Sunday, 31 July 2011

Singing the same song in the same key

As a Paramedic, you are entrusted with a lot of responsibility. You are given lots of shiny toys, a fair number of drugs, even more if you become a PP (Paramedic Practitioner) or CCP (Critical Care Paramedic), and are let loose on the general public who, on the whole, will let you do almost anything to them when you turn up in your shiny ambulance.

This leaves us with a need to ensure we practice properly and are doing things because patients NEED them doing, not BECAUSE WE CAN do them. It means we have to be evidence based practitioners and ensure we are doing everything in the patients best interest.

Now, most Paramedics I know are ethical and sensible with their treatments, although I do know of some who cannulate "because they can". My question to them is "Why? How is you sticking a needle in them in a dirty out-of-hospital setting benefiting that patient?" Quite often they have no intention of giving them anything iv, and I think this is wrong. I do know of a service where some medics can take pre-hospital blooded when they cannulate to prevent a second invasive procedure, which is brill. However I have heard that some are using this as a justification TO cannulate. This I don't agree with. There are other practices done "because that's just the way we do things here" and other such phrases, and things done because it's easier.

I also know of some services where they have told medics to do / not to do certain things that fly in the face of all the published evidence for best practice. We as employees then have to follow these poor practices even when we know it isn't in the patients best interest.

So, where do we stand as Paramedics? As a fairly new medic (although recently I've looked around and started to feel more of an old hand on station than a newbie!) I still find it difficult to question practices of those who have been in the job for longer than me. I still see people doing things and want to stop or correct them but don't do it, and as such I feel I'm failing in my duty to give everyone my 100% best.

But as a whole, I feel we as Paramedics are not united as one. We have multiple unions who fight amongst themselves, the services we work for all seem to sing from different hymn sheets, and even within the same service there can be many people singing in VERY different keys. There are guidelines, protocols and evidence which all contradict each other. Yet as practitioners we are supposed to know what to do?

While I'm not specifically here to promote the College of Paramedics (Yes I know this is the second post in a row where I've gone on about them, I promise I won't on the next post!), I do firmly believe in them as a potential unifying force that all UK Paramedics should be getting behind. Only by uniting and getting one voice can we as a group of health care professionals begin to influence practice on a grander scale, to get one voice saying to all UK ambulance trusts "oi, let's get x y z standardised across all services", to have once voice TO all Paramedics guiding and advising us as a whole, and taking a lead in collating, disseminating and even producing research relevant to our profession and using it to guide practice. I know its more expense but I do feel that we need it and is ask any of you out there who are not members to seriously consider signing up.

On a personal note, I believe that we all as Paramedics also need to be prepared to do what we know is right and challenge that which we believe to be wrong, even if it is uncomfortable to do so. After all, its in out patients best interest and that's why we are here isn't it??

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