Comfort zone

img_1785
Talking to people, reading books and surfing the net, you regularly come across a statement when it comes to personal development: “Get out of your comfort zone!”

So I did. I got off the couch.

And proceeded to board a flight to Switzerland – and I must commend the pilot for one of the smoothest landings I have ever experienced. Very comfortable. As are swiss trains. And my friend’s spare bed where I stayed a night (thank you hpcpr!).

Why was I actually there? I had signed up for was an Advanced Cardiac Life Support (ACLS) course, at a small but great little Paramedic School near Lucerne. I had spoken at a conference there last year which left me a good impression, plus I knew one of the staff there…and thought to myself “wouldn’t it be great to get some clinical skills done in a different language, in a beautiful country?”

Now, having grown up speaking German, and lived in Germany for 17 years, I’m au fait with the lingo. But I a) haven’t lived there for 10 years now, and b) the swiss dialect is comparable to Scotsman having a raging throat infection whilst simultaneously suffering a stroke.

Needless to say, I had my work cut out for me.

The ACLS bit wasn’t too difficult. I had the handbook (in Hochdeutsch, equivalent to Oxford English), and most of the clinical stuff was (well needed) revision. But I still went home with a bit of a buzzing head after each of the two days. Listening to conversations, let alone instructions, in a tricky dialect does push you out of your comfort zone.

So – what do we learn from all of this? My take home message (literally, as I’m writing these lines on my way home from Gatwick Airport) is that getting myself out of my comfortable, well known and understood environment got me more than just an ACLS certificate. It got me a shift in a different ambulance service, it got me a relaxing holiday, it allowed me to catch up with friends…but most of all, it was a humbling experience. All my professional knowledge and expertise doesn’t count for much when you are (at times) desperately trying to understand what’s going on, and formulate a fitting response in a way that the others will understand.

Experiencing that humility every once in a while is vital. Not only as a paramedic, or a manager or a leader, but as a human.

Gen Y – Who We Are, What We See

So after countless hours of preparation, xprevaluation, frustration and procrastination, here I was. Das 1. Zukunftsforum Rettungsdienst, the ‘First Paramedic Future Forum’ was going to begin in a few hours, with yours truly about to give a speech on a bit of a provocative issue, not only within paramedic services. I have split the talk in to three blog posts: This one will present the “whos, whys and whats” about us, the next post will follow on our expectations, finally, the last post will be on how to bring it all together. As always, feedback (via social media or the contact form) is muchly appreciated.

 

IMG_6415

 

Who are we?

Being a Gen Yer myself, I am writing this post in first person – I am after all talking about my generation, my peers, our (general) viewpoints and our issues! But firstly, why Generation Y? Because Y comes after X, simple. Additionally, we are Generation WHY? – more on that later. It is not clearly defined who is and isn’t Gen Y. Depending on your sources, it is roughly those born between 1980 and 2000.

 

Our Influences

Think back two or three decades ago. What was going on in the world back then was what shaped us. The big one was obviously the rise of computing technology – it was coming from academia and defence in to commercial applications, and quickly spread in to our personal homes (and continuing in to our pockets!). We are the first generation to grow up with computers – we are Digital Natives. We understand, use, and trust technology.

The rise of technology also meant the rise of instant access to tons of information – we know our surroundings much better than we used to, and what we want to know is just a few clicks away. The media has obviously grown with this; advertising and marketing means that specially selected information has bombarded us from an early age, mostly without any clicks necessary.

The removal of many boundaries and borders, geographical, economical, political etc, has made the world a smaller place. Trade has increased, giving us access to exotic goods. And if we want to find out more about whatever we fancy, the advent of available, cheap, and safe mass travel has enabled us to move around the globe much more easily than ever before. This is not a privilege for rich white men anymore either – think of how far womens rights have come in the past decades, as well as the recognition and support of various minorities, access for lesser abled, decrease of global poverty etc – all this has given us a different view of the world.

