Posted by: medicblog999 | March 24, 2009

A Helping Hand

 frustration_relief

Warning – This is a long one!!!

I received an email today from a student paramedic somewhere in the UK. For the benefit of the post I will call him Michael.

Michael has given me permission to post his email on my blog after I asked if I could as I felt that many of his concerns and feelings will be universal around the world for any newly qualified member of EMS. I will post my reply to him and then hopefully all you good folk out there may have some pertinent points to help reassure him that he really has just joined the ranks of one of the most challenging but fulfilling jobs in the world.

His email read:

Hi
 
I hope you don’t mind me contacting you I am a newbie SAP, and if possible would like your advise on my situation, it goes like this.
 
I have been on the road now for a couple of months, in my view the training we had on our 13 week course was very poor until I started on the road and discovered that is where the training stopped and now will be learnt they way they have all learnt, so I am told, which is on the job.
 
We have been placed on a relief rota, told to start our KSF, have not been given a mentor and being on the relief rota no real stability. I really did want this job when I first started but with all the lack of support I am beginning to wonder if we really are just numbers and bums on seats, don’t get me wrong some people who I have worked have been a real help and you do pick up things from these people and some are not so helpful which does bring me down but what I have noticed is that all seem to be on a right downer and I don’t know if it is because of change in the service or it is what the job does to you over time?
 
As I said I did want the job and the satisfaction it can give (on my first week I helped bring a guy back from a cardiac arrest) but working with new people every shift has its setbacks in the fact that I feel like I am starting a new job everyday and wondered how long it takes to start feeling really confident and not left in the back with patients who I am not really trained to look after, only be it for 10 – 20 mins at a time and do you agree that it is a good way to learn. 
 
Thanks for any advice you can give and installing some of your positive thinking on me.
 
This post is about Michael and any advice and support we can give him, so lets take some of his concerns and deal with them.
 
“in my view the training we had on our 13 week course was very poor until I started on the road and discovered that is where the training stopped and now will be learnt they way they have all learnt, so I am told, which is on the job”
 
Every paramedic in the world will agree with the opinion that all of the real learning and experience comes with actually getting hands on with your patients and dealing with the ‘real world’ situations that will be presented to you. I cannot comment on the training that you had in your introductory part of your training before you came onto the road, but in my experience it is a hard slog, with much of the subject material being apparently irrelevant and just getting in the way of the things that you feel you should be spending more time on such as ALS, cannualtion, intubation etc. 
The advice I normally give to students who have been struggling with their first part training or becoming disillusioned about the training they are receiving is based on what you have already stated. The real learning will take place on the road, but what you are learning in college is the background material that is going to be the basis for the clinical decisions that you are going to make and ultimately is equally important. Whether you are finding it a hard slog, or whether you are finding that you are not getting the lessons you require or the support you need, it is essential that you get the most out of this early time. If the instructor support isn’t there, then that is when your fellow students become invaluable and you will learn from each other. Its adult learning after all and the buzz words are ‘self directed study’ ,which if it doesn’t fit your style of learning will easily make you feel as though you havent had any, or enough ‘taught’ lessons, but have been left to yourself to find everything out.
At the end of the day, you do whatever it takes to get you to your goal – that of being a state registered paramedic.
 
“I really did want this job when I first started, but with all the lack of support I am beginning to wonder if we really are just numbers and bums on seats”
To be honest, yes, you are just a bum on a seat. Your service will have its targets just like all of the others in the UK, and for it to achieve those targets, they need the paramedics in the ambulances and on the cars. You have to remember though, that they will want safe, competent and highly skilled paramedics to deliver high standard care to the patients in your geographical areas. Your service has invested alot of money in hopefully getting you through your training and into an ambulance. You also need to have the commitment and the drive to ensure that you do everything needed to become that competent paramedic. If you feel you arent getting the support you need, speak up about it to someone you trust and find those paramedics who you have worked with, who you admire, and make your own support network.
 
“some people who I have worked have been a real help and you do pick up things from these people and some are not so helpful which does bring me down but what I have noticed is that all seem to be on a right downer and I don’t know if it is because of change in the service or it is what the job does to you over time?”
The UK ambulance service has undergone huge changes over the past couple of years and is showing no signs of settling down anytime soon. You have to understand that for many paramedics, change comes hard, especially if they have been around for a while. As you will be well aware, there are many new practices, workforce changes, and national changes that have happened and that are still to come, and for some, its getting a bit too much. They need their outlet for their frustration, so as soon as you get more than two paramedics together, they will take the opportunity to try and put the world to right and have their complaints, but just like you , they are looking for support from their peers to help them through the difficult times too. No matter how much of a downer they are on, I bet the vast majority still love  looking after their patients! (or at least most of their patients!!!)
As far as working with lots of different people and not getting a chance to settle down – This can be both a positive and a negative. Yes, its hard to have to adapt to how different paramedics work (because we all like things done in a certain way) but you also get the opportunity to work and learn from alot of different people. Remember, you learn from good practice – “I`ll have to remember how/why he did that!” as well as bad “Christ, I`ll never ever do that!!”
I personally would have no problem with a new student coming to work with me and whilst we are checking the vehicle ask up front how I like things done and if I have any special things I like to do for certain types of patient. In fact, I would probably think more of them for it!
 
