Friday, 29 October 2010

Keeping up to date

As a Paramedic, I am responsible for ensuring I keep myself up to date with all the latests guidelines, practices and to make sure I keep my skills up and prove that I can still do those things that I was taught many moons ago. This is part of my profession and part of being a professional, taking responsibility for ones "upkeep".

However, this is not easy. Yes, you can read journals. Yes, you can keep reflective accounts of jobs you do etc to help learn what you have done and how you could improve it. But, and I don't know if I am alone in this (which is one of the reasons I blog - to see if I am alone or if others are in the same boat and how they deal with it!), I do find that my trust is not hugely supportive of on going training and development. I also feel there are limited courses out there in commercial world specifically designed for the Paramedic market, and many of these courses are not cheap either!

Now, don't get me wrong, but I think trusts (well my trust at least) are trying. Rota's now have (or are getting) training days built into them. There does seem to be more of a push towards yearly reviews for staff and individual training plans. They are trying to get more training staff available more of the time to more staff, which is all good. However, as soon as the pressure levels increase and the trust is over worked *poof* away goes the training. Certainly, in the trust I am in, we seem to be "under pressure" more and more these days, and I guess it is the same for many with the wanting us to do more for less. But is this really an excuse? While I am not going to go into the intubation debate here (I'll save that for another post!) even though it is recognised that Paramedics don't get as much exposure to this skill as is desirable, there is little that trusts seem to be doing to address this. One trust I know of has even stopped training intubation to all it's new Paramedics - so instead of trying to find a solution to the training they have just removed it which, given we are in the 21st century and wanting to move the profession forward (well I know I do and I am sure I am not alone!) this only seems to be a step backwards.

As for external course, yes you have things like PHTLS and ALS but really these are Doctor courses and while they are relevant for Paramedics in the whole, they have not been designed FOR the paramedic. If I am honest, I'd love to see some courses with us in mind being developed between the College of Paramedics and HPC. In my little brain I can see a huge market here - perhaps a course that you could do where you can have simulation manikins and practice intubating (to reduce the aparent skill fade and thus stave off the skill removal), prove compitence in managing cardiac arrests or truama or any number of scenarios, perhaps some theory and even an exam. Perhaps even make this a mandatory course which you need to do every 2 years and produce the certificate when re-registering with the HPC. Some people reading this (assuming anyone does) may think I am crazy, and in part this may be true. But surely, something like this, designed for paramedics, making sure we keep skills up to date, proving that we still know stuff can only help to improve the profession. It would ensure we keep ourselves up to date. It would ensure we do still remember things and are regularly tested on them, not only proving to ourselves that and our peers that we can remember it but proving to the public that paramedics are not just a group who have done training once but are constantly being re-tested to protect them. Yes, I know this in part is what CPD (Continual Professional Development) is about, along with folders, but wouldn't it be good to have specific courses targeted at paramedics with this in mind?

Ah well. Until such time as these sort of courses appear I shall keep doing whatever training I can get out of my trust, probably some additional courses on top (if my bank balance will allow!) and perhaps a conference or two. Will definately keep reading blogs and listening to the Ambulance Matters podcast - - (strongly recommend this to people!) as this seems to be quite a good way of reflecting...

Oh, and if anyone has any great learning resources, any tips or tricks, or any courses they'd recommend, I'd be really interested to hear. I want to become a good paramedic and I know I am right at the beginning of this journey. Like I have said before, anyone who thinks "I'm now registered. I've got there" is in for a shock as there is always more to learn. And if anyone fancies setting up some Paramedic Training Courses designed by paramedics, for paramedics, let me know!

Friday, 8 October 2010

Who wants trauma?

What is it with Trauma? You've probably heard similar comments as I have...

"Went to this wicked job last night"
"Oh, what happened"
"Well it was this proper trauma job...."

I have heard people talk, even rave about trauma jobs, "proper jobs", jobs where people are significantly injured and it takes a lot of effort to save them. So many people, and often new people particularly, seem to be transfixed on these jobs, some I'd say even look forward to them.

And, to a point, I understand their "attraction" - the fact you have to use your skills, think on your feet, actually use all that training you once did, cannulation, the needle chest decompression (sticking a needle in the chest to relieve a potentially fatal pressure build up), giving fluids, working alongside HEMS. It's a proper job. The sort we all trained for.

But, is this right? We are a profession that exists to care, to help the sick and injured. So how can we WANT a trauma job when that requires someone to be seriously injured? In fact, any "proper" job where someone is unwell enough for them to require full blown paramedic interventions, drugs etc surely is a bad thing? After all, we want people to be well do we not? Surely a day with no patients would mean a day where everyone is well and not injured??

It seems to be a contradiction - liking the trauma jobs (or other such hard working jobs) yet wanting to make people better. A bit of a moral nightmare. And this got me thinking....

I can't speak for everyone, but I don't want people to be injured or sick just so I can use a skill I haven't done in a while. Some of the least used skills are ones that I don't want to use (they mostly involve very unwell kids / babies - which is why I don't want to use them!). However, I think we all can agree that a day with no illness / injury is not something we are likely to see. And so, I'd rather be somewhere where I can help those who most need it.

It's still morally shaky. Still not sure how I feel about trauma. I wouldn't say I "enjoy" a trauma job, again there is a sick and injured human being at the centre of all of it - someone's son/daughter, brother/sister - but as a job, whatever the outcome I find it brings the best out of people. There is definite teamwork, there's a yearning to do the best, do it well and do it quickly. We all pull together and fight together for the same outcome, and it is this shared experience, this teamwork that I think I enjoy.

So, judge me if you will, but I do like a proper job, trauma or otherwise, but not because I like guts and gore or really sick people, but that as a job it's one that brings the best out in people and you really work as a team. But I'd still rather I was never needed.