I have now been in position as ED paramedic for 4 months, 2 left to go.
My skill set is still rising and the role getting more defined.
Again the days are quite different depending on which consultant is on, but essentially I am selecting my own patients fro majors and minors. In minors I am trying to see patients that the nurse practitioners can't see, such as head injuries, collapses and more time consuming complexes jobs. This is because I review all my patients with a consultant and I am keen to.see as wide a variety of patients as possible.
In majors I feel the junior docs have the edge with more complex medical patients and I dong really pick up the eg. Collapses with loads of co morbidities. However I feel I can get through the traumas and eg cardiac patients quickly and efficiently.
I was told when I started it is a lot of pattern recognition. Definitely true! For example a chest pain requires immediate stabilisation and pain relief, clinical assessment, history taking, ECG, referral (generally) bloods, chest xray, review with consultant and clinical coding before they are taken up to the ward.
I have also been given my own patients in resus. Really satisfying. Slightly terrifying although it is something we do every day on the ambulances. Just slightly different In terms of taking and interpreting blood gases, bloods, xrays, urinalysis and clinical symptoms. Some of the people you refer to can also be a bit funny about taking a referal from a paramedic but that is entirely understandable due to the new role.
The lead consultant and I have started making plans to write up the role in the form of a clinical paper. Probably a reflection and we are also beginning to talk about a replacement.
Performed a femoral nerve block last week and decompressed a chest aspirating nearly 3 l of air the week before.
It's a good role.
Tuesday 7 June 2011
Thursday 21 April 2011
Bank holiday Friday. Technically I should be in work in 30 mins but I have been asked to work a late tomorrow to help with the anticipated large numbers of patients.
It's been a really productive week. I have been working with some great people and realised that more often than not the way your day goes is closely linked to who you have worked with. That said, I did have a bit of a dissapointing day last week. I was working with someone I had not worked with much before and asked them to review one of my patients with an injured foot. Fortunately I did nothing that was dangerous or was likely to affect patient outcome but I didn't really present my case as well as would have liked and felt like a bit of an idiot. He assured me it was no big deal but I am aware of the importance of reputation and credibility and feel I have a bit of a way to go to make it up. Annoying having worked so hard to create a good impression.
Rest of the week was really good. I have had much more of a free reign and people have been putting their trust in me to select my own patients from minors, majors and resus, assessing, managing and treating their conditions. I have selected trauma cases, SOBs, chest pains etc but am still erring slightly away from the elderly complex medical patients. I am happy with initiating emergency treatment but complex pathologies and co-morbidities mean that a more medical view point is required. Whilst I am keen to push my self and step outside my comfort zone (where real learning takes place) I think it is important not to step too deep onto the turf of the more medically minded doctors, especially when I am trying to gain their confidence and carve out a role that others can follow.
It's been a really productive week. I have been working with some great people and realised that more often than not the way your day goes is closely linked to who you have worked with. That said, I did have a bit of a dissapointing day last week. I was working with someone I had not worked with much before and asked them to review one of my patients with an injured foot. Fortunately I did nothing that was dangerous or was likely to affect patient outcome but I didn't really present my case as well as would have liked and felt like a bit of an idiot. He assured me it was no big deal but I am aware of the importance of reputation and credibility and feel I have a bit of a way to go to make it up. Annoying having worked so hard to create a good impression.
Rest of the week was really good. I have had much more of a free reign and people have been putting their trust in me to select my own patients from minors, majors and resus, assessing, managing and treating their conditions. I have selected trauma cases, SOBs, chest pains etc but am still erring slightly away from the elderly complex medical patients. I am happy with initiating emergency treatment but complex pathologies and co-morbidities mean that a more medical view point is required. Whilst I am keen to push my self and step outside my comfort zone (where real learning takes place) I think it is important not to step too deep onto the turf of the more medically minded doctors, especially when I am trying to gain their confidence and carve out a role that others can follow.
Saturday 9 April 2011
Morning all, (again apologies for grammar/ spelling, blame minute iPhone keypad)
I seem to say it every week, but that was another busy one! Lots of learning this week. One of the consultants spent quite a bit of time going through epistaxis management. Not just nose packing , but using ENT techniques to evacuate anterior chamber, isolate bleed, cauterise and repack if necessary.
