I've just mentored a student. Four weeks of trying to improve their skills, teach them all I know, and introduce them to the world of ambulancing. And whilst I'm at it, enthuse them about this job of ours. And therein lies the problem.
I love my job. I love everything about it. Everything, except:
The lack of decent vehicles.
The lack of equipment.
The lack of training possibilities.
The lack of pay.
The lack of respect from other medical professionals.
And most importantly -
When people, including me, complain about everything that's lacking. Yes, including me.
I'm overly, sickeningly positive about EMS. I can be, because I try my damnedest not to let the things all around me decide how I'm going to treat the people I meet. After all, they're what this job is all about.
There are always frustrations. The recent plethora of them has made me write this post in the first place.
It's wrong that I have to provide some of my own equipment because there are those who are dishonest enough at best to lose the kit and not report it, or at worst, steal it.
It's wrong that we're driving around in some vehicles that are nearly a decade old.
It's wrong that some of the calls we are asked to attend don't even come close to qualifying for something that needs an ambulance.
It's wrong that there is such a strong anti-management culture.
Equally, it's wrong that it seems as though that feeling is mutual.
A recent tweet from someone I follow, someone relatively new to EMS, mentioned that 90% of our calls could be attended by a horse and cart. I don't think that that's even close to being true, but it does show that this negativity is reaching and emanating from all corners, old and new.
Not all our calls are life-threatening emergencies. Not even the majority. From personal experience, and being one who tends to attract trouble when it's around, I'd say that the number of these calls is lower than 15%. But that's not all that our job is about.
There are loud mutterings in the ambulance service that this job isn't what it used to be.
I'm pleased to hear it.
I don't want to go back to the days of being just an ambulance man.
A recent shift with a different student showed me why. Their regular mentor was having a day off, so I was filling the gap. This student was enthusiastic, hungry for knowledge and experience, yet being mentored by someone who repeatedly claimed to be "just an ambulance man". This mentor started this job whilst I was still at school, when ambulances did nothing but pick people up, take them to hospital, and let the doctors there decide what was wrong and how they would treat them. The student, despite their enthusiasm, was being drawn into a world that I just don't want to be a part of. A world of pessimism, of negativity, of apathy.
I was trained by someone who said that our job isn't to diagnose, merely to take a history, treat only what we see, and transport. The Happy Medic has a post about paramedics diagnosing. I'm with him on this one.
We are so much more than we used to be. And we can be so much more.
Change is coming to the ambulance service. There's going to be much more of that stuff we're told that we don't do. You know - diagnosing. There are going to be paramedics trained to a higher level so that they can assess, treat, and refer to a much higher standard, all as necessary. And not necessarily transport. Some of the calls we'll be attending in future, are those that were traditionally seen and treated by GPs. The truth is, we're already attending them. We just don't yet have the system in place to do anything but transport them to hospital. That's changing too.
There are those who see these changes reflect an admission of defeat by the ambulance service. Rather than educate the public about who we are and what our role is in the health-care system, we are adapting to what we think the public would like to use us for.
Personally, I'd like the two ideas to meet in the middle.
I'd like to see more education for the staff, more training, more ability to treat at home and refer if necessary. Who hasn't thought about simply gluing the little kid's head wound back together, or the 90-year-old for that matter. Then they can stay in the comfort of their own home, rather than endure the trauma of several hours of an A&E visit for a ten-minute consultation and treatment.
I'd like to see more back-up from the system when we do leave patients at home, whether it's our decision or theirs.
I'd like to see that ambulances are waiting for calls, not calls waiting for ambulances. Why?
Because I'd love to see that we have time and the resources, like the fire-brigade for example, to go into schools, summer schemes, mother-and-toddler groups, anywhere, to educate the masses. Both about what we do, and about what they can do to help themselves and their loved ones.
I'd love to have all the latest vehicles, fully kitted with the best equipment, and attending calls that truly require our knowledge, our expertise, and our passion.
Until all that happens, I'll work with what I've got, to the best of my ability. And strive for more.
I'll keep enthusing about my work to anyone who'll listen, especially students.
Change is coming.
So are we going to fight it, or are we going to take the lead and steer it in the right direction?
Change is coming.
The question is, are we afraid of it, or are we willing to embrace it, pioneer it, and grow with it?