 

Our Traits & Characteristics

So what do our influences translate to in reality? What can one say about us? One major fact about Gen Y is our high education – we make up a higher qualified and skilled workforce than ever before. The number of university graduates has continually increased (see AustraliaGermanyUK, US). We also know that with the attainment of our education, our dream job is often not around the corner. We are mobile, and happy to travel to get to the job we want, where we want it. To stay in touch with friends and family, we use technology, the same way we found the job in the first place. This also allows us to find out how the service in the next city, county, or country works. Maybe we should move there? Or even move to a different profession all together – we’re mobile in between industries.

This does show as less employer loyalty – but to many of us who have grown up with parents who dedicated years or even decades to the same employer, to be at best thanked with a sloppy handshake for all their toil, or at worst with ruthless redundancy when the economy folded, we have lost some faith in employers. After all, we work to live, not live to work! We like money, we want money (we want to express personality and individuality), but we want the flexibility to go away on holiday or more, to experience life from a different angle. Reading, watching, hearing about new places and things – that isn’t enough, we want to experience them! On top of that, we have an increased social and ecological conscience. We’ll do whats right, but also what is right for us (we’re still humans after all!).

I have often heard that ‘kids these days just sit in front of the screen’. Yes, we love our screens, but we use that as a connection with others – calling up another friends landline is outdated, and usually will be a fruitless exercise anyway because they won’t have a landline. With all the social media messaging services (and SMS prices dropping drastically) we connect online, digitally. It’s not necessarily better or worse, just different – with a whole world of new possibilities attached.

 

I digress a little…

Let’s get this edging towards the Paramedic side of things a little. Take a trip back in a time capsule, back to Station 51, riding along with Johnny & Roy in Emergency!

What were Paramedics Services then? Yes, correct: Ambulance services. Transport Services. Actual treatment was just beginning to be introduced. They really were, no disrespect, Ambulance Drivers.

 

 

clinicial w patient (12)Well, those Good ol’ Days are gone. Things have changed. But was everything really good? What has improved, what has become worse? Think about what kind of jobs we go to these days predominantly, and how many of them we attend. Paramedic services have moved, developing both clinically and operationally. Some of our interventions would have been doctor only 10-15 years ago, which is a strong nod to our increased capabilities due to increased education and knowledge.

 

 

 

What are we confronted with?

So now you know who we are. We’ve touched on where Paramedic Services have come from, but I believe we all know that we are not yet where we want to, could or should be (with very few exceptions).

Look around and you will see ossified structures, making it nigh impossible to implement change. And if you are lucky to get to the stage of being able to adjust and improve an issue, the tables are guaranteed to turn very slow indeed, resulting in something between frustration and capitulation. Let’s face it: we are working with outdated systems.

There is much to be changed and improved. The 20th century finished over one and a half decades ago. Let Gen Y help with bringing our profession in to the 21st century.

 

 

Generation Y

Earlier this week I travelled to Hamburg, a great city in the far north of Germany, with a rich history of trade and some beautiful views (especially in the snow), even if the general attitude of the folk there can be rather cool and direct…consider yourself warned 🙂

IMG_6323There was a lot to see and do, including some very early Porsche experimental vehicles in the Prototyp Museum, strolling along the Reeperbahn, and finding out that apparently the fifth member of The Beatles was a police van. Who knew?

Hamburg, being a hanseatic city, thrived and thrives on trade through its port, which it has been relying upon for centuries. Knowledge, experience and wisdom has continually been passed down from one generation to the next in a move to keep the city, and the trade, at the top of its game.

What has that got to do with Paramedic Services, I hear you ask? And for the more established adults amongst you, dear readers, do I detect a hint of frustrations at us Young ‘uns, with all their Facetagram, Twitspace, Blogtube, glued to their screens all day and night? And for fellow Young ‘uns, I can hear your sighs when you think about those old guys who just don’t get what the net is all about.