I have also relocated a couple more anterior shoulder dislocations under N2O, propofol or midazolam ( depending on condition and consultant) which is extremely satisfying. One young fit lad came in with a painful shoulder, I assessed it, x rayed it, identified an anterior dislocation, went into resus and relocated it under guidance and discharged patient with a follow up clinic appointment. I later saw the same lad down the pub, carrying his shopping in his injured arm, nursing a pint with the other. He cheerfully thanked me and informed me not to worry, his sling was in the bag!
Friday was entertaining as I attended the ED plastering and minor treatments study day. We spent the day learning how to apply volar, below knee, scaphoid and full leg backslabs, as well as brushing up our skills in thumb spica application, future splints, ankle strapping and other techniques. Really useful skills for the road and expeditions as well as ED! A good day, lots more learnt.
Combined with the weekly consultant led junior doctors teaching sessions, daily lunch time 'teaching bites' and optional middle grade training sessions the formal learning opportunities are endless and are definitely things we could do more of in the ambulance service! It really does create a learning culture that I feel we sometimes lack. This culture really motivates people to search out new techniques and develop best practice hence making the job much more rewarding for the clinician to say nothing of the benefits for the patients. OK, soap box moment over.
In short, many skills learnt this week.
Thoughts of the day;
1. Ongoing work based teaching/education is a very good idea for many reasons
2. Continuously self critiquing own practice makes for a better, more confident and contented clinician
3. Simple practical skills can keep people out of hospital
I seem to say it every week, but that was another busy one! Lots of learning this week. One of the consultants spent quite a bit of time going through epistaxis management. Not just nose packing , but using ENT techniques to evacuate anterior chamber, isolate bleed, cauterise and repack if necessary.
I have also relocated a couple more anterior shoulder dislocations under N2O, propofol or midazolam ( depending on condition and consultant) which is extremely satisfying. One young fit lad came in with a painful shoulder, I assessed it, x rayed it, identified an anterior dislocation, went into resus and relocated it under guidance and discharged patient with a follow up clinic appointment. I later saw the same lad down the pub, carrying his shopping in his injured arm, nursing a pint with the other. He cheerfully thanked me and informed me not to worry, his sling was in the bag!
Friday was entertaining as I attended the ED plastering and minor treatments study day. We spent the day learning how to apply volar, below knee, scaphoid and full leg backslabs, as well as brushing up our skills in thumb spica application, future splints, ankle strapping and other techniques. Really useful skills for the road and expeditions as well as ED! A good day, lots more learnt.
Combined with the weekly consultant led junior doctors teaching sessions, daily lunch time 'teaching bites' and optional middle grade training sessions the formal learning opportunities are endless and are definitely things we could do more of in the ambulance service! It really does create a learning culture that I feel we sometimes lack. This culture really motivates people to search out new techniques and develop best practice hence making the job much more rewarding for the clinician to say nothing of the benefits for the patients. OK, soap box moment over.
In short, many skills learnt this week.
Thoughts of the day;
1. Ongoing work based teaching/education is a very good idea for many reasons
2. Continuously self critiquing own practice makes for a better, more confident and contented clinician
3. Simple practical skills can keep people out of hospital
Wednesday 30 March 2011
Sunday 27 March 2011
Good, pretty full on day yesterday.
Started the morning in Minors picking up some seemingly straight forward complaints that had interesting twists. Needless to say I learnt quite alot about autism and Christmas disease (haemophilia b). The afternoon slot was pretty epic in Majors and resus. I managed to select a patient with an array of differential diagnoses that finally was diagnosed as pneumonia, after an initial presentation of central chest and abdo pain. Required a thorough assessment as well as bloods, cultures, chest X-rays, urinalysis, ECG and aggressive pain management. Great consultant support too.
Then went on to manipulate an open ankle fracture dislocation as the boss administered ketomone. Was pretty chugged as they really had to look hard for the fracture on X-ray as the relocation was so successful. Boosted my confidence after the shift the day before endedwith a simple head lac that turned out to be a 15 cm full thickness scalp lac with arterial bleeding! Again good support from some of the senior docs. Learnt an excellent way to make a head pressure dressing with bandages!
