As the next edition of “The Handover” is coming up at Happy Medics place, and he is asking us to think of a learning moment, I thought I better get going and submit a post too. It would look bad if the originator decided to opt out at such an early stage!!
However, I have found it really hard to think of a specific learning moment, one that sticks in my head as a eureka moment, or a pivotal point in my development as a paramedic in the UK ambulance service.
As I have been thinking, I realised that I have been continuously having these little moments since my very first shift and continue to have them to this day. That is what makes this job so interesting and varied. Learning moments come from direct experiences you have had, but also from stories told by colleagues and things you witness that make you think, I wouldn’t do that!
So instead of one job to write about, I thought I would give you a list of some of these moments I have experienced. What would be interesting would be to see how many of these are truly international experiences:
- Fast on the straights, slow on the corners – Best bit of driving advice I have ever been given and the one piece I always dish out to new starters.
- Don’t rely on the Sat Nav – Local area knowledge will get you there much quicker and you wont be absolutely lost when the sat nav goes down.
- If the crew you are taking over from says the vehicle is OK and doesn’t need any kit, still check it. If something is missing and things go pear shaped, saying that you were told its was ok is no defence.
- Just because a patient is a good colour, all observations are normal and they have epigastric pain and not chest pain (like was sent to the MDT) doesn’t mean that they are not having a MI – I bet all of the EMS staff reading this have had that particular ‘oh crap’ moment.
- If a patient is fully conscious and orientated, good colour, sitting up having a nice chat and giving you a full and comprehensive history – that unilaterally dilated pupil is unlikely to be a significant head injury causing compression of the optic nerve, and is more likely to be normal for them.
- If a patients states they have central neck pain and the mechanism of injury is virtually non existent, as much as it may pain you, they still need to be boarded and collared
- Some patients can walk surprisingly well on a fractured neck of femur
- Don’t believe what you read on the MDT screen. Control can only put on what they have been told and many, many times this bears absolutely no resemblance to what you are about to walk in on.
- A drunken patient who has fallen over and hit his head is one of the most risky patients that you will get. Take great care and treat appropriately
- A good patient report form, well completed and containing relevant and pertinent information is a paramedics best friend and will protect him more than any partner ever could.
- Learn to keep your distance until you know it is safe to approach a patient and get within that close space for hands on care.
- Never rush into a house. See here for a good reason why!
- Police are there to protect us, don’t try and be a hero and go rushing into a situation that you know may be dangerous.
- No job is so important that you put your own safety and that of your partner at risk by driving with the ‘red mist’ clouding your judgement.
- If you have any doubt about a patient and the pathway of care that is suitable for them, always air on the side of caution.
- Trust your instincts, if you think the patient is ‘about to go off’ they probably will.
- Never, ever, go into a house without your kit, no matter how trivial the job seems to be.
- Utilise the hospital staff for information and education. Don’t pretend you know everything and ask questions whenever you can. Follow up on your patients if you are not sure exactly what was going on and read up on conditions that catch you out.
- Just because you are a paramedic, this does not mean that the best actions for the patient are always to ‘stay and play’ when really you should be ‘loading and going’!
- Understand and accept that shit happens sometimes. You could be the best paramedic in the entire world, but there will still be some conditions you miss, some interventions that you think may have made a difference that you didn’t do, and some patients that will surprise you and die with no warning what so ever.
I could go on and on, as I am only scratching the surface here, but hopefully you get the picture.
What I learned on my Technician course, my Paramedic course, and my Nurse training before I joined the ambulance service, has given me a fantastic base to learn from. They have been my introduction to health care and emergency medicine, but the learning that I have done on the job, the other paramedics that I have worked with and admired, and even those I have worked with who have left me thinking that “I would never have done that”, have moulded me into the paramedic I am today.
I wonder what I will learn on my shift tonight??