366 days – a short film about a young paramedic in Austria.
These 12 minutes really brought back some memories, feeling and thoughts not only from when I started, but also where I am now. A very touching insight in to life as a Paramedic.
…or Overload, Procrastination, Quiet Reflection, Structure, Time to shine!
I’ve got a lot going on at the moment, keeping myself busy in and outside of work. Too busy, it felt at times, and too uncoordinated. Overload, and with it, Procrastination (of the bad kind)
Time to simplify. Out with the unnecessary, focus on the big picture. Not always easy in the age of information overload and the ever luring presence of social media to get your procrastination fix, but it can be done.
Reflective cap on, time for some introspection, reflection, rearranging, reprioritising. What do I want to do, what can I do, where do I want to go, how do I get there, who do I want to be?
But first, get the basics sorted, daily life. Bringing in some structure:
Interested in the outcome? Watch this space.
Thirty people, spread over four countries and two continents, and with a variety of backgrounds, meet in a wooden hut in the alps for 48 hours. The only thing they have in common, apart from the german language, is an interest – a passion – for paramedicine. Why do people travel hundreds of kilometres on their days off, organise shift swaps, and take annual leave ‘just’ to be with colleagues and to talk shop? Why would mostly underpaid paramedics spend their hard earned money to be in company of others in the same profession?
Dedication and Desire. Dedication to the Profession, and the Desire to improve. Make things better. Improve systems. Improve working conditions. Optimise procedures. Exchange ideas and experiences. Discuss thoughts. Improve outcomes. Save lives. Working and focussing on our raison d’être, our motivation and purpose of existence: the patient, and the community.
It is easy to get stuck in the negative spiral with burnt out, cynical and overly sarcastic colleagues. But nobody ever said it would be easy sailing in this job; that is true from a clinical perspective, but also from an operational point of view. Think back to the time when you were but a newby in the job.. Think of what motivated you to get in to this great and noble profession. What gave you your drive? What were the deciding factors? What grabbed you, and made you go “YES! I want to be a Paramedic!” ?
Make sure to hold your head high, and be a proud professional. We all have our ups and downs, and if you ever find yourself doubting – get out of the rut and surround yourself with some like minded individuals to lift your spirits. Add some clean alpine air to the mix and you’re sorted.
It was a great time meeting with the group, and I, for one, will return home just that little bit more refreshed with just that little bit more motivation to do what I love doing: being a paramedic.
I am refuelled. The flame is still burning strong.
OxyBear is saturated.
Thanks to Martin Greca for the photos. They are Creative Commons licence, but please get in touch with me via the Contact! page if you want to use them.
Up next on the second day of the meet up was a guided tour of the Paramedic Service in the Swiss City of Bern, curiously named the “Sanitätspolizei”, literally “medical police”. I guess that gives a whole new meaning to the term “Cardiac Arrest”…
In reality though, the terminology can be explained historically – over a century ago, it was realised that a dedicated corps was needed to help people with medical problems in the community (well, get them to hospital). This group was recruited from the police force, and the police moniker stuck, although they have nothing to do with the police at all.
When the service was being set up early last century, a specialised water rescue group was also needed. So the Sanitätspolizei got lumped with that too, and has proudly kept it to this day and age. Every ambulance is fitted to tow one of the many boats that can be found at their HQ.
The 6 day rota that staff work seemed interesting; day shifts on day 1 & 2, moving on to a night shift from the evening of day 3, finishing on the morning of day 4, and having day 5 & 6 off.
Far more interesting (read: different, strange) was the way vehicles are staffed. To understand this, I will list the “clinical points” that are given to staff of varying clinical grades:
There are a pool of staff floating around the station (the only station in Bern) at any given time. Staff are not assigned to a specific vehicle during shift, or have a certain partner. When an emergency call comes in, the calltaker/dispatcher (same person) triages the call. Depending on the nature of the call, a varying amount of “clinical points” are needed to appropriately staff the vehicle. A patient transfer job (all done by these guys and girls) can be handled by a single qualified person, only three points are needed (there will always be a fully qualified Paramedic on every vehicle). If a call is deemed low to medium priority and needs (minimum of) six clinical points, it could be two qualified paramedics, or an experienced qualified paramedic with a year three student. Cardiac arrest calls have the highest point count at 9, and one of the staff have to have at least 4 points to their name. For calls like this, they try to put three staff on a vehicle.
