For the past four or five months I have been coasting at work. It's not really my fault, it's just that none of my patients have been… challenging.

I've been going to a seemingly endless supply of patients who either do not need an ambulance because their 'illness' is so minor, or have had such simple problems that helping them doesn't require much in the way of thought.

I haven't had to 'blue light' a patient into hospital for this period.

And so I find myself settling into a fug of relaxed 'easy jobs'. Nothing much requires thought and, for many of my calls all I need to do is a set of basic observations and write down a name and date of birth.

It seems to last forever, being able to walk through my workday without having to think, without having any worry.

It makes the days go very slowly.


And then…

Then I turn up to a patient, one who, to start with, doesn't seem too unwell.

But then he begins to get worse, he's getting a lot worse.

He starts sweating, he starts edging around collapsing, he asks me if he's going to die.

Suddenly, after months of sleepwalking through my day, I'm having to make decisions. I'm throwing drugs into him. Hell, I'm giving him drugs and I can't remember the last time I gave them.

We blue light to hospital and I'm eyeing up the ventilator, wondering if I'm going to have to use it when he stops breathing.


We get to the hospital and the doctor there does a stunning save. No faffing about, just straight in there with the best treatment.

By the time I've completed my paperwork, cleaned and restocked the ambulance and washed my hands, the patient has turned the corner – we part company with him shaking my hand and thanking me.

Which, you know, is not a bad way to end the day.


The trick is to be prepared for that worrying call. To not let the nearly endless stream of simple stuff blind you to the occasional, but important, serious job. You must not let yourself be caught out by it.

And lets face it, that's a lesson that works outside of the medical field.


Now, I have a serious question for any ambulance people who read this blog, and I think the answer will say a lot about the state of the ambulance services in the UK.

Who is the top EMS educator in the UK?

12 thoughts on “Wakeup”

  1. No got a scooby! Its certainly not the service up here in Scotland! Theres an awful lot of variety throughout the country and nothing really centralised. I've heard good things about BASICS courses but haven't been able to do any yet because of the price (the Scottish service will not subsidise money for training, blood out of a stone comes to mind).As for sleep walking through work, I'm beginning to know that feeling well. I've just registered as paramedic in the last month and haven't had anything particularly taxing or requiring much of my newly extended skils. Its getting to point where I'm kind of anxious about using the skills as I'm relief and not always on with another paramedic for back up.

  2. “Who is the top EMS educator in the UK?”The simplest answer there is the A&E doctors. But that includes the experienced nurses, and paramedics you'll come across, and discounts the juniors who know less than you.

    Your paramedic degrees or equivalent, whatever are great at teaching you to think like a clinician, a scientist, but for actual advice on patient management and “real life” presentations, it's the experienced staff you hand over to and work with.

  3. Bite size chunks of the following: patients, ourselves and other EMS colleagues, senior A & E doctors (dependant on whether they have a God complex and are approachable). I've just noticed, perhaps quite strangely, that the ambulance service training department haven't yet been mentioned!!

  4. I think you are being slightly unfair, requesting a specific name. There are many committees and working groups that build best practise, gold standards and provide updates advice after considering all the recent research and studies. The one that springs immediately to mind is of course JRCALC.Is that not what you are going for?

  5. I still don't get the people who phone an ambulance when it's completely unnecessary. Boggles the mind.

  6. Best educator? As a CFR, I reckon it's a tie between the patient and some of the excellent paramedics I've been privileged to assist.Most of these paramedics are CPs, so they work alone for a while too. They are obviously experienced but also have the willingness, almost a need, to help interested CFRs learn. (If a CFR isn't interested in getting better at what they do, they should pack it in.)

    I've been in the position where a CP has chucked the BM kit at me and asked me to take the reading, as he was busy doing other things. CFRs, in our Trust, aren't trained in BM. However, he knew my interest and was confident that I could do the small test.

    This bloke never wastes a chance to teach me more about life saving techniques and how the patient's body is working. Several of his colleagues do the same; they believe we're part of the team, and they want us as good as they can make us. Our formal training only goes so far, but they know what they'd like us to do.

    They won't just do it for every First Aider or CFR they come across. They want to know that you want to learn, and have enough stuff between your tabs to be able to use it safely.

    Many thanks to paramedics XXX, YYY, ZZZ, XZY & YYX. (Names have been changed to protect the guilty, but you know who you are.) I really enjoy assisting these guys/gals, as they treat me like a junior professional, and not just a bandage monkey.

    These paramedics are also good with praise. I attended a patient tonight who had PEA, arriving just after the CP. I was doing CPR for a fair time. (Not that long in fact, but it was hot and I have to wear a hi-viz vest over my shirt. I was dripping sweat, and my specs kept falling off!) When the crew arrived, one of them took me off but in the finish they had to call it.

    On the way out, the CP said “Really good CPR”. That was excellent; the CP didn't have to say that (and I've done sooooo much practice CPR over the last 30 years I SHOULD be good) but it was a real boost after a sad ending.

    Like I said, patients and paramedics are really good educators.

  7. here in LaLa land, they charge for each trip, as an OAP it costs me 100$ where the cab fare be less than 15$ if no Insurance coverage, the charge is 400$ and up thus the ambulances have some spare time to brush up on their techniques, as you can find them waiting for customers/clients ala the taxis, So we do use these services with due caution.

  8. i've been on the road for 3 years and so far have received no further education from any source other than myself. no training courses, no clinical updates, no clinical reviews, nothing at all in the way of formal education.but then i am governed in my actions by the JRCALC and NICE and other regional guidelines, so even if i learn new skills, techniques, etc. i am limited as to what i can put into practice.

    all i can do really is revise what i was taught in basic training and pick up tips from colleagues on areas which weren't covered.

    i have to say that training and education is one of the areas in which the NHS Ambulance Service really lets its staff down.

    to to answer your question 'Who is the top EMS educator in the UK?' – from my experience, that would be me, myself and I.

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