and be permanently annoyed. Why would you limit yourself by only learning things that you’ve been told to learn? I don’t do much formal study myself but I spend a lot of time chasing up topics that interest me. This can be as simple as looking up Wikipedia while stuck at hospital or as time consuming as writing a research paper “for fun”. The pre-hospital research world is pretty barren at the moment and people who are keen to learn are helping their careers.
Part 4 coming soon…