To get the resource running, the dispatcher broadcasts the names of the staff that they want to respond, they go down to the garage, get a “job fax” (a printout stating the nature of the call). Staff then grab a vehicle, tell control what vehicle they are on, the call details are sent to that vehicle (including sat nav), and away they go. After a call is finished, the vehicle is returned to base, the crew restock and clean it, as it unlikely that they will use it themselves in that configuration again.
Confused much? So were we.
Emergency! Jackets and boots are not allowed past the garage, so staff leaver them here, ready for their next call
A few numbers before I leave you with a selection of vehicle pictures:
The Sanitätspolizei Bern
And now, finally, the moment you’ve been waiting for. Colorful cars!
The group around a Mercedes Sprinter 315, coachwork by the German company Ambulanzmobile, type “Delfis”. This is the main type of emergency ambulance in use in Bern.
Mainly used for nonemergency calls is the smaller VW T5, coachwork again from Ambulanzmobile, type “Hornis”. Can be used for emergencies as well, has all the same kit, just less room.
The so called “Hochlang” (literally: talllong, because it is tall and long) built on a Mercedes E Class chassis is a dying breed – as they age, they will not be replaced by newer versions. They are primarily used for long distance transfers – colleagues who have used them love the smooth ride, but this comes at the expense of far less room compared to other types of vehicles.
An officers/supervisor car, Mercedes ML.
And they even have a Lambo in the garage!
Thanks for additional pictures by © Nils Düster and (cc) Martin Greca. To get in touch with them, please contact me via the Contact! page
A few months back I was made aware of rettungsfachpersonal.de – a high quality German speaking forum for paramedics and those interested in topics about and around paramedicine. Their user meeting was coming up in May, and I might be interested in coming down to Switzerland for a few days. Well….why not?
The meet up was spread over three days. The first day was more of a get to know each other day between paramedics and some emergency physicians from all over Germany, Switzerland, one from Papua New Guinea and yours truly from London. The interesting thing when meeting people in real life after knowing them only from a forum, is the need to establish a link between their online user name and their real name (and their face). Having been quite new to the forum I just had to get to know everybody, end of story. Nothing better than a good old fashioned barbecue then!
Set in a scout style wooden hut in the swiss alps (you’d have to be about 1.50m (4’11”) to walk around comfortably in the bedrooms), it was back to the basics: five minute drive to the next tiny village, luckily we had running water and electricity. But no comforts of a luxury hotel – wash up yourself, make your own room (i.e. bring your own sleeping bag for the 8 person sleeping room with bunk beds). I didn’t mind it, nothing wrong with making do with the bare necessities…we’re often enough used to it at work after all! Even the (very) near by (restless) cows with their bells around their necks all too soon became a background noise that I could easily zone out from.
The afternoon, the evening and the night progressed. Food was heaped on to the flames, drinks (kept cold in a trough) were distributed generously (but not too generously). Stories, systems, scenarios and studies were exchanged. Ideas and concepts were conceived, discussed, formed, changed and adapted.
After surviving a night bunched together with various snoring colleagues of various snoring intensities and various snoring intervals (with varying snoring rhythms and notes, including but not limited to: staccato, legato, samba, jive, E flat minor and G sharp), the late morning breakfast was just what was needed to wake us up for the afternoon, our visit of the Paramedic Service in the Swiss City of Bern, the Sanitätspolizei Bern…
“Every hospital should follow every patient it treats long enough to determine whether the treatment has been successful, and then to inquire ‘if not, why not’ with a view to preventing similar failures in the future.”
Ernest Codman 1914
Let me adapt that to our profession, one hundred years later:
“Every Paramedic Service should follow every patient it treats long enough to determine whether the treatment has been successful, and then to inquire ‘if not, why not’ with a view to preventing similar failures in the future. This information should be shared openly with staff for education purposes and to allow a greater interprofessional understanding of each role involved in patient care”
Florian Breitenbach 2014 (Thanks @MDuschl)