Life of a Trainee Paramedic

There has been a lot going on for me in the past couple of week’s.  I have worked quite a lot of shifts, both day’s and night’s, I am also going to have a change of mentor and I’ve also had 2 quite big job’s which I’ve never had before.  I had 4 day shifts last week and the 1st 2 were quite busy with some decent jobs, but Saturday and Sunday were not so good.  I think Sunday would have to be the longest day I have ever worked, even though it was still 12 hours, time really dragged.  It might also have had something to do with the type of job’s we were getting, where there was not one job that we had to put the blue light’s on for, and we were getting pushed from pillar to post.  Thankfully there are only a few day’s that are like that.

In regards to my mentor, the Paramedic that I have been working with since February has now got a job up at the Training Centre and leaves after Thursday’s night shift.  With him just having a new baby, and already having an 18month old, I think it’s a good move for him as it’s 9-5, and doesn’t involve weekend’s or night’s.  He said he’ll still be doing a few shifts on the road to keep his registration up but I was a little sad when he said he was leaving, but I was also a little worried also.  Worried because I had built up that trust that you get from working with someone for a while, and with it being the most important time in my course, I didn’t want to spend that much time building up another relationship with someone.  Since February, when my mentor has been off, I have been working with another Paramedic, who I get on really well with, but who unfortunately only work’s part time, so he was out of the picture.  One of my ‘current’ mentor’s partner’s qualified as a Paramedic earlier this year and he offered to take me on, which I felt a lot better about as I get on well with him, and I’ve worked with him a lot also and I know he trust’s me to get on with things.  At the moment we are waiting for a letter from the Trust to say that we can cannulate patients.  I have already passed the exam, but until I receive this letter, I’m not able to cannulate out on the road, and with it being an invasive procedure, I was glad that I would be doing it under a Paramedic who knows me and won’t be to worried that I don’t have a clue what I’m doing.  My ‘new’ mentor is also moving onto my ‘old’ mentor’s line so there will be a space for someone to come in and fill.  The Trust has recently been training up Emergency Care Support Worker’s who are coming in to replace the Technician role.  They won’t be as qualified as Technician’s but will be able to support the Paramedic.  I am kind of hoping that one of them will fill that space, as depending on what they did before that got the job, I should hopefully have more knowledge that they do, and so I will be getting even more involved in dealing with patient’s and being at the front of their care.  I think this would really benefit me. 

I’m having mini test’s given to me while were on Standby waiting for a call, so I’m being given things to go home and learn and then talk about them when I’m back at work.  On night’s I’m only good for doing work up until about 1am, and after that I can’t seem to do any reading so any work I do get’s done before then.  Last night, we all got stuffed on Pistachio nut’s as I bought a big bag, and I took some to work, which I could eat instead of going to but a chocolate bar.  Now I know that they ahve a lot of salt in, but they are just so nice.  I find I can’t stop breaking the shell’sand eating them.  After getting the taste for them, the Technician we were working had to go and get some for herself so we went on a drive to Tesco.  I had a really good job last night that I’m going to talk about in my next post, but it is now 17.13pm, and I need to have my dinner and get ready for work.  Sleep Tight.

TP

We found this while we were on a break at Uni, and I think it’s the funniest of the lot.

You can find the other’s here!

TP

Well last night’s shift was quite easy compared to what I was expecting it to be with it being a Friday and  Children in Need.  Apparantely, more peopledo stupid things when that program is on.  Our 1st job was a priority transfer out of the area to a hospital that was more suited to dealing with spinal injuries.  Our patient was chatty throughout the journey, and she wasn’t in a critical condition in the way I would think of a critical patient, but because she had been experiencing gradual loss of sensation over a period of 6 weeks in her right leg and then buttock, a pro lapsed disk was considered and they wanted to get her sorted out straight away, which is why it was a priority.

