I've not been writing because I've been incredibly busy of late, working my normal LAS shifts (my last shift is on Friday, three more to go and, yes, I'm counting the hours), plus the paperwork for my new job (currently filling out the second Criminal Records Check form because I was sent an out of date one earlier), as well as all the normal stuff that keeps us busy, like laundry and shopping and making sure my Sky+ box doesn't get filled up with too many programmes.
Hopefully this will all soon change, giving me more time to put finger to keyboard.
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I've been talking to a lot of people about my upcoming change in jobs to the local hospital – both ambulance and nursing staff, and the thing I've noticed is that sometimes people just don't get on.
For example – I explain to one of my ambulance friends that I was talking to Nurse Smith about my upcoming job change and that she was very happy for me. 'Ergh', says my ambulance colleague, 'Nurse Smith? I can't stand her…'
And I find that on both sides, nurses and ambulance staff that I consider good clinicians and good people looked on with some disdain.
I think I've worked it out.
It's because we don't know what each other does.
Many of the nurses that aren't liked by ambulance crews are those nurses that expect more. They forget that, for a great number of us, our training is 16 weeks in a classroom. We've never been taught 'reflective practice', or how to read a research paper, or learnt the meaning of the word 'holistic'.
These nurses get annoyed when an ambulance worker doesn't know about a certain obscure disease, or something happens that highlights something that was lacking in our initial training.
And if nurse gets annoyed, then you can be sure that the ambulance worker concerned will get annoyed as well.
On the flip-side, there are the nurses who think that we are little more than removal drivers – we pick people up, wrap them in a blanket, and take them to hospital. They can't see the reason why we bring to hospital some of the dross that we do (personal favourite call from last night – '33 year old male with cold'). These are the nurses who have asked me in the past 'can you do a blood pressure'.
To be fair, that is from a ward nurse, A&E nurses have a better idea of what we do, but can still have some strange ideas of what our work is really like. Some don't realise that we refer vulnerable children and adults to social services. They may not realise exactly how many patients we leave at home (endless panic attacks, diabetic hypoglycaemia and epileptics). They also may not know that if someone wants to go to hospital then we can't refuse them.
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It's not particularly anyone's fault – certainly it works both ways, ambulance staff don't really understand the pressures that A&E nurses are under. I know that I have a privileged knowledge, coming from both worlds.
What is annoying is that the solution is very simple – nurses spending some observation shifts with ambulance staff, and ambulance staff spending some time in A&E, but it'l never happen because of those self-same pressures. Ours to hit eight minute arrival targets, and A&E to cope with understaffing and having too many patients to deal with.
And our free time is precious – spent sleeping rather than volunteering to go rattling around London in an ambulance, or being asked to do ECGs on endless patients in A&E.
Besides, it's not that important to deal with little episodes of misunderstanding brought about by not knowing each other's jobs.
Is it?
Cross purposes and misunderstanding are a major problem between interacting services, be it between tankers or infantry or any group whom in theory are on the same tug of war rope.It is always a good idea to wear the moccasins of all those groups you interface with, a little cross training would help.Supervisors or leaders should always get members of their own team to see the snafus on the turf by a having a ride along.Else it be like belling the cat.
The misunderstanding of people in differnt positions happens in all industries and it is just as frustrating.
I've just qualified as a nurse (literally this week) and have got a job in an emergency services rotation in a hospital on the edge of London. I recognise that not only is my skill mix not going to be up to scratch at the moment due to lack of experience in A&E, but I also have little insight into the working day of a paramedic / EMT. I've requested placements, changes to the teaching program, and even day experiences in all aspects of healthcare so that I will have an understanding of all patients needs; yet i have had 6 practice experience placements that the university chose for me, meaning that my experience and knowledge base is confined to those areas. How does this make a well rounded (experience-wise) nurse?! This also makes for a nurse with little understanding of the work that other clinical areas or community services do.We were taught during my degree training to learn all about inter-professional working; what I ask is, why if teaching organisations are going to preach about better partnership working and recognising the unique input of the multi-disciplinary team, do these same educational institutions not provide a conducive learning environment where newly qualifying healthcare professionals get to see what the other professions do first hand?! To this end, I realised that I was fighting an uphill struggle and paid for myself to go on an EMT course in Nottingham next month. This way I get extra knowledge and experience and can actually make a difference by knowing and respecting the job my co-workers undertake on a daily basis.I think it's a shame that in this society of ever changing needs and a health service that calls for better communication, that there seems to be little effort made in bridging the gap.
Next time – during your final few shifts – some snotty nurse asks you about an obscure disease, ask her if she knows what ZOOPHOTIC LYMPHAMGITIS is.An old mate of mine from my previous life invented it, in order to explain to his children what he was suffering from, when struck down with an unfortunate case of intoxication.
Bogglehttp://www.bbc.co.uk/news/uk-england-sussex-10989598
“A taxi driver has been arrested after allegedly getting behind the wheel of an ambulance which was blocking his path.”
Luckily, during my final year medical school training, we spent a day with the paramedics. It really opened my eyes as to what you guys do. In my experience, as a whole, most staff who work in the hospital really have no idea what staff outside the hospital do – a day with the paramedics, as you say, would sort it out, but I sadly doubt it'll ever happen.Inter-staff suspicion will always be part of the job it seems.
What a coincidence. I have been speaking about this very thing with colleagues only today after a particularly testing time with one such member of A+E staff. The reality is, we are only talking about a very small percentage of such staff across this great capital of ours. Personally I am tired of being patronised and moaned at, so I challenge and complain to the neccessary people with every instance of such behaviour; it's a shame, but it's the only way I can see of stopping the nit-picking and rhetorical remarks that are daily thrown my way; only to be met with a grunt or worse still being ignored when an explaination is offered. Some people just can't help themselves I guess. It's a shame they see the uniform before they hear the problem.
As always in the NHS, the solution might be simple, but the implementing of it is another story.
I find this really interesting! I'm a student nurse, who had a placement in A&E and I hope to work in A&E when I qualify next summer. Because I worked in A&E and received many patients from ambulance crews, and I knew that I wanted to work in A&E in the future, I spent my “professional development experience” (3 week block to do what ever you want as long as you can justify it) on the ambulances. I wanted to learn more about what goes on “out there”. And I really did learn so much! It was really really interesting, and, I think, beneficial to my practice.I think that all A&E nurses should spend some time (even just a shift or two) out with the ambulance crews, just so we understand better!
Very true. The everyday difficulties of a job just don't seem to be enough for some people.
Sadly kasbrak the EMT course you have paid to go on will probably not be the same course that NHS staff do, that is 12-14 wks with a further 4-5 wks on the job training then a year as a sort of probationer, or at least that is how it used to be for staff such as Reynolds and myself.Though thanks to “progress” they now train in a slightly different way, don't worry this will soon fall on it's face and the old way reintroduced under the guise of “more progress”