Tuesday, 22 April 2014

Wind shift

It has been more than a year since my last post and there have been many changes.

I have changed, my job has changed and the profession has changed. Its simply not what it used to be.

I am reluctant to write in the open and honest way that I used to; there are too many sensitive people out there. It's too easy to offend and bother, either by accident or by being truthful. The design of this blog was deliberate. I set out to let readers know what I experienced and how I experienced it. The result of this, over the years, has been that a number of individuals have become paramedics after reading and following the words I wrote.

A change in my posting methodology is required; I need to write only that which is relevant and neutral while I am professionally bound to one or the other. This is the way of things these days.

The profession is different too. We are answering emergency calls that can, at best, be described as not in the least life-threatening. Insect bites, toilet-tissue incidents and sore thumbs now, apparently, count as worth our lives and the risk of losing them while we run on blue lights and sirens through an ever-obstructive and seemingly non-caring driver world. In the year that has passed, I have had my life threatened directly, been verbally and physically abused by those I tried to help and have had less and less time with my family as the tide changes in favour of the thousands of callers who simply do not need an ambulance, but who call one because they think there is no other option, or they have little or no understanding of their medical or physical problem. All of this is well documented; all of this is on your TV in the shape of fly-on-the-wall entertainment. I am not saying anything here that you do not already know.

My colleagues are tired and depressed. They are leaving the profession, or going to places where there is still hope for pre-hospital care. Paramedics have become nomadic. Almost every ambulance service in the country is experiencing a filter-through of new and experienced personnel. Potentially, if enough of the more experienced paramedics leave their service, the patient knowledge-base will stagnate to only that which is within a few years scope of practice.

Perhaps this is the best way to develop the profession. I haven't met anyone yet who agrees that it is, but nothing here makes me right until it has run its course.

Paramedics are also still extremely vulnerable to losing all that they have worked so hard to achieve because we are still registered with a body that encompasses many other 'peripheral' medical professions. We are not registered alongside nurse or doctors, where I believe we should be. Neither do we have our own professional society - we have a college but its not a 'Royal College'. Not enough paramedics have signed up for it, so it doesn't have the teeth it needs to defend us when the smallest error and sometimes (as recent stories will confirm) doing what we thought was the right thing, can get you sacked and struck off. In comparison to other medical professions, we appear to be the ones set  up to fall the hardest. Where's our protection and assurance?

I still care deeply about my patients and I still love what I do (when I'm doing it properly) but I'm less passionate about my direction of travel. I can't see how on earth we are going to be able to sustain things as they are. Everyone wants an answer; everyone wants to know how we can save money and cut the NHS workload... but nobody is asking us.

What we need is a shift in the wind.