Volume 10 Issue 4


What are paramedics tweeting about?Paramedic Practice @Para_PracticeSurvey reveals that NHS #ambulance staff have poor training and development compared to other #health professions and that they are the worst for: work-related stress, giving staff appraisals, appraisal quality, team working and staff engagement.@AndrewYorke6I'd love to say I'm shocked but unfortunately I'm not. Unfortunately the ambulance service has always been the poor relation of the nhs. Staff development has continually been sacrificed to support operational performance. Operations is grossly under funded. Vicious circle.@LucaAlfattiJust confirming most of my points on my dissertation. Nothing new and is not only about ‘operational demand’ is actually also about status quo, changing management (people) and changing culture in the service. I don't see this happening anytime soon.Jon Almond @NWAmb_JonAWe expect to work without fear, Tonight however, I have been assaulted and had a patient spit in my eye. This is NOT acceptable! To clean my ambulance & be treated at hospital for IPC compliance has taken me off the road for 3 hours. #workingwithoutfear #Team999 #InfectionriskJason Carlyon @jcarlyonAmazing response from #yorkshire #secondaryschools already signed up to @ YorksAmbulance #restartaheart campaign, register early to avoid missing out #cprsaveslives #CPRRichard McManus @NWAmb_RichMHilarious watching people trying to be caught on camera as they film Rip-off Britain at the Trafford Centre. Hopefully I made it on, walked past 16 times.Matt Green @mig1611When giving buccal midazolam, avoid the temptation to massage the patient's cheeks - it pushes the drug into the oropharynx and saliva, and away from the more vascular mucosa.

Embrace the evidence or not—a book for the masses

Three Key TakeawaysThere are those paramedics that run a mile at hearing evidence-based practice and those that embrace it all day long—this book is suitable for both of those extremes and anyone in betweenThe authors succeed in explaining difficult concepts using easily readable, jargon-free languageMany of the examples are only indirectly relevant to paramedic practice, but the authors acknowledge this and kindly ask readers to think about the underlying principles that can be learned from the examples.

Examining the true impact of alcohol on the heart

Emergency care practitioners regularly respond to alcohol-related call-outs. In this comment, Sarah Jane Palmer investigates the true impact of alcohol on the heart, and demystifies some commonly held misconceptions

Handling dyslexia while becoming a paramedic

In this month's column, 3rd year student Eleanor Chapman describes studying with dyslexia and explains how her learning difficulty is not a hindrance, but a motivation to continue learning.

Fitness-to-practise concerns and preventative strategies

Paramedicine is evolving into a graduate occupation underpinned by evidence-based practice and the development of professionalism. There is a disproportionate number of fitness-to-practise concerns against paramedics in the UK compared with other health professions, with the exception of medicine and dentistry. This article details findings from a Delphi process which invited expert responses to questions relating to concerns and preventative measures. The findings highlighted three levels of explanation: societal issues (public expectations and media attention); organisational issues (pressure on services and employer factors); and issues relating to individual paramedics. Preventative measures focused on input from employers, regulators, educators and registrants themselves and included: managing public expectations; more regulatory engagement; increasing organisational support; and changes to the selection and education of the workforce. A Delphi statement that reached 100% consensus pointed to the positive implications of reporting as it suggests increased awareness of avenues for raising concerns.

Increasing scope—decreasing pay?

In a time and place where everyone appears to be sold on the idea of borrowing money to live—mortgages, car loans, credit cards, and even financing for kitchen appliances—I prefer to use the money I work so hard for and actually earn my keep. This means that while it feels like everyone is always asking, why rent when you can own?; I find myself asking, why own when you can rent?

Medical vs. true physical traffic collision entrapment

Motor vehicle collisions (MVCs) are the leading cause of major trauma in the UK. The extrication phase following an MVC represents an important and largely unstudied part of the patient journey from injury to definitive care. Current methods result in significant patient delays and potential for patient deterioration. This article reports on the incidence of medical vs. true physical entrapment following MVCs in a UK population. The low incidence of true physical entrapment (12%) gives significant potential for clinicians to adapt extrication plans to optimise care for each patient.

Capnography: monitoring CO2

In each issue, the paramedic education team at Edge Hill University focuses on the clinical skills carried out by paramedics on the frontlines, highlighting the importance of these skills and how to perform them. In this issue, Rob Deighton discusses the uses of capnography as a non-invasive and inexpensive rapid assessment tool.

Building psychological resilience in the paramedic

Paramedics face the need to be critically introspective, reflective and reflexive every working day. Their work involves not only the functional need to clinically assess, diagnose and manage critically ill and injured members of the public, but also a situated responsiveness to the scenes of severe trauma and death. Few other professions demand such an acute degree of personal and professional resilience; an underpinning education is therefore pivotal to facilitate the development of this resilience to equip and ensure an effective healthcare workforce. For all paramedics, the need to facilitate deconstruction of their experience and meaning-making from constituent aspects of paramedic practice, culture and context is a central element of their capacity for resilience, as well as their psychological ability to recognise and apply coping strategies in their everyday roles. This affective domain learning has been embedded across academic curricula and traditionally taught via methods such as role play, inquiry-based learning, and simulation. The current article presents gamification as another potential methodology for inclusion in undergraduate curricula that can provide the future workforce with transferable skills of reflection and reflexivity in situational responsiveness. LEGO® Serious Play® and narrative storytelling are used to illustrate this discussion; a technique that originates from business and leadership teaching and learning methodologies, but the origins of which lie in the philosophy of social constructionism. An adaptation of Gilbert's Multi-Modal Compassionate Mind Training is used to illustrate how LEGO® Serious Play® might facilitate the construction of affective domain learning for resilience in paramedic practice.

Humour in reflective practice

Models of reflectionSeveral models can be used in health care to assist reflective practice. Some examples include the Johns Model (2004), The Gibbs Reflective Cycle (1988), and Driscoll's ‘The What?’ Reflective Model (1994).Cyclic models such as Johns (2004) and Gibbs Reflective Cycle (1988) often too easily push the participant into a retrospective process and since the purpose of reflection is to improve future practice, equal consideration should be distributed to previous and future actions (Forrest, 2008). Heavily structured models such as these can often be found to be restrictive, confining the natural process of reflection.

Continuing Professional Development: Reflecting on our own professional values and behaviours as paramedics

OverviewProfessional values and behaviours of paramedics often influence our clinical performance, as well as our ability to actively and professionally interact with colleagues, patients and the multi-professional healthcare team. This short CPD article explores how our behaviour, and that of colleagues, inform and shape our interactions with people whose values may differ from our own (Clompus and Albarran, 2016).

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