Lessons:
Ask for help early if things look bigger than expected
Give antibiotics in first 2 hours if they are required
Started the morning in Minors picking up some seemingly straight forward complaints that had interesting twists. Needless to say I learnt quite alot about autism and Christmas disease (haemophilia b). The afternoon slot was pretty epic in Majors and resus. I managed to select a patient with an array of differential diagnoses that finally was diagnosed as pneumonia, after an initial presentation of central chest and abdo pain. Required a thorough assessment as well as bloods, cultures, chest X-rays, urinalysis, ECG and aggressive pain management. Great consultant support too.
Then went on to manipulate an open ankle fracture dislocation as the boss administered ketomone. Was pretty chugged as they really had to look hard for the fracture on X-ray as the relocation was so successful. Boosted my confidence after the shift the day before endedwith a simple head lac that turned out to be a 15 cm full thickness scalp lac with arterial bleeding! Again good support from some of the senior docs. Learnt an excellent way to make a head pressure dressing with bandages!
Lessons:
Ask for help early if things look bigger than expected
Give antibiotics in first 2 hours if they are required
Thursday 24 March 2011
Just finished a fantastic Patient Management in Hostile Environments course at the Shelterbox International Academy on the Lizard Penninsula, Cornwall, with students from the Rescue and Emergency Management FdSc course at Cirnwall College. Final scenario included 2 real downed helicopters and 5 serious trauma patients on an operational airbase at 2300!
Back to the day job today! Another excellent and varied day managing patients with serious facial trauma, cauda equina syndrome, spinal damage and the usual array of limb injuries. Without wanting to sound corny, every job is a learning experience. Trying to look up each condition as, or after, I deal with it.
Lesson of the day:
Don't be complacent! An old lesson that needs re emphasising every so often!
Back to the day job today! Another excellent and varied day managing patients with serious facial trauma, cauda equina syndrome, spinal damage and the usual array of limb injuries. Without wanting to sound corny, every job is a learning experience. Trying to look up each condition as, or after, I deal with it.
Lesson of the day:
Don't be complacent! An old lesson that needs re emphasising every so often!
Saturday 19 March 2011
4 th week completed and to be honest I'm pretty knackered!
It's been pretty full on and the learning curve is still going up. I am now selecting patients from mainly minors, but also majors lists at my discretion and seeing them through to discharge or referal. I have done lots of wound closure and limb assessments but also enjoying the challenges of managing majors patients. A lot more time consuming than I had anticipated.
All patients are reviewed by consultants even if they don't see the patient ( which is happening more regularly). You really couldn't pay for the learning opportunity. I also am beginning to feel like I am actually contributing to the dept (even though I had a breach today :(. There are still some nurses and docs who I think are a bit resistant to the idea of paras/ ECPs working in ED but overall the support has been fantastic!
Learning points:
1. Anatomy
2. Anatomy
3. Anatomy
4. Biochemistry
It's been pretty full on and the learning curve is still going up. I am now selecting patients from mainly minors, but also majors lists at my discretion and seeing them through to discharge or referal. I have done lots of wound closure and limb assessments but also enjoying the challenges of managing majors patients. A lot more time consuming than I had anticipated.
All patients are reviewed by consultants even if they don't see the patient ( which is happening more regularly). You really couldn't pay for the learning opportunity. I also am beginning to feel like I am actually contributing to the dept (even though I had a breach today :(. There are still some nurses and docs who I think are a bit resistant to the idea of paras/ ECPs working in ED but overall the support has been fantastic!
Learning points:
1. Anatomy
2. Anatomy
3. Anatomy
4. Biochemistry
Monday 14 March 2011
Pretty tired after a really busy fri sat and Sunday shift. It definitely flies by when there are a lot of patients but your feet and brain certainly know about it afterwards. I take my hats off to the guys who do it day in day out continuously,
I have been selecting, assessing and treating my own patients from minors and more recently from majors. I find majors a lot more time consuming as the patients often requir bloods, X-rays and advanced investigations. They are also less likely to be going home, or if they do it is with a much more robust and structured care plan in place. It is also extremely rewarding to receive a patient from ambulance crews, assess them and discharge them with consultant review, it also means my personal knowledge is increasing all the time, especially as I have the oppotunity to review all my patients with the consultants.