Well, earlier this week I attended the 1. Zukunftsforum Rettungsdienst, the 1. Future Forum for Paramedic Services in Hamburg, to talk about just that: Generation Y – our expectations and demands.

Keep your eyes peeled for next weeks post…

Goodbye EMSBlogs.com

Hello all,

The EMSBlogs.com network is closing. Thank you very much to Dave for all the support over the past years, your help and assistance was mutely appreciated.

http://emsblogs.com/blog/2015/07/the-future-of-the-emsblogs-com-network/

This blog will re-emerge with a new design and focus within the next few weeks – stay tuned.

Florian

 

Free

Hello to all dear readers,

There hasn’t been much happening here as of late. Much of that has had to do with my energy being channeled in to my last module of my uni course, which, as you can hopefully understand, is draining. But you know what? I handed in my final essay this week, and I can feel the tension and the pressure slip away – and all that energy being available for other good things. I have some plans for some interesting blog posts in my mind, so keep an eye out.

Cheers,

flobach

This means nothing to me…oh Vienna!

Untitled
Schloss Schönbrunn. And snow, lots of it, in fact!

 

Actually, it meant quite a lot – so enough of the reference to 80’s pop music. I chose Vienna for my birthday destination because….well, I don’t really know. I had been before, couldn’t remember much – I believe I had not hit my teens yet, and as such it was a few earth rotations around the sun ago.

Vienna turns out to be a beautiful place, with spectacular old buildings, scrumptious food and a sophisticated yet laid-back cultured vibe. I can only recommend that you should visit it, and eat, drink and be merry there. I’m not one for much repetition, so I’ll leave you to check out my other halves delectable musings here.

Untitled   Untitled   Untitled

 Through conference attendances I had got to know some lovely Austrian Paramedic folk. As one does when visiting a country of foreign friends, one calls up (well, emails) in advance to organise a coffee together and the next thing you know you have a shift on an ALS response vehicle booked. Can’t help myself – and I count myself especially lucky as my other half is not only tolerant of such fun outings, but actively encourages me to do them (which she planned to turn in to some time to pursue her own interests, like watching some equine practice prancing. I might be losing some brownie points here, but I really can’t warm myself to horses. They have big teeth and don’t talk).

My alarm went off at 5am. Early? Yes. Girlfriend snuggled beside me on the mattress all warm and cozy? Tick. Could I have done with a bit more sleep? Indeed…but I was up and showered and ready to go in no time, excited by the prospect of experiencing another ambulance service!

After finding a little local bakery that mercifully opened early enough for me to buy all the danish (read: viennese) pastries within the city limits, I was fed and watered and awake to jump in to my Wiener Rettung (Viennese Rescue) experience. Now only to find out where I have to go…

IMG_3765
The Entrance Sign

As has often been the case in the past, someone saw me confused & pondering in front of the new building (the main building was closed and locked and dark), let me in and in a friendly manner pointed me in the right direction.

After a quick tour around the building (nice and modern, with beds, a comfortable communal, kitchen and outdoor area), and I am introduced to the Paramedic I will be following for half the shift. I say half a shift, as I only wanted to spend a coupe of hours to gain some insight, and not a whole day; it turned out to be a quarter of a shift, as the guys and girls in Vienna still do 24hr shifts, with the possibility of 15-20 jobs in that time frame. Phew!

Untitled
My ride for the day.

I was going out on the ALS response car that morning, with a Paramedic driving, and an emergency doctor treating. When I say Paramedic, I mean a person who is trained in emergency care, and – at the highest level – can intubate and cannulate. Nevertheless, they are still very transport focussed, and paramedics take a backseat in clinical care, leadership and development – most likely because the system is so heavily focussed on doctors as advanced providers. Even worse, Vienna is the only city in Austria that has an entirely career based ambulance service – the rest of the countries ambulance services release heavily on volunteer input. Often, I was told,  the ambulances are staffed with two volunteers with lower qualifications. Vienna is fighting this, and trying to bring forward the concept of a paramedic services within the country. They are doing a fine job it seems within Austria, but in an international comparison there are some areas where they are lacking.

