Florian Breitenbach

Rettungsdienst und mehr

Change is inevitable…

…except from a vending machine, as the saying goes.

Some may be sad, some may be worried, but autonomous vehicles (and automation in general) will be *the* next big thing.

Generations to come will have other play things, and the smell of fumes, the sight of congestion, the horror of car crashes will be a sealed in an envelope, filed away in history, stamped with “It was fun while it lasted, I got some sideways action, but it’s time, as a race, to move on to a brighter tomorrow.”

“Bob Lutz: Kiss the good times goodbye”

Comfort zone

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.




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…


Hello all,

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

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




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.




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

March 28, 2015 Add Comment



…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:


IMG_1034Soon, blogging should be back on the list.

Interested in the outcome? Watch this space.


October 28, 2014 3 Comments


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.


June 6, 2014 Add Comment

Bern Baby Bern



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.

044When 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:

  1. Student Paramedic, year 2
  2. Student Paramedic, year 3
  3. Qualified Paramedic
  4. Experienced Qualified Paramedic
  5. Experienced Qualified Paramedic with ICU/Anaesthesiology nursing qualifications, OR Junior Emergency Doctor
  6. Experienced Emergency Doctor

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.

IMG_8208Emergency! 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.


036Mainly 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.


049The 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

June 4, 2014 4 Comments