Getting pretty good at wound care and more confident working in majors although I still have a long way to go before I feel comfortable working there.
Apologies for poor grammar and spelling as I'm on an iPhone and trying to do several things at once as I write...
I have been selecting, assessing and treating my own patients from minors and more recently from majors. I find majors a lot more time consuming as the patients often requir bloods, X-rays and advanced investigations. They are also less likely to be going home, or if they do it is with a much more robust and structured care plan in place. It is also extremely rewarding to receive a patient from ambulance crews, assess them and discharge them with consultant review, it also means my personal knowledge is increasing all the time, especially as I have the oppotunity to review all my patients with the consultants.
Getting pretty good at wound care and more confident working in majors although I still have a long way to go before I feel comfortable working there.
Apologies for poor grammar and spelling as I'm on an iPhone and trying to do several things at once as I write...
Thursday 10 March 2011
Started of Wednesday morning with Junior Doctors training, as usual. 1 1/2 hours of teaching from consultant plus a case revew or teaching slot by one of junior docs. Todays topics; Burns and anaphylaxis.
I was then asked if I would go and help with the registrars training in the postgrad centre. There are quite a few senior doctors whp are going for their RCEM (Fellow of College Emerg Medicine) and a series of moulages and skill stations had been set up. I was assisting in the FAST (Focused Abdominal Sonography in Trauma) skill station. Really interesting, useful bit of kit. 5 years time I reckon they will be (or a portable version) on selected pre-hospital vehicles.
After a bit of teaching on FAST scan use in cardiac arrest I went back to the dept. Turned into one of the more unproductive afternoons. Consultants were in a meeting and there just werent too many patients in the department. Provided a welcome change to many of the staff but I am still keen to get stuck in. I ended up going through all the paediatric kit in Resus and trying to familiarise myself with how it all works and what it all does.
Plan;
-get involved/assist in MAU clinic (Manipulation under anaesthesia)
-go on plastercast study day
I was then asked if I would go and help with the registrars training in the postgrad centre. There are quite a few senior doctors whp are going for their RCEM (Fellow of College Emerg Medicine) and a series of moulages and skill stations had been set up. I was assisting in the FAST (Focused Abdominal Sonography in Trauma) skill station. Really interesting, useful bit of kit. 5 years time I reckon they will be (or a portable version) on selected pre-hospital vehicles.
After a bit of teaching on FAST scan use in cardiac arrest I went back to the dept. Turned into one of the more unproductive afternoons. Consultants were in a meeting and there just werent too many patients in the department. Provided a welcome change to many of the staff but I am still keen to get stuck in. I ended up going through all the paediatric kit in Resus and trying to familiarise myself with how it all works and what it all does.
Plan;
-get involved/assist in MAU clinic (Manipulation under anaesthesia)
-go on plastercast study day
systematic review of PAs in US
Interesting article on efficacy of Pysicians Assistants in US.
Emergency Medicine Australasia (2011) 23, 7–15
A systematic review: The role and impact of
the physician assistant in the emergency
department
Abstract:
This systematic review describes the role and impact of physician assistants (PAs) in the
ED. It includes reports of surveys, retrospective and prospective studies as well as guidelines
and reviews. Seven hundred and twelve studies were identified of which only 66 were
included, and many of these studies were limited by methodological quality. Generally the
use of PAs in the ED is modest with 13–18% of US EDs having PAs although academic
medical centres report PA use in 65–68% of EDs. The evidence indicates that PAs are
reliable in assessing certain medical complaints and performing procedures, and are well
accepted by ED staff and patients alike. There is limited evidence as to whether PAs
improve ED flow or are cost-effective. Future studies on work processes, cost-effectiveness,
unfamiliar patients’ willingness to be treated by non-physician providers, and ED physicians’
acceptability of PAs are needed to inform and guide the integration of PAs into EDs.