But don’t write them off just yet, they have some interesting things to show to the world! They have just started a new level of Paramedic within the service. Qualified Paramedics are undergoing a three year course to further their knowledge and experience in such areas as critical care, primary care (community paramedicine), and field supervision (teaching and quality assurance), and they are building the course on input from a variety of international best practices – so hats off to them! I am looking forward to seeing them progress, and hopefully joining the international Paramedic playing field in due course.

IMG_3773
The ambulance garage. Obviously.

I went out on three jobs all together, including a 20+ minute run to backup a cardiac arrest. Not only was the job on the other side of the city, but it had also just started snowing heavily – and with heavily I mean approximately 15cm (6 inches) of snow in one morning. A standing and sliding ovation to the Paramedic I was with who safely navigated the traffic that morning.

And now, a few impressions, facts a figures from my shift:

Vienna runs approximately 35 ambulances throughout the day, additionally 6 ALS response units staffed by a Paramedic and a Doctor. The ambulances are staffed with three people – a wheeler, a healer and a dealer (OK, I made that rhyme up…one person drives, one attends and one is an additional pair of hands). This can get quite cramped inside the van conversion ambulances they use – working on a sick patient, there were two paramedics, a doctor and myself squeezed around the patient, and we could barely close the door. The service is considering in to larger vehicles for the future I have been told.

The Wiener Rettung only do emergency work, all patient transport is done by private and/or not for profit organisations such as the Red Cross or the Samaritans.

In the event of a cardiac arrest, the closest vehicle is sent – including the above mentioned patient transport vehicles or as well as the police as first responders. They are backed up by an ambulance and an ALS response car. The fire brigade are not involved at all – they were apparently invited, but declined.

There are no response time targets to be upheld, but a unit that has been alerted from station must be mobile within 2 minutes during the day, and three minutes at night.

Joining the service is an interesting path, one that I had not heard of before, some interesting ideas. After being accepted, either as a rookie to Paramedicine, or even as a qualified member, you start off doing station duties. You get to work, put on your uniform, and you clean and restock vehicles, inside and out. This is to get to know how the station operates, picking up the culture (e.g. cleanliness) and where everything is kept in the vehicles. If there is a staff shortage on that day, you will also man the ambulance if need be. After a period of station duties, you then progress to permanent on road duties.

After five years as a Paramedic, one can apply to work in the control room – this is often done by those who have injured themselves on the job and cannot work on the road, or those who have done their decades of work and prefer the slightly more controlled environment. Calltaking (via AMPDS) and dispatch is done at the same desk by the same person.

Untitled
Goodbye Vienna, hope to see you again soon!

I had a great time in Vienna, and being allowed to experience their ambulance system was the cherry on top of the trip. I would like to sincerely thank all involved for giving up their time in showing me around and meeting me, it was very appreciated.

Finally, I would urge everyone working in the field of paramedicine to consider visiting other services when they are on holiday. Not only do you get great insights and make some new friends, but you also get to see the area you are visiting from a local paramedics perspective – a view that is quite different than that of a tourist. Give it a go, I’d be very interested in your experiences.

For those wanting more information:

Tired

I’m awake, I’m away
I’m confined, I’m astray
I’m a rebel, I obey
When I’m tired.

I’m switched, I’m flipped
I’m down, I’m dipped
I’m quiet, tight lipped
When I’m tired.

I’m lonely, I’m horny
I’m passive, I’m thorny
I’ll listen, so bore me
When I’m tired.

I long for the days where I drift along
Not from fatigue, but from song
Immersed in the warm, sweet scent of life
But then it grips me, and stabs me like a knife.

I’m automatic, I’m robotic
I’m static, postraumatic
I’m erratic, far from ecstatic
When I’m tired