Our next job I attended and it was a patient who had been having a panic attack who was still at little agitated when we got there but calmed down completely by the time we left.  The call had come through as a chest pain, but the gentleman said that he normally get’s this pain when he has a panic attack and his GP had prescribed some Diazapam so try and calm him down.  He had also taken some GTN, which was two and a half years out of date, which gave him a headache.  GTN would do this anyway, but he then remembered he had a newer version stashed away somewhere.  As the patient had a previous MI about 10 years ago, I did a 12 lead ECG just to be sure.  I’m getting a little better at reading them now as I’ve changed the book I use to learn them, as my previous book really had to many word’s in, can confused the hell out of me, where my new book explain’s things really simply, and then has a few examples.  An example wouold be how the previous book listed 7 thing that you need to look for on an ECG and then told you to do it, where this book goes through them one by one, so it’s easier to take in.

We had a break then until our break and then after a nice ‘lunch’ we were called to a guy who had been assaulted while walking home.  He was on his way to the taxi rank when he was set upon for no apparant reason.  He remember’s waking up on the floor, and didn’t really wanted to go to hospital but we persuaded him that it was probably best to get checked over due to his loss of consciousness.

Our next and final job of the night was to an elderly gentleman had become increasingly confused over the past few day’s and had been found on the floor a few times by the neighbour and it was recommended by a fellow HCP that he go to hospital, so we duly obliged.  After a few hour of standby we were sent back to base to wait for the day shift, who luckly arrived before the next job came in as we were in the ‘hot seat’, so I was able to get home, have breakfast, and snuggle up in bed by 7.15am!

I wonder what tonight will bring?

TP

Well these are going to be my first night shift’s since July, and although I can’t say that I’m looking forward to them that much (I prefer day’s), I hope that they will be busy instead of having a job every few hours, which makes getting into the routine of night’s even harder.  I always hate waking up on the day of night’s because the first thought that enter’s my head is how long it will be before I’m back under my quilt!  It’s a run of four 12 hour shifts, and I’m going to do them with a raging cold that I could feel coming on all week but which only decided to rear it’s ugly head yesterday.  It’s not really the cold that’s the problem, it’s the sneezing! I am someone who really can’t sneeze quietly, no matter what I do, and my sneezes are so stong, that I get a headache after each one.  I hope I don’t burst to many blood vessels! 

In regards to illness, I’ve been quite lucky since I got up here, I can’t remember having a cold last year, with the only thing I remember is when I sort of missed the kerb getting off the bus on my very first day which invited my ankle to swell up like a balloon.  With the temperature going down, I’m going to make sure that I’m completely wrapped up as it’s not that much of a stretch to think I may be outside on a job at some point tonight.  I hope that I get used to going to work when it’s dark, and going to sleep when it’s still dark.  I probably won’t see any daylight for a few day’s now.  I hope they all go well.

TP

Two Friday’s ago was my last day in Uni until January as this was the day that we had some practical exam’s.  There were 4 station’s where we had to go an be assessed, and we had to pass them all, or we would be returning the week after.

My first station was a manual handling station which we have to do every year apparently which just involved me helping lift a patient (aka a dummy) up and down some stair’s.  Now having done this every time that I’m on placement, it wasn’t any trouble at all.  The other 3 station’s took on the format of our previous exam’s, expect these were not patient assessment station’s, but practical ones.

My second station was to show that I know how to perform Needle Cricothyroidotomy and Needle Thoracocentesis.  this involved me going through the procedure on some dummy’s and discussing the reason for use, caution’s and contra-indications.  The assessor for this was really good as he was able to put you at ease so you didn’t worry as much as you were before you went in.

The third station for me was the cannulation, both IV and IO, and this again involved me demonstrating this on a dummy arm and a dummy baby’s leg.  Once we get a letter on confirmation through from the Trust, we are then able to cannulate out on the road

The final station was Intubation on both a baby and an adult dummy.  We are not allowed to do any intubation until we have done our hospital placement’s which we have been told can be as early as the end of Feb, rather than having to wait until after our final exams in May, and then possibly missing the July exam board meaning that we would be technically pass the course until September, which would then put back everything from HPC registration to applying for a job.

I had the last week at home as both my mentor’s were off that week, so it was a chance to un-wind a little.  While I was there I was looking back over my holiday photo’s from the States, and for some unknown reason I got thinking about time travel, and how whenever when you talk to someone in another country, say Australia, that you are actually talking through time, either the future, or the past depending on which way you look at it.  This I think exposes our limited understanding of time, not that I’m a temporal physicist or anything.