Emergency Medicine Australasia (2011) 23, 7–15
A systematic review: The role and impact of
the physician assistant in the emergency
department
Abstract:
This systematic review describes the role and impact of physician assistants (PAs) in the
ED. It includes reports of surveys, retrospective and prospective studies as well as guidelines
and reviews. Seven hundred and twelve studies were identified of which only 66 were
included, and many of these studies were limited by methodological quality. Generally the
use of PAs in the ED is modest with 13–18% of US EDs having PAs although academic
medical centres report PA use in 65–68% of EDs. The evidence indicates that PAs are
reliable in assessing certain medical complaints and performing procedures, and are well
accepted by ED staff and patients alike. There is limited evidence as to whether PAs
improve ED flow or are cost-effective. Future studies on work processes, cost-effectiveness,
unfamiliar patients’ willingness to be treated by non-physician providers, and ED physicians’
acceptability of PAs are needed to inform and guide the integration of PAs into EDs.
Monday 7 March 2011
Had some very interesting jobs over the weekend including a crushed toe that required ring block ( me) deriding (by consultant) cleaning (with a toothbrush) (me) and nail bed sutures(me) also saw a patient whose fingers were swollen to 3 times the normal size but hadn't managed to take of their rings... One for the surgeons... Not me...
I Worked with a consultant I had not worked with before. Initially everything i did was checked and each patient reassessed. As the day progressed however, i felt i was given more space and responsibility. I totally understand that people are initially cautious and it re emphasised the fact that this really is a new role and I have to really prove myself in order to gain peoples trust and create a good reputation. Fortunately I quite enjoy this pressure but I hope that when I do mess up ( which is an inevitable part of emergency medicine) that I don't go back to square 1.
Tips of the day:
1. If you are told something, remember it
2. When you ask a question listen carefully to the answer and don't reask the same question
3. Learn your anatomy
4. Know your limits
I Worked with a consultant I had not worked with before. Initially everything i did was checked and each patient reassessed. As the day progressed however, i felt i was given more space and responsibility. I totally understand that people are initially cautious and it re emphasised the fact that this really is a new role and I have to really prove myself in order to gain peoples trust and create a good reputation. Fortunately I quite enjoy this pressure but I hope that when I do mess up ( which is an inevitable part of emergency medicine) that I don't go back to square 1.
Tips of the day:
1. If you are told something, remember it
2. When you ask a question listen carefully to the answer and don't reask the same question
3. Learn your anatomy
4. Know your limits
Friday 4 March 2011
Another day done.
Certainly not drinking as much tea as on the road.
Got stuck into a long minors cue as soon as I arrived. Quite satisfying to take a patient handover from the ambulance crew (head inj, mech fall), assess patient, stitch head wound, give advice, make arrangements for getting patient home, assess social arrangements and discharging patient from dept.
Also performed a finger dislocation manipulation under n2o and a ring block on a nasty finger lac that finally required plastics referral.
Support from middle grades and consultants seems to be increasing as they become more familiar seeing me in dept.
Had my first official review with lead consultant as well. It went well and was very positive. Plans for next review will include a formal review of cases and paperwork which I am looking forward to. A bit of critical reflection will be good. Also need to start thinking about writing experience up for a publication. Any ideas on a postcard;).
Certainly not drinking as much tea as on the road.
Got stuck into a long minors cue as soon as I arrived. Quite satisfying to take a patient handover from the ambulance crew (head inj, mech fall), assess patient, stitch head wound, give advice, make arrangements for getting patient home, assess social arrangements and discharging patient from dept.
Also performed a finger dislocation manipulation under n2o and a ring block on a nasty finger lac that finally required plastics referral.
Support from middle grades and consultants seems to be increasing as they become more familiar seeing me in dept.
Had my first official review with lead consultant as well. It went well and was very positive. Plans for next review will include a formal review of cases and paperwork which I am looking forward to. A bit of critical reflection will be good. Also need to start thinking about writing experience up for a publication. Any ideas on a postcard;).
Wednesday 2 March 2011
Great shift yesterday.
I walked into a very busy dept. Consultants were all in a meeting so I asked around the doctors to see if there was anything could do to help. There was. I was soon transporting a potential CVE patient round to the CT scanners taking the resus bag with us in case anything should happen. On my return I walked into an eventful traumatic resuscitation in Resus. There were a lot of clinicians in the roomhelping and I was tasked with managing the airway. The pt had been brought in by the HEMS crew and was intubated. The capnography kit was not working, so we put a new adaptor on and got it back on track. A surgeon arrived to drain a tampoade whilst the ED consultant performed a FAST ultrasound and IDd lots of free fluid in abdo. Unfortunately the pt went into asystole and it was called shortly after.