“wondering how long it takes to start feeling really confident and not left in the back with patients who I am not really trained to look after, only be it for 10 – 20 mins at a time and do you agree that it is a good way to learn.” 
 
Honestly, it takes years to feel really confident and competent. I came from a nursing background, so had a head start in some ways from some of the other people on my course, but we have all developed the same way once out on the road. Your comfort zone will come, but it depends on how often you are exposed to certain types of job and how much experience you have in dealing with a certain type of patient or situation.
I can honestly say that it was about 3 years until I felt really confident in taking control of a large RTC scene and telling the fire brigade what I wanted doing, instead of them telling me what they were going to do. There are still some jobs which take me out of my comfort zone, as I mentioned here, but you still deal with them and do the best for your patient.
The most important thing is to not expect things to come really quickly. It takes time to develop into a good paramedic, and it takes years to become a paramedic who your peers respect too.
As far as being in the back for cases that you are not really trained to look after, this can be part and parcel of feeling unsupported and not confident. To look at what you have learned so far in the cold light of day, can you honeslty say you have not been trained to a level where you cannot look after these types of patients. If the answer to that is yes, you have not been trained, then really, you shouldnt be in the back and you need to say as much to the person you are working with. Hopefully you get some supernumery time where you can have the opportunity to be in the back for complex cases with another paramedic without the responsibilty on your shoulders. If the case is that you have had the training, but you just dont feel confident, then you need to talk to the paramedics you work with and if you feel uncomfortbale with a patient in the back, you need to let them know, and hopefully they can help you get through your concerns and move forward in your development.
 
The one thing that jumps out of your email, is the obvious passion and commitment that you seem to have for doing this job. You need to remember that everything you are going through, all of the hard times that you have faced and all of the harder times that are still to come, are all part of your development and are all essential in making you a good paramedic and one that will be able to support and mentor student paramedics coming through after you.
 
It s the best job in the world, and you have already succeeded by getting on the course in the first place. Stick with it, don’t give up and role with the punches. Most of all, confide in and get the support of some close friends and colleagues. We have all been where you are, and anyone who tells you that had it easy are just lying!!
 
All of the best, and let us know how you get on.
 
Over to you, dear readers. Do you have anything to offer Michael?
Advertisements

Responses

  1. Even though you are not assigned a mentor you should find one. Someone with a few years under their belt who can help navigate you through the system and to answer all the self doubting questions you are going to have. Someone who has learned the ropes and will help guide you. A sponsor of sorts. They don’t have to be on your shift or even ride with you. They are just willing to help guide you.

    Yes you will feel as if you are not ready to handle certain calls. When in doubt ask for help. No shame in asking for help when you are in the weeds. This is also how you learn to trust yourself. Fall back on the basics that you know and work from there.

    Remember we all make mistakes, it takes a while to settle into this job and realy feel comfortable with our decision making skills. As a paramedic you have to grow into your skin. You will always have moments of self doubt, but over time you learn to deal with them.

    Find an outlet. You need to relieve stress. This job has a lot of it and carries a heavy burden at times. Find a way to let it out. I don’t mean always going out to have a pint either. Something real and something that is just for you. People don’t have to understand it, it just has to work for you.

    Take breaks when you need to. And you will need to. The average career of a medic is not really that long. To extend it oyu have to take care of yourself.

    Never ever stop learning. Medicine changes rapidly and there are new things to learn all the time. Even the same old patients can teach you something new. You never know everything, so always seek more.

    Never ask someone to do something for you that you are not willing to do yourself. Don’t be the medic that stands in the back and never gets his hands dirty. If you don’t jump in you won’t learn and your crew will not like working for or with you when the time comes. Always be respectful of your crew.

    Set the tone. You are leading the way. Set the tone of the call by how you act and react to the situation around you. Fake the confidence until you have it. if you remain calm and confident your patient will trust you and your crew will trust you.

    Like I said somewhere in all that fall back on your basics. Every call starts the same, every assessment starts the same. ABC…. you cannot go wrong with that. Don’t jump to use all the fancy gadgets and knowledge until you have gone through the basics. That approach will never fail you.

    Good luck!


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Categories

%d bloggers like this: