Enough for one day?
15 August 2017
I hope you’ve had an excellent couple of weeks! I want to start off by thanking you all for checking out my vlog and for all the kind feedback I’ve had. I have been advised that there has been over 14000 views on our video which is absolutely amazing!!
I hope that somewhere in those 14000, I have been able to inspire at least one person into coming over and joining our team. Hint hint.
So the plan for this week is to write about a day in a life on the road here in the UK. Bearing in mind, some of these stories might be slightly vague because I have to consider patient confidentiality above everything but I would like to give you all an idea of the range of conditions we manage everyday out on the road. This may be a bit longer than previous blogs because once I get started in story telling mode, I know it’s going to be tough to stop.
Let me set the scene for you!
You’re still an enthusiastic newbie, so you show up for your 0600 start, half an hour early. You have a bit of chat with your colleagues about to finish up for the night and then you head upstairs to check your emails and grab the keys for your beautifully made-ready truck (just while we’re here, our make-ready teams are an absolute godsend. We never had the luxury at home, but these guys are basically a team that makes sure our trucks are all stocked up and ready to go for the shift- amazing!). Head on downstairs, check the morphine safe, sign into the electronic patient report form, the radio and then a quick check of the most important things in the truck for a bit of peace of mind. Key things being drugs, the monitor plus defib pads and a working stereo!
Your crew mate arrives, you have a bit of a catch up and then you sign onto the truck, ready for your 12 hours of work ahead. First job comes through within minutes of doing a radio check with your control room, your crewmate flicks on the lights and sirens and your day begins. You’re off to a local care home. The notes say, the patient has had a fall and is now struggling to walk. You arrive on scene and have a quick chat with the care staff and the patient. After assessment, you find the patient has pain in their right hip and they’re unable to weight bear. Maybe a neck of femur fracture? The only way to rule that out is an x-ray at hospital. You give the patient some pain relief, load them into the ambulance and transport to hospital. Handover to clear up at the hospital takes about 30mins and then you’re back out on your next job. Back pain. On assessment, you find this is an exacerbation of a known chronic condition. You give the patient some pain relief and contact the out of hours GP and make a plan for them to give the patient a welfare call in the next 30 mins to see if the pain relief we have provided is sufficient, otherwise the GP will do a house call and prescribe something stronger to get the patient through the weekend. You make the patient a cup of tea, give them advise on what worsening signs to look for and say goodbye, leaving them with a smile on their face that they certainly didn’t have before.
Next job comes through as a red job (higher priority)- stroke. You’re met by family at the door and advised the patient is sitting upstairs. You know from one look at the patient and a quick history from the family that this patient is definitely FAST (Face, arms, slurred speech and time of symptom onset) positive and as a crew you have to move quickly because you only have 4 hours from the onset of symptoms, to get this patient to the stroke centre so if it is caused by a clot, the hospital has an opportunity to disintegrate it and restore normal blood flow to the brain. You and your crew mate do a quick set of observations, blood sugar especially to be sure these symptoms are not due to low blood sugar. After these are done, your crew mate works on an exit strategy while you make a phone call to Luton and Dunstable, your local stroke hospital. They accept the patient and it’s a rapid transport into the East of England region to get your patient the best care possible. Luckily enroute, your patient’s symptoms start to resolve and you realise this was a mini stroke. Much less serious but still needs to be assessed and managed to hopefully stop this progressing to a full on stroke in the future.
A trip to L&D hospital now means you’re outside of SCAS area and the control room are a vehicle short in your area so they always work hard to get us back, this generally means having us running to a job. On this particular shift, the call came through that you and your crew partner will be running to a cardiac arrest. It will take about 20-25mins under lights to get to the job from where you are so you call control to check if there is another vehicle responding. They tell you there a rapid response car ahead of you, currently you’re the only double manned ambulance (DMA) enroute but there are some crews at the hospital due to clear and become available. 10 minutes later, a call from control has you stood down because of closer available units and you’re sent back to base for your break.
30 minutes later, the peace and quiet of your break is interrupted by the handheld radios letting you know there’s a job waiting for you in the ambulance. Chest pain. A quick history, set of observations and an ECG show nothing immediately life threatening but you’re thinking this is of cardiac origin. Your partner gets the aspirin and GTN ready to give to the patient while you gain IV access to give the patient some morphine and anti-sickness medication. They almost immediately start to feel a bit of relief. Enroute to hospital you top up the pain relief every so often and keep an eye on their ECG to ensure there are no changes. Safely arrive at the hospital with no deterioration. Perfect
Leaving the hospital, control starts sending you to a patient with abdo pain but you are quickly stood down and redirected as another call for a cardiac arrest comes in. You, another ambulance and a car arrive at virtually the same time. Everyone grabs their share of gear from your truck as you’re closest to the door, and heads on upstairs. The patient is on the floor and chest compressions have been started. The first paramedic through the door asks for the chest compressions to stop and does an assessment. The patient has a heartbeat but is not breathing sufficiently. This patient is in respiratory arrest. While the first paramedic manages the patient’s airway, a quick history is gathered. This patient has overdosed on heroin. I draw the naloxone, a reversal agent for opiate overdoses, and give them an injection into their arm. I then work to insert a cannula into the patients vein so that we can have faster administration of naloxone if another dose is required while the rest of the team gains observations and works out an exit strategy if required. 2 minutes later the patient starts to breathe adequately and attempts to sit up. We have a chat about the situation and determine they now have full capacity. The patient does not want to go to hospital and we are in no position to force them. We wish them all the best and tell them that in the nicest possible way, we don’t want to see them again. They promise us that they’ve had enough for one day and we say goodbye.
Its nearing the end of the day and your crew partner muses that they reckon you guys have got another two jobs in you! Just as they say that, a call for a hypoglycaemic (low blood sugar) comes in. This patient is known diabetic and is semi unconscious when you walk through the door. Their blood sugar levels show 1.4mmol (normal is between 4 and 7). Definitely on the low side. You put a cannula into the patients arm while your crew partner sets up the glucose bag. Glucose is fast acting so after the first lot of administration, the patient starts to sit up and talk to you. You ask their husband if they could make some food for the patient and he comes back with jam on toast. You get the patient to eat some food and then you check their sugar levels. 5.2mmol, excellent! They tell you they don’t want to go to hospital and they’re feeling much better. You ask them to pop in and see their GP ASAP as they have had a few lows over the past few days and something might need adjusting. They promise they’ll make an appointment and you say goodbye.
Last job comes through with an hour left to go! Another abdo pain with vomiting. The patient is in a lot of pain but it is all very non-specific. There is a lot of stuff that goes on in the abdomen so you’re not too sure of what the cause of this is. Best you can do is manage the pain, the vomiting and take them to hospital for further assessment. Another cannula, some pain relief and some anti-sickness and you’re back at the hospital with another patient to hand over, almost bang on 1800! Back to station to tidy up and log off. You’ll be back in 12 hours to do it all over again!
Obviously, every day is different and it’s hard to capture that in a couple of thousand words but hopefully this has given you some indication on what our lives look like on a reasonably average day at work. The only things I haven’t mentioned are the non-stop banter, the ambulance karaoke sessions and the amazing people you are lucky enough to meet every single day. As you can tell, I love my job and right now, I wouldn’t want to be doing anything else!
Take care everyone and I’ll be back in a couple of weeks J
Jess Anderson Vlog July 2017
24 July 2017
Training – The Final Countdown!
11 May 2017
Since my last blog, I’ve enjoyed my first Easter in the UK and as you can see from the photo, training with my new colleagues continued – with some additional chocolate motivation!
We’ve been able to spend some days outside doing scenarios (that’s right, OUTSIDE… the weather is looking up!), including advanced life support cardiac arrests and vehicle extrication. Now I want you to imagine the chaos that can occur on scene when there are a lot of strong paramedic personalities. Have you got that image? Now I want you to imagine that but these paramedics are from four different countries, with four different ways of doing things and all trying to adapt to the British way. Yeah, so that was us.
I like to think we actually did an excellent job though and we still love each other at the end of it all so I would mark it as a success. Not sure if Alex loves us quite as much though after being c-collared, wrapped in the KED, strapped to the extrication board and having his ears unintentionally yelled in during car extrication exercises (sorry about that).
We’ve also recently teamed up with the Emergency Care Assistants (ECAs) at Boars Hill for an obstetrics and neonatal resus day. This was probably my favourite day so far during our first six weeks of training. It was really great to muck in with some of the guys we might be working with out on the road, share some of our knowledge and just get to meet some really fantastic people so thank you to the instructors for making this happen and to the ECAs we were lucky enough to spend the day with. I hope we were helpful and I’m hoping I get to spend some time with you out on the road! I also hope we get a birth together because you guys are going to be so great at managing them while I oversee it from far, far away……….. kidding! Well, kind of.
Over the long Easter weekend, I headed to Milton Keynes for a look at my eventual home and base station. The thing that I noticed first was that the streets were much wider and less cobbly! I think I’m getting an easier driving deal than my fellow internationals. The streets in Milton Keynes look a lot more like what I am used to from home so that is exciting. The city also seems to make a degree of sense from a layout perspective. I have found that old cities here, because they weren’t originally designed for cars can be just a tad confusing to navigate.
Other training we’ve done includes spending a week with Sid and Laura doing mainly neurological injuries and wading through the drug pouches on the truck trying to memorise where everything lives and remind ourselves of what new and different drugs we have available to us here. We have also spent a bit of time covering a range of other conditions that don’t really have their own category.
One of the lovely ECAs we’ve met told us they had organised a night of extrication and car cutting for the ECAs with Charlbury Fire Station and being nosey paramedics, myself and one of the other internationals tagged along to see how things were done in this corner of the globe. We found that it was very similar to paramedicine around the world – many things are the same and many are done differently! We definitely have a lot to learn when we get out on the road but I tell you what, I never thought I would say this but I am already missing New Zealand Police and Fire Service. You take for granted just knowing how things are done and what you can and can’t ask for from you emergency service family!
Also, some more exciting news from my perspective is that I have been told quite a few times over the past couple of weeks that people have actually been reading my blog!! I honestly thought it was just my mum and dad reading it and then of course Alex to double check I’m saying nice things so thank you to everyone who has taken the time to keep up with my story. It’s nice to know I’m not just writing this for the giant black hole that is the internet.
By the time of my next blog I will have finished my training at Boars Hill and myself and my fellow southern hemispherians will have completed a UK road familiarisation week in Gloucester. We’re getting ever closer to being out on the road in SCAS vehicles for real!
PS. Uniforms have arrived!! We’re finally starting to look like real SCAS medics.
Do you speak ‘New Zealand’?
10 April 2017
Today marks one month in the UK and one month of working for SCAS!
It has been another interesting couple of weeks. Many times during these past couple of weeks, I have felt homesick and lonely. I have missed the support system that I am so used to having around me and I have had to come to the realisation that it is sink or swim when you move to a new country by yourself. I refuse to sink so I have very quickly found a way to stay afloat and I think this is true for most, if not all of us international transferees. It is exciting, of course but it is also not home. Not yet anyway so some days; ordinary seeming days, life can just feel a little bit more difficult than it would in our respective countries. Maybe I sound a little bit melodramatic, but I’m sure that anyone who has moved countries by themselves can relate!
Anyway, on to the good stuff! In week 3 we covered cardiac arrests, basic and advanced life support and cardiac conditions. All very similar stuff to home, all excellent revision! There have only been a couple of minor differences between the way we run arrests at home and the way they are run here. I am already starting to miss having Intensive Care Paramedics (ICPs) around to come and take control of an arrest like they do at home. Over here, it seems like most of the time, you’re it! For me, this is such a big mental shift. Something I definitely know I am capable of but it will just be something else that I will have in the back of my mind once I’m out on the road.
We also covered analgesia in the 3rd week and we have been discussing the wonder drug- IV paracetamol!! Wee back story here- in our first week, I made an announcement (a very excited announcement!) that I loved the idea of finally having IV paracetamol in my toolkit. This news travelled very, VERY quickly amongst the instructors and two days later, our main instructor Alek, hand delivers me a bottle of IV paracetamol from Martin, one of the other instructors! 4 weeks later, I am known as the queen of IV paracetamol, with Alek even suggesting to the class that for my birthday they should get me a shirt printed that says “keep calm and give IV paracetamol”. Got to be passionate about something right? My something just happens to be the intravenous form of a very common, over the counter pain medication. I digress.
Week 4 has been covering mainly trauma conditions and internal bleeding. Once again, all very similar stuff to home with the main differences for us kiwis is not being able to relocate dislocations but being able to needle decompress tension pneumothoraxes! You seem to win some skills and lose some when transferring between countries!
Outside of work, things are finally starting to fall into place and a life in the UK is starting to take shape. There have been some very eye opening moments these past few weeks though. I’ve found that living in your own country, you don’t realise how much people in other countries don’t know about your home. There have been many things said to me over the last month that have made me stop and think “is this a joke??” for example! I have had people tell me (outside of SCAS) that I will have to get my New Zealand documents translated into English….Ok… From what language?
I have had people say they know stuff about New Zealand, like the fact that Brisbane is the capital… Brisbane isn’t even the capital of its own country, let alone of mine.
And I have had people say to me that my English is actually really good…. Well I’d hope so because I don’t know any other language!
I suppose because I am from such a small country, we have always taken interest in the rest of the world so maybe our general knowledge is a little bit better than that of bigger countries but it is still a bit of a surprise! In saying this, plenty of my friends and family at home are still convinced that I am living and working in London regardless of how many times I have told them that I am in fact, living an hour and a half away in Oxford. Sorry to say it but outside of the UK/Europe, London is considered as the whole of England!
Once again, I want to say how wonderful the people are that I am spending my days with and a huge big thank you to our instructors, Alek especially, for tolerating us and all our quirky behaviour! You are all making this transition such a fun and memorable experience!
One more thing (possibly the most important of this blog), in the middle of these two weeks it was the 25th birthday of one of our own. Happy (belated) birthday to Daniel, one of SCAS’s newest Polish medics! You’re an absolute legend my friend and I hope you had a really nice birthday!
Back again in two weeks, which will be nearing the end of our clinical training. A few more weeks and I will be out on my C1 driver training course, assuming I get my drivers license back in time! It’s like waiting for my passport and visa all over again.
Training – two weeks in!
29 March 2017
Week two is almost over here at Boars Hill, Oxfordshire, and I’ve had an absolute ball!
The instructors are great, the city is great and my colleagues are the greatest! The first week was mainly induction type stuff; conflict resolution (AKA fight club), safeguarding and manual handling. In my intake, I’m one of eight international transferees: four from Poland, one from Finland, one from Australia and one other from the mighty New Zealand. Everyone has varying degrees of experience, different ages and different backgrounds. It’s so great to have so much diversity in one class and we have found that we all have something to teach each other.
Some of the stuff we have covered over the past couple of weeks is vastly different to NZ with some stuff seeming much more practical and other stuff… well I think I’ll have to wait until I’m out on the road to judge this.
I have been incredibly impressed by the safeguarding referrals that are in place here in the UK. As health care professionals and the only health service that is really privileged enough to be invited in to a variety of different people’s homes and personal lives with no real forward notice, I think it is incredibly important that we are looking out for the general wellbeing of every single person we encounter. Something we often take for granted is how much of a unique position we are in and how much we are trusted by the community. How often do you call upon a stranger to come to your house and welcome them in with open arms during your time of real crisis?
We are the eyes and ears of the community and we can do our part in ensuring that no one that we come into contact with falls through the cracks.
I think what has impressed me most about SCAS so far though is how passionate everyone that I have met is about their jobs. You can’t fake that! You can’t fake that type of enthusiasm for a job and it is really nice to know that we are entering a service where the staff genuinely feel fulfilled and respected. One of the highest priorities on my list for why I would want to work for any given organisation is job satisfaction. There is definitely some good stuff going on here and I can’t wait to be further involved in it as time goes on!! You’re probably thinking that SCAS has asked me to say something like this but they have given me the freedom to write about whatever I want (within reason) so you can trust that this is my honest opinion!
Week two has been our first week of clinical and the first time we have stepped foot into a UK ambulance (well, for most of us anyway) so it has been an exciting week!! We have spent an awful lot of time rummaging through the drawers and pulling equipment out with puzzled looks on our faces.
The main aim of this week was to cover airway and respiratory conditions, drugs and equipment and marrying up what we know from home with how things are done here in the UK. I would describe the ambulance world as a lot like the English language. We all speak the same language (emergency medicine) but different accents mean we can have trouble understanding each other sometimes just because of the way things are said… or done as the case may be.
It has amazed me the different paramedic scopes of practice throughout the different countries!! I definitely didn’t think there would be this much of a variety and looking at it, I think New Zealand and Australia have the smallest skills range transferrable to the UK so far but our knowledge base is certainly up there and running with the best! It’ll be interesting to see if that gap narrows or widens throughout the course.
Outside of training there has also been a lot to do! Opening a bank account, navigating the city and buying a car with insurance are just three of the challenges I have encountered so far with others loitering in the horizon like registering at a GP, transferring my New Zealand driver’s licence to a UK licence and finding a place to call home in Milton Keynes. Don’t underestimate how frustrating all of this will be! We have found nothing is as easy as you think it should be. Luckily, the fantastic people you spend your days with will make up for it.
Alright, I’ll be back in the next couple of weeks when I’ll hopefully be a bit more settled into British life! Happy reading everyone!!
Jess sets off for the UK
7 March 2017
My passport is back, the day is finally here and in just a few short hours I will be on a plane headed towards London!
It amazes me how much stuff I have managed to accumulate throughout the years but packing is a cut throat business so I have managed to get my life down to a suitcase and a backpack. A pretty impressive feat if I do say so myself! My parents are pretty pleased that half my life isn’t going to be left to clog up their house.
The couple of weeks since I last wrote have been really relaxed. Most of the paperwork had been done and it has just been a waiting game. The down time has given me a well needed opportunity to spend time with my friends and family and the chance to travel around my beautiful wee country (come check it out sometime, you’ll love it!).
I have had a lot of time to reflect on my life in New Zealand and the wonderful people that I have met on my journey. Now is a perfect opportunity to thank everyone who has been a part of my life so far, and helped to shape me into the person I am today, my parents especially. Also to thank my mentors, medical or otherwise, over the past three and a half years for your patience and kindness. I absolutely would not be living such a cool reality if it wasn’t for you!
Alright, the mushy part is over. I’d like to explain the process of getting a job in the UK from New Zealand or just from overseas (because I assume the process is reasonably similar) to give anyone who is considering the move a bit of an idea of what is involved.
I think compared to other people I know who have made the jump, I was on a reasonably tight time constraint for meeting document deadlines so the first few weeks were a bit hectic, however, I was fortunate enough to be able to interview over skype with SCAS at the beginning of December so I didn’t have to travel anywhere to meet with the interviewers. I received my job offer just before Christmas and all the information I needed arrived early-mid January so I could get started on the paperwork.
Medical clearance from both a GP and an optometrist is required, with the information then needing to be posted back to England (via pigeon it seems). This takes a while to be cleared in the UK so it needs to be done reasonably promptly to give them time on the other end to process it.
I had to apply for my HCPC registration seeing as paramedics in NZ are not registered… yet! This is a tonne of paperwork, so I would recommend getting started as early as possible on this as well. Being from small town New Zealand where you could find a job without even an interview or a CV, I think it’s fair to say it has felt a bit overwhelming at times!
I then had to apply for a Tier 2 working visa so that I could stay in the country for longer than two years. This is also a lot of paperwork and involves making an appointment to get fingerprints and photos taken. I got mine done on a typical Wellington day. Wind + sideways rain is a terrible combination for trying to look semi acceptable in photos. This is the main thing that needs to be done sooner rather than later because your passport needs to be sent to the Philippines and this can take up to a month. Fast tracking costs a bit more but it really is fast tracked; mine was back within a week and a half. Wondering if your passport will be back in time is a stress you can do without.
Official ID documents had to be sent back to SCAS as well as your normal employment paperwork.
Then of course, booking flights and sorting accommodation in a city you have never visited before. It’s tricky trying to figure out the best area to live in that is close to training or has an easy transport route to get there when you have no concept of the place you’ll be moving to. Thank goodness for Google maps!
Now that I write all this down it doesn’t sound like a lot, but I promise you, there has been a lot of running around in the last couple of months trying to organise all of it.
I’m so excited though and it will be the perfect opportunity to travel, gain experience, make some new buddies and expand my skills base all in one.
Ok, so that’s all I can think to ramble about today. Next time you hear from me I will wrapped up in my winter clothes in Oxford, a good couple of weeks into my initial training with SCAS!
See you at the other end!
Jess Anderson’s 11,500 mile journey to SCAS
23 February 2017
My name is Jess Anderson; I’m a 23 year old paramedic graduate from New Zealand and in two weeks I am packing up my life and moving half way across the world to start a job with SCAS!
I’d like to start by telling you a bit of my story and how I found myself trying to fit my life into a single suitcase only a few months after completing my degree in paramedicine.
I didn’t always know I wanted to be a paramedic. I spent the first few years of my post-high school life globetrotting and jumping between jobs, just waiting for something to click. In February of 2011, the first real stirring of what I wanted to do showed up when Christchurch, where I was living at the time, was devastated by a 6.3 magnitude earthquake and 185 people were killed. I felt an overwhelming urge to help and get involved but still not knowing entirely sure how. Six years on, I still remember that day and the huge amount of respect that I felt for every member of our emergency services family who worked tirelessly to save lives.
I carried on pottering around for the next few months until I decided to pack up my life and head over to Vietnam to live. I was assigned as an English teacher in a private school (a couple of hours South East of Hanoi in a place called Hai Duong, for those of you that have been there). I stayed there for six months and in this time when I was seeing so much poverty everywhere, it occurred to me that I had a real interest in relief work, medicine and search and rescue so I applied for the paramedicine degree and thankfully I was accepted for the following year!
I spent three years studying in Wellington at Whitireia and during this time I volunteered for St John Ambulance, the New Zealand Fire Service and Special Olympics as a basketball coach. I also worked part time for Idea Services, supporting youths who have intellectual disabilities. Now that I had found my direction, I was keen to learn as much as possible and keen to be involved with people from all different walks of life. As you can imagine, I wasn’t home a lot!
In 2015 I had the privilege of travelling to Nepal to volunteer in a hospital and to learn the different ways that thing were done in less fortunate countries. I very quickly found that I had huge gaps in my primary health care knowledge and how important that aspect of this medicine was to my learning so when I got back to New Zealand I made that my main focus for 2016. I even signed up to do a Bachelor of Nursing in 2017. I never followed through with this though because I was more than ready to be out on the road and utilising my newly acquired skills as a paramedic! Two of my friends had been talking about the jobs that they had been offered with another service in the UK and I think it was fair to say, I was feeling a little bit left out of all the exciting travel talk so I jumped onto the NHS website and did a bit of research into the services that were offering jobs. SCAS stood out instantly because there appeared to be a huge interest in diversity and evidence based medicine which were two things that really resonated with me. It incorporated my love of medical research and of being in a diverse environment, I was sold. I applied and everything moved promptly from there which I really appreciated. I was hoping I would know if I had the job before the end of last year and I was not disappointed. I guess you could call the job offer an early Christmas present!
I am really looking forward to starting my career with SCAS, being back out on the road, learning new skills and meeting some new people! I’d be lying if I didn’t also say that I was also really looking forward to having the UK and Europe on my doorstep.
Of course, fitting everything I want to take over into one suitcase is definitely going to prove as a mission and I have all my fingers and toes crossed that my passport with my visa arrives back in time for my flight out. Hands down, I think one of the biggest hurdles I will have to overcome when I arrive though is my thick New Zealand accent and the pronunciation of my name. You won’t believe the amount of the times that people from overseas have thought I said my name is “Juice”.
Well, 15 days and counting! Looking forward to meeting you all soon.