I was then allocated some patients from majors including a collapse ? Cause with a head inj that I sutured and an Epileptic patient with a head injury before managing some minors patients. A good shift, lots of learning. Managed to discuss all patients in some depth with the consultant before he went on to review them. For me this is one of the best ways to develop my practice/ knowledge. Something we should do more of when working on the road!
I walked into a very busy dept. Consultants were all in a meeting so I asked around the doctors to see if there was anything could do to help. There was. I was soon transporting a potential CVE patient round to the CT scanners taking the resus bag with us in case anything should happen. On my return I walked into an eventful traumatic resuscitation in Resus. There were a lot of clinicians in the roomhelping and I was tasked with managing the airway. The pt had been brought in by the HEMS crew and was intubated. The capnography kit was not working, so we put a new adaptor on and got it back on track. A surgeon arrived to drain a tampoade whilst the ED consultant performed a FAST ultrasound and IDd lots of free fluid in abdo. Unfortunately the pt went into asystole and it was called shortly after.
I was then allocated some patients from majors including a collapse ? Cause with a head inj that I sutured and an Epileptic patient with a head injury before managing some minors patients. A good shift, lots of learning. Managed to discuss all patients in some depth with the consultant before he went on to review them. For me this is one of the best ways to develop my practice/ knowledge. Something we should do more of when working on the road!
Monday 28 February 2011
Another day down and more lessons learnt.
VERY busy day in the department, again I was in minors, seeing treating and discharging; with all my patients being discussed with lead consultant. This is important. Apparently a patient I saw the other day had a missed fracture. Had I not got the consultant to document he had reviewed the xeay with me it might have been difficult to explain. Another lesson in the importance of keeping good documentation!
More orthopaedic referrals today (incl an interesting patellar fracture that was initially missed by triage staff due to it bring relatively painless on palpation and the patient having no bony tenderness. Only real clue was unable to straight leg raise) as well as having to pursue the vulnerable child pathway for a young patient and assisting with relocating an anteriorly dislocated left shoulder under midazolam sedation.
I am on the road (RRV rapid response vehicle) today to keep skills up. Looking forward to getting head in books. Out will come the clinical examination books!
Back on we'd. Managed to get a copy of the consultants rota. Discovering who is more supportive/ enthusiastic about the role amd trying to work/learn with them!
VERY busy day in the department, again I was in minors, seeing treating and discharging; with all my patients being discussed with lead consultant. This is important. Apparently a patient I saw the other day had a missed fracture. Had I not got the consultant to document he had reviewed the xeay with me it might have been difficult to explain. Another lesson in the importance of keeping good documentation!
More orthopaedic referrals today (incl an interesting patellar fracture that was initially missed by triage staff due to it bring relatively painless on palpation and the patient having no bony tenderness. Only real clue was unable to straight leg raise) as well as having to pursue the vulnerable child pathway for a young patient and assisting with relocating an anteriorly dislocated left shoulder under midazolam sedation.
I am on the road (RRV rapid response vehicle) today to keep skills up. Looking forward to getting head in books. Out will come the clinical examination books!
Back on we'd. Managed to get a copy of the consultants rota. Discovering who is more supportive/ enthusiastic about the role amd trying to work/learn with them!
Sunday 27 February 2011
Week 2 completed!
Going really well and enjoying it immensely.
Spent most of this week working in minors, selecting patients, assessing, treating and discharging. All under the close supervision of the consultant in charge.
At this stage all my patients are being reviewed by the consultant in charge as a safety net. There is a lot to get my head around, especially in terms of care pathways. Even discharging a patient and ensuring they are capable of managing at home is fraught with complications!
I have found myself referring patients to specialities, seeing treating and discharging, assisting in manipulations under anaesthesia, closing wounds, learning and performing ring blocks amongst other things.
I have discovered that a really sound underpinning knowledge of anatomy is vital if anyone is interested in the role, get your head in the books! It gives you really good credibility with the doctors if you are good in this area.