There has also been an article on BBC News, about how Paramedic’s want stab vest’s, and after I had read this article, that night I actually had a dream about being stabbed while I was at work.  I can say I was glad to wake up again!

TP

It has been a really good week for me as far as the course is concerned.  After my little trip up north, I had 2 days of Uni, and then a nice weekend off.  These 2 days were based around medical problems, as opposed to trauma problems we have been doing in the previous weeks.  We had a few PowerPoint’s, but thankfully not too many, and then a few skill station’s to try and get us thinking.  The format for the key station’s involves us being split into groups of about 5 with there being a scenario, where someone takes the lead, one of us is a helper and a patient, and then the rest are ‘critical observers’ to say how the lead person has got on.  We don’t know what these scenario’s will be until one of the lecturers explains it to us.  They are also in the room to offer their advice at the end also.  These are not ‘marked’ scenario’s but it tries to get us to go through a methodical approach to patient assessment to ensure that we don’t miss anything out.

After the weekend, I was at work Tuesday and Wednesday with my secondary mentor and they were both quite busy days.  Wednesday was an especially good day for me, and I came home feeling quite pumped up.  As I’m now in my 2nd year, I have started attending a lot more of the jobs now and it was one of these such jobs where the patient could have been having trouble for quite a few reason’s.  The patient had COPD, and was sitting in the usual ‘tripod position’ so on just looking at the patient, it would have been possible to think that it was just an exacerbation of this.  When I got into the questioning, the patient had pain just under their shoulder blades and down their right flank, with a slight build up of oedema in the feet.  He was also finding it increasingly hard to breath.  He had been to the doctor’s on Monday who after listening to the chest, considered it most likely to be a chest infection, and so was prescribed some antibiotics.  The patient had been quite ill though during the night with a lot of sickness, which I thought was most likely a reaction to the antibiotic’s that he had been prescribed.  He had no other pain, so looking at it, it could be presumed that the chest infection isn’t going to well with his COPD.  I decided that he should go to hospital, so my colleagues went to turn the ambulance round and get a chair for me.  While they were gone, I thought to ask him if he had any recent operation’s, where he then told me that he had only 2 weeks ago had a operation on his legs to remove blockages in his arteries in his left leg.  This immediately made me think that he could be suffering from a PE (pulmonary embolism), as the way he was presenting, and how his symptoms had progressed over several days, combined with his past history, seemed a likely explanation.  The buzz word’s from Uni about this would be ‘differential diagnosis’.  So week took him to hospital, and later on in the day I enquired about the patient and I found out that he was being admitted so that they could perform a special scan that will then show if he indeed does have a PE.  For some reason I was really happy after this job, as I knew that if I hadn’t asked the question, then we would have thought it was something completely different, as the patient was volunteering any information.  It made me realise that it is really important to make sure you get a good history as it can determine the type of care that you give the patient.  I know that this might seem like a run of the mill job, but for me it was quite important.  I’m going to be using it as a job which I can include my portfolio, part’s of which have to be in January!

The last job of the day was an RTC, where a motorcyclist had collided with a lamppost.  When we arrived, it was clear this was going to be a trauma job, which I hardly ever have, so I was quite pleased from a professional point of view.  The patient had an open fracture of his tibia and fibula, which are the bones in your leg below the knee.  While getting the equipment that we would need, my mentor and I were discussing what we thought should be done with the patient, and this was the 1st time that I had actually thought that I am playing a part in the care of this patient, being part of the crew rather than just a student.  There was a lot of things involved in the management of the patient, and when I was asked to do something, I was able to do it, and I was trusted to do it without everything I do having to be checked, so I was quite happy.  As a result we were 45 minutes late off, but I didn’t care, I was really pumped up, and I’m also going to use this job in my portfolio, and we only have to do 2 reflections for January, and I’ve now got them both in one day so I was really pleased. 

On Thursday and Friday have a practice day for our exams, and then some practical exams on the Friday, which I will talk about in my next post.

TP