In the June issue, I shared with you the first few weeks of being a Newly Qualified Paramedic (NQP); discussing the induction process and my first shifts ‘out on the road’. Up to now, I have been working with paramedics of varying experience, and have had a few shifts with emergency medical technicians (EMTs). I have settled well into my station and am fortunate to be able to attend a variety of ‘jobs’; I could be in the city centre of Belfast or down towards Portaferry - the joys of working in a small country!
It is safe to say that there are typical ‘city jobs’, mainly being drug- or alcohol-related. There has been a recent surge in drug overdoses, mainly on MSJ or ‘street diazepam’; so much so, you could easily bet money on your next call being a drug overdose in the city centre. If you're based in Belfast—as I am—you can expect to attend at least one of these patients per shift, but lately, it is fast-becoming ‘the norm’ to attend between two or three of these patients daily, most of which are on standby as NARCAN (naloxone) has little-to-no effect on them.
This started to take its toll on me. I felt a bit helpless, as what I was taught at university wasn't working. In addition, the majority of these incidents took place in the public eye, which often led to abuse being thrown at a vulnerable individual or myself and my colleagues, while we are simply trying to do our jobs. I never knew that the drug problem in Belfast was this severe until I started working as a paramedic here.
Up until the end of July, I could only work with fully qualified paramedics; 2+ years post registration. While this is a mandatory safety-net for myself and patients, it has allowed me to develop my clinical decision-making in a supportive environment. In most cases, it has been a simple ‘yes, I agree’ from my paramedic crewmate, which has boosted my confidence. But when it is a no, it offers a good opportunity to reflect and have a conversation about it.
I have worked with a variety of paramedics, which I enjoy as I get to learn a lot from every single one. Recently, I have worked with paramedics who promote ‘see and treat’, and others who have a high conveyance rate to accident and emergency (A&E), which has knocked my confidence a little as I have encountered times where I would explore an alternative care pathway for a patient, but my colleague would not. Neither of us is wrong in this scenario, as we could justify our decisions for both approaches. However, as an NQP (and in general), I overthink a lot. In these situations, I often doubt my ability as a paramedic. However, it is just something I will have to work on through reflection and time. Nonetheless, I have a good support network around me for decision-making, such as my clinical support officer (CSO) and integrated clinical hub (ICH).
I typically like to promote the positives of being an NQP. However, if I were to do that in every column, I would be painting a different picture to what the reality of being an NQP is like. It is necessary to highlight both sides to convey a more complete and authentic impression of the experience – and it allows us to appreciate the positives of this career even more.