Most people are being really supportive which is a big relief!
I'm able to be a bit more selective with shifts too which is good.
Roll on next week...
Going really well and enjoying it immensely.
Spent most of this week working in minors, selecting patients, assessing, treating and discharging. All under the close supervision of the consultant in charge.
At this stage all my patients are being reviewed by the consultant in charge as a safety net. There is a lot to get my head around, especially in terms of care pathways. Even discharging a patient and ensuring they are capable of managing at home is fraught with complications!
I have found myself referring patients to specialities, seeing treating and discharging, assisting in manipulations under anaesthesia, closing wounds, learning and performing ring blocks amongst other things.
I have discovered that a really sound underpinning knowledge of anatomy is vital if anyone is interested in the role, get your head in the books! It gives you really good credibility with the doctors if you are good in this area.
Most people are being really supportive which is a big relief!
I'm able to be a bit more selective with shifts too which is good.
Roll on next week...
Wednesday 23 February 2011
Half way through my second week in the department and learning a lot! I am working directly for the consultants and am being allocated patients and tasks by them on a case by case basis, referring back to them after each assessment and discussing management plans and treatment options.
Most consultants are aware of what we are trying to achieve but a couple, I think, are not quite sure where it is going which makes quite a big difference to my day. I am still trying to get to grips with the dept and have found there is a lot to learn. New, common, proceedures such as blood/ABG sampling, forms, kit and departmental processes are going to take time to learn before I can be more useful.
I still feel a little like a fish out of water but am slowly beginning to see my role and it's potential, although I have to say the ECP kill set and good A&P skills are a pre requisite if you are to hold your own.
Today I am getting my IT training for the computer systems which will enable me to book out my own patients, really looking forward to doing this, one step closer to becoming useful! I also plan to spend a day with the resuscitate nurse to get familiar with proceedures and kit in resus, I have written a long list of objectives that I want to achieve.
The support from the senior docs/ consultants has been great! I am also becoming proficient at explaining my role as everyone is interested. In short; not a doctor, not a nurse but developing a new role for paramedics working in ED!
Most consultants are aware of what we are trying to achieve but a couple, I think, are not quite sure where it is going which makes quite a big difference to my day. I am still trying to get to grips with the dept and have found there is a lot to learn. New, common, proceedures such as blood/ABG sampling, forms, kit and departmental processes are going to take time to learn before I can be more useful.
I still feel a little like a fish out of water but am slowly beginning to see my role and it's potential, although I have to say the ECP kill set and good A&P skills are a pre requisite if you are to hold your own.
Today I am getting my IT training for the computer systems which will enable me to book out my own patients, really looking forward to doing this, one step closer to becoming useful! I also plan to spend a day with the resuscitate nurse to get familiar with proceedures and kit in resus, I have written a long list of objectives that I want to achieve.
The support from the senior docs/ consultants has been great! I am also becoming proficient at explaining my role as everyone is interested. In short; not a doctor, not a nurse but developing a new role for paramedics working in ED!
Tuesday 22 February 2011
So...Whats it all about?
I have been in the ambulance Service for ten years and I am currently a Paramedic Training Officer for a UK Ambulance Trust.
I have also recently completed my Emergency Care Practitioners PG Dip and am working towards a MSc in Remote Healthcare.
Over the last year I have been setting up a project with the local Emergency Department and the lead consultant. The plan is to create a new role within the ED of a Emergency Department Paramedic. The ED Paramdic will work directly for the consultant in charge of the shift and be fully accountable to him. The exact nature of the role is uncertain but is intended to mirror quite closely the Physicians Assistant role used in the US.
On the 14th February I began a 6 month, full time, pilot study to see whether this role will be effective...
I have also recently completed my Emergency Care Practitioners PG Dip and am working towards a MSc in Remote Healthcare.
Over the last year I have been setting up a project with the local Emergency Department and the lead consultant. The plan is to create a new role within the ED of a Emergency Department Paramedic. The ED Paramdic will work directly for the consultant in charge of the shift and be fully accountable to him. The exact nature of the role is uncertain but is intended to mirror quite closely the Physicians Assistant role used in the US.
On the 14th February I began a 6 month, full time, pilot study to see whether this role